{"id":837,"date":"2024-07-22T11:31:34","date_gmt":"2024-07-22T09:31:34","guid":{"rendered":"https:\/\/helan.biometriq.be\/?page_id=837"},"modified":"2025-01-13T08:27:50","modified_gmt":"2025-01-13T07:27:50","slug":"checklist-form","status":"publish","type":"page","link":"https:\/\/helan.biometriq.be\/fr\/checklist\/checklist-form\/","title":{"rendered":"Checklist form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"837\" class=\"elementor elementor-837\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-afb5357 e-flex e-con-boxed e-con e-parent\" data-id=\"afb5357\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9ebfb21 elementor-button-align-center elementor-widget elementor-widget-form\" data-id=\"9ebfb21\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Volgende &gt;&quot;,&quot;step_previous_label&quot;:&quot;&lt; Keer terug&quot;,&quot;step_type&quot;:&quot;progress_bar&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;dce_confirm_dialog_enabled&quot;:&quot;no&quot;,&quot;label_icon_size&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;field_icon_size&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]}}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"Checklist Form\" aria-label=\"Checklist Form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"837\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"9ebfb21\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Vind een geschikte di\u00ebtist - Vul de checklist in\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"837\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-field_8b6e778 elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Waar kan de di\u00ebtist jou het meeste mee helpen?\" data-previousButton=\"&lt; Keer terug\" data-nextButton=\"Volgende &gt;\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_581b01c elementor-col-100\">\n\t\t\t\t\t<h2>Waar kan de di\u00ebtist jou het <br>meeste mee <strong>helpen?<\/strong><\/h2>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_b8344ae elementor-col-100\">\n\t\t\t\t\t<h5>Meerdere antwoorden zijn mogelijk<\/h5>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_467332a elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_467332a\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tAangeduid\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Afslanken\" id=\"form-field-field_467332a-0\" name=\"form_fields[field_467332a][]\"> <label for=\"form-field-field_467332a-0\">Afslanken<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Voeding bij (top)sport\" id=\"form-field-field_467332a-1\" name=\"form_fields[field_467332a][]\"> <label for=\"form-field-field_467332a-1\">Voeding bij (top)sport<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Voeding bij intoleranties of allergie\u00ebn\" id=\"form-field-field_467332a-2\" name=\"form_fields[field_467332a][]\"> <label for=\"form-field-field_467332a-2\">Voeding bij intoleranties of allergie\u00ebn<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Voeding bij diabetes\" id=\"form-field-field_467332a-3\" name=\"form_fields[field_467332a][]\"> <label for=\"form-field-field_467332a-3\">Voeding bij diabetes<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_ce66049 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ce66049\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tAangeduid\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Voeding bij eetstoornissen\" id=\"form-field-field_ce66049-0\" name=\"form_fields[field_ce66049][]\"> <label for=\"form-field-field_ce66049-0\">Voeding bij eetstoornissen<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Voeding bij  bij spijsverteringsklachten\" id=\"form-field-field_ce66049-1\" name=\"form_fields[field_ce66049][]\"> <label for=\"form-field-field_ce66049-1\">Voeding bij  bij spijsverteringsklachten<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Voeding bij darmproblematiek\" id=\"form-field-field_ce66049-2\" name=\"form_fields[field_ce66049][]\"> <label for=\"form-field-field_ce66049-2\">Voeding bij darmproblematiek<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Andere\" id=\"form-field-field_ce66049-3\" name=\"form_fields[field_ce66049][]\"> <label for=\"form-field-field_ce66049-3\">Andere<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-field_0fbb0be elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Is de locatie voor jou belangrijk om mogelijke vervolg afspraken te kunnen inplannen?\" data-previousButton=\"&lt; Keer terug\" data-nextButton=\"Volgende &gt;\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_234d33f elementor-col-100\">\n\t\t\t\t\t<h2>Is de <strong>locatie<\/strong> voor jou belangrijk om mogelijke<br> vervolg afspraken te kunnen inplannen?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_34b1695 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_34b1695\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tAangeduid\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Ja\" id=\"form-field-field_34b1695-0\" name=\"form_fields[field_34b1695][]\"> <label for=\"form-field-field_34b1695-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Neen\" id=\"form-field-field_34b1695-1\" name=\"form_fields[field_34b1695][]\"> <label for=\"form-field-field_34b1695-1\">Neen<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_265f399 elementor-col-100\">\n\t\t\t\t\t<h5>Indien het antwoord ja is gelieve hier je postcode in te geven<\/h5>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_8aa46f7 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_8aa46f7\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tPostcode\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_8aa46f7]\" id=\"form-field-field_8aa46f7\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Postcode\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-field_d2a857b elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Spreek je graag met een di\u00ebtist  van gelijkaardige leeftijd?\" data-previousButton=\"&lt; Keer terug\" data-nextButton=\"Volgende &gt;\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_bdaade8 elementor-col-100\">\n\t\t\t\t\t<h2>Spreek je graag met een di\u00ebtist<br> \nvan <strong>gelijkaardige leeftijd?<\/strong><\/h2>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_31e0e10 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_31e0e10\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tAangeduid\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Ja\" id=\"form-field-field_31e0e10-0\" name=\"form_fields[field_31e0e10][]\"> <label for=\"form-field-field_31e0e10-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Neen\" id=\"form-field-field_31e0e10-1\" name=\"form_fields[field_31e0e10][]\"> <label for=\"form-field-field_31e0e10-1\">Neen<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_56abde9 elementor-col-100\">\n\t\t\t\t\t<h5>Indien het antwoord ja is gelieve hier je leeftijd  in te geven<\/h5>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_b739848 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_b739848\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tLeeftijd\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_b739848]\" id=\"form-field-field_b739848\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Leeftijd\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-field_9dada0f elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Mocht je een vervolgtraject willen in plannen, welke zou dit dan zijn?\" data-previousButton=\"&lt; Keer terug\" data-nextButton=\"Volgende &gt;\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_d24dd9a elementor-col-100\">\n\t\t\t\t\t<h2>Mocht je een <strong>vervolgtraject<\/strong> willen in plannen,<br> welke zou dit dan zijn?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_e64894a elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_e64894a\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tAangeduid\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Individuele begeleiding\" id=\"form-field-field_e64894a-0\" name=\"form_fields[field_e64894a][]\"> <label for=\"form-field-field_e64894a-0\">Individuele begeleiding<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Groepstrajecten\" id=\"form-field-field_e64894a-1\" name=\"form_fields[field_e64894a][]\"> <label for=\"form-field-field_e64894a-1\">Groepstrajecten<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-field_46b1d8f elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Jouw resultaat!\" data-previousButton=\"&lt; Keer terug\" data-nextButton=\"Volgende &gt;\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_e1c4498 elementor-col-100\">\n\t\t\t\t\t<h2><strong>Jouw resultaat!<\/strong><\/h2>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_d4ab4cc elementor-col-100\">\n\t\t\t\t\t<h5>Dit resultaat in jouw mailbox? Geef je mailadres in en we sturen jouw resultaat door<\/h5>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-field_5364d33 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_5364d33\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tEmailadres\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[field_5364d33]\" id=\"form-field-field_5364d33\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Emailadres\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-recaptcha_v3 elementor-field-group elementor-column elementor-field-group-field_6d07d30 elementor-col-100 recaptcha_v3-bottomright\">\n\t\t\t\t\t<div class=\"elementor-field\" id=\"form-field-field_6d07d30\"><div class=\"elementor-g-recaptcha\" data-sitekey=\"6LeyeBYqAAAAAB7pEdFaYfwryg5wpSBonNACVaRC\" data-type=\"v3\" data-action=\"Form\" data-badge=\"bottomright\" data-size=\"invisible\"><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Verstuur<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":36,"menu_order":8,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-837","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/helan.biometriq.be\/fr\/wp-json\/wp\/v2\/pages\/837","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/helan.biometriq.be\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/helan.biometriq.be\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/helan.biometriq.be\/fr\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/helan.biometriq.be\/fr\/wp-json\/wp\/v2\/comments?post=837"}],"version-history":[{"count":0,"href":"https:\/\/helan.biometriq.be\/fr\/wp-json\/wp\/v2\/pages\/837\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/helan.biometriq.be\/fr\/wp-json\/wp\/v2\/pages\/36"}],"wp:attachment":[{"href":"https:\/\/helan.biometriq.be\/fr\/wp-json\/wp\/v2\/media?parent=837"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}