{"id":112,"date":"2023-08-31T13:23:19","date_gmt":"2023-08-31T13:23:19","guid":{"rendered":"http:\/\/www.triademiddelburg.nl\/wptriade\/?page_id=112"},"modified":"2025-12-15T13:08:55","modified_gmt":"2025-12-15T13:08:55","slug":"contactformulier","status":"publish","type":"page","link":"https:\/\/www.triademiddelburg.nl\/wptriade\/contactformulier\/","title":{"rendered":"Contactformulier"},"content":{"rendered":"\n<p>Zo kunt u ons bereiken<\/p>\n\n\n\n<!--more-->\n\n\n\n<p>Via dit contactformulier kunt u uw gegevens invullen, zodat wij u kunnen bellen of via een beveiligde mail contact met u kunnen opnemen. Of u kunt bellen tijdens telefonische spreekuren: op weekdagen van 12:30 &#8211; 13:00 uur, telefoonnummer: 0118 &#8211; 63 40 40. <\/p>\n\n\n\n<p>LET OP: op dit moment geldt helaas een aanmeldstop voor de praktijken onder Triade volwassenen en ouderen. U kunt zich dus helaas niet aanmelden. U kunt met uw huisarts of uw zorgverzekeraar overleggen waar u terecht kunt. <\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n<style id=\"wpforms-css-vars-425-block-1a97d0e3-2f43-4ccb-810c-c503109cf35e\">\n\t\t\t\t#wpforms-425.wpforms-block-1a97d0e3-2f43-4ccb-810c-c503109cf35e {\n\t\t\t\t--wpforms-field-size-input-height: 43px;\n--wpforms-field-size-input-spacing: 15px;\n--wpforms-field-size-font-size: 16px;\n--wpforms-field-size-line-height: 19px;\n--wpforms-field-size-padding-h: 14px;\n--wpforms-field-size-checkbox-size: 16px;\n--wpforms-field-size-sublabel-spacing: 5px;\n--wpforms-field-size-icon-size: 1;\n--wpforms-label-size-font-size: 16px;\n--wpforms-label-size-line-height: 19px;\n--wpforms-label-size-sublabel-font-size: 14px;\n--wpforms-label-size-sublabel-line-height: 17px;\n--wpforms-button-size-font-size: 17px;\n--wpforms-button-size-height: 41px;\n--wpforms-button-size-padding-h: 15px;\n--wpforms-button-size-margin-top: 10px;\n\t\t\t}\n\t\t\t<\/style><div class=\"wpforms-container wpforms-container-full wpforms-block wpforms-block-1a97d0e3-2f43-4ccb-810c-c503109cf35e wpforms-render-modern\" id=\"wpforms-425\"><form id=\"wpforms-form-425\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"425\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/wptriade\/wp-json\/wp\/v2\/pages\/112\" data-token=\"40cacce40c2ab7d06bb0f4da1bfc79f0\" data-token-time=\"1775253470\"><noscript class=\"wpforms-error-noscript\">Schakel JavaScript in je browser in om dit formulier in te vullen.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Schakel JavaScript in je browser in om dit formulier in te vullen.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-425-field_0-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"0\"><fieldset><legend class=\"wpforms-field-label\">Naam <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-425-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" aria-errormessage=\"wpforms-425-field_0-error\" required><label for=\"wpforms-425-field_0\" class=\"wpforms-field-sublabel after\">Voornaam<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-425-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" aria-errormessage=\"wpforms-425-field_0-last-error\" required><label for=\"wpforms-425-field_0-last\" class=\"wpforms-field-sublabel after\">Achternaam<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-425-field_1-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-425-field_1\">E-mail <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-425-field_1\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][1]\" spellcheck=\"false\" aria-errormessage=\"wpforms-425-field_1-error\" required><\/div><div id=\"wpforms-425-field_4-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-425-field_4\">Telefoonnummer <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-425-field_4\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][4]\" aria-errormessage=\"wpforms-425-field_4-error\" required><\/div><div id=\"wpforms-425-field_5-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-425-field_5\">Huisarts <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-425-field_5\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][5]\" aria-errormessage=\"wpforms-425-field_5-error\" required><\/div><div id=\"wpforms-425-field_3-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"3\"><fieldset><legend class=\"wpforms-field-label\">Kies de belangrijkste reden voor contact<\/legend><ul id=\"wpforms-425-field_3\" class=\"wpforms-icon-choices wpforms-icon-choices-default wpforms-icon-choices-large\" style=\"--wpforms-icon-choices-color: #066aab;\"><li class=\"choice-2 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-425-field_3_2\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"80\" height=\"64\" viewBox=\"0 0 512 512\"><!--! 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Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M64 64a64 64 0 1 1 128 0A64 64 0 1 1 64 64zM25.9 233.4C29.3 191.9 64 160 105.6 160h44.8c27 0 51 13.4 65.5 34.1c-2.7 1.9-5.2 4-7.5 6.3l-64 64c-21.9 21.9-21.9 57.3 0 79.2L192 391.2V464c0 26.5-21.5 48-48 48H112c-26.5 0-48-21.5-48-48V348.3c-26.5-9.5-44.7-35.8-42.2-65.6l4.1-49.3zM448 64a64 64 0 1 1 128 0A64 64 0 1 1 448 64zM431.6 200.4c-2.3-2.3-4.9-4.4-7.5-6.3c14.5-20.7 38.6-34.1 65.5-34.1h44.8c41.6 0 76.3 31.9 79.7 73.4l4.1 49.3c2.5 29.8-15.7 56.1-42.2 65.6V464c0 26.5-21.5 48-48 48H496c-26.5 0-48-21.5-48-48V391.2l47.6-47.6c21.9-21.9 21.9-57.3 0-79.2l-64-64zM272 240v32h96V240c0-9.7 5.8-18.5 14.8-22.2s19.3-1.7 26.2 5.2l64 64c9.4 9.4 9.4 24.6 0 33.9l-64 64c-6.9 6.9-17.2 8.9-26.2 5.2s-14.8-12.5-14.8-22.2V336H272v32c0 9.7-5.8 18.5-14.8 22.2s-19.3 1.7-26.2-5.2l-64-64c-9.4-9.4-9.4-24.6 0-33.9l64-64c6.9-6.9 17.2-8.9 26.2-5.2s14.8 12.5 14.8 22.2z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-425-field_3_3\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][3]\" value=\"ik wil contact met mijn therapeut\" aria-errormessage=\"wpforms-425-field_3_3-error\"  >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">ik wil contact met mijn therapeut<\/span>\n\t\t\t<\/label><\/li><li class=\"choice-4 depth-1 wpforms-icon-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-425-field_3_4\">\n\t\t\t\t<span class=\"wpforms-icon-choices-icon\">\n\t\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"80\" height=\"64\" viewBox=\"0 0 384 512\"><!--! Font Awesome Free 6.4.0 by @fontawesome - https:\/\/fontawesome.com License - https:\/\/fontawesome.com\/license\/free (Icons: CC BY 4.0, Fonts: SIL OFL 1.1, Code: MIT License) Copyright 2023 Fonticons, Inc. --><path d=\"M192 0c-41.8 0-77.4 26.7-90.5 64H64C28.7 64 0 92.7 0 128V448c0 35.3 28.7 64 64 64H320c35.3 0 64-28.7 64-64V128c0-35.3-28.7-64-64-64H282.5C269.4 26.7 233.8 0 192 0zm0 64a32 32 0 1 1 0 64 32 32 0 1 1 0-64zM105.8 229.3c7.9-22.3 29.1-37.3 52.8-37.3h58.3c34.9 0 63.1 28.3 63.1 63.1c0 22.6-12.1 43.5-31.7 54.8L216 328.4c-.2 13-10.9 23.6-24 23.6c-13.3 0-24-10.7-24-24V314.5c0-8.6 4.6-16.5 12.1-20.8l44.3-25.4c4.7-2.7 7.6-7.7 7.6-13.1c0-8.4-6.8-15.1-15.1-15.1H158.6c-3.4 0-6.4 2.1-7.5 5.3l-.4 1.2c-4.4 12.5-18.2 19-30.6 14.6s-19-18.2-14.6-30.6l.4-1.2zM160 416a32 32 0 1 1 64 0 32 32 0 1 1 -64 0z\"\/><\/svg>\n\t\t\t\t\t<span class=\"wpforms-icon-choices-icon-bg\"><\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"radio\" id=\"wpforms-425-field_3_4\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][3]\" value=\"Ik heb een vraag over de wachtljist\" aria-errormessage=\"wpforms-425-field_3_4-error\"  >\n\t\t\t\t<span class=\"wpforms-icon-choices-label\">Ik heb een vraag over de wachtljist<\/span>\n\t\t\t<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-425-field_2-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-425-field_2\">Eventuele opmerkingen<\/label><textarea id=\"wpforms-425-field_2\" class=\"wpforms-field-small\" name=\"wpforms[fields][2]\" aria-errormessage=\"wpforms-425-field_2-error\" ><\/textarea><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-recaptcha-container wpforms-is-turnstile\" ><div class=\"wpforms-turnstile\" data-sitekey=\"0x4AAAAAAALCWdZJdVBhADju\" data-action=\"FormID-425\"><\/div><input type=\"text\" name=\"g-recaptcha-hidden\" class=\"wpforms-recaptcha-hidden\" style=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\" data-rule-turnstile=\"1\"><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"425\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/www.triademiddelburg.nl\/wptriade\/wp-json\/wp\/v2\/pages\/112\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-425\" class=\"wpforms-submit\" data-alt-text=\"Verzenden...\" data-submit-text=\"Verzend\" aria-live=\"assertive\" value=\"wpforms-submit\">Verzend<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.triademiddelburg.nl\/wptriade\/wp-content\/plugins\/wpforms-lite\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Aan het laden\"><\/div><\/form><\/div>  <!-- .wpforms-container -->","protected":false},"excerpt":{"rendered":"<p>Zo kunt u ons bereiken<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"template-parts\/template-no-sidebar.php","meta":{"footnotes":""},"class_list":["post-112","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.triademiddelburg.nl\/wptriade\/wp-json\/wp\/v2\/pages\/112","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.triademiddelburg.nl\/wptriade\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.triademiddelburg.nl\/wptriade\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.triademiddelburg.nl\/wptriade\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.triademiddelburg.nl\/wptriade\/wp-json\/wp\/v2\/comments?post=112"}],"version-history":[{"count":13,"href":"https:\/\/www.triademiddelburg.nl\/wptriade\/wp-json\/wp\/v2\/pages\/112\/revisions"}],"predecessor-version":[{"id":537,"href":"https:\/\/www.triademiddelburg.nl\/wptriade\/wp-json\/wp\/v2\/pages\/112\/revisions\/537"}],"wp:attachment":[{"href":"https:\/\/www.triademiddelburg.nl\/wptriade\/wp-json\/wp\/v2\/media?parent=112"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}