{"id":22664,"date":"2024-02-19T22:39:13","date_gmt":"2024-02-19T15:39:13","guid":{"rendered":"https:\/\/vietnamdetox.com\/gesundheitscheck-formular-schritt-3\/"},"modified":"2026-10-18T01:25:05","modified_gmt":"2026-10-17T18:25:05","slug":"gesundheitscheck-formular-schritt-3","status":"publish","type":"page","link":"https:\/\/vietnamdetox.com\/de\/gesundheitscheck-formular-schritt-3\/","title":{"rendered":"Gesundheitscheck-Formular \u2013 Schritt 3"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"22664\" class=\"elementor elementor-22664 elementor-9329\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-34fea9a6 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"34fea9a6\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5db05f3f\" data-id=\"5db05f3f\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-52f83667 elementor-widget elementor-widget-text-editor\" data-id=\"52f83667\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Gut gemacht <b> <\/b>, und hier sind die wichtigsten Fragen:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4ecdc73c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4ecdc73c\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4752c6c3\" data-id=\"4752c6c3\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-655aa600 elementor-widget elementor-widget-heading\" data-id=\"655aa600\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">SCHRITT 3:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-104b622d elementor-widget elementor-widget-html\" data-id=\"104b622d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t\t<div class=\"e-form__indicators e-form__indicators--type-number\"><div class=\"e-form__indicators__indicator e-form__indicators__indicator--state-inactive\"><div class=\"e-form__indicators__indicator__number e-form__indicators__indicator--shape-circle\">1<\/div><\/div><div class=\"e-form__indicators__indicator__separator\"><\/div><div class=\"e-form__indicators__indicator e-form__indicators__indicator--state-inactive\"><div class=\"e-form__indicators__indicator__number e-form__indicators__indicator--shape-circle\">2<\/div><\/div><div class=\"e-form__indicators__indicator__separator\"><\/div><div class=\"e-form__indicators__indicator e-form__indicators__indicator--state-active\"><div class=\"e-form__indicators__indicator__number e-form__indicators__indicator--shape-circle\">3<\/div><\/div><div class=\"e-form__indicators__indicator__separator\"><\/div><div class=\"e-form__indicators__indicator e-form__indicators__indicator--state-inactive\"><div class=\"e-form__indicators__indicator__number e-form__indicators__indicator--shape-circle\">4<\/div><\/div><div class=\"e-form__indicators__indicator__separator\"><\/div><div class=\"e-form__indicators__indicator e-form__indicators__indicator--state-inactive\"><div class=\"e-form__indicators__indicator__number e-form__indicators__indicator--shape-circle\">5<\/div><\/div><\/div>\n\n<style>\n    .e-form__indicators__indicator__separator {\n    width: 100%;\n    height: 1px !important;\n    background-color: #babfc5;\n    margin: 0 10px;\n}\n<\/style>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-60bb87a elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"60bb87a\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column 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Please contact the site administrator.<\/div>\t\t\t<script>\n\t\t\tsetTimeout(function() {\n\t\t\t\tlet el = document.querySelector(\".dce-conditions-js-error-notice\");\n\t\t\t\tif (el)\n\t\t\t\t\tel.style.display = \"block\";\n\t\t\t}, 6000);\n\t\t\t<\/script>\t\t<form class=\"elementor-form\" method=\"post\" name=\"HealthCheckS3\" aria-label=\"HealthCheckS3\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"22664\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"3ced5e1\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Vietnamdetox\" \/>\n\n\t\t\t\n\t\t\t<div data-field-conditions=\"[{&quot;id&quot;:&quot;field_q22&quot;,&quot;condition&quot;:&quot;(field_q21 == &#039;Yes&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;field_q18&quot;,&quot;condition&quot;:&quot;(field_q21 == 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elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q19\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tTrinken Sie regelm\u00e4\u00dfig Kaffee, schwarzen oder gr\u00fcnen Tee?\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=\"radio\" value=\"Ja\" id=\"form-field-field_q19-0\" name=\"form_fields[field_q19]\" required=\"required\"> <label for=\"form-field-field_q19-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q19-1\" name=\"form_fields[field_q19]\" required=\"required\"> <label for=\"form-field-field_q19-1\">Nein<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_q20 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q20\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tRauchen oder dampfen Sie?\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=\"radio\" value=\"Ja\" id=\"form-field-field_q20-0\" name=\"form_fields[field_q20]\" required=\"required\"> <label for=\"form-field-field_q20-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q20-1\" name=\"form_fields[field_q20]\" required=\"required\"> <label for=\"form-field-field_q20-1\">Nein<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_q21 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q21\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNehmen Sie derzeit oder haben Sie in den letzten vier Wochen verschreibungspflichtige Medikamente eingenommen?\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=\"radio\" value=\"Ja\" id=\"form-field-field_q21-0\" name=\"form_fields[field_q21]\" required=\"required\"> <label for=\"form-field-field_q21-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q21-1\" name=\"form_fields[field_q21]\" required=\"required\"> <label for=\"form-field-field_q21-1\">Nein<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_q22 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q22\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t-- Welche Medikamente, wie lange und warum?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_q22]\" id=\"form-field-field_q22\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-field_q18 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q18\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t-- Laden Sie ein Bild Ihrer Medikamente hoch\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[field_q18]\" id=\"form-field-field_q18\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" data-maxsize=\"5\" data-maxsize-message=\"Diese Datei \u00fcbersteigt die maximale Dateigr\u00f6\u00dfe.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_q23 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q23\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tLeiden Sie unter Kopfschmerzen oder Migr\u00e4ne?\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=\"radio\" value=\"Ja\" id=\"form-field-field_q23-0\" name=\"form_fields[field_q23]\" required=\"required\"> <label for=\"form-field-field_q23-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q23-1\" name=\"form_fields[field_q23]\" required=\"required\"> <label for=\"form-field-field_q23-1\">Nein<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_q24 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q24\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHaben Sie aktuell oder hatten Sie in der Vergangenheit R\u00fcckenschmerzen oder Verletzungen?\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=\"radio\" value=\"Ja\" id=\"form-field-field_q24-0\" name=\"form_fields[field_q24]\" required=\"required\"> <label for=\"form-field-field_q24-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q24-1\" name=\"form_fields[field_q24]\" required=\"required\"> <label for=\"form-field-field_q24-1\">Nein<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_q25 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q25\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tLeiden Sie unter niedrigem oder hohem Blutdruck? \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=\"radio\" value=\"Ja\" id=\"form-field-field_q25-0\" name=\"form_fields[field_q25]\" required=\"required\"> <label for=\"form-field-field_q25-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q25-1\" name=\"form_fields[field_q25]\" required=\"required\"> <label for=\"form-field-field_q25-1\">Nein<\/label><\/span><\/div>\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_63590dc elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_63590dc\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t-- Wie hoch ist Ihr Blutdruckwert und wann wurde er gemessen?\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_63590dc]\" id=\"form-field-field_63590dc\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\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-radio elementor-field-group elementor-column elementor-field-group-field_q27 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q27\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSind Sie schwanger oder stillen Sie?\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=\"radio\" value=\"Ja\" id=\"form-field-field_q27-0\" name=\"form_fields[field_q27]\" required=\"required\"> <label for=\"form-field-field_q27-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q27-1\" name=\"form_fields[field_q27]\" required=\"required\"> <label for=\"form-field-field_q27-1\">Nein<\/label><\/span><\/div>\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_q28 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q28\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t-- In welcher Schwangerschaftswoche sind Sie oder wie lange stillen Sie schon?\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_q28]\" id=\"form-field-field_q28\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\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-radio elementor-field-group elementor-column elementor-field-group-field_q29 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q29\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHatten Sie in den letzten sechs Monaten eine Operation?\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=\"radio\" value=\"Ja\" id=\"form-field-field_q29-0\" name=\"form_fields[field_q29]\" required=\"required\"> <label for=\"form-field-field_q29-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q29-1\" name=\"form_fields[field_q29]\" required=\"required\"> <label for=\"form-field-field_q29-1\">Nein<\/label><\/span><\/div>\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_q30 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q30\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t-- Welche Art von Operation, wann, und wie ist sie verlaufen?\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_q30]\" id=\"form-field-field_q30\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\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-radio elementor-field-group elementor-column elementor-field-group-field_q31 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q31\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHaben Sie aktuell oder hatten Sie in der Vergangenheit Verdauungsprobleme oder -erkrankungen?\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=\"radio\" value=\"Ja\" id=\"form-field-field_q31-0\" name=\"form_fields[field_q31]\" required=\"required\"> <label for=\"form-field-field_q31-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q31-1\" name=\"form_fields[field_q31]\" required=\"required\"> <label for=\"form-field-field_q31-1\">Nein<\/label><\/span><\/div>\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_q32 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q32\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t-- Wie lauten Diagnose, Behandlung und aktueller Status Ihres Zustands?\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_q32]\" id=\"form-field-field_q32\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\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-radio elementor-field-group elementor-column elementor-field-group-field_q33 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q33\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNeigen Sie zu Erbrechen, Durchfall oder Verstopfung?\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=\"radio\" value=\"Ja\" id=\"form-field-field_q33-0\" name=\"form_fields[field_q33]\" required=\"required\"> <label for=\"form-field-field_q33-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q33-1\" name=\"form_fields[field_q33]\" required=\"required\"> <label for=\"form-field-field_q33-1\">Nein<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_q34 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q34\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHaben Sie aktuell oder hatten Sie in der Vergangenheit Herz-, Leber- oder Nierenerkrankungen?\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=\"radio\" value=\"Ja\" id=\"form-field-field_q34-0\" name=\"form_fields[field_q34]\" required=\"required\"> <label for=\"form-field-field_q34-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q34-1\" name=\"form_fields[field_q34]\" required=\"required\"> <label for=\"form-field-field_q34-1\">Nein<\/label><\/span><\/div>\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_q35 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q35\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t-- Wie lauten Diagnose, Behandlung und aktueller Status Ihres Zustands?\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_q35]\" id=\"form-field-field_q35\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\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-radio elementor-field-group elementor-column elementor-field-group-field_q36 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q36\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWerden Sie wegen Diabetes mellitus Typ 1 oder Typ 2 behandelt?\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=\"radio\" value=\"Ja\" id=\"form-field-field_q36-0\" name=\"form_fields[field_q36]\" required=\"required\"> <label for=\"form-field-field_q36-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q36-1\" name=\"form_fields[field_q36]\" required=\"required\"> <label for=\"form-field-field_q36-1\">Nein<\/label><\/span><\/div>\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_q37 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q37\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t-- Wie hoch ist Ihr Blutzuckerspiegel und wann wurde er gemessen?\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_q37]\" id=\"form-field-field_q37\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\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-radio elementor-field-group elementor-column elementor-field-group-field_q38 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q38\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHaben oder hatten Sie jemals eine Essst\u00f6rung? \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=\"radio\" value=\"Ja\" id=\"form-field-field_q38-0\" name=\"form_fields[field_q38]\" required=\"required\"> <label for=\"form-field-field_q38-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q38-1\" name=\"form_fields[field_q38]\" required=\"required\"> <label for=\"form-field-field_q38-1\">Nein<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_q39 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q39\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHaben oder hatten Sie eine Lebensmittelallergie\/-unvertr\u00e4glichkeit?\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=\"radio\" value=\"Ja\" id=\"form-field-field_q39-0\" name=\"form_fields[field_q39]\" required=\"required\"> <label for=\"form-field-field_q39-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q39-1\" name=\"form_fields[field_q39]\" required=\"required\"> <label for=\"form-field-field_q39-1\">Nein<\/label><\/span><\/div>\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_q40 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q40\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t-- Gegen welche Lebensmittel sind Sie allergisch oder intolerant, und was sind die Symptome?\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_q40]\" id=\"form-field-field_q40\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\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-radio elementor-field-group elementor-column elementor-field-group-field_q41 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q41\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHaben Sie aktuell oder hatten Sie in der Vergangenheit eine Schilddr\u00fcsenerkrankung?\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=\"radio\" value=\"Ja\" id=\"form-field-field_q41-0\" name=\"form_fields[field_q41]\" required=\"required\"> <label for=\"form-field-field_q41-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q41-1\" name=\"form_fields[field_q41]\" required=\"required\"> <label for=\"form-field-field_q41-1\">Nein<\/label><\/span><\/div>\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_q42 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q42\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t-- Welche Art von Schilddr\u00fcsenerkrankung, wie wird sie behandelt und wie ist Ihr aktueller Status?\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_q42]\" id=\"form-field-field_q42\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\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-radio elementor-field-group elementor-column elementor-field-group-field_q43 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q43\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHaben Sie in den letzten sechs Monaten ungewollt mehr als 5 % Ihres K\u00f6rpergewichts verloren?\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=\"radio\" value=\"Ja\" id=\"form-field-field_q43-0\" name=\"form_fields[field_q43]\" required=\"required\"> <label for=\"form-field-field_q43-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q43-1\" name=\"form_fields[field_q43]\" required=\"required\"> <label for=\"form-field-field_q43-1\">Nein<\/label><\/span><\/div>\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_q44 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q44\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t-- Wie viel Gewicht haben Sie verloren und was ist Ihrer Meinung nach der Grund daf\u00fcr?\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_q44]\" id=\"form-field-field_q44\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\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-radio elementor-field-group elementor-column elementor-field-group-field_q45 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q45\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHaben Sie aktuell oder hatten Sie in der Vergangenheit eine psychische Erkrankung?\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=\"radio\" value=\"Ja\" id=\"form-field-field_q45-0\" name=\"form_fields[field_q45]\" required=\"required\"> <label for=\"form-field-field_q45-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein\" id=\"form-field-field_q45-1\" name=\"form_fields[field_q45]\" required=\"required\"> <label for=\"form-field-field_q45-1\">Nein<\/label><\/span><\/div>\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_q46 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q46\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t-- Welche Art von psychischer Erkrankung, wie wird sie behandelt und wie ist Ihr aktueller Status?\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_q46]\" id=\"form-field-field_q46\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\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-textarea elementor-field-group elementor-column elementor-field-group-field_q52 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_q52\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHaben Sie weitere gesundheitliche Bedenken, nach denen wir in diesem Formular nicht gefragt haben? Wenn ja, bitte erl\u00e4utern Sie diese. \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_q52]\" id=\"form-field-field_q52\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-hidden elementor-field-group elementor-column elementor-field-group-field_registration_id elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"hidden\" name=\"form_fields[field_registration_id]\" id=\"form-field-field_registration_id\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\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-hidden elementor-field-group elementor-column elementor-field-group-field_customer_id elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"hidden\" name=\"form_fields[field_customer_id]\" id=\"form-field-field_customer_id\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\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-hidden elementor-field-group elementor-column elementor-field-group-field_healthcheck_id elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"hidden\" name=\"form_fields[field_healthcheck_id]\" id=\"form-field-field_healthcheck_id\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\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-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\">WEITER<\/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<input type='hidden' name='lang' value='de' \/><\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Gut gemacht , und hier sind die wichtigsten Fragen: SCHRITT 3: 12345<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-22664","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.7 (Yoast SEO v28.7) - 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