{"id":419,"date":"2024-01-07T22:25:28","date_gmt":"2024-01-07T21:25:28","guid":{"rendered":"https:\/\/www.medisch-keuringscentrum.nl\/mediwp\/medischwp\/?page_id=419"},"modified":"2024-01-09T17:08:01","modified_gmt":"2024-01-09T16:08:01","slug":"reserve-afspraak","status":"publish","type":"page","link":"https:\/\/www.medisch-keuringscentrum.nl\/mediwp\/medischwp\/reserve-afspraak\/","title":{"rendered":"reserve afspraak"},"content":{"rendered":"<p><img decoding=\"async\" title=\"Medisch Keuringscentrum\" src=\"\/mediwp\/medischwp\/images\/logo.png\" alt=\"image\" \/><\/p>\n<div class=\"container\">\n<h1 class=\"entry-title\">AFSPRAAK<\/h1>\n<\/div>\n<h2 class=\"light bordered main-title vbs-subject\">Heeft u vragen, opmerkingen en\/of wilt u tijdig afmelden?<\/h2>\n<div class=\"col-md-8\">\n<p style=\"text-align: justify; padding-left: 0;\">Vul onderstaand formulier in met uw gegevens en vraag of opmerking en wij zullen spoedig reageren.<\/p>\n<p style=\"text-align: justify; padding-left: 0;\"><b style=\"color: red;\">LET OP!<\/b><br \/>\nOm wachttijden te voorkomen wordt voor elke keuring tijd gereserveerd.<br \/>\nMocht u verhinderd zijn, meldt dit dan vroegtijdig (tot 24 uren van tevoren)<br \/>\nen voorkom daarmee dat wij u later kosten in rekening moeten brengen.<\/p>\n<table style=\"width: 90.1879%; height: 631px;\" border=\"5\" cellspacing=\"5\" cellpadding=\"5\">\n<tbody>\n<tr style=\"border-bottom: dotted; border-bottom-width: dotted;\">\n<td style=\"text-align: right; width: 29.5255%; height: 77px;\" title=\"Maak een keuze uit \u00e9\u00e9n van de twee formulieren\"><b>Kies uw Formulier: <\/b><\/td>\n<td style=\"width: 47.8032%; height: 77px;\">\n<table id=\"frm_choice\" style=\"width: 60.0867%; height: 73px;\" title=\"Kies uw formulier\">\n<tbody>\n<tr>\n<td style=\"width: 100%;\"><input id=\"radio1\" checked=\"checked\" name=\"contact_keuze\" type=\"radio\" value=\"afspraak\" \/> \u00a0 afspraak maken<br \/>\n<input id=\"radio2\" name=\"contact_keuze\" type=\"radio\" value=\"afmelden\" \/> \u00a0 afmelden afspraak<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr style=\"height: 35px;\">\n<td style=\"width: 77.3287%; height: 10px;\" colspan=\"2\"><strong>Velden gemerkt met <span style=\"color: #ff0000;\">*<\/span> zijn verplicht<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 35px;\">\n<td style=\"text-align: right; width: 29.5255%; height: 35px;\"><b><span style=\"color: red;\">*<\/span>Naam volledig:<\/b><\/td>\n<td style=\"width: 47.8032%; height: 35px;\"><input class=\"form-control\" style=\"width: 300px;\" maxlength=\"60\" name=\"name\" required=\"required\" type=\"text\" placeholder=\"Name\" \/><\/td>\n<\/tr>\n<tr id=\"geslacht\" style=\"height: 67px;\">\n<td style=\"text-align: right; width: 29.5255%; height: 67px;\"><b>Geslacht:<br \/>\nGeboortedatum:<\/b><\/td>\n<td style=\"width: 47.8032%; height: 67px;\"><select id=\"geslacht\" class=\"form-control\" style=\"width: 140px;\" name=\"geslacht\"><option>Uw Keuze<\/option><option>Man<\/option><option>Vrouw<\/option><\/select><br \/>\n<input class=\"form-control\" style=\"width: 140px;\" maxlength=\"10\" name=\"geboortedd\" type=\"date\" \/><\/td>\n<\/tr>\n<tr style=\"height: 35px;\">\n<td style=\"text-align: right; width: 29.5255%; height: 35px;\"><b><span style=\"color: red;\">*<\/span>Adres:<\/b><\/td>\n<td style=\"width: 47.8032%; height: 35px;\"><input class=\"form-control\" style=\"width: 300px;\" maxlength=\"60\" name=\"adres\" required=\"required\" type=\"text\" placeholder=\"Adres + huisnummer\" \/><\/td>\n<\/tr>\n<tr style=\"height: 35px;\">\n<td style=\"text-align: right; width: 29.5255%; height: 35px;\"><b><span style=\"color: red;\">*<\/span>Postcode \/ Woonplaats:<\/b><\/td>\n<td style=\"width: 47.8032%; height: 35px;\"><input class=\"form-control\" style=\"width: 85px;\" maxlength=\"7\" name=\"postcode\" required=\"required\" type=\"text\" placeholder=\"Postcode\" \/><input class=\"form-control\" style=\"width: 215px;\" maxlength=\"50\" name=\"woonplaats\" required=\"required\" type=\"text\" placeholder=\"Woonplaats\" \/><\/td>\n<\/tr>\n<tr style=\"height: 35px;\">\n<td style=\"text-align: right; width: 29.5255%; height: 35px;\"><b>Organisatie:<\/b><\/td>\n<td style=\"width: 47.8032%; height: 35px;\"><input class=\"form-control\" style=\"width: 300px;\" maxlength=\"60\" name=\"organization\" type=\"text\" placeholder=\"Organisatie\" \/><\/td>\n<\/tr>\n<tr style=\"height: 35px;\">\n<td style=\"text-align: right; width: 29.5255%; height: 35px;\"><b><span style=\"color: red;\">*<\/span>Telefoonnummer:<\/b><\/td>\n<td style=\"width: 47.8032%; height: 35px;\"><input class=\"form-control\" style=\"width: 300px;\" maxlength=\"43\" name=\"phonenumber\" required=\"required\" type=\"text\" placeholder=\"Telefoonnummer\" \/><\/td>\n<\/tr>\n<tr style=\"height: 35px;\">\n<td style=\"text-align: right; width: 29.5255%; height: 35px;\"><b><span style=\"color: red;\">*<\/span>E-mail adres:<\/b><\/td>\n<td style=\"width: 47.8032%; height: 35px;\"><input id=\"email\" class=\"form-control\" style=\"width: 300px;\" maxlength=\"60\" name=\"email\" required=\"required\" type=\"text\" placeholder=\"Email\" \/><\/td>\n<\/tr>\n<tr id=\"typekeuring\" style=\"height: 35px;\">\n<td style=\"text-align: right; width: 29.5255%; height: 35px;\"><b><span style=\"color: red;\">*<\/span>Type keuring:<\/b><\/td>\n<td style=\"width: 47.8032%; height: 35px;\"><select class=\"form-control\" style=\"width: 300px;\" name=\"keuring\" required=\"required\"><optgroup label=\"Particulier\"><option>Maak uw keuze<\/option><option>Adoptiekeuring<\/option><option>Fit to fly verklaring<\/option><option>Gezondheidsverklaring<\/option><option>Health check<\/option><option>HIV<\/option><option>Hypotheek keuring<\/option><option>Medische verklaring<\/option><option>Rijbewijs- en chauffeurskeuring<\/option><option>SOA screening<\/option><option>Sportkeuring<\/option><option>Vaccinaties<\/option><option>Visum keuring<\/option><option>Aanstellingskeuring<\/option><option>Asbestkeuring<\/option><option>Beroepssportkeuring<\/option><option>Bodemsaneringskeuring<\/option><option>Chauffeurskeuring<\/option><option>Chemiekeuring<\/option><option>Kraanmachinistenkeuring<\/option><option>Persluchtkeuring<\/option><option>Acceptatiekeuring<\/option><option>Arbeidsongeschiktheidskeuring<\/option><option>Huisartsenkeuring<\/option><option>Internistenkeuring<\/option><option>Klein Gericht Onderzoek<\/option><option>Levensverzekering<\/option><option>Ongevallenverzekering<\/option><option>Pensioenverzekering<\/option><option>Verzekeringskeuring<\/option><option>PMO Keuring<\/option><\/optgroup><br \/>\n<\/select><\/td>\n<\/tr>\n<tr id=\"afspraak-maken\" style=\"height: 35px;\">\n<td style=\"text-align: right; width: 29.5255%; height: 35px;\"><b><span style=\"color: red;\">*<\/span>Afspraak maken op:<\/b><\/td>\n<td style=\"width: 57.8032%; height: 35px;\"><input id=\"datepicker1\" class=\"form-control\" name=\"Date1\" type=\"date\" \/><\/td>\n<\/tr>\n<tr id=\"afspraak-afzeggen\" style=\"display: none;\">\n<td style=\"text-align: right; width: 29.5255%; height: 0px;\"><b><span style=\"color: red;\">*<\/span>Afspraak datum:<\/b><\/td>\n<td style=\"width: 47.8032%; height: 0px;\"><input id=\"datepicker\" class=\"form-control\" name=\"Date2\" type=\"date\" \/><\/td>\n<\/tr>\n<tr id=\"vraag\" style=\"height: 40px;\">\n<td style=\"text-align: right; width: 29.5255%; height: 40px;\"><b>Geef hier uw vraag in:<\/b><\/td>\n<td style=\"width: 47.8032%; height: 40px;\"><textarea id=\"vraag\" style=\"width: 300px; border: 1px solid #999999;\" cols=\"40\" name=\"vraag\" rows=\"1\" placeholder=\"Geef hier uw vraag in\"><\/textarea><\/td>\n<\/tr>\n<tr id=\"bericht\" style=\"height: 35px;\">\n<td style=\"text-align: right; width: 29.5255%; height: 35px;\"><b><span style=\"color: red;\">*<\/span>Bericht \/ Commentaar:<\/b><\/td>\n<td style=\"width: 47.8032%; height: 35px;\"><input class=\"ui-corner-all\" style=\"width: 300px; border: 1px solid #999999;\" name=\"bericht\" type=\"text\" placeholder=\"Commentaar\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><input class=\"btn btn-default btn-rounded\" name=\"submit\" type=\"submit\" value=\" VERZENDEN \" \/><br \/>\n<input style=\"background-color: green; color: black;\" type=\"reset\" value=\"RESET\" \/><br \/>\n<input style=\"background-color: blue; color: black;\" type=\"button\" value=\"TERUG\" \/><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>AFSPRAAK Heeft u vragen, opmerkingen en\/of wilt u tijdig afmelden? Vul onderstaand formulier in met uw gegevens en vraag of opmerking en wij zullen spoedig reageren. LET OP! Om wachttijden te voorkomen wordt voor elke keuring tijd gereserveerd. Mocht u verhinderd zijn, meldt dit dan vroegtijdig (tot 24 uren van tevoren) en voorkom daarmee dat [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-419","page","type-page","status-publish","hentry","post"],"_links":{"self":[{"href":"https:\/\/www.medisch-keuringscentrum.nl\/mediwp\/medischwp\/wp-json\/wp\/v2\/pages\/419","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.medisch-keuringscentrum.nl\/mediwp\/medischwp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.medisch-keuringscentrum.nl\/mediwp\/medischwp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.medisch-keuringscentrum.nl\/mediwp\/medischwp\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.medisch-keuringscentrum.nl\/mediwp\/medischwp\/wp-json\/wp\/v2\/comments?post=419"}],"version-history":[{"count":6,"href":"https:\/\/www.medisch-keuringscentrum.nl\/mediwp\/medischwp\/wp-json\/wp\/v2\/pages\/419\/revisions"}],"predecessor-version":[{"id":460,"href":"https:\/\/www.medisch-keuringscentrum.nl\/mediwp\/medischwp\/wp-json\/wp\/v2\/pages\/419\/revisions\/460"}],"wp:attachment":[{"href":"https:\/\/www.medisch-keuringscentrum.nl\/mediwp\/medischwp\/wp-json\/wp\/v2\/media?parent=419"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}