{"id":503,"date":"2026-04-29T09:35:49","date_gmt":"2026-04-29T09:35:49","guid":{"rendered":"https:\/\/www.residentiedokters.nl\/?page_id=503"},"modified":"2026-06-23T09:43:15","modified_gmt":"2026-06-23T09:43:15","slug":"repeat-prescriptions","status":"publish","type":"page","link":"https:\/\/www.residentiedokters.nl\/en\/herhaalrecepten\/","title":{"rendered":"Repeat prescriptions"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"503\" class=\"elementor elementor-503\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2c5b00f section-container  vertical60 e-flex e-con-boxed e-con e-parent\" data-id=\"2c5b00f\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c333062 elementor-widget__width-inherit elementor-widget elementor-widget-text-editor\" data-id=\"c333062\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><nav aria-label=\"breadcrumbs\" class=\"rank-math-breadcrumb\"><p><span class=\"last\">Home<\/span><\/p><\/nav><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-58861f7 elementor-widget elementor-widget-heading\" data-id=\"58861f7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Herhaalrecepten<\/h1>\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<div class=\"elementor-element elementor-element-db1ab23 section-container vertical60 e-flex e-con-boxed e-con e-parent\" data-id=\"db1ab23\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-fd92c35 e-con-full e-flex e-con e-child\" data-id=\"fd92c35\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[],&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f158225 elementor-widget elementor-widget-heading\" data-id=\"f158225\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Herhaalrecepten aanvragen\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1316d9b elementor-widget elementor-widget-text-editor\" data-id=\"1316d9b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Gebruikt u medicijnen die u regelmatig opnieuw nodig heeft? Vul dan onderstaand formulier zo volledig mogelijk in. Uw recept ligt binnen 3 werkdagen klaar bij uw apotheek.<\/p><p>Heeft u nog geen bericht ontvangen van de apotheek? Contact eerst de apotheek of het receptbericht goed ontvangen is.\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-528ec7a elementor-widget elementor-widget-heading\" data-id=\"528ec7a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Snel &amp; gemakkelijk via het pati\u00ebntenportaal<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f5ff092 elementor-widget elementor-widget-text-editor\" data-id=\"f5ff092\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tEen herhaalrecept vraagt u het snelst en gemakkelijkst aan via het pati\u00ebntenportaal. \t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ea2eef1 reloop-icon elementor-hidden-mobile elementor-widget elementor-widget-button\" data-id=\"ea2eef1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/residentiedokters.uwzorgonline.nl\/inloggen-en-registratie\/app\/\" target=\"_blank\" rel=\"noopener\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-arrow-right\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M190.5 66.9l22.2-22.2c9.4-9.4 24.6-9.4 33.9 0L441 239c9.4 9.4 9.4 24.6 0 33.9L246.6 467.3c-9.4 9.4-24.6 9.4-33.9 0l-22.2-22.2c-9.5-9.5-9.3-25 .4-34.3L311.4 296H24c-13.3 0-24-10.7-24-24v-32c0-13.3 10.7-24 24-24h287.4L190.9 101.2c-9.8-9.3-10-24.8-.4-34.3z\"><\/path><\/svg>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Patientenportaal<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fa8d0c3 elementor-widget elementor-widget-heading\" data-id=\"fa8d0c3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Liever bellen?<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5a6f964 elementor-widget elementor-widget-text-editor\" data-id=\"5a6f964\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tSpreek uw aanvraag in via de receptenlijn: 070 &#8211; 345 06 50, optie 3. Dit kan 24 uur per dag, 7 dagen per week. Vermeld uw naam, geboortedatum, de naam van het medicijn, de sterkte en het gebruik.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6cc360d elementor-widget elementor-widget-heading\" data-id=\"6cc360d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Let op: vraag op tijd aan\n<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-670d8d2 elementor-widget elementor-widget-text-editor\" data-id=\"670d8d2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tTijdens vakantieperiodes kan de verwerking langer duren. Houd hier rekening mee en vraag uw recept tijdig aan.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1411c1a e-con-full e-flex e-con e-child\" data-id=\"1411c1a\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-aef973c elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"aef973c\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Volgende&quot;,&quot;step_previous_label&quot;:&quot;Vorige&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&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=\"Herhalreceptenform\" aria-label=\"Herhalreceptenform\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"503\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"aef973c\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"\" \/>\n\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-text elementor-field-group elementor-column elementor-field-group-voornaam elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-voornaam\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tVoornaam\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[voornaam]\" id=\"form-field-voornaam\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"voornaam\" 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-text elementor-field-group elementor-column elementor-field-group-achternaam elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-achternaam\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tAchternaam\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[achternaam]\" id=\"form-field-achternaam\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"achternaam\" 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-radio elementor-field-group elementor-column elementor-field-group-geslacht elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-geslacht\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tGeslacht\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=\"Vrouw\" id=\"form-field-geslacht-0\" name=\"form_fields[geslacht]\" required=\"required\"> <label for=\"form-field-geslacht-0\">Vrouw<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Man\" id=\"form-field-geslacht-1\" name=\"form_fields[geslacht]\" required=\"required\"> <label for=\"form-field-geslacht-1\">Man<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Anders\" id=\"form-field-geslacht-2\" name=\"form_fields[geslacht]\" required=\"required\"> <label for=\"form-field-geslacht-2\">Anders<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-geboortedatum elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-geboortedatum\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tGeboortedatum\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[geboortedatum]\" id=\"form-field-geboortedatum\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field elementor-use-native\" placeholder=\"Geboortedatum\" required=\"required\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-telefoon elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-telefoon\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\ttelefoon\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[telefoon]\" id=\"form-field-telefoon\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"telefoon\" required=\"required\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\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-email elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tE-mail\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[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"E-mail\" 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-text elementor-field-group elementor-column elementor-field-group-apotheek elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-apotheek\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tapotheek\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[apotheek]\" id=\"form-field-apotheek\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Uw apotheek\" 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-html elementor-field-group elementor-column elementor-field-group-field_abd6b79 elementor-col-100\">\n\t\t\t\t\t<b>Voor welk middel wilt u een herhaalrecept?<\/b>\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-naam_middel elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-naam_middel\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tnaam_middel\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=\"Acenocoumarol (bijv. Sintrom)\" id=\"form-field-naam_middel-0\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-0\">Acenocoumarol (bijv. Sintrom)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Acetylsalicylzuur (bijv. Asperine)\" id=\"form-field-naam_middel-1\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-1\">Acetylsalicylzuur (bijv. Asperine)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Acetylcysteine (bijv. Fluimucil)\" id=\"form-field-naam_middel-2\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-2\">Acetylcysteine (bijv. Fluimucil)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Amlodipine (bijv. Norvasc)\" id=\"form-field-naam_middel-3\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-3\">Amlodipine (bijv. Norvasc)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Atenolol (bijv. Tenormin)\" id=\"form-field-naam_middel-4\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-4\">Atenolol (bijv. Tenormin)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Atorvastatine (bijv. Lipitor)\" id=\"form-field-naam_middel-5\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-5\">Atorvastatine (bijv. Lipitor)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Beclomethason (bijv. Becotide)\" id=\"form-field-naam_middel-6\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-6\">Beclomethason (bijv. Becotide)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Bisacodyl (bijv. Dulcolax)\" id=\"form-field-naam_middel-7\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-7\">Bisacodyl (bijv. Dulcolax)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Bromazepam (bijv. Lexotanil)\" id=\"form-field-naam_middel-8\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-8\">Bromazepam (bijv. Lexotanil)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Budesonide (bijv. Pulmicort)\" id=\"form-field-naam_middel-9\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-9\">Budesonide (bijv. Pulmicort)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Bemetanide bijv. Burinex)\" id=\"form-field-naam_middel-10\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-10\">Bemetanide bijv. Burinex)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Calciumcarbonaat (bijv. Cacit)\" id=\"form-field-naam_middel-11\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-11\">Calciumcarbonaat (bijv. Cacit)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Carbamazepine (bijv. Carbyma, Tegretol)\" id=\"form-field-naam_middel-12\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-12\">Carbamazepine (bijv. Carbyma, Tegretol)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Carbasalaatcalcium (bijv. Ascal)\" id=\"form-field-naam_middel-13\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-13\">Carbasalaatcalcium (bijv. Ascal)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Cetirizine (bijv. Zyrtec)\" id=\"form-field-naam_middel-14\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-14\">Cetirizine (bijv. Zyrtec)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Chloortalidon (bijv. Hygroton)\" id=\"form-field-naam_middel-15\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-15\">Chloortalidon (bijv. Hygroton)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Cimetidine (bijv. Tagamet)\" id=\"form-field-naam_middel-16\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-16\">Cimetidine (bijv. Tagamet)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Codeine\" id=\"form-field-naam_middel-17\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-17\">Codeine<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Cyproteronacetaat\/eth.estr (bijv. Diane)\" id=\"form-field-naam_middel-18\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-18\">Cyproteronacetaat\/eth.estr (bijv. Diane)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Diazepam (bijv. Valium)\" id=\"form-field-naam_middel-19\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-19\">Diazepam (bijv. Valium)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Diclofenac (bijv. Voltaren)\" id=\"form-field-naam_middel-20\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-20\">Diclofenac (bijv. Voltaren)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Diclofenac\/Misoprostol (bijv. Arthrotec)\" id=\"form-field-naam_middel-21\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-21\">Diclofenac\/Misoprostol (bijv. Arthrotec)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Digoxine (bijv. Lanoxin)\" id=\"form-field-naam_middel-22\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-22\">Digoxine (bijv. Lanoxin)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Diltiazem (bijv. Tildiem)\" id=\"form-field-naam_middel-23\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-23\">Diltiazem (bijv. Tildiem)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Domperidon (bijv. Motilium)\" id=\"form-field-naam_middel-24\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-24\">Domperidon (bijv. Motilium)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Esomeprazol (bijv. Nexium)\" id=\"form-field-naam_middel-25\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-25\">Esomeprazol (bijv. Nexium)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Ethinylestr.\/Desogestrel (bijv. Marvelon)\" id=\"form-field-naam_middel-26\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-26\">Ethinylestr.\/Desogestrel (bijv. Marvelon)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Ethinylestr.\/Levonorgestrel (bijv. Microgynon)\" id=\"form-field-naam_middel-27\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-27\">Ethinylestr.\/Levonorgestrel (bijv. Microgynon)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Fenprocoumon (bijv. Marcoumar)\" id=\"form-field-naam_middel-28\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-28\">Fenprocoumon (bijv. Marcoumar)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Ferrofumaraat\" id=\"form-field-naam_middel-29\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-29\">Ferrofumaraat<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Fexofenadine (bijv. Telfast)\" id=\"form-field-naam_middel-30\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-30\">Fexofenadine (bijv. Telfast)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Fluoxetine (bijv. Prozac)\" id=\"form-field-naam_middel-31\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-31\">Fluoxetine (bijv. Prozac)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Fluticazon (bijv. Flixotide)\" id=\"form-field-naam_middel-32\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-32\">Fluticazon (bijv. Flixotide)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Fluvastatine (bijv. Lescol)\" id=\"form-field-naam_middel-33\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-33\">Fluvastatine (bijv. Lescol)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Fluvoxamine (bijv. Fevarin)\" id=\"form-field-naam_middel-34\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-34\">Fluvoxamine (bijv. Fevarin)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Formoterol (bijv. Oxis)\" id=\"form-field-naam_middel-35\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-35\">Formoterol (bijv. Oxis)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Furosemide (bijv. Lasix)\" id=\"form-field-naam_middel-36\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-36\">Furosemide (bijv. Lasix)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Glibenclamide (bijv. Daonil)\" id=\"form-field-naam_middel-37\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-37\">Glibenclamide (bijv. Daonil)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Gliclazide (bijv. Diamicron)\" id=\"form-field-naam_middel-38\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-38\">Gliclazide (bijv. Diamicron)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Glimepiride (bijv. Amaryl)\" id=\"form-field-naam_middel-39\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-39\">Glimepiride (bijv. Amaryl)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Hydrocloortiazide (bijv. Esidrex)\" id=\"form-field-naam_middel-40\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-40\">Hydrocloortiazide (bijv. Esidrex)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Ibuprofen (bijv. Brufen)\" id=\"form-field-naam_middel-41\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-41\">Ibuprofen (bijv. Brufen)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Ipratropium (bijv. Atrovent)\" id=\"form-field-naam_middel-42\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-42\">Ipratropium (bijv. Atrovent)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Isosorbidedinnitraat (bijv. Cedocard)\" id=\"form-field-naam_middel-43\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-43\">Isosorbidedinnitraat (bijv. Cedocard)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Isossorbidemononitraat (bijv. Promocard)\" id=\"form-field-naam_middel-44\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-44\">Isossorbidemononitraat (bijv. Promocard)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Lansoprazol (bijv. Prezal)\" id=\"form-field-naam_middel-45\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-45\">Lansoprazol (bijv. Prezal)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Levocetirizide (bijv Xyzal)\" id=\"form-field-naam_middel-46\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-46\">Levocetirizide (bijv Xyzal)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Levothyroxine (bijv. Thyrax Duotab)\" id=\"form-field-naam_middel-47\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-47\">Levothyroxine (bijv. Thyrax Duotab)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Loperamide (bijv. Imodium)\" id=\"form-field-naam_middel-48\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-48\">Loperamide (bijv. Imodium)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Loratadine (bijv. Claritine)\" id=\"form-field-naam_middel-49\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-49\">Loratadine (bijv. Claritine)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Lorazepam (bijv. Temesta)\" id=\"form-field-naam_middel-50\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-50\">Lorazepam (bijv. Temesta)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Magnesiumhydroxide\" id=\"form-field-naam_middel-51\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-51\">Magnesiumhydroxide<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Meloxicam (bijv. Movicox)\" id=\"form-field-naam_middel-52\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-52\">Meloxicam (bijv. Movicox)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Metformine (bijv. Glucophage)\" id=\"form-field-naam_middel-53\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-53\">Metformine (bijv. Glucophage)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Metoclopramide (bijv. Primperan)\" id=\"form-field-naam_middel-54\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-54\">Metoclopramide (bijv. Primperan)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Metoprolol (bijv. Selokeen)\" id=\"form-field-naam_middel-55\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-55\">Metoprolol (bijv. Selokeen)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Mirtazepine (bijv. Remeron)\" id=\"form-field-naam_middel-56\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-56\">Mirtazepine (bijv. Remeron)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Naproxen\" id=\"form-field-naam_middel-57\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-57\">Naproxen<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Nifedipine (bijv. Adalat)\" id=\"form-field-naam_middel-58\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-58\">Nifedipine (bijv. Adalat)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Omeprazol (bijv. Losec)\" id=\"form-field-naam_middel-59\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-59\">Omeprazol (bijv. Losec)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Oxazepam (bijv. Seresta)\" id=\"form-field-naam_middel-60\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-60\">Oxazepam (bijv. Seresta)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Pantoprazol (bijv. Pantozol)\" id=\"form-field-naam_middel-61\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-61\">Pantoprazol (bijv. Pantozol)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Paracetamol&quot; &quot;Paracetamol\/Codeine\" id=\"form-field-naam_middel-62\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-62\">Paracetamol\" \"Paracetamol\/Codeine<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Paroxetine (bijv. Seroxat)\" id=\"form-field-naam_middel-63\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-63\">Paroxetine (bijv. Seroxat)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Pravastatine (bijv. Selektine)\" id=\"form-field-naam_middel-64\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-64\">Pravastatine (bijv. Selektine)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Propranolol (bijv. Inderal)\" id=\"form-field-naam_middel-65\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-65\">Propranolol (bijv. Inderal)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Ranitidine (bijv. Zantac)\" id=\"form-field-naam_middel-66\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-66\">Ranitidine (bijv. Zantac)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Rizatriptan (bijv. Maxalt)\" id=\"form-field-naam_middel-67\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-67\">Rizatriptan (bijv. Maxalt)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Salbutamol (bijv. Ventolin)\" id=\"form-field-naam_middel-68\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-68\">Salbutamol (bijv. Ventolin)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Salmeterol (bijv. Serevent)\" id=\"form-field-naam_middel-69\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-69\">Salmeterol (bijv. Serevent)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Sertraline (bijv. Zoloft)\" id=\"form-field-naam_middel-70\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-70\">Sertraline (bijv. Zoloft)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Simvastatine (bijv. Zocor)\" id=\"form-field-naam_middel-71\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-71\">Simvastatine (bijv. Zocor)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Sotalol (bijv. Sotacor)\" id=\"form-field-naam_middel-72\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-72\">Sotalol (bijv. Sotacor)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Sumatriptan (bijv. Imigran)\" id=\"form-field-naam_middel-73\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-73\">Sumatriptan (bijv. Imigran)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Tamsulosine&quot; &quot;Temazepam (bijv. Normison)\" id=\"form-field-naam_middel-74\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-74\">Tamsulosine\" \"Temazepam (bijv. Normison)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Terbutaline (bijv. Bricanyl)\" id=\"form-field-naam_middel-75\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-75\">Terbutaline (bijv. Bricanyl)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Thiamazol (bijv. Strumazol)\" id=\"form-field-naam_middel-76\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-76\">Thiamazol (bijv. Strumazol)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Tolbutamide\" id=\"form-field-naam_middel-77\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-77\">Tolbutamide<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Tramadol (bijv. Tramal)\" id=\"form-field-naam_middel-78\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-78\">Tramadol (bijv. Tramal)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Triamtereen\/hydrochl.th. (bijv. Dytenzide)\" id=\"form-field-naam_middel-79\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-79\">Triamtereen\/hydrochl.th. (bijv. Dytenzide)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Venlafaxine (bijv. Efexor)\" id=\"form-field-naam_middel-80\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-80\">Venlafaxine (bijv. Efexor)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Verapamil (bijv. Isoptin)\" id=\"form-field-naam_middel-81\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-81\">Verapamil (bijv. Isoptin)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Zolmitriptan (bijv. Zomig)\" id=\"form-field-naam_middel-82\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-82\">Zolmitriptan (bijv. Zomig)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Zolpidem (bijv. Stilnoct)\" id=\"form-field-naam_middel-83\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-83\">Zolpidem (bijv. Stilnoct)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Zoplicon (bijv. Imovane)\" id=\"form-field-naam_middel-84\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-84\">Zoplicon (bijv. Imovane)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Iets anders...\" id=\"form-field-naam_middel-85\" name=\"form_fields[naam_middel][]\"> <label for=\"form-field-naam_middel-85\">Iets anders...<\/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-ander_middel elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-ander_middel\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tAnder middel\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[ander_middel]\" id=\"form-field-ander_middel\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Een ander middel\">\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-html elementor-field-group elementor-column elementor-field-group-field_191ccf5 elementor-col-100\">\n\t\t\t\t\t<b>Huidige dosering\u00a0<\/b>\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-dosering elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-dosering\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tdosering\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[dosering]\" id=\"form-field-dosering\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"... (milli-\/ microgram)\" 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-html elementor-field-group elementor-column elementor-field-group-field_78177be elementor-col-100\">\n\t\t\t\t\t<b>huidig gebruik<\/b>\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-gebruik elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-gebruik\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tGebruik\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[gebruik]\" id=\"form-field-gebruik\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Aantal tabletten \" 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-text elementor-field-group elementor-column elementor-field-group-frequentie elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-frequentie\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tFrequentie\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[frequentie]\" id=\"form-field-frequentie\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Aantal keer\" 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-radio elementor-field-group elementor-column elementor-field-group-per_periode elementor-col-66\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-per_periode\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tper\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=\"Dag \" id=\"form-field-per_periode-0\" name=\"form_fields[per_periode]\"> <label for=\"form-field-per_periode-0\">Dag <\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Etmaal \" id=\"form-field-per_periode-1\" name=\"form_fields[per_periode]\"> <label for=\"form-field-per_periode-1\">Etmaal <\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Week \" id=\"form-field-per_periode-2\" name=\"form_fields[per_periode]\"> <label for=\"form-field-per_periode-2\">Week <\/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-opmerkingen elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-opmerkingen\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tOpmerkingen\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[opmerkingen]\" id=\"form-field-opmerkingen\" rows=\"4\" placeholder=\"opmerkingen\"><\/textarea>\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<\/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":"<p>Do you use medication that you need to refill regularly? If so, please fill in the form below as completely as possible. Your prescription will be ready at your pharmacy within 3 working days.<\/p>","protected":false},"author":1,"featured_media":2333,"parent":0,"menu_order":10,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[12],"class_list":["post-503","page","type-page","status-publish","has-post-thumbnail","hentry","category-online-regelen"],"_links":{"self":[{"href":"https:\/\/www.residentiedokters.nl\/en\/wp-json\/wp\/v2\/pages\/503","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.residentiedokters.nl\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.residentiedokters.nl\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.residentiedokters.nl\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.residentiedokters.nl\/en\/wp-json\/wp\/v2\/comments?post=503"}],"version-history":[{"count":3,"href":"https:\/\/www.residentiedokters.nl\/en\/wp-json\/wp\/v2\/pages\/503\/revisions"}],"predecessor-version":[{"id":2480,"href":"https:\/\/www.residentiedokters.nl\/en\/wp-json\/wp\/v2\/pages\/503\/revisions\/2480"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.residentiedokters.nl\/en\/wp-json\/wp\/v2\/media\/2333"}],"wp:attachment":[{"href":"https:\/\/www.residentiedokters.nl\/en\/wp-json\/wp\/v2\/media?parent=503"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.residentiedokters.nl\/en\/wp-json\/wp\/v2\/categories?post=503"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}