{"id":46040,"date":"2026-02-27T11:58:35","date_gmt":"2026-02-27T10:58:35","guid":{"rendered":"https:\/\/panadent.ch\/erstellen-sie-jetzt-ihren-raum\/"},"modified":"2026-02-27T11:58:46","modified_gmt":"2026-02-27T10:58:46","slug":"erstellen-sie-jetzt-ihren-raum","status":"publish","type":"page","link":"https:\/\/panadent.ch\/de\/erstellen-sie-jetzt-ihren-raum\/","title":{"rendered":"Erstellen Sie jetzt Ihren Raum"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"46040\" class=\"elementor elementor-46040 elementor-31820\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c8a4050 elementor-reverse-mobile elementor-section-height-min-height elementor-section-boxed elementor-section-height-default elementor-section-items-middle\" data-id=\"c8a4050\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\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-68d6e83\" data-id=\"68d6e83\" 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-4bf0ffd elementor-widget__width-inherit elementor-widget elementor-widget-heading\" data-id=\"4bf0ffd\" 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\">Erstellen Sie jetzt Ihren Raum<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3a0e0e3 elementor-widget elementor-widget-text-editor\" data-id=\"3a0e0e3\" 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>Geben Sie online Ihre Informationen ein und alles ist bereit, wenn Sie ankommen!<\/p>\t\t\t\t\t\t\t\t<\/div>\n\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-4861de5 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4861de5\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\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-f8e02fa\" data-id=\"f8e02fa\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\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-10b4034 elementor-widget elementor-widget-heading\" data-id=\"10b4034\" 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\">Registrierung<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0f2de9c elementor-widget__width-inherit elementor-widget elementor-widget-heading\" data-id=\"0f2de9c\" 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\">Konventioneller Besuch<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6bbce1a elementor-button-align-start elementor-widget elementor-widget-form\" data-id=\"6bbce1a\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&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=\"New Form\" aria-label=\"New Form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"46040\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"6bbce1a\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Erstellen Sie jetzt Ihren Raum - PANADENT\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"46040\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName\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[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" 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-field_ea7437e elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ea7437e\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tVorname\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_ea7437e]\" id=\"form-field-field_ea7437e\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" 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-date elementor-field-group elementor-column elementor-field-group-field_813ebd4 elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_813ebd4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tGeburtsdatum\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_813ebd4]\" id=\"form-field-field_813ebd4\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" 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-text elementor-field-group elementor-column elementor-field-group-field_98d0576 elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_98d0576\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tOrt\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_98d0576]\" id=\"form-field-field_98d0576\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" 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-field_82e4632 elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_82e4632\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAdresse\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_82e4632]\" id=\"form-field-field_82e4632\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" 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-field_f5d81d4 elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_f5d81d4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPLZ\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_f5d81d4]\" id=\"form-field-field_f5d81d4\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" 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-select elementor-field-group elementor-column elementor-field-group-cabinets elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-cabinets\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tIch m\u00f6chte in diese Praxis kommen\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-caret-down\"><\/i>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[cabinets]\" id=\"form-field-cabinets\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"Domdidier\">Domdidier<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Payerne\">Payerne<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Yvonand\">Yvonand<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"\u00c9challens\">\u00c9challens<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Riaz\">Riaz<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Le Landeron\">Le Landeron<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Saint-Blaise\">Saint-Blaise<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Boudry\">Boudry<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Chaux-de-Fonds\">Chaux-de-Fonds<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Bulle\">Bulle<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Orbe\">Orbe<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Mies\">Mies<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Crans-pr\u00e8s-C\u00e9ligny\">Crans-pr\u00e8s-C\u00e9ligny<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Saint-Prex\">Saint-Prex<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Gland\">Gland<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\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-field_52034a4 elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_52034a4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tTel.-Nr.\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_52034a4]\" id=\"form-field-field_52034a4\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" 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-email elementor-field-group elementor-column elementor-field-group-email elementor-col-33 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\">\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=\" \" 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-acceptance elementor-field-group elementor-column elementor-field-group-field_9716e32 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[field_9716e32]\" id=\"form-field-field_9716e32\" class=\"elementor-field elementor-size-sm  elementor-acceptance-field\" required=\"required\">\n\t\t\t\t<label for=\"form-field-field_9716e32\">Ich bin damit einverstanden, \u00fcber die neuesten in der Zahnarztpraxis erh\u00e4ltlichen Produkte informiert zu werden (Ohne Verpflichtungen, jederzeit k\u00fcndbar).<\/label>\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_6990a92 elementor-col-100\">\n\t\t\t\t\tWenn ich minderj\u00e4hrig bin, meldet sich bitte auch mein gesetzlicher Vertreter:\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_0374a91 elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_0374a91\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName\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_0374a91]\" id=\"form-field-field_0374a91\" 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-text elementor-field-group elementor-column elementor-field-group-field_13527c4 elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_13527c4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tVorname\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_13527c4]\" id=\"form-field-field_13527c4\" 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-date elementor-field-group elementor-column elementor-field-group-field_3b793f2 elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_3b793f2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tGeburtsdatum\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_3b793f2]\" id=\"form-field-field_3b793f2\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" 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-checkbox elementor-field-group elementor-column elementor-field-group-field_e174054 elementor-col-60\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_e174054\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMeine Zahnarztkosten werden \u00fcbernommen von :\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=\"Ich selbst\" id=\"form-field-field_e174054-0\" name=\"form_fields[field_e174054][]\"> <label for=\"form-field-field_e174054-0\">Ich selbst<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Ein Sozialdienst\" id=\"form-field-field_e174054-1\" name=\"form_fields[field_e174054][]\"> <label for=\"form-field-field_e174054-1\">Ein Sozialdienst<\/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_ac6cecf elementor-col-40\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ac6cecf\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWenn es sich um einen sozialen Dienst handelt, wie hei\u00dft er?\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_ac6cecf]\" id=\"form-field-field_ac6cecf\" 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-checkbox elementor-field-group elementor-column elementor-field-group-field_8b6aa01 elementor-col-60\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_8b6aa01\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHaben Sie eine Zahnzusatzversicherung?\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=\"Ja \" id=\"form-field-field_8b6aa01-0\" name=\"form_fields[field_8b6aa01][]\"> <label for=\"form-field-field_8b6aa01-0\">Ja <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Nein\" id=\"form-field-field_8b6aa01-1\" name=\"form_fields[field_8b6aa01][]\"> <label for=\"form-field-field_8b6aa01-1\">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_050298a elementor-col-40\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_050298a\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWenn ja, wie lautet sein Name?\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_050298a]\" id=\"form-field-field_050298a\" 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-html elementor-field-group elementor-column elementor-field-group-field_6e4cf06 elementor-col-100\">\n\t\t\t\t\tIhre allgemeine Gesundheit\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_80f12b7 elementor-col-40\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_80f12b7\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNehmen Sie Medikamente ein?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Ja \" id=\"form-field-field_80f12b7-0\" name=\"form_fields[field_80f12b7][]\"> <label for=\"form-field-field_80f12b7-0\">Ja <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Nein\" id=\"form-field-field_80f12b7-1\" name=\"form_fields[field_80f12b7][]\"> <label for=\"form-field-field_80f12b7-1\">Nein<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_6fd406f elementor-col-60\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_6fd406f\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWenn ja, f\u00fcr:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Blut\" id=\"form-field-field_6fd406f-0\" name=\"form_fields[field_6fd406f][]\"> <label for=\"form-field-field_6fd406f-0\">Blut<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Epilepsie \" id=\"form-field-field_6fd406f-1\" name=\"form_fields[field_6fd406f][]\"> <label for=\"form-field-field_6fd406f-1\">Epilepsie <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Knochen \" id=\"form-field-field_6fd406f-2\" name=\"form_fields[field_6fd406f][]\"> <label for=\"form-field-field_6fd406f-2\">Knochen <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Krebs\" id=\"form-field-field_6fd406f-3\" name=\"form_fields[field_6fd406f][]\"> <label for=\"form-field-field_6fd406f-3\">Krebs<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Autoimmunkrankheit\" id=\"form-field-field_6fd406f-4\" name=\"form_fields[field_6fd406f][]\"> <label for=\"form-field-field_6fd406f-4\">Autoimmunkrankheit<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_8d3f16b elementor-col-60\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_8d3f16b\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHaben Sie Allergien (Latex, Medikamente, andere)?\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=\"Ja \" id=\"form-field-field_8d3f16b-0\" name=\"form_fields[field_8d3f16b][]\"> <label for=\"form-field-field_8d3f16b-0\">Ja <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Nein\" id=\"form-field-field_8d3f16b-1\" name=\"form_fields[field_8d3f16b][]\"> <label for=\"form-field-field_8d3f16b-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_c911af4 elementor-col-40\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_c911af4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWenn ja, welche?  \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_c911af4]\" id=\"form-field-field_c911af4\" 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-checkbox elementor-field-group elementor-column elementor-field-group-field_753081e elementor-col-60\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_753081e\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSind Sie auf ein Herzproblem gesto\u00dfen (Herzklappe, Endokarditis, Missbildung, Herzger\u00e4usch)?\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=\"Ja \" id=\"form-field-field_753081e-0\" name=\"form_fields[field_753081e][]\"> <label for=\"form-field-field_753081e-0\">Ja <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Nein\" id=\"form-field-field_753081e-1\" name=\"form_fields[field_753081e][]\"> <label for=\"form-field-field_753081e-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_a91fbb4 elementor-col-40\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a91fbb4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWenn ja, welche?\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_a91fbb4]\" id=\"form-field-field_a91fbb4\" 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-checkbox elementor-field-group elementor-column elementor-field-group-field_84f6b29 elementor-col-60\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_84f6b29\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tTragen Sie Prothesen? (Platte, Schraube, Herzschrittmacher)\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=\"Ja \" id=\"form-field-field_84f6b29-0\" name=\"form_fields[field_84f6b29][]\"> <label for=\"form-field-field_84f6b29-0\">Ja <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Nein\" id=\"form-field-field_84f6b29-1\" name=\"form_fields[field_84f6b29][]\"> <label for=\"form-field-field_84f6b29-1\">Nein<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_351dc78 elementor-col-40\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_351dc78\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWenn ja, seit:  \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=\"Weniger als ein Jahr \" id=\"form-field-field_351dc78-0\" name=\"form_fields[field_351dc78][]\"> <label for=\"form-field-field_351dc78-0\">Weniger als ein Jahr <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Mehr als ein Jahr  \" id=\"form-field-field_351dc78-1\" name=\"form_fields[field_351dc78][]\"> <label for=\"form-field-field_351dc78-1\">Mehr als ein Jahr  <\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_d933905 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_d933905\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tLeiden Sie an Diabetes?\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=\"Ja \" id=\"form-field-field_d933905-0\" name=\"form_fields[field_d933905][]\"> <label for=\"form-field-field_d933905-0\">Ja <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Nein\" id=\"form-field-field_d933905-1\" name=\"form_fields[field_d933905][]\"> <label for=\"form-field-field_d933905-1\">Nein<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_2603806 elementor-col-40\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2603806\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHaben Sie eine Radio- oder Chemotherapie erhalten?\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=\"Ja \" id=\"form-field-field_2603806-0\" name=\"form_fields[field_2603806][]\"> <label for=\"form-field-field_2603806-0\">Ja <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Nein\" id=\"form-field-field_2603806-1\" name=\"form_fields[field_2603806][]\"> <label for=\"form-field-field_2603806-1\">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_29a16f4 elementor-col-30\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_29a16f4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWenn ja, auf welcher Ebene?\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_29a16f4]\" id=\"form-field-field_29a16f4\" 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-checkbox elementor-field-group elementor-column elementor-field-group-field_ccee1b8 elementor-col-30\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ccee1b8\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWann?\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=\"Im Moment\" id=\"form-field-field_ccee1b8-0\" name=\"form_fields[field_ccee1b8][]\"> <label for=\"form-field-field_ccee1b8-0\">Im Moment<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"In der Vergangenheit  \" id=\"form-field-field_ccee1b8-1\" name=\"form_fields[field_ccee1b8][]\"> <label for=\"form-field-field_ccee1b8-1\">In der Vergangenheit  <\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_d42ab26 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_d42ab26\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSind Sie schwanger?\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=\"Ja\" id=\"form-field-field_d42ab26-0\" name=\"form_fields[field_d42ab26][]\"> <label for=\"form-field-field_d42ab26-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Nein\" id=\"form-field-field_d42ab26-1\" name=\"form_fields[field_d42ab26][]\"> <label for=\"form-field-field_d42ab26-1\">Nein<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_1d420c1 elementor-col-100\">\n\t\t\t\t\tIhre Mundgesundheit  \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_234d187 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_234d187\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWie wichtig ist Ihnen Ihre Mundgesundheit?\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=\"Gro\u00df\" id=\"form-field-field_234d187-0\" name=\"form_fields[field_234d187][]\"> <label for=\"form-field-field_234d187-0\">Gro\u00df<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Gering\" id=\"form-field-field_234d187-1\" name=\"form_fields[field_234d187][]\"> <label for=\"form-field-field_234d187-1\">Gering<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_e3a4082 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_e3a4082\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWann waren Sie das letzte Mal beim Zahnarzt?\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=\"Mehr als zwei Jahre\" id=\"form-field-field_e3a4082-0\" name=\"form_fields[field_e3a4082][]\"> <label for=\"form-field-field_e3a4082-0\">Mehr als zwei Jahre<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Mehr als ein Jahr\" id=\"form-field-field_e3a4082-1\" name=\"form_fields[field_e3a4082][]\"> <label for=\"form-field-field_e3a4082-1\">Mehr als ein Jahr<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Einige Monate\" id=\"form-field-field_e3a4082-2\" name=\"form_fields[field_e3a4082][]\"> <label for=\"form-field-field_e3a4082-2\">Einige Monate<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_207ae82 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_207ae82\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHaben Sie Z\u00e4hne, die in der Vergangenheit abgebrochen sind?\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=\"Ja\" id=\"form-field-field_207ae82-0\" name=\"form_fields[field_207ae82][]\"> <label for=\"form-field-field_207ae82-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Nein\" id=\"form-field-field_207ae82-1\" name=\"form_fields[field_207ae82][]\"> <label for=\"form-field-field_207ae82-1\">Nein<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_918aaeb elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_918aaeb\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tStecken Lebensmittel zwischen den Z\u00e4hnen fest?\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=\"Ja\" id=\"form-field-field_918aaeb-0\" name=\"form_fields[field_918aaeb][]\"> <label for=\"form-field-field_918aaeb-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Nein\" id=\"form-field-field_918aaeb-1\" name=\"form_fields[field_918aaeb][]\"> <label for=\"form-field-field_918aaeb-1\">Nein<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_ef1008b elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ef1008b\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSind Sie mit der Ausrichtung Ihrer Z\u00e4hne zufrieden?\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=\"Ja\" id=\"form-field-field_ef1008b-0\" name=\"form_fields[field_ef1008b][]\"> <label for=\"form-field-field_ef1008b-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Nein\" id=\"form-field-field_ef1008b-1\" name=\"form_fields[field_ef1008b][]\"> <label for=\"form-field-field_ef1008b-1\">Nein<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_a6043fb elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a6043fb\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tM\u00f6gen Sie Ihr L\u00e4cheln?\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=\"Ja\" id=\"form-field-field_a6043fb-0\" name=\"form_fields[field_a6043fb][]\"> <label for=\"form-field-field_a6043fb-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Nein\" id=\"form-field-field_a6043fb-1\" name=\"form_fields[field_a6043fb][]\"> <label for=\"form-field-field_a6043fb-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_cc383bf elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_cc383bf\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWenn nein, warum nicht?\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_cc383bf]\" id=\"form-field-field_cc383bf\" 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-checkbox elementor-field-group elementor-column elementor-field-group-field_2fdcc9d elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2fdcc9d\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHaben Sie wiederkehrende Schmerzen oder Beschwerden? (Tinnitus, Kopfschmerzen, Schulter-\/Knieschmerzen, Sonstiges)\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=\"Ja\" id=\"form-field-field_2fdcc9d-0\" name=\"form_fields[field_2fdcc9d][]\"> <label for=\"form-field-field_2fdcc9d-0\">Ja<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Nein\" id=\"form-field-field_2fdcc9d-1\" name=\"form_fields[field_2fdcc9d][]\"> <label for=\"form-field-field_2fdcc9d-1\">Nein<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_b60e980 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_b60e980\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWie sind Sie auf PanaDent aufmerksam geworden?\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=\"Beziehung\" id=\"form-field-field_b60e980-0\" name=\"form_fields[field_b60e980][]\"> <label for=\"form-field-field_b60e980-0\">Beziehung<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Google\" id=\"form-field-field_b60e980-1\" name=\"form_fields[field_b60e980][]\"> <label for=\"form-field-field_b60e980-1\">Google<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Soziale Netzwerke\" id=\"form-field-field_b60e980-2\" name=\"form_fields[field_b60e980][]\"> <label for=\"form-field-field_b60e980-2\">Soziale Netzwerke<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_190dc9f elementor-col-100\">\n\t\t\t\t\tGr\u00fcnde f\u00fcr die Konsultation\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_359e851 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_359e851]\" id=\"form-field-field_359e851\" rows=\"5\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-field_00b04fe elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[field_00b04fe]\" id=\"form-field-field_00b04fe\" class=\"elementor-field elementor-size-sm  elementor-acceptance-field\" required=\"required\">\n\t\t\t\t<label for=\"form-field-field_00b04fe\">Ich erm\u00e4chtige meinen behandelnden Zahnarzt, die f\u00fcr die Durchf\u00fchrung meiner Behandlung erforderlichen Daten an alle Personen, Institutionen oder andere Beteiligte weiterzugeben. Ich stimme auch der \u00dcbermittlung der Daten f\u00fcr die Rechnungsstellung und das Inkasso der Honorare f\u00fcr die von mir in Anspruch genommenen zahn\u00e4rztlichen Leistungen zu (Zahn\u00e4rztekasse AG und EOS Suisse AG). Ich verpflichte mich, p\u00fcnktlich zur Sprechstunde zu erscheinen und einen Termin mindestens 24 Stunden im Voraus abzusagen, da mir dieser sonst in Rechnung gestellt werden kann. Abgesagte Termine sind angemessen begrenzt. PanaDent beh\u00e4lt sich das Recht vor, mich bei wiederholten Verst\u00f6\u00dfen nicht mehr aufzunehmen. Auf Ihre Mitarbeit z\u00e4hlend, w\u00fcnschen wir Ihnen eine angenehme Pflege und stehen Ihnen jederzeit gerne zur Verf\u00fcgung.  <\/label>\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-field_bf4d575 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[field_bf4d575]\" id=\"form-field-field_bf4d575\" class=\"elementor-field elementor-size-sm  elementor-acceptance-field\" required=\"required\">\n\t\t\t\t<label for=\"form-field-field_bf4d575\">Indem ich dieses K\u00e4stchen ankreuze, best\u00e4tige ich, dass alle angegebenen Informationen wahr und vollst\u00e4ndig sind, und stimme zu, sie mit PanaDent zu teilen.<\/label>\t\t\t<\/span>\n\t\t<\/div>\n\t\t\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-field_5599ebd elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_5599ebd\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDatum\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_5599ebd]\" id=\"form-field-field_5599ebd\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" 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-select elementor-field-group elementor-column elementor-field-group-recipient elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-recipient\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tKabinett\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-caret-down\"><\/i>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[recipient]\" id=\"form-field-recipient\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"info@panadent.ch\">Domdidier<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"payerne@panadent.ch\">Payerne<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"yvonand@panadent.ch\">Yvonand<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"echallens@panadent.ch\">Echallens<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"riaz@panadent.ch\">Riaz<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"landeron@panadent.ch\">Le Landeron<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"blaise@panadent.ch\">Saint-Blaise<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"boudry@panadent.ch\">Boudry<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"cdf@panadent.ch\">Chaux-de-Fonds<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"bulle@panadent.ch\">Bulle<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"orbe@panadent.ch\">Orbe<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"_mies@panadent.ch\">Mies<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"crans@panadent.ch\">Crans-pr\u00e8s-C\u00e9ligny<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"contact@lacotedentaire.ch\">Saint-Prex<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\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\">Senden \u27f6<\/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\n                    class=\"apbct_special_field apbct_email_id__elementor_form\"\n                    name=\"apbct__email_id__elementor_form\"\n                    aria-label=\"apbct__label_id__elementor_form\"\n                    type=\"text\" size=\"30\" maxlength=\"200\" autocomplete=\"off\"\n                    value=\"\"\n                \/><\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d953f05 elementor-widget elementor-widget-html\" data-id=\"d953f05\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<script>jq2 = jQuery.noConflict();\r\njq2(function( $ ) {\r\n\r\n\r\n    \/\/ My dental expenses are covered by:\r\n    $('input[name=\"form_fields[field_e174054][]\"]').click(function () {\r\n        if ($('#form-field-field_e174054-1').is(':checked')) {\r\n            $('#form-field-field_ac6cecf').attr('required','required');\r\n        } else {\r\n            $(\"#form-field-field_ac6cecf\").removeAttr(\"required\");\r\n        }\r\n    });\r\n\r\n    \/\/ supplementary dental insurance\r\n    $('input[name=\"form_fields[field_8b6aa01][]\"]').click(function () {\r\n        if ($('#form-field-field_8b6aa01-0').is(':checked')) {\r\n            $('#form-field-field_050298a').attr('required','required');\r\n        } else {\r\n            $(\"#form-field-field_050298a\").removeAttr(\"required\");\r\n        }\r\n    });\r\n\r\n    \/\/ Do you have any allergies\r\n    $('input[name=\"form_fields[field_8d3f16b][]\"]').click(function () {\r\n        if ($('#form-field-field_8d3f16b-0').is(':checked')) {\r\n            $('#form-field-field_c911af4').attr('required','required');\r\n        } else {\r\n            $(\"#form-field-field_c911af4\").removeAttr(\"required\");\r\n        }\r\n    });\r\n\r\n    \/\/ Have you had a heart problem\r\n    $('input[name=\"form_fields[field_753081e][]\"]').click(function () {\r\n        if ($('#form-field-field_753081e-0').is(':checked')) {\r\n            $('#form-field-field_a91fbb4').attr('required','required');\r\n        } else {\r\n            $(\"#form-field-field_a91fbb4\").removeAttr(\"required\");\r\n        }\r\n    });\r\n\r\n    \/\/ Have you had radio or chemotherapy?\r\n    $('input[name=\"form_fields[field_2603806][]\"]').click(function () {\r\n        if ($('#form-field-field_2603806-0').is(':checked')) {\r\n            $('#form-field-field_29a16f4').attr('required','required');\r\n        } else {\r\n            $(\"#form-field-field_29a16f4\").removeAttr(\"required\");\r\n        }\r\n    });\r\n\r\n    \/\/ Do you like your smile?\r\n    $('input[name=\"form_fields[field_ef1008b][]\"]').click(function () {\r\n        if ($('#form-field-field_ef1008b-0').is(':checked')) {\r\n            $('#form-field-field_cc383bf').attr('required','required');\r\n        } else {\r\n            $(\"#form-field-field_cc383bf\").removeAttr(\"required\");\r\n        }\r\n    });\r\n\r\n    \/\/ Do you take medication?\r\n    $('input[name=\"form_fields[field_80f12b7][]\"]').click(function () {\r\n        if ($('#form-field-field_80f12b7-0').is(':checked')) {\r\n\r\n            dytm_checked = $('input[name=\"form_fields[field_6fd406f][]\"]:checked').length;\r\n\r\n            if(!dytm_checked) {\r\n                $('#form-field-field_6fd406f-0').attr('required','required');\r\n            } else {\r\n                $(\"#form-field-field_6fd406f-0\").removeAttr(\"required\");    \r\n            }\r\n        } else {\r\n            $(\"#form-field-field_6fd406f-0\").removeAttr(\"required\");\r\n        }\r\n    });\r\n    $('input[name=\"form_fields[field_6fd406f][]\"]').click(function () {\r\n        \r\n        dytm_checked = $('input[name=\"form_fields[field_6fd406f][]\"]:checked').length;\r\n\r\n        if(!dytm_checked && $('#form-field-field_80f12b7-0').is(':checked') ) {\r\n            $('#form-field-field_6fd406f-0').attr('required','required');\r\n        } else {\r\n            $(\"#form-field-field_6fd406f-0\").removeAttr(\"required\");    \r\n        }\r\n    });\r\n\r\n    \/\/ Do you wear prosthetic material?\r\n    $('input[name=\"form_fields[field_84f6b29][]\"]').click(function () {\r\n        if ($('#form-field-field_84f6b29-0').is(':checked')) {\r\n\r\n            dywpm_checked = $('input[name=\"form_fields[field_351dc78][]\"]:checked').length;\r\n\r\n            if(!dywpm_checked) {\r\n                $('#form-field-field_351dc78-0').attr('required','required');\r\n            } else {\r\n                $(\"#form-field-field_351dc78-0\").removeAttr(\"required\");    \r\n            }\r\n        } else {\r\n            $(\"#form-field-field_351dc78-0\").removeAttr(\"required\");\r\n        }\r\n    });\r\n    $('input[name=\"form_fields[field_351dc78][]\"]').click(function () {\r\n        \r\n        dywpm_checked = $('input[name=\"form_fields[field_351dc78][]\"]:checked').length;\r\n\r\n        if(!dywpm_checked && $('#form-field-field_84f6b29-0').is(':checked') ) {\r\n            $('#form-field-field_351dc78-0').attr('required','required');\r\n        } else {\r\n            $(\"#form-field-field_351dc78-0\").removeAttr(\"required\");    \r\n        }\r\n    });\r\n        \r\n    $('#form-field-cabinets').change(function(){\r\n        var pdlocation = $(this).val();\r\n\r\n        console.log(pdlocation);\r\n        \r\n        if( pdlocation == 'Domdidier' ) {\r\n            $('#form-field-recipient').val('info@panadent.ch');\r\n        } else if( pdlocation == 'Payerne' ) {\r\n            $('#form-field-recipient').val('payerne@panadent.ch');\r\n        } else if( pdlocation == 'Yvonand' ) {\r\n            $('#form-field-recipient').val('yvonand@panadent.ch');\r\n        } else if( pdlocation == '\u00c9challens' ) {\r\n            $('#form-field-recipient').val('echallens@panadent.ch');\r\n        } else if( pdlocation == 'Riaz' ) {\r\n            $('#form-field-recipient').val('riaz@panadent.ch');\r\n        } else if( pdlocation == 'Le Landeron' ) {\r\n            $('#form-field-recipient').val('landeron@panadent.ch');\r\n        } else if( pdlocation == 'Saint-Blaise' ) {\r\n            $('#form-field-recipient').val('blaise@panadent.ch');\r\n        } else if( pdlocation == 'Boudry' ) {\r\n            $('#form-field-recipient').val('boudry@panadent.ch');\r\n        } else if( pdlocation == 'Chaux-de-Fonds' ) {\r\n            $('#form-field-recipient').val('cdf@panadent.ch');\r\n        } else if( pdlocation == 'Bulle' ) {\r\n            $('#form-field-recipient').val('bulle@panadent.ch');\r\n        }else if( pdlocation == 'Orbe' ) {\r\n            $('#form-field-recipient').val('orbe@panadent.ch');\r\n        }else if( pdlocation == 'Crans-pr\u00e8s-C\u00e9ligny' ) {\r\n            $('#form-field-recipient').val('crans@panadent.ch');\r\n        }else if( pdlocation == 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Registrierung Konventioneller Besuch<\/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-46040","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Erstellen Sie jetzt Ihren Raum - PANADENT<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/panadent.ch\/de\/erstellen-sie-jetzt-ihren-raum\/\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Erstellen Sie jetzt Ihren Raum - PANADENT\" \/>\n<meta property=\"og:description\" content=\"Geben Sie online Ihre Informationen ein und alles ist bereit, wenn Sie ankommen! 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