{"id":5273,"date":"2026-08-11T09:23:33","date_gmt":"2026-08-11T07:23:33","guid":{"rendered":"https:\/\/www.skoliosenetzwerkoesterreich.at\/experten\/form\/eintrag-in-die-expertensuche-orthopaedie-copy\/"},"modified":"2026-08-11T12:11:47","modified_gmt":"2026-08-11T10:11:47","slug":"eintrag-in-die-expertensuche-orthopaedie-copy","status":"publish","type":"formgent_form","link":"https:\/\/www.skoliosenetzwerkoesterreich.at\/experten\/form\/eintrag-in-die-expertensuche-orthopaedie-copy\/","title":{"rendered":"Daten\u00e4nderung &#8211; Orthop\u00e4die"},"content":{"rendered":"\n<style>\n    .formgent-form-5273 {\n        \/* Form variables *\/\n        --formgent-form-background-color: #ffffff;\n        --formgent-form-background-image: ;\n        --formgent-form-background-image-position:\n        center center;\n\n        --formgent-form-padding-desktop: 20px 20px 40px 20px;\n        --formgent-form-padding-tablet: 20px 20px 40px 20px;\n        --formgent-form-padding-mobile: 20px 20px 40px 20px;\n        --formgent-form-margin-desktop: 0 0 0 0;\n        --formgent-form-margin-tablet: 0 0 0 0;\n        --formgent-form-margin-mobile: 0 0 0 0;\n        --formgent-form-border-width: 0;\n        --formgent-form-border: 0 solid transparent;\n        --formgent-form-border-radius: 16px 16px 16px 16px;\n\n        \/* Field variables *\/\n        --formgent-field-vertical-spacing-desktop: 35px;\n        --formgent-field-vertical-spacing-tablet: 35px;\n        --formgent-field-vertical-spacing-mobile: 35px;\n        --formgent-field-horizontal-spacing-desktop: 12px;\n        --formgent-field-horizontal-spacing-tablet: 12px;\n        --formgent-field-horizontal-spacing-mobile: 12px;\n        --formgent-field-background-color: transparent;\n        --formgent-field-background-color-hover: transparent;\n        --formgent-field-placeholder-color: #a1a9b2;\n        --formgent-field-label-color: #000000;\n        --formgent-field-description-color: #747c89;\n        --formgent-field-error-message-color: #c83a3a;\n        --formgent-field-input-color: #4d5761 ;\n        --formgent-field-options-color: #4d5761;\n        --formgent-field-border: 1px solid #d2d6db;\n        --formgent-field-border-radius: 8px 8px 8px 8px;\n        --formgent-field-rating-color: #a1a9b2;\n        --formgent-field-rating-color-hover: #5e53f9;\n        --formgent-field-range-slider-color: #000000;\n        \/* Fixed submit button variables *\/\n        --formgent-fixed-btn-bg-color: #000000;\n        --formgent-fixed-btn-text-color: #ffffff;\n        --formgent-fixed-btn-border-color: #000000;\n        --formgent-fixed-btn-style: default;\n        --formgent-fixed-btn-alignment: left;\n    }\n    .display-none {\n        display: none;\n    }\n<\/style><style>\n    <\/style>\n<div class=\"formgent-form formgent-form-5273 formgent-form-general \">\n            <div class=\"formgent-confirmation-wrap formgent-confirmation-wrap--hidden\">\n            <div class=\"formgent-notices formgent-notices--classic-form\"\n                data-message=\"&lt;div&gt;\n&lt;div&gt;\n&lt;h2&gt;Vielen Dank&lt;\/h2&gt;\n&lt;\/div&gt;\n&lt;div&gt;\n&lt;p&gt;Ihr \u00c4nderungsformular ist bei uns eingegangen. Wir freuen uns, dass Sie sich auch f\u00fcr einen Eintrag in die neue Expertensuche entschieden haben, die 1. September 2026 online geht.&lt;\/p&gt;\n&lt;\/div&gt;\n&lt;div&gt;\n&lt;p&gt;Bitte beachten Sie, dass Ihre \u00c4nderungsw\u00fcnsche und Korrekturen in die neue Expertensuche erfolgt, die am 1. September 2026 online geht.&lt;\/p&gt;\n&lt;\/div&gt;\n&lt;div&gt;\n&lt;p&gt;Sollten Sie auf ein Premium- oder VIP-Paket umgestiegen sein, erhalten Sie die Rechnung separat, sobald die neue Expertensuche im September 2026 verf\u00fcgbar ist. Zus\u00e4tzliche Bild- und Textdateien k\u00f6nnen Sie uns auch gerne per E-Mail info@skoliosenetzwerkoesterreich.com zukommen lassen.&lt;\/p&gt;\n&lt;\/div&gt;\n&lt;div&gt;\n&lt;p&gt;Bei Fragen k\u00f6nnen Sie sich jederzeit an uns wenden.&lt;\/p&gt;\n&lt;\/div&gt;\n&lt;div&gt;\n&lt;p&gt;Vielen Dank und freundliche Gr\u00fc\u00dfe,&lt;\/p&gt;\n&lt;\/div&gt;\n&lt;div&gt;\n&lt;p&gt;Ihr Team vom Skoliose Netzwerk \u00d6sterreich&lt;\/p&gt;\n&lt;\/div&gt;\n&lt;div&gt;\n&lt;p&gt;Daniela Hohenwarter &amp;amp; Tina Pfister&lt;\/p&gt;\n&lt;\/div&gt;\n&lt;\/div&gt;\">\n            <\/div>\n            <div class=\"formgent-quiz-result\"><\/div>\n        <\/div>\n        <form id=\"formgent-formgent_store3\"         data-wp-interactive=\"formgent\/form\"\n        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will be redirected in&quot;,&quot;plugin_url&quot;:&quot;https:\\\/\\\/www.skoliosenetzwerkoesterreich.at\\\/experten\\\/wp-content\\\/plugins&quot;,&quot;external_data&quot;:[]}'\n        data-wp-init=\"callbacks.initClassicForm\"\n        data-wp-bind--disabled=\"context.global.is_response_submitting\" data-wp-watch=\"callbacks.watchForm\">\n                        <div class=\"formgent-field-list formgent-field-list--frontend\"\n            data-wp-class--formgent-field-list-loading=\"!context.is_form_loaded\"\n            data-wp-class--formgent-partial-submitting=\"!context.is_partial_submitting\">\n            \n<h2 data-wp-bind--hidden=\"state.hideField\" data-wp-context=\"{ &quot;name&quot;: &quot;qtcP7wk_pMn3Ak6ypgxHu&quot; }\" class=\"wp-block-heading has-text-align-center display-none\"><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-black-color\">Daten\u00e4nderung Orthop\u00e4die - Ihr Eintrag in der Expertensuche von Skoliose Netzwerk 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<span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper formgent-field-single__wrapper--multi-choice\">\n            <div class=\"formgent-field-single__box formgent-multiple-choice-multiple-choice-2 formgent-field-single__box--full_width\"\n                id=\"formgent-lysL9kv0UaDF\"\n                data-wp-init=\"callbacks.multipleChoiceKeyboard\">\n                                        <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;HZzzZmtUbKVOwRWu-Omi_&quot;,&quot;label&quot;:&quot;Ich m\\u00f6chte eine Daten\\u00e4nderung, Erg\\u00e4nzung oder Korrektur bekanntgeben.&quot;,&quot;value&quot;:&quot;ich-m-chte-eine-daten-nderung-erg-nzung-oder-korrektur-bekanntgeben&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                <\/div>\n\n                            <span class=\"formgent-field-sub-label\">\n                    Pflichtfeld                <\/span>\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n\n<h4 data-wp-bind--hidden=\"state.hideField\" data-wp-context=\"{ &quot;name&quot;: &quot;OFFlhc_Dvamb3iSWtLOBe&quot; }\" class=\"wp-block-heading has-text-align-left display-none\"><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-vivid-green-cyan-color\">Informationen zu Ihrer Praxis<\/mark><\/h4>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"text-5\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-T6imJ3003YqB\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Praxisname                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-T6imJ3003YqB\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                    <\/div>\n    <\/div>\n<\/div>\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"name-2\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\" id=\"formgent-CwjPJvV6443q\">\n    <div class=\"formgent-field-single formgent-field-align-top\" data-wp-context='{ \"parent_name\": \"name-2\" }'>\n        <span class=\"formgent-field-label formgent-label-align-top\">\n        Name    <\/span>\n    \n<div class=\"formgent-field-list formgent-field-list--frontend\">\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"first_name\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-33\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-yGrfYQPDnmZh\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Titel                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-yGrfYQPDnmZh\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"middle_name\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-33\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-3wIp6ylDlrHi\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Vorname                                     <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-3wIp6ylDlrHi\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                            <span class=\"formgent-field-sub-label\">\n                    Pflichtfeld                <\/span>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"last_name\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-33\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-j9KSySkoOz-O\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Nachname                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-j9KSySkoOz-O\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                            <span class=\"formgent-field-sub-label\">\n                    Pflichtfeld                <\/span>\n                    <\/div>\n    <\/div>\n<\/div><\/div>\n    <\/div>\n<\/div>\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"address\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\" id=\"formgent-5DrZhLrbiEcz\">\n    <div class=\"formgent-field-single formgent-field-align-top\" data-wp-context='{ \"parent_name\": \"address\" }'>\n        <span class=\"formgent-field-label formgent-label-align-top\">\n        Kontaktinformationen (bitte keine privaten Daten!)    <\/span>\n    \n<div class=\"formgent-field-list formgent-field-list--frontend\">\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"address_line_one\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-w-xfBKfjtEgY\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Stra\u00dfe und Hausnummer                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-w-xfBKfjtEgY\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                            <span class=\"formgent-field-sub-label\">\n                    Pflichtfeld                <\/span>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"zip_code\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-50\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-Oa7y-fBLmwBX\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Postleitzahl                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-Oa7y-fBLmwBX\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                            <span class=\"formgent-field-sub-label\">\n                    Pflichtfeld                <\/span>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"zip_code-1\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-50\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-TOtu5O6cYEp7\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Ort                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-TOtu5O6cYEp7\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                            <span class=\"formgent-field-sub-label\">\n                    Pflichtfeld                <\/span>\n                    <\/div>\n    <\/div>\n<\/div><\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"email\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field formgent-field-width-100 formgent-field-email\">\n    <div class=\"formgent-field-single formgent-field-align-top formgent-field-single-email-primary\">\n                    <label\n                for=\"formgent-iV0HZhmo49Eb\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                E-Mail                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <div class='formgent-has-input-icon'>\n                \n                <input\n                    class=\"formgent-field-single__input\"\n                    type=\"email\"\n                    id=\"formgent-iV0HZhmo49Eb\"\n                    placeholder=\"\"\n                    data-wp-on--input=\"actions.updateInput\"\n                    data-wp-bind--value=\"state.getValue\"\n                \/>\n            <\/div>\n\n                    <\/div>\n    <\/div>\n\n    <\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"phone-number\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-single--csr formgent-field-align-top\">\n                    <label\n                for=\"formgent--Sx1BKWbqMnl\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Telefon                            <\/label>\n                <div\n            class=\"formgent-field-single__wrapper\"\n        >\n            <div class=\"formgent-field-single__phone\">\n                <div class=\"formgent-field-single__dialer__content\">\n                    <input\n                        class=\"formgent-field-single__input \"\n                        type=\"tel\"\n                        id=\"formgent--Sx1BKWbqMnl\"\n                        placeholder=\"+43\"\n                        data-wp-init=\"callbacks.phoneNumberInit\"\n                    >\n                <\/div>\n            <\/div>\n                            <span class=\"formgent-field-sub-label\">\n                    Pflichtfeld                <\/span>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"phone-number-1\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-single--csr formgent-field-align-top\">\n                    <label\n                for=\"formgent-PIzjJ4Bgef3F\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Telefon 2                            <\/label>\n                <div\n            class=\"formgent-field-single__wrapper\"\n        >\n            <div class=\"formgent-field-single__phone\">\n                <div class=\"formgent-field-single__dialer__content\">\n                    <input\n                        class=\"formgent-field-single__input \"\n                        type=\"tel\"\n                        id=\"formgent-PIzjJ4Bgef3F\"\n                        placeholder=\"+43\"\n                        data-wp-init=\"callbacks.phoneNumberInit\"\n                    >\n                <\/div>\n            <\/div>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-init=\"callbacks.initSelectField\"\n    data-wp-context='{&quot;name&quot;:&quot;multiple-choice&quot;,&quot;field_label&quot;:&quot;Krankenkassen&quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;RBLsc4v6zqrgj5LtMZ7e7&quot;,&quot;label&quot;:&quot;\\u00d6GK&quot;,&quot;value&quot;:&quot;gk&quot;},{&quot;id&quot;:&quot;t_o9eaUqE6zxpEHkt12Fn&quot;,&quot;label&quot;:&quot;BVAEB&quot;,&quot;value&quot;:&quot;bvaeb&quot;},{&quot;id&quot;:&quot;gsZGVoKrmiWGfAbgJveQ7&quot;,&quot;label&quot;:&quot;SVS&quot;,&quot;value&quot;:&quot;svs&quot;},{&quot;id&quot;:&quot;CZcEKXkTmZDPjP7MpRIo-&quot;,&quot;label&quot;:&quot;KFA&quot;,&quot;value&quot;:&quot;kfa&quot;},{&quot;id&quot;:&quot;NZd4UWCC2_tqt6hllSu6E&quot;,&quot;label&quot;:&quot;Wahlarztpraxis&quot;,&quot;value&quot;:&quot;wahlarztpraxis&quot;},{&quot;id&quot;:&quot;EjRaCbLOs0eRVzFxzS8I0&quot;,&quot;label&quot;:&quot;Patienten aus dem Ausland (EU)&quot;,&quot;value&quot;:&quot;patienten-aus-dem-ausland-eu&quot;},{&quot;id&quot;:&quot;3Lgu73wN3eRTMcKQbyTOO&quot;,&quot;label&quot;:&quot;Privat&quot;,&quot;value&quot;:&quot;privat&quot;}],&quot;field_type&quot;:&quot;multiple-choice&quot;}'\n    data-wp-bind--hidden=\"state.hideField\"\n    class=\"display-none formgent-field formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label for=\"formgent-multiple-choice\"\n                class=\"formgent-field-label formgent-label-align-top\">\n                Krankenkassen                            <\/label>\n                <div class=\"formgent-field-single__wrapper formgent-field-single__wrapper--multi-choice\">\n            <div class=\"formgent-field-single__box formgent-multiple-choice-multiple-choice formgent-field-single__box--two_columns\"\n                id=\"formgent-5BDOFWfhtVmq\"\n                data-wp-init=\"callbacks.multipleChoiceKeyboard\">\n                                        <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;RBLsc4v6zqrgj5LtMZ7e7&quot;,&quot;label&quot;:&quot;\\u00d6GK&quot;,&quot;value&quot;:&quot;gk&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;t_o9eaUqE6zxpEHkt12Fn&quot;,&quot;label&quot;:&quot;BVAEB&quot;,&quot;value&quot;:&quot;bvaeb&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;gsZGVoKrmiWGfAbgJveQ7&quot;,&quot;label&quot;:&quot;SVS&quot;,&quot;value&quot;:&quot;svs&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;CZcEKXkTmZDPjP7MpRIo-&quot;,&quot;label&quot;:&quot;KFA&quot;,&quot;value&quot;:&quot;kfa&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;NZd4UWCC2_tqt6hllSu6E&quot;,&quot;label&quot;:&quot;Wahlarztpraxis&quot;,&quot;value&quot;:&quot;wahlarztpraxis&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;EjRaCbLOs0eRVzFxzS8I0&quot;,&quot;label&quot;:&quot;Patienten aus dem Ausland (EU)&quot;,&quot;value&quot;:&quot;patienten-aus-dem-ausland-eu&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;3Lgu73wN3eRTMcKQbyTOO&quot;,&quot;label&quot;:&quot;Privat&quot;,&quot;value&quot;:&quot;privat&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                <\/div>\n\n                            <span class=\"formgent-field-sub-label\">\n                    Pflichtfeld                <\/span>\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-init=\"callbacks.initSelectField\"\n    data-wp-context='{&quot;name&quot;:&quot;multiple-choice-3&quot;,&quot;field_label&quot;:&quot;Gesprochene Sprachen&quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;ipXB5x0DByKOCMOuikHcC&quot;,&quot;label&quot;:&quot;Deutsch&quot;,&quot;value&quot;:&quot;deutsch&quot;},{&quot;id&quot;:&quot;hU1x4y77uu1TmBtupyEl7&quot;,&quot;label&quot;:&quot;Englisch&quot;,&quot;value&quot;:&quot;englisch&quot;},{&quot;id&quot;:&quot;fpjLzWG5c-XlwWdMeQ-zH&quot;,&quot;label&quot;:&quot;Italienisch&quot;,&quot;value&quot;:&quot;italienisch&quot;},{&quot;id&quot;:&quot;9M5JC4M4Er6dI9LJDPUDF&quot;,&quot;label&quot;:&quot;Ungarisch&quot;,&quot;value&quot;:&quot;ungarisch&quot;},{&quot;id&quot;:&quot;other-formgent-u8-ZaZxKUdRI&quot;,&quot;label&quot;:&quot;Weitere&quot;,&quot;value&quot;:&quot;formgent_other&quot;,&quot;is_other&quot;:&quot;1&quot;}],&quot;field_type&quot;:&quot;multiple-choice&quot;}'\n    data-wp-bind--hidden=\"state.hideField\"\n    class=\"display-none formgent-field formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label for=\"formgent-multiple-choice-3\"\n                class=\"formgent-field-label formgent-label-align-top\">\n                Gesprochene Sprachen                            <\/label>\n                <div class=\"formgent-field-single__wrapper formgent-field-single__wrapper--multi-choice\">\n            <div class=\"formgent-field-single__box formgent-multiple-choice-multiple-choice-3 formgent-field-single__box--two_columns\"\n                id=\"formgent-u8-ZaZxKUdRI\"\n                data-wp-init=\"callbacks.multipleChoiceKeyboard\">\n                                        <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;ipXB5x0DByKOCMOuikHcC&quot;,&quot;label&quot;:&quot;Deutsch&quot;,&quot;value&quot;:&quot;deutsch&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;hU1x4y77uu1TmBtupyEl7&quot;,&quot;label&quot;:&quot;Englisch&quot;,&quot;value&quot;:&quot;englisch&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;fpjLzWG5c-XlwWdMeQ-zH&quot;,&quot;label&quot;:&quot;Italienisch&quot;,&quot;value&quot;:&quot;italienisch&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;9M5JC4M4Er6dI9LJDPUDF&quot;,&quot;label&quot;:&quot;Ungarisch&quot;,&quot;value&quot;:&quot;ungarisch&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;other-formgent-u8-ZaZxKUdRI&quot;,&quot;label&quot;:&quot;Weitere&quot;,&quot;value&quot;:&quot;formgent_other&quot;,&quot;is_other&quot;:&quot;1&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                                    <input type=\"text\" class=\"formgent-field-other-input\"\n                                        data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                        data-wp-bind--value=\"state.getOtherOptionValue\"\n                                        data-wp-on--input=\"actions.updateMultiSelectSpecify\"\n                                        placeholder=\"Please specify\" \/>\n                                                            <\/label>\n                        <\/div>\n                                <\/div>\n\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-init=\"callbacks.initSelectField\"\n    data-wp-context='{&quot;name&quot;:&quot;multiple-choice-11&quot;,&quot;field_label&quot;:&quot;Fachrichtung \\\/ Zusatzausbildungen&quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;TxXuFnZE6ElwSAxJu5BR-&quot;,&quot;label&quot;:&quot;FA f\\u00fcr Orthop\\u00e4die und orthop\\u00e4dische Chirurgie&quot;,&quot;value&quot;:&quot;fa-f-r-orthop-die-und-orthop-dische-chirurgie&quot;},{&quot;id&quot;:&quot;7t7BzX4bDfjvGMyqNLVNF&quot;,&quot;label&quot;:&quot;FA f\\u00fcr Orthop\\u00e4die und Unfallchirurgie&quot;,&quot;value&quot;:&quot;fa-f-r-orthop-die-und-unfallchirurgie&quot;},{&quot;id&quot;:&quot;GaJygAUTYs9PkDCV2xLIg&quot;,&quot;label&quot;:&quot;FA f\\u00fcr Kinderorthop\\u00e4die&quot;,&quot;value&quot;:&quot;fa-f-r-kinderorthop-die&quot;},{&quot;id&quot;:&quot;0GpkY0jPFBpHU-8nw7AWv&quot;,&quot;label&quot;:&quot;FA f\\u00fcr Neurochirurgie&quot;,&quot;value&quot;:&quot;fa-f-r-neurochirurgie&quot;},{&quot;id&quot;:&quot;fyhkCYjOYbzRg-gYdl5zM&quot;,&quot;label&quot;:&quot;FA f\\u00fcr Neuroorthop\\u00e4die&quot;,&quot;value&quot;:&quot;fa-f-r-neuroorthop-die&quot;},{&quot;id&quot;:&quot;other-formgent-MNgYgRtMQWby&quot;,&quot;label&quot;:&quot;Weitere&quot;,&quot;value&quot;:&quot;formgent_other&quot;,&quot;is_other&quot;:&quot;1&quot;}],&quot;field_type&quot;:&quot;multiple-choice&quot;}'\n    data-wp-bind--hidden=\"state.hideField\"\n    class=\"display-none formgent-field formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label for=\"formgent-multiple-choice-11\"\n                class=\"formgent-field-label formgent-label-align-top\">\n                Fachrichtung \/ Zusatzausbildungen                            <\/label>\n                <div class=\"formgent-field-single__wrapper formgent-field-single__wrapper--multi-choice\">\n            <div class=\"formgent-field-single__box formgent-multiple-choice-multiple-choice-11 formgent-field-single__box--two_columns\"\n                id=\"formgent-MNgYgRtMQWby\"\n                data-wp-init=\"callbacks.multipleChoiceKeyboard\">\n                                        <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;TxXuFnZE6ElwSAxJu5BR-&quot;,&quot;label&quot;:&quot;FA f\\u00fcr Orthop\\u00e4die und orthop\\u00e4dische Chirurgie&quot;,&quot;value&quot;:&quot;fa-f-r-orthop-die-und-orthop-dische-chirurgie&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;7t7BzX4bDfjvGMyqNLVNF&quot;,&quot;label&quot;:&quot;FA f\\u00fcr Orthop\\u00e4die und Unfallchirurgie&quot;,&quot;value&quot;:&quot;fa-f-r-orthop-die-und-unfallchirurgie&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;GaJygAUTYs9PkDCV2xLIg&quot;,&quot;label&quot;:&quot;FA f\\u00fcr Kinderorthop\\u00e4die&quot;,&quot;value&quot;:&quot;fa-f-r-kinderorthop-die&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;0GpkY0jPFBpHU-8nw7AWv&quot;,&quot;label&quot;:&quot;FA f\\u00fcr Neurochirurgie&quot;,&quot;value&quot;:&quot;fa-f-r-neurochirurgie&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;fyhkCYjOYbzRg-gYdl5zM&quot;,&quot;label&quot;:&quot;FA f\\u00fcr Neuroorthop\\u00e4die&quot;,&quot;value&quot;:&quot;fa-f-r-neuroorthop-die&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;other-formgent-MNgYgRtMQWby&quot;,&quot;label&quot;:&quot;Weitere&quot;,&quot;value&quot;:&quot;formgent_other&quot;,&quot;is_other&quot;:&quot;1&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                                    <input type=\"text\" class=\"formgent-field-other-input\"\n                                        data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                        data-wp-bind--value=\"state.getOtherOptionValue\"\n                                        data-wp-on--input=\"actions.updateMultiSelectSpecify\"\n                                        placeholder=\"Hier schreiben ...\" \/>\n                                                            <\/label>\n                        <\/div>\n                                <\/div>\n\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-init=\"callbacks.initSelectField\"\n    data-wp-context='{&quot;name&quot;:&quot;multiple-choice-1&quot;,&quot;field_label&quot;:&quot;Behandlungszielgruppe&quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;vhMx2FgV0AqdTscmHd6Dw&quot;,&quot;label&quot;:&quot;Kleinkinder&quot;,&quot;value&quot;:&quot;kleinkinder&quot;},{&quot;id&quot;:&quot;uJuxozhlhbwlflsKUlAG0&quot;,&quot;label&quot;:&quot;Kinder und Jugendliche&quot;,&quot;value&quot;:&quot;kinder-und-jugendliche&quot;},{&quot;id&quot;:&quot;R_wIxNBrtz52-eErAt_MS&quot;,&quot;label&quot;:&quot;Erwachsene&quot;,&quot;value&quot;:&quot;erwachsene&quot;},{&quot;id&quot;:&quot;cwe8Lx9WXDLJlSqzKf18O&quot;,&quot;label&quot;:&quot;Neurogene Skoliosen&quot;,&quot;value&quot;:&quot;neurogene-skoliosen&quot;},{&quot;id&quot;:&quot;zN4aXRr8NAUYp9Uqx-L01&quot;,&quot;label&quot;:&quot;Idiopathische Skoliosen&quot;,&quot;value&quot;:&quot;idiopathische-skoliosen&quot;},{&quot;id&quot;:&quot;AodwJPNoLnNdt9T52nMUT&quot;,&quot;label&quot;:&quot;Postoperative Skoliosen&quot;,&quot;value&quot;:&quot;postoperative-skoliosen&quot;},{&quot;id&quot;:&quot;bwVIn6iEeP66XMcReSf3y&quot;,&quot;label&quot;:&quot;Korsetttr\\u00e4ger&quot;,&quot;value&quot;:&quot;korsetttr-ger&quot;},{&quot;id&quot;:&quot;other-formgent-h-pnSBx9Ih5N&quot;,&quot;label&quot;:&quot;Weitere&quot;,&quot;value&quot;:&quot;formgent_other&quot;,&quot;is_other&quot;:&quot;1&quot;}],&quot;field_type&quot;:&quot;multiple-choice&quot;}'\n    data-wp-bind--hidden=\"state.hideField\"\n    class=\"display-none formgent-field formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label for=\"formgent-multiple-choice-1\"\n                class=\"formgent-field-label formgent-label-align-top\">\n                Behandlungszielgruppe                            <\/label>\n                <div class=\"formgent-field-single__wrapper formgent-field-single__wrapper--multi-choice\">\n            <div class=\"formgent-field-single__box formgent-multiple-choice-multiple-choice-1 formgent-field-single__box--two_columns\"\n                id=\"formgent-h-pnSBx9Ih5N\"\n                data-wp-init=\"callbacks.multipleChoiceKeyboard\">\n                                        <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;vhMx2FgV0AqdTscmHd6Dw&quot;,&quot;label&quot;:&quot;Kleinkinder&quot;,&quot;value&quot;:&quot;kleinkinder&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;uJuxozhlhbwlflsKUlAG0&quot;,&quot;label&quot;:&quot;Kinder und Jugendliche&quot;,&quot;value&quot;:&quot;kinder-und-jugendliche&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;R_wIxNBrtz52-eErAt_MS&quot;,&quot;label&quot;:&quot;Erwachsene&quot;,&quot;value&quot;:&quot;erwachsene&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;cwe8Lx9WXDLJlSqzKf18O&quot;,&quot;label&quot;:&quot;Neurogene Skoliosen&quot;,&quot;value&quot;:&quot;neurogene-skoliosen&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;zN4aXRr8NAUYp9Uqx-L01&quot;,&quot;label&quot;:&quot;Idiopathische Skoliosen&quot;,&quot;value&quot;:&quot;idiopathische-skoliosen&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;AodwJPNoLnNdt9T52nMUT&quot;,&quot;label&quot;:&quot;Postoperative Skoliosen&quot;,&quot;value&quot;:&quot;postoperative-skoliosen&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;bwVIn6iEeP66XMcReSf3y&quot;,&quot;label&quot;:&quot;Korsetttr\\u00e4ger&quot;,&quot;value&quot;:&quot;korsetttr-ger&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;other-formgent-h-pnSBx9Ih5N&quot;,&quot;label&quot;:&quot;Weitere&quot;,&quot;value&quot;:&quot;formgent_other&quot;,&quot;is_other&quot;:&quot;1&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                                    <input type=\"text\" class=\"formgent-field-other-input\"\n                                        data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                        data-wp-bind--value=\"state.getOtherOptionValue\"\n                                        data-wp-on--input=\"actions.updateMultiSelectSpecify\"\n                                        placeholder=\"Hier schreiben ....\" \/>\n                                                            <\/label>\n                        <\/div>\n                                <\/div>\n\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n\n<h4 data-wp-bind--hidden=\"state.hideField\" data-wp-context=\"{ &quot;name&quot;: &quot;157aabD2BPbq7IO9tlNKZ&quot; }\" class=\"wp-block-heading display-none\"><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-vivid-green-cyan-color\">Mediale Pr\u00e4senz<\/mark> <mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-vivid-green-cyan-color\">(Premium-** und VIP-Paket***)<\/mark><\/h4>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"website\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-942B1PDm6VDF\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Webseite URL  - Premium-Paket** und VIP Paket***                             <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"url\"\n                id=\"formgent-942B1PDm6VDF\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                            <span class=\"formgent-field-sub-label\">\n                    Nicht im Basis-Paket enthalten! Ausschlie\u00dflich Paket Premium und VIP                <\/span>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"website-1\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-GLJUZXAMN74C\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                YouTube (VIP Paket)***                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"url\"\n                id=\"formgent-GLJUZXAMN74C\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                            <span class=\"formgent-field-sub-label\">\n                    Nicht im Basis-Paket enthalten! Ausschlie\u00dflich Paket VIP                <\/span>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"website-2\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-Vx7sMMCpAd8V\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Facebook (VIP Paket)***                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"url\"\n                id=\"formgent-Vx7sMMCpAd8V\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                            <span class=\"formgent-field-sub-label\">\n                    Nicht im Basis-Paket enthalten! Ausschlie\u00dflich Paket VIP                <\/span>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"website-3\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-l5HYkA6JlpyX\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Instagram (VIP Paket)***                             <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"url\"\n                id=\"formgent-l5HYkA6JlpyX\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                            <span class=\"formgent-field-sub-label\">\n                    Nicht im Basis-Paket enthalten! Ausschlie\u00dflich Paket VIP                <\/span>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"text-4\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-67\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-xuZBhYU2Dn_C\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                \u00d6ffnungszeiten (VIP Paket)***                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-xuZBhYU2Dn_C\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-init=\"callbacks.initSelectField\"\n    data-wp-context='{&quot;name&quot;:&quot;multiple-choice-12&quot;,&quot;field_label&quot;:&quot;Orthop\\u00e4dische Leistungen und Behandlungsm\\u00f6glichkeiten bei Skoliose&quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;Em6qxTzJnOpa_aIpDQhgK&quot;,&quot;label&quot;:&quot;Abkl\\u00e4rung und Diagnose &quot;,&quot;value&quot;:&quot;abkl-rung-und-diagnose&quot;},{&quot;id&quot;:&quot;gDM-2y9bzBIPFajUf628V&quot;,&quot;label&quot;:&quot;Konservative Therapie&quot;,&quot;value&quot;:&quot;konservative-therapie&quot;},{&quot;id&quot;:&quot;-ssBLJG933iY7_QMrXgvJ&quot;,&quot;label&quot;:&quot;Interventionelle Schmerztherapie&quot;,&quot;value&quot;:&quot;interventionelle-schmerztherapie&quot;},{&quot;id&quot;:&quot;CM1Kb_7HMq4X5sDpqaAQw&quot;,&quot;label&quot;:&quot;Neuromuskul\\u00e4re Skoliosen&quot;,&quot;value&quot;:&quot;neuromuskul-re-skoliosen&quot;},{&quot;id&quot;:&quot;HaF8ICflo88FS8yBps719&quot;,&quot;label&quot;:&quot;Skoliose \\\/ Kyphose \\\/ Lordose&quot;,&quot;value&quot;:&quot;skoliose-kyphose-lordose&quot;},{&quot;id&quot;:&quot;fj1vcKEdZHPi8h_Ar8Ren&quot;,&quot;label&quot;:&quot;Korsettversorgung Kinder und Jugendliche&quot;,&quot;value&quot;:&quot;korsettversorgung-kinder-und-jugendliche&quot;},{&quot;id&quot;:&quot;NX8ivBE89aTSLw5Jsh4CP&quot;,&quot;label&quot;:&quot;Korsettversorgung Erwachsene&quot;,&quot;value&quot;:&quot;korsettversorgung-erwachsene&quot;},{&quot;id&quot;:&quot;zTONvsDpwF-1zVqyVhU4d&quot;,&quot;label&quot;:&quot;Postoperative Skoliosen&quot;,&quot;value&quot;:&quot;postoperative-skoliosen&quot;},{&quot;id&quot;:&quot;a8Y8bOdNGqPSg2gdOnFxm&quot;,&quot;label&quot;:&quot;Postoperative Skoliosen nach Harrington&quot;,&quot;value&quot;:&quot;postoperative-skoliosen-nach-harrington&quot;},{&quot;id&quot;:&quot;kznzXUCpdsFIb4idWR1M-&quot;,&quot;label&quot;:&quot;Stabilisationsoperationen&quot;,&quot;value&quot;:&quot;stabilisationsoperationen&quot;},{&quot;id&quot;:&quot;other-formgent-7nXQpBS1dACB&quot;,&quot;label&quot;:&quot;Weitere&quot;,&quot;value&quot;:&quot;formgent_other&quot;,&quot;is_other&quot;:&quot;1&quot;}],&quot;field_type&quot;:&quot;multiple-choice&quot;}'\n    data-wp-bind--hidden=\"state.hideField\"\n    class=\"display-none formgent-field formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label for=\"formgent-multiple-choice-12\"\n                class=\"formgent-field-label formgent-label-align-top\">\n                Orthop\u00e4dische Leistungen und Behandlungsm\u00f6glichkeiten bei Skoliose                            <\/label>\n                <div class=\"formgent-field-single__wrapper formgent-field-single__wrapper--multi-choice\">\n            <div class=\"formgent-field-single__box formgent-multiple-choice-multiple-choice-12 formgent-field-single__box--two_columns\"\n                id=\"formgent-7nXQpBS1dACB\"\n                data-wp-init=\"callbacks.multipleChoiceKeyboard\">\n                                        <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;Em6qxTzJnOpa_aIpDQhgK&quot;,&quot;label&quot;:&quot;Abkl\\u00e4rung und Diagnose &quot;,&quot;value&quot;:&quot;abkl-rung-und-diagnose&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;gDM-2y9bzBIPFajUf628V&quot;,&quot;label&quot;:&quot;Konservative Therapie&quot;,&quot;value&quot;:&quot;konservative-therapie&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;-ssBLJG933iY7_QMrXgvJ&quot;,&quot;label&quot;:&quot;Interventionelle Schmerztherapie&quot;,&quot;value&quot;:&quot;interventionelle-schmerztherapie&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;CM1Kb_7HMq4X5sDpqaAQw&quot;,&quot;label&quot;:&quot;Neuromuskul\\u00e4re Skoliosen&quot;,&quot;value&quot;:&quot;neuromuskul-re-skoliosen&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;HaF8ICflo88FS8yBps719&quot;,&quot;label&quot;:&quot;Skoliose \\\/ Kyphose \\\/ Lordose&quot;,&quot;value&quot;:&quot;skoliose-kyphose-lordose&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;fj1vcKEdZHPi8h_Ar8Ren&quot;,&quot;label&quot;:&quot;Korsettversorgung Kinder und Jugendliche&quot;,&quot;value&quot;:&quot;korsettversorgung-kinder-und-jugendliche&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;NX8ivBE89aTSLw5Jsh4CP&quot;,&quot;label&quot;:&quot;Korsettversorgung Erwachsene&quot;,&quot;value&quot;:&quot;korsettversorgung-erwachsene&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;zTONvsDpwF-1zVqyVhU4d&quot;,&quot;label&quot;:&quot;Postoperative Skoliosen&quot;,&quot;value&quot;:&quot;postoperative-skoliosen&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;a8Y8bOdNGqPSg2gdOnFxm&quot;,&quot;label&quot;:&quot;Postoperative Skoliosen nach Harrington&quot;,&quot;value&quot;:&quot;postoperative-skoliosen-nach-harrington&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;kznzXUCpdsFIb4idWR1M-&quot;,&quot;label&quot;:&quot;Stabilisationsoperationen&quot;,&quot;value&quot;:&quot;stabilisationsoperationen&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;other-formgent-7nXQpBS1dACB&quot;,&quot;label&quot;:&quot;Weitere&quot;,&quot;value&quot;:&quot;formgent_other&quot;,&quot;is_other&quot;:&quot;1&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                                    <input type=\"text\" class=\"formgent-field-other-input\"\n                                        data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                        data-wp-bind--value=\"state.getOtherOptionValue\"\n                                        data-wp-on--input=\"actions.updateMultiSelectSpecify\"\n                                        placeholder=\"Hier eingeben\" \/>\n                                                            <\/label>\n                        <\/div>\n                                <\/div>\n\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-init=\"callbacks.initSelectField\"\n    data-wp-context='{&quot;name&quot;:&quot;multiple-choice-8&quot;,&quot;field_label&quot;:&quot;Zusatzleistungen&quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;TAV8TPTrxDcwufSza1nqu&quot;,&quot;label&quot;:&quot;Online-Sprechstunde&quot;,&quot;value&quot;:&quot;online-sprechstunde&quot;},{&quot;id&quot;:&quot;other-formgent-_tfyV3g9DMjR&quot;,&quot;label&quot;:&quot;Weitere&quot;,&quot;value&quot;:&quot;formgent_other&quot;,&quot;is_other&quot;:&quot;1&quot;}],&quot;field_type&quot;:&quot;multiple-choice&quot;}'\n    data-wp-bind--hidden=\"state.hideField\"\n    class=\"display-none formgent-field formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label for=\"formgent-multiple-choice-8\"\n                class=\"formgent-field-label formgent-label-align-top\">\n                Zusatzleistungen                            <\/label>\n                <div class=\"formgent-field-single__wrapper formgent-field-single__wrapper--multi-choice\">\n            <div class=\"formgent-field-single__box formgent-multiple-choice-multiple-choice-8 formgent-field-single__box--two_columns\"\n                id=\"formgent-_tfyV3g9DMjR\"\n                data-wp-init=\"callbacks.multipleChoiceKeyboard\">\n                                        <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;TAV8TPTrxDcwufSza1nqu&quot;,&quot;label&quot;:&quot;Online-Sprechstunde&quot;,&quot;value&quot;:&quot;online-sprechstunde&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;other-formgent-_tfyV3g9DMjR&quot;,&quot;label&quot;:&quot;Weitere&quot;,&quot;value&quot;:&quot;formgent_other&quot;,&quot;is_other&quot;:&quot;1&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                                    <input type=\"text\" class=\"formgent-field-other-input\"\n                                        data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                        data-wp-bind--value=\"state.getOtherOptionValue\"\n                                        data-wp-on--input=\"actions.updateMultiSelectSpecify\"\n                                        placeholder=\"Hier schreiben ...\" \/>\n                                                            <\/label>\n                        <\/div>\n                                <\/div>\n\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"text-3\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-67\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-4LBqyGNw49BT\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Ordinationszeiten(VIP Paket)***                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-4LBqyGNw49BT\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"textarea\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-KixVe-kLJN0e\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <mark class=\"has-inline-color has-black-color\"><strong><strong>Ihre Termine f\u00fcr Vortr\u00e4ge, Veranstaltungen, Webinare, Online-Fortbildungsprogramme, Tage der offenen T\u00fcr usw., einschlie\u00dflich aller relevanten Informationen (VIP-Paket***).<\/strong><\/strong><\/mark>                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <textarea\n                class=\"formgent-field-single__input formgent-field-single__input--textarea\"\n                type=\"text\"\n                id=\"formgent-KixVe-kLJN0e\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            ><\/textarea>\n                            <span class=\"formgent-field-sub-label\">\n                    Termine werden sowohl auf unserer Webseite unter \u201eVeranstaltungen\u201c als auch \u00fcber unseren Newsletter angek\u00fcndigt.                <\/span>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"textarea-1\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-I4qfzkEiIv8A\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                <mark class=\"has-inline-color has-black-color\"><strong>Anmerkungen und Hinweise<\/strong><\/mark>                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <textarea\n                class=\"formgent-field-single__input formgent-field-single__input--textarea\"\n                type=\"text\"\n                id=\"formgent-I4qfzkEiIv8A\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            ><\/textarea>\n                            <span class=\"formgent-field-sub-label\">\n                    Hier haben Sie die M\u00f6glichkeit uns weitere Informationen mitzuteilen.<br><strong>Wichtig:\u00a0<\/strong>F\u00fcr die Ver\u00f6ffentlichung von Website Adresse, Sozialmedia Links und \u00d6ffnungszeiten bitte das jeweilige Paket ausw\u00e4hlen!                <\/span>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<h3 data-wp-bind--hidden=\"state.hideField\" data-wp-context=\"{ &quot;name&quot;: &quot;VtdR-eTUFFu_axjfU5dJ-&quot; }\" class=\"wp-block-heading display-none\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-vivid-green-cyan-color\">Folgende Pakete stehen Ihnen zur Auswahl<\/mark><\/strong><\/h3>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-init=\"callbacks.initSelectField\"\n    data-wp-context='{&quot;name&quot;:&quot;multiple-choice-5&quot;,&quot;field_label&quot;:&quot;W\\u00e4hlen Sie hier das passendes Paket f\\u00fcr Ihre zuk\\u00fcnftige Eintragung. &quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;P8Iu7kycV4o_NlBVgVif7&quot;,&quot;label&quot;:&quot;Basis-Paket - Kostenlos (exkl. Logo und Verlinkung Webseite - siehe unten)*&quot;,&quot;value&quot;:&quot;paket-xs-150-00-j-hrlich-u-strong-nd-auch-strong-ihre-patient-innen-profitieren-davon&quot;,&quot;isCustomValue&quot;:&quot;1&quot;,&quot;collapsed&quot;:&quot;1&quot;},{&quot;id&quot;:&quot;pu002du002dqy7YOoPnwANRnXi2n4&quot;,&quot;label&quot;:&quot;Premium-Paket - 50\\u20ac (J\\u00e4hrliche Abrechnung) **&quot;,&quot;value&quot;:&quot;premium-paket-50-j-hrliche-abrechnung&quot;},{&quot;id&quot;:&quot;iI8SqQzszqm6A4hIR06Xl&quot;,&quot;label&quot;:&quot;VIP-Paket - 170\\u20ac (J\\u00e4hrliche Abrechnung) ***&quot;,&quot;value&quot;:&quot;vip-paket-170-j-hrliche-abrechnung&quot;}],&quot;field_type&quot;:&quot;multiple-choice&quot;}'\n    data-wp-bind--hidden=\"state.hideField\"\n    class=\"display-none formgent-field formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label for=\"formgent-multiple-choice-5\"\n                class=\"formgent-field-label formgent-label-align-top\">\n                W\u00e4hlen Sie hier das passendes Paket f\u00fcr Ihre zuk\u00fcnftige Eintragung.                                     <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper formgent-field-single__wrapper--multi-choice\">\n            <div class=\"formgent-field-single__box formgent-multiple-choice-multiple-choice-5 formgent-field-single__box--full_width\"\n                id=\"formgent-eoQC5YxgDzHx\"\n                data-wp-init=\"callbacks.multipleChoiceKeyboard\">\n                                        <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;P8Iu7kycV4o_NlBVgVif7&quot;,&quot;label&quot;:&quot;Basis-Paket - Kostenlos (exkl. Logo und Verlinkung Webseite - siehe unten)*&quot;,&quot;value&quot;:&quot;paket-xs-150-00-j-hrlich-u-strong-nd-auch-strong-ihre-patient-innen-profitieren-davon&quot;,&quot;isCustomValue&quot;:&quot;1&quot;,&quot;collapsed&quot;:&quot;1&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;pu002du002dqy7YOoPnwANRnXi2n4&quot;,&quot;label&quot;:&quot;Premium-Paket - 50\\u20ac (J\\u00e4hrliche Abrechnung) **&quot;,&quot;value&quot;:&quot;premium-paket-50-j-hrliche-abrechnung&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;iI8SqQzszqm6A4hIR06Xl&quot;,&quot;label&quot;:&quot;VIP-Paket - 170\\u20ac (J\\u00e4hrliche Abrechnung) ***&quot;,&quot;value&quot;:&quot;vip-paket-170-j-hrliche-abrechnung&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                <\/div>\n\n                            <span class=\"formgent-field-sub-label\">\n                    *<strong>Basis-Paket:<\/strong>\u00a0Es werden ausschlie\u00dflich Ihre Kontaktdate, Behandlungszielgruppe und Leistungen Ihrem Eintrag hinzugef\u00fcgt. Exklusiv Logo und Verlinkung Webseite!<br><br>**<strong>Premium-Paket<\/strong>: Neben dem Basis-Paket wird Ihrem Profil Ihr Portraitfoto\u00a0<strong>oder<\/strong>\u00a0Logo hinzugef\u00fcgt, sowie eine Verlinkung zu Ihrer Praxis-Website. Dar\u00fcber hinaus erhalten Sie einen Rabattcode in Form von Rabattkarten, der Ihren Patienten einen Rabatt von 25 % in unserem Online-Shop (ausgenommen Aktionsware) gew\u00e4hrt.<br><br><strong>***VIP-Paket:<\/strong>\u00a0Zus\u00e4tzlich zu den Leistungen des Premium-Pakets haben Sie die M\u00f6glichkeit weitere Bilder zB Ihrer Praxis, Behandlungen, etc., Videodateien und eine Unternehmensanzeige einzuf\u00fcgen. Dar\u00fcber hinaus wird Ihr Praxislogo oder Ihre Unternehmensanzeige als Banner auf der Startseite des Skoliose Netzwerks \u00d6sterreich und in der Expertensuche angezeigt.\u00a0Zudem besteht die Option, einen Blogbeitrag \u00fcber Ihr Leistungsangebot, Ihre T\u00e4tigkeit oder ein Thema im Zusammenhang mit Skoliose zu verfassen. Weiters wird Ihr Eintrag mit Ihrer Praxis-Homepage sowie Ihren Profilen auf Facebook, Instagram und YouTube verlinkt, sofern diese vorhanden sind.\u00a0Zus\u00e4tzlich erhalten Sie einen Rabattcode in Form von Rabattkarten, der Ihren Patienten einen Rabatt von 30 % in unserem Online-Shop (ausgenommen Aktionsware) gew\u00e4hrt.\u00a0Weitere Leistungen zum VIP-Paket erfahren Sie<mark>\u00a0<strong><a href=\"https:\/\/www.skoliosenetzwerkoesterreich.at\/fuer-experten-2\/\">hier<\/a><\/strong><\/mark><strong>.<\/strong><br><br>Das Premium- und VIP-Paket stellt einen j\u00e4hrlichen Beitrag dar. Die Mindestvertragslaufzeit betr\u00e4gt 12 Monate. Nach Ablauf dieser Frist verl\u00e4ngert sich der Vertrag automatisch auf unbestimmte Zeit und kann jederzeit schriftlich per E-Mail oder Post mit einer K\u00fcndigungsfrist von 4 Wochen gek\u00fcndigt werden.                <\/span>\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-init=\"callbacks.initSelectField\"\n    data-wp-context='{&quot;name&quot;:&quot;multiple-choice-6&quot;,&quot;field_label&quot;:&quot;Bitte w\\u00e4hlen Sie hier aus, wie die Rechnung f\\u00fcr das von Ihnen gew\\u00e4hlte Paket (Premium oder VIP) \\u00fcbermittelt werden soll:&quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;d0RGSlBBgjFrEiU3vk8FV&quot;,&quot;label&quot;:&quot;Per Postweg&quot;,&quot;value&quot;:&quot;per-postweg&quot;},{&quot;id&quot;:&quot;other-formgent-ZfXTyLlUVEi9&quot;,&quot;label&quot;:&quot;Per E-Mail&quot;,&quot;value&quot;:&quot;formgent_other&quot;,&quot;is_other&quot;:&quot;1&quot;}],&quot;field_type&quot;:&quot;multiple-choice&quot;}'\n    data-wp-bind--hidden=\"state.hideField\"\n    class=\"display-none formgent-field formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-justify\">\n                    <label for=\"formgent-multiple-choice-6\"\n                class=\"formgent-field-label formgent-label-align-justify\">\n                Bitte w\u00e4hlen Sie hier aus, wie die Rechnung f\u00fcr das von Ihnen gew\u00e4hlte Paket (Premium oder VIP) \u00fcbermittelt werden soll:                            <\/label>\n                <div class=\"formgent-field-single__wrapper formgent-field-single__wrapper--multi-choice\">\n            <div class=\"formgent-field-single__box formgent-multiple-choice-multiple-choice-6 formgent-field-single__box--full_width\"\n                id=\"formgent-ZfXTyLlUVEi9\"\n                data-wp-init=\"callbacks.multipleChoiceKeyboard\">\n                                        <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;d0RGSlBBgjFrEiU3vk8FV&quot;,&quot;label&quot;:&quot;Per Postweg&quot;,&quot;value&quot;:&quot;per-postweg&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                            <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;other-formgent-ZfXTyLlUVEi9&quot;,&quot;label&quot;:&quot;Per E-Mail&quot;,&quot;value&quot;:&quot;formgent_other&quot;,&quot;is_other&quot;:&quot;1&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                                    <input type=\"text\" class=\"formgent-field-other-input\"\n                                        data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                        data-wp-bind--value=\"state.getOtherOptionValue\"\n                                        data-wp-on--input=\"actions.updateMultiSelectSpecify\"\n                                        placeholder=\"\" \/>\n                                                            <\/label>\n                        <\/div>\n                                <\/div>\n\n                            <span class=\"formgent-field-sub-label\">\n                    Nur ausf\u00fcllen wenn sie das Premium-Paket oder VIP-Paket ausgew\u00e4hlt haben.                 <\/span>\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n<style>\n        .formgent-upload-container {\n            min-height: 150px;\n            display: flex;\n            align-items: center;\n            justify-content: center;\n            flex-direction: column;\n            cursor: pointer;\n            border-radius: 8px;\n            border: 1px dashed var(--formgent-color-gray-300);\n            background: var(--formgent-field-background-color);\n            width: 100%;\n            padding: 20px;\n            text-align: center;\n        }\n        .formgent-upload-container .formgent-upload-area {\n            border: 0 none;\n        }\n        .formgent-upload-container p {\n            color: var(--formgent-field-placeholder-color);\n            text-align: center;\n            font-size: 14px;\n            font-weight: 400;\n            line-height: 1.6;\n            margin: 8px 0 0 0;\n        }\n        .formgent-upload-button {\n            display: inline-flex;\n            padding: 8px 12px;\n            justify-content: center;\n            align-items: center;\n            gap: 6px;\n            border-radius: 8px;\n            background: var(--formgent-color-gray-500, #747c89);\n            cursor: pointer;\n            color: #fff;\n            text-align: center;\n            font-size: 13px;\n            font-weight: 500;\n            transition: 0.3s ease;\n            border: 0 none;\n            box-shadow: none;\n        }\n    <\/style>\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{\"name\":\"file-upload-1\",\"highlightFileUpload\":false,\"uploadedFiles\":[],\"maxSizeError\":false,\"maxFileError\":false,\"maxAllowed\":5,\"notAllowed\":false,\"maxAllowedReached\":false}' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-single--file-upload formgent-field-align-top\">\n                    <span\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Hochladen von Bilddateien \/ Portraitfoto \/  Logo \/ Unternehmensanzeige, Video, Textdokumente, Flyer, Folder, (Premium und VIP Paket)**\/***                            <\/span>\n                <div\n            class=\"formgent-upload-container\"\n        >\n            <label aria-disabled=\"false\"\n                for=\"formgent-O2M6xChDW5_r\"\n                class=\"formgent-upload-area\"\n                tabindex=\"0\"\n                role=\"button\"\n                aria-label=\"Upload\"\n                data-wp-class--formgent-file-upload-highlight=\"context.highlightFileUpload\"\n                data-wp-class--formgent-file-upload-disabled=\"context.maxAllowedReached\"\n                data-wp-bind--aria-disabled=\"context.maxAllowedReached\"\n                data-wp-on--dragenter=\"actions.fileDragEnter\"\n                data-wp-on--dragover=\"actions.fileDragEnter\"\n                data-wp-on--dragleave=\"actions.fileDragLeave\"\n                data-wp-on--drop=\"actions.fileDrop\"\n                data-wp-on--keydown=\"actions.handleUploadAreaKeydown\"\n            >\n                <span class=\"formgent-upload-button\">\n                    <svg width=\"14\" height=\"14\" viewBox=\"0 0 14 14\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0.333252 1.00016C0.333252 0.631973 0.631729 0.333496 0.999919 0.333496H12.9999C13.3681 0.333496 13.6666 0.631973 13.6666 1.00016C13.6666 1.36835 13.3681 1.66683 12.9999 1.66683H0.999919C0.631729 1.66683 0.333252 1.36835 0.333252 1.00016ZM6.99992 3.00016C7.17673 3.00016 7.3463 3.0704 7.47132 3.19542L11.4713 7.19543C11.7317 7.45577 11.7317 7.87788 11.4713 8.13823C11.211 8.39858 10.7889 8.39858 10.5285 8.13823L7.66659 5.27631V13.0002C7.66659 13.3684 7.36811 13.6668 6.99992 13.6668C6.63173 13.6668 6.33325 13.3684 6.33325 13.0002V5.27631L3.47132 8.13823C3.21097 8.39858 2.78886 8.39858 2.52851 8.13823C2.26816 7.87788 2.26816 7.45577 2.52851 7.19543L6.52851 3.19542C6.65354 3.0704 6.82311 3.00016 6.99992 3.00016Z\" fill=\"currentColor\"\/>\n<\/svg>\n                    Upload                <\/span>\n                <input\n                    multiple\n                    type=\"file\"\n                    class=\"formgent-file-input\"\n                    style=\"display: none;\"\n                    id=\"formgent-O2M6xChDW5_r\"\n                    data-wp-on--change=\"actions.onChangeFile\"\n                    data-wp-bind--disabled=\"context.maxAllowedReached\"\n                \/>\n\n                <!-- Hidden validation input for required field validation -->\n                <input\n                    type=\"hidden\"\n                    class=\"formgent-validate-field-input\"\n                    name=\"file-upload-1\"\n                    value=\"\"\n                \/>\n\n                <p>Datei hier herziehen oder zum Hochladen klicken. Maximal zul\u00e4ssige Dateigr\u00f6\u00dfe: <\/p>\n\n                                    <p> 250KB<\/p>\n                \n                            <\/label>\n\n            <span hidden class=\"formgent-warning-message\" data-wp-bind--hidden=\"!context.maxSizeError\">\n                 250KB            <\/span>\n            <span hidden class=\"formgent-warning-message\" data-wp-bind--hidden=\"!context.maxFileError\">\n                Maximum number of files allowed: 5            <\/span>\n            <span hidden class=\"formgent-warning-message\" data-wp-bind--hidden=\"!context.notAllowed\">\n                File type not allowed. Allowed file types: image\/jpeg, image\/png, application\/pdf            <\/span>\n\n\n            <div hidden class=\"formgent-file-preview\" data-wp-bind--hidden=\"!state.hasFiles\">\n                <ul class=\"formgent-preview-items\">\n                    <template data-wp-each=\"context.uploadedFiles\">\n                        <li class=\"formgent-preview-container\">\n                            <div class=\"formgent-file-preview-media\">\n                                <div>\n                                    <img\n                                        data-wp-bind--hidden=\"!context.item.isImage\"\n                                        class=\"formgent-preview-image\"\n                                        data-wp-bind--src=\"context.item.src\"\n                                    \/>\n                                    <video\n                                        data-wp-bind--hidden=\"!context.item.isVideo\"\n                                        class=\"formgent-preview-image\"\n                                        width=\"120\"\n                                        height=\"100\"\n                                    >\n                                        <source data-wp-bind--src=\"context.item.src\">\n                                    <\/video>\n                                    <span data-wp-bind--hidden=\"!context.item.isOther\">\n                                                                            <\/span>\n                                <\/div>\n                                <p class=\"formgent-file-name\">\n                                    <span data-wp-text=\"context.item.name\"><\/span><br\/>\n                                    <span data-wp-text=\"context.item.size\"><\/span>\n                                <\/p>\n                                <div\n                                    data-wp-bind--hidden=\"context.item.uploaded\"\n                                    class=\"formgent-file-preview-status\"\n                                >\n                                    <span\n                                        data-wp-style----formgent-file-upload-progress=\"context.item.progress\"\n                                        class=\"formgent-file-upload-progress\"\n                                    ><\/span>\n                                    <span\n                                        data-wp-text=\"context.item.progress\"\n                                        class=\"formgent-file-upload-progress-text\"\n                                    >\n                                        0%\n                                    <\/span>\n                                <\/div>\n                            <\/div>\n                            <div data-wp-bind--hidden=\"!context.item.uploaded\" class=\"formgent-file-preview-action\">\n                                <span\n                                    class=\"formgent-file-delete\"\n                                    tabindex=\"0\"\n                                    role=\"button\"\n                                    aria-label=\"Delete file\"\n                                    data-wp-on--click=\"actions.removeFile\"\n                                    data-wp-on--keydown=\"actions.handleRemoveFileKeydown\"\n                                >\n                                    <svg width=\"100%\" height=\"100%\" viewBox=\"0 0 24 24\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n <path d=\"M16 6V5.2C16 4.0799 16 3.51984 15.782 3.09202C15.5903 2.71569 15.2843 2.40973 14.908 2.21799C14.4802 2 13.9201 2 12.8 2H11.2C10.0799 2 9.51984 2 9.09202 2.21799C8.71569 2.40973 8.40973 2.71569 8.21799 3.09202C8 3.51984 8 4.0799 8 5.2V6M10 11.5V16.5M14 11.5V16.5M3 6H21M19 6V17.2C19 18.8802 19 19.7202 18.673 20.362C18.3854 20.9265 17.9265 21.3854 17.362 21.673C16.7202 22 15.8802 22 14.2 22H9.8C8.11984 22 7.27976 22 6.63803 21.673C6.07354 21.3854 5.6146 20.9265 5.32698 20.362C5 19.7202 5 18.8802 5 17.2V6\" stroke=\"currentColor\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/>\n <\/svg>\n                                <\/span>\n                            <\/div>\n                        <\/li>\n                    <\/template>\n                <\/ul>\n            <\/div>\n        <\/div>\n    <\/div>\n            <span class=\"formgent-field-sub-label\">\n            Bitte senden Sie uns Bilddateien (Logo, Unternehmensanzeige, Portraitbild etc.) f\u00fcr Ihren Eintrag im JPG- oder PNG-Format.\u00a0        <\/span>\n    <\/div>\n\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-init=\"callbacks.initSelectField\"\n    data-wp-context='{&quot;name&quot;:&quot;multiple-choice-7&quot;,&quot;field_label&quot;:&quot;Informationspaket f\\u00fcr die Praxis&quot;,&quot;options&quot;:[{&quot;id&quot;:&quot;CPSIQRPgKl_tCoUHmdnYW&quot;,&quot;label&quot;:&quot;Bitte senden Sie mir ein Informationspaket an meine Praxisadresse. Beinhaltet 20 Infoflyer, 5 Fr\\u00fcherkennungsbrosch\\u00fcren und ein Reiskissen.&quot;,&quot;value&quot;:&quot;bitte-senden-sie-mir-ein-informationspaket-an-meine-praxisadresse-beinhaltet-20-infoflyer-5-fr-herkennungsbrosch-ren-und-ein-reiskissen&quot;}],&quot;field_type&quot;:&quot;multiple-choice&quot;}'\n    data-wp-bind--hidden=\"state.hideField\"\n    class=\"display-none formgent-field formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label for=\"formgent-multiple-choice-7\"\n                class=\"formgent-field-label formgent-label-align-top\">\n                Informationspaket f\u00fcr die Praxis                            <\/label>\n                <div class=\"formgent-field-single__wrapper formgent-field-single__wrapper--multi-choice\">\n            <div class=\"formgent-field-single__box formgent-multiple-choice-multiple-choice-7 formgent-field-single__box--full_width\"\n                id=\"formgent-rAgXFdanJ6py\"\n                data-wp-init=\"callbacks.multipleChoiceKeyboard\">\n                                        <div\n                            class=\"formgent-field-single__box__choice formgent-field-single__box__choice--frame\"\n                            data-wp-context='{&quot;option&quot;:{&quot;id&quot;:&quot;CPSIQRPgKl_tCoUHmdnYW&quot;,&quot;label&quot;:&quot;Bitte senden Sie mir ein Informationspaket an meine Praxisadresse. Beinhaltet 20 Infoflyer, 5 Fr\\u00fcherkennungsbrosch\\u00fcren und ein Reiskissen.&quot;,&quot;value&quot;:&quot;bitte-senden-sie-mir-ein-informationspaket-an-meine-praxisadresse-beinhaltet-20-infoflyer-5-fr-herkennungsbrosch-ren-und-ein-reiskissen&quot;}}'>\n                            <input class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                                type=\"checkbox\" data-wp-on--change=\"actions.updateMultiChoice\"\n                                data-wp-bind--id=\"state.getOptionId\"\n                                data-wp-bind--checked=\"state.isMultiSelectOptionChecked\"\n                                data-wp-bind--disabled=\"state.isMultiSelectOptionDisabled\"\n                                data-wp-bind--name=\"state.getOptionName\" \/>\n                            <label data-wp-bind--for=\"state.getOptionId\" class=\"formgent-field-single__label\">\n                                <span class=\"formgent-field-single__checkbox\">\n                                                                    <\/span>\n                                                                <span data-wp-text=\"state.getOptionLabel\"><\/span>\n                                                            <\/label>\n                        <\/div>\n                                <\/div>\n\n                    <\/div>\n    <\/div>\n\n    <!-- <div data-wp-bind--hidden=\"!state.showFieldQuantityInput\" class=\"formgent-field-single formgent-field-quantity\" data-wp-class--formgent-field-quantity-hidden=\"!state.showFieldQuantityInput\">\n        <label for=\"\"\n            class=\"formgent-field-label\" data-wp-text=\"state.getQuantityLabel\">\n        <\/label>\n        <input class=\"formgent-field-single__input\" type=\"number\"\n            id=\"\"\n            name=\"_quantity\"\n            data-wp-on--input=\"actions.updatePaymentQuantity\"\n            data-wp-bind--value=\"state.getFieldQuantity\"\n            data-wp-bind--min=\"state.getFieldQuantityMin\"\n            data-wp-bind--max=\"state.getFieldQuantityMax\"\n            value=\"1\" \/>\n    <\/div> -->\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"gdpr\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single\">\n        <div class=\"formgent-field-single__wrapper formgent-field-single__wrapper--gdpr formgent-label-align-left\">\n            <input\n                class=\"formgent-field-single__input formgent-field-single__input--checkbox\"\n                type=\"checkbox\"\n                id=\"formgent-k_arq4LacaHV\"\n                data-wp-on--change=\"actions.updateGdpr\"\n                data-wp-bind--checked=\"state.getValue\"\n            \/>\n            <label for=\"formgent-k_arq4LacaHV\" class=\"formgent-field-label\">\n                <span class=\"formgent-field-gdpr-checkbox\">\n                                    <\/span>\n                <span class=\"formgent-field-sub-label\">\n                    Ich stimme den Bestimmungen der DSGVO zu.                    <span class=\"formgent-field-required\">*<\/span>\n                <\/span>\n            <\/label>\n        <\/div>\n    <\/div>\n<\/div>\n\n\n<div data-wp-interactive=\"formgent\/form\" data-wp-context='{ \"name\": \"text\" }' data-wp-bind--hidden=\"state.hideField\" class=\"display-none formgent-field   formgent-field-width-100\">\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-2KRCErZjPMrf\"\n                class= \"formgent-field-label formgent-label-align-top\"\n            >\n                Mit dem Absenden best\u00e4tige ich, dass ich den allgemeinen Vertragsbedingungen des SN\u00d6 zustimme.                                    <span class=\"formgent-field-required\">\n                        *\n                    <\/span>\n                            <\/label>\n                <div class=\"formgent-field-single__wrapper\">\n            <input\n                class=\"formgent-field-single__input\"\n                type=\"text\"\n                id=\"formgent-2KRCErZjPMrf\"\n                placeholder=\"\"\n                data-wp-on--input=\"actions.updateInput\"\n                data-wp-bind--value=\"state.getValue\"\n            \/>\n                            <span class=\"formgent-field-sub-label\">\n                    Ort, Datum - Pflichtfeld                <\/span>\n                    <\/div>\n    <\/div>\n<\/div>\n\n<div \n    data-wp-interactive=\"formgent\/form\" \n    data-wp-context='{\"name\":\"captcha\",\"field_type\":\"range-slider\",\"slider_type\":\"number\",\"text_options\":[{\"id\":\"option_1\",\"label\":\"Option 1\",\"value\":\"option_1\"},{\"id\":\"option_2\",\"label\":\"Option 2\",\"value\":\"option_2\"},{\"id\":\"option_3\",\"label\":\"Option 3\",\"value\":\"option_3\"}],\"sliderState\":{\"value\":0,\"valueLabel\":\"\"}}' \n    data-wp-bind--hidden=\"state.hideField\" \n    class=\"display-none formgent-field formgent-field-width-50\"\n    data-wp-init=\"callbacks.initRangeSlider\"\n>\n    <div class=\"formgent-field-single formgent-field-align-top\">\n                    <label\n                for=\"formgent-VCNOv52mkyl1\"\n                class=\"formgent-field-label formgent-label-align-top\"\n            >\n                Captcha: Ergebnis aus f\u00fcnf mal 6 =                                     <span class=\"formgent-field-required\">*<\/span>\n                            <\/label>\n                \n        <div class=\"formgent-field-single__wrapper\">\n            <div class=\"formgent-range-slider\">\n                <div \n                    class=\"formgent-range-slider__control\"\n                >\n                    <div \n                        class=\"formgent-slider-wrap\"\n                        id=\"formgent-VCNOv52mkyl1\"\n                        data-slider-min=\"0\"\n                        data-slider-max=\"50\"\n                        data-slider-step=\"1\"\n                        data-value-prefix=\"F\u00fcnf mal 6 = \"\n                        data-value-suffix=\"\"\n                        data-slider-type=\"number\"\n                        data-default-value=\"0\"\n                        data-default-index=\"0\"\n                        data-text-options='[{&quot;id&quot;:&quot;option_1&quot;,&quot;label&quot;:&quot;Option 1&quot;,&quot;value&quot;:&quot;option_1&quot;},{&quot;id&quot;:&quot;option_2&quot;,&quot;label&quot;:&quot;Option 2&quot;,&quot;value&quot;:&quot;option_2&quot;},{&quot;id&quot;:&quot;option_3&quot;,&quot;label&quot;:&quot;Option 3&quot;,&quot;value&quot;:&quot;option_3&quot;}]'\n                        tabindex=\"0\"\n                        role=\"slider\"\n                     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<\/form>\n\n<\/div>\n\n\n","protected":false},"author":1,"template":"","meta":{"_formgent_fields":[],"_formgent_page_break_settings":{"next_button_style":"default","next_button_bg_color":"#4cafaa","next_button_border_color":"#000000","next_button_text_color":"#000000","back_button_style":"default","back_button_bg_color":"#4cafaa","back_button_border_color":"#000000","back_button_text_color":"#000000","progress_indicator":"progress_bar","show_labels":true},"_formgent_form_settings":{"toggle_form_type":false,"form_background":"color","form_background_color":"#ffffff","form_background_image":[],"form_padding":[],"form_margin":[],"form_border":[],"field_border":{"border":{"width":"1px","style":"solid","color":"#d2d6db"},"radius":{"topLeft":"8px","topRight":"8px","bottomRight":"8px","bottomLeft":"8px"}},"field_colors":{"background":{"default":"transparent","hover":"transparent"},"placeholder":{"default":"#a1a9b2"},"label":{"default":"#000000"},"description":{"default":"#747c89"},"error":{"default":"#c83a3a"},"input_color":{"default":"#4d5761"},"options_color":{"default":"#4d5761"},"rating_color":{"default":"#a1a9b2","hover":"#5e53f9"},"range_slider_color":{"default":"#000000"}},"field_horizontal_spacing":{"desktop":"12px","tablet":"12px","mobile":"12px"},"field_vertical_spacing":{"desktop":"35px","tablet":"35px","mobile":"35px"},"show_page_break_labels":"","page_break_progress_indicator":"none","next_button_style":"default","next_button_bg_color":"#000000","next_button_text_color":"#ffffff","next_button_border_color":"#000000","back_button_style":"default","back_button_bg_color":"#000000","back_button_text_color":"#ffffff","back_button_border_color":"#000000","submit_button_alignment":"left","submit_button_style":"default","submit_button_background_color":"#000000","submit_button_border_color":"#000000","submit_button_text_color":"#ffffff","submit_button_label":"Submit","submit_button_disabled":false,"use_label_as_placeholder":false,"switch_to_conversational":false},"_formgent_type":"general","_formgent_pending_type_migration":""},"class_list":["post-5273","formgent_form","type-formgent_form","status-publish","hentry"],"yoast_head":"<!-- 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