{"id":1222,"date":"2017-10-25T14:21:56","date_gmt":"2017-10-25T12:21:56","guid":{"rendered":"https:\/\/www.mmc.nl\/obesitascentrum\/?page_id=1222"},"modified":"2022-05-31T13:23:13","modified_gmt":"2022-05-31T11:23:13","slug":"contactformulier","status":"publish","type":"page","link":"https:\/\/www.mmc.nl\/obesitascentrum\/contactformulier\/","title":{"rendered":"Contactformulier"},"content":{"rendered":"<p>Bent u al pati\u00ebnt bij M\u00e1xima MC? MijnMMC is d\u00e9 digitale omgeving voor u als pati\u00ebnt. Via uw computer, tablet of smartphone heeft u altijd uw medische gegevens bij de hand en kunt u zelf veilig en gemakkelijk uw ziekenhuiszaken regelen. Waar en wanneer het u uitkomt.<\/p>\n<p><a class=\"button-primary\" href=\"https:\/\/medimapp1.mmc.nl\/\">Ga naar MijnMMC<\/a><\/p>\n<p><strong>Contactformulier<\/strong><br \/>\nBent u (nog) geen pati\u00ebnt in M\u00e1xima MC en heeft u een algemene (niet-medische) vraag? Maak dan gebruik van onderstaand contactformulier.<\/p>\n<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_unknown gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_9' ><div id='gf_9' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_9'  action='\/obesitascentrum\/wp-json\/wp\/v2\/pages\/1222\/#gf_9' data-formid='9' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_page_9_1' class='gform_page ' data-js='page-field-id-1' >\n                                    <div class='gform_page_fields'><ul id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_9_2\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_9_2\" ><label class='gfield_label gform-field-label' for='input_9_2'>Naam<span class=\"gfield_required\"><span class=\"gfield_required 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gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_9_5\" ><label class='gfield_label gform-field-label' for='input_9_5'>Telefoonnummer<\/label><div class='ginput_container ginput_container_phone'><input name='input_5' id='input_9_5' type='tel' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_9_6\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_9_6\" ><label class='gfield_label gform-field-label' for='input_9_6'>Geboortedatum<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_6' id='input_9_6' type='text' value='' class='datepicker gform-datepicker dmy_dash datepicker_no_icon gdatepicker-no-icon'   placeholder='dd-mm-yyyy' aria-describedby=\"input_9_6_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_9_6_date_format' class='screen-reader-text'>DD dash MM dash JJJJ<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_9_6' class='gform_hidden' value='https:\/\/www.mmc.nl\/obesitascentrum\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_9_7\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_9_7\" ><label class='gfield_label gform-field-label' for='input_9_7'>Bericht<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_7' id='input_9_7' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_9_8\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_9_8\" ><p><span style=\"font-size:10px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Wij vragen u om uw contactgegevens en uw geboortedatum zodat wij gericht uw vraag kunnen beantwoorden.Bekijk ook onze <a href=\"https:\/\/www.mmc.nl\/privacy\" target=\"_blank\">privacystatement<\/a>.<\/span><\/span><\/p>\n<\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <input type='button' 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