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1 forms found in the DOM

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<form enctype="multipart/form-data" data-mollie-forms="2.6.15" method="post" id="rfmp_2797" class=""><input type="hidden" id="mollie_forms_2797_nonce" name="mollie_forms_2797_nonce" value="671bf1a069"><input type="hidden" name="_wp_http_referer"
    value="/betalen/"><input type="hidden" name="mollie-forms-post" value="2797">
  <p><br><input type="text" name="form_2797_field_0" id="form_2797_field_0" value="" label="Voor- en achternaam" class="voor-achternaam" required="" placeholder="Voor- en achternaam *" style="width: 100%"></p>
  <p><br><input type="text" name="form_2797_field_1" id="form_2797_field_1" value="" label="Dossiernummer" class="dossiernummer" required="" placeholder="Dossiernummer *" style="width: 100%"></p>
  <p><br><input type="email" name="form_2797_field_2" id="form_2797_field_2" value="" label="E-mailadres" class="e-mailadres" required="" placeholder="E-mailadres *" style="width: 100%"></p>
  <p><br></p>
  <ul id="form_2797_field_3" label="" class="" required="" style="list-style-type:none;margin:0;">
    <li>
      <label>
        <input type="radio" onchange="mollie_forms_recurring_methods_2797();mollie_forms_2797_totals();" data-frequency="once" data-freq="" data-pricetype="open" data-price="5.00" data-vat="" name="rfmp_priceoptions_2797" value="3" checked="">
        Betaling </label>
    </li>
  </ul>
  <p id="rfmp_open_amount_2797" style="display: block;">
    <label>Bedrag <span style="color:red;">*</span><br>
      <span class="rfmp_currency_2797">€</span>
      <input type="number" step="any" value="" onchange="mollie_forms_2797_totals();" name="rfmp_amount_2797" min="5.00">
      <span id="rfmp_amount_freq_2797"></span>
    </label>
    <input type="hidden" name="rfmp_amount_required_2797" id="rfmp_open_amount_required_2797" value="1">
  </p>
  <script>
    window.onload = setTimeout(mollie_forms_2797_totals, 100);

    function mollie_forms_2797_totals() {
      var priceoption = document.getElementsByName("rfmp_priceoptions_2797");
      var quantities = document.getElementsByClassName("rfmp_priceoptions_2797_quantity");
      var subtotal = 0,
        total = 0,
        vat = 0;
      // Add shipping costs to total
      var shippingCosts = "";
      if (shippingCosts) {
        var shippingVat = 0.21 * parseFloat(shippingCosts);
        vat += shippingVat;
        total += parseFloat(shippingCosts);
        subtotal += parseFloat(shippingCosts);
      }
      if (0 in priceoption) {
        // single price option
        if (priceoption[0].tagName == "INPUT") {
          for (var i = 0, length = priceoption.length; i < length; i++) {
            if (priceoption[i].checked) {
              if (priceoption[i].dataset.pricetype == "open") {
                var openAmount = document.getElementsByName("rfmp_amount_2797");
                openAmount[0].setAttribute("min", priceoption[i].dataset.price);
                var optionPrice = parseFloat(openAmount[0].value);
              } else {
                var optionPrice = parseFloat(priceoption[i].dataset.price);
              }
              var optionVat = (parseInt(priceoption[i].dataset.vat) / 100) * optionPrice;
              vat += optionVat;
              total += optionPrice;
              subtotal += optionPrice;
              break;
            }
          }
        } else {
          if (priceoption[0].options[priceoption[0].selectedIndex].dataset.pricetype == "open") {
            var openAmount = document.getElementsByName("rfmp_amount_2797");
            openAmount[0].setAttribute("min", priceoption[0].options[priceoption[0].selectedIndex].dataset.price);
            var optionPrice = parseFloat(openAmount[0].value);
          } else {
            var optionPrice = parseFloat(priceoption[0].options[priceoption[0].selectedIndex].dataset.price);
          }
          var optionVat = (parseInt(priceoption[0].options[priceoption[0].selectedIndex].dataset.vat) / 100) * optionPrice;
          vat += optionVat;
          total += optionPrice;
          subtotal += optionPrice;
        }
      } else if (quantities) {
        // multiple price options with quantity
        for (var i = 0; i < quantities.length; i++) {
          var q = parseInt(quantities[i].value);
          var optionPrice = parseFloat(parseFloat(quantities[i].dataset.price) * q);
          var optionVat = (parseInt(quantities[i].dataset.vat) / 100) * optionPrice;
          vat += optionVat;
          total += optionPrice;
          subtotal += optionPrice;
        }
      }
      // payment method extra costs
      var methods = document.getElementsByName("rfmp_payment_method_2797");
      if (0 in methods) {
        if (methods[0].tagName == "INPUT") {
          // radio buttons
          for (var i = 0; i < methods.length; i++) {
            if (methods[i].checked) {
              var methodAmount = ((parseInt(methods[i].dataset.variable) / 100) * total) + parseFloat(methods[i].dataset.fixed);
              var methodVat = 0.21 * methodAmount;
              vat += methodVat;
              total += methodAmount;
              subtotal += methodAmount;
              break;
            }
          }
        } else {
          // dropdown
          var methodAmount = ((parseInt(methods[0].options[methods[0].selectedIndex].dataset.variable) / 100) * total) + parseFloat(methods[0].options[methods[0].selectedIndex].dataset.fixed);
          var methodVat = 0.21 * methodAmount;
          vat += methodVat;
          total += methodAmount;
          subtotal += methodAmount;
        }
      }
      // Display subtotal
      var subtotalValue = document.getElementById("rfmp_totals_2797_subtotal_value");
      if (subtotalValue) {
        var subtotalAmount = subtotal.toFixed(2) > 0 ? subtotal.toFixed(2) : "0.00";
        subtotalValue.innerHTML = subtotalAmount.replace(".", ",");
      }
      // Display total
      var totalValue = document.getElementById("rfmp_totals_2797_total_value");
      if (totalValue) {
        var totalAmount = total.toFixed(2) > 0 ? total.toFixed(2) : "0.00";
        totalValue.innerHTML = totalAmount.replace(".", ",");
      }
      // Display VAT
      var totalVatValue = document.getElementById("rfmp_totals_2797_vat_value");
      if (totalVatValue) {
        var totalVat = vat.toFixed(2) > 0 ? vat.toFixed(2) : "0.00";
        totalVatValue.innerHTML = totalVat.replace(".", ",");
      }
    }
  </script>
  <p></p>
  <p><br>
    <script>
      window.onload = setTimeout(mollie_forms_recurring_methods_2797, 100);

      function mollie_forms_recurring_methods_2797() {
        var priceoptions = document.getElementsByName("rfmp_priceoptions_2797");
        var freq = "";
        if (0 in priceoptions) {
          if (priceoptions[0].tagName == "INPUT") {
            for (var i = 0, length = priceoptions.length; i < length; i++) {
              if (priceoptions[i].checked) {
                var frequency = priceoptions[i].dataset.frequency;
                var pricetype = priceoptions[i].dataset.pricetype;
                freq = priceoptions[i].dataset.freq;
                break;
              }
            }
          } else {
            var frequency = priceoptions[0].options[priceoptions[0].selectedIndex].dataset.frequency;
            var pricetype = priceoptions[0].options[priceoptions[0].selectedIndex].dataset.pricetype;
            freq = priceoptions[0].options[priceoptions[0].selectedIndex].dataset.freq;
          }
        } else {
          var quantities = document.getElementsByClassName("rfmp_priceoptions_2797_quantity");
          var pricetype = "fixed";
          var frequency = "once";
          for (var i = 0, length = quantities.length; i < length; i++) {
            if (quantities[i].value > 0) {
              if (quantities[i].dataset.frequency != "once") {
                frequency = "recurring";
              }
            }
          }
        }
        var checkbox = document.getElementsByName("rfmp_checkbox_2797")[0];
        if (frequency == "once") {
          checkbox.removeAttribute("required");
        } else {
          checkbox.setAttribute("required", "required");
        }
        document.getElementById("rfmp_checkbox_2797").style.display = (frequency == "once" ? "none" : "block");
        document.getElementById("rfmp_checkbox_hidden_2797").value = (frequency == "once" ? 0 : 1);
        document.getElementById("rfmp_open_amount_2797").style.display = (pricetype == "open" ? "block" : "none");
        document.getElementById("rfmp_open_amount_required_2797").value = (pricetype == "open" ? 1 : 0);
        document.getElementById("rfmp_amount_freq_2797").innerHTML = freq;
        if (location.protocol === "https:" && window.ApplePaySession && window.ApplePaySession.canMakePayments()) {
          //
        } else if (document.getElementById("rfmp_pm_applepay_2797") !== null) {
          document.getElementById("rfmp_pm_applepay_2797").remove();
        }
        if (document.getElementById("rfmp_pm_ideal_2797") !== null) {
          document.getElementById("rfmp_pm_ideal_2797").style.display = (frequency != "once" ? "none" : "block");
        }
      }
    </script>
  </p>
  <ul id="form_2797_field_4" label="" class="" required="" style="list-style-type:none;margin:0;">
    <li id="rfmp_pm_ideal_2797" style="display: block;">
      <input type="radio" name="rfmp_payment_method_2797" value="ideal" data-fixed="0" data-variable="0" onchange="mollie_forms_2797_totals();" checked="">
      <img decoding="async" style="vertical-align:middle;display:inline-block;" src="https://www.mollie.com/external/icons/payment-methods/ideal.svg">
    </li>
  </ul><input type="hidden" id="rfmp_checkbox_hidden_2797" name="rfmp_checkbox_hidden_2797" value="0"><br><label id="rfmp_checkbox_2797" style="display:none;">
    <input type="checkbox" name="rfmp_checkbox_2797" value="1">Hierbij geef ik toestemming om het terugkerende bedrag periodiek van mijn rekening te incasseren. </label>
  <p></p>
  <p></p>
  <p></p>
  <p><input type="hidden" id="rfmp_2797_token" name="token" value=""><button type="submit" style="display:none;" id="rfmp_2797_submit">Betalen</button><br><button type="button" onclick="onSubmit2797(event)" data-action="submit"
      name="form_2797_field_7" id="form_2797_field_7" value="" label="Betalen" class="" required="" placeholder="Betalen *">Betalen</button></p>
</form>

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Hierbij geef ik toestemming om het terugkerende bedrag periodiek van mijn
rekening te incasseren.







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DATUM KEURMERK: 28-11-2023.
GELDIG TOT 28-11-2025

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Incasso- en adviesbureau
VMP & Partners B.V.
Sidderaalpad 5
1317 HJ Almere
Nederland
036 5460505
info@vmp-partners.nl
KvK 39064288
AFM-licentienummer 12046218


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