berechnung.teachower24.de Open in urlscan Pro
2a06:98c1:3121::3  Public Scan

URL: https://berechnung.teachower24.de/
Submission: On August 21 via automatic, source certstream-suspicious — Scanned from DE

Form analysis 1 forms found in the DOM

POST

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          <h2><span style="color: var(--primary)">Wie sind Sie aktuell krankenversichert?&nbsp;</span></h2>
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                        <div class="label">Nicht so wichtig</div>
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    <div class="block  " style=" " data-blocktype="multiple-choice">
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                      data-variable="Bereits versichert?4" value="id-6c21b5ee" data-answer="Ja, sehr wichtig" data-destination="next" data-priority="0">
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                            <title>style-three-pin-dentist</title>
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                              d="M16.223,8.425A2.348,2.348,0,0,0,12,6.886,2.348,2.348,0,0,0,7.777,8.425a3.845,3.845,0,0,0,1.252,3.068,5.683,5.683,0,0,0-.548,2.474,5.947,5.947,0,0,0,.158,1.372.451.451,0,0,0,.452.322.463.463,0,0,0,.479-.376,2.774,2.774,0,0,1,2.43-2.7A2.781,2.781,0,0,1,14.432,15.3a.445.445,0,0,0,.461.364.473.473,0,0,0,.472-.338,5.975,5.975,0,0,0,.154-1.356,5.683,5.683,0,0,0-.548-2.474A3.848,3.848,0,0,0,16.223,8.425Z"
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                        <div class="label">Ja, sehr wichtig</div>
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                      data-variable="Bereits versichert?4" value="id-35469ec7" data-answer="Nicht so wichtig" data-destination="next" data-priority="0">
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                            <title>dislike</title>
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                              d="M23.25,2.25v10.5h-1.5a7.5,7.5,0,0,0-7.5,7.5V21a2.25,2.25,0,0,1-4.5,0V17.25a1.5,1.5,0,0,0-1.5-1.5h-3A4.5,4.5,0,0,1,.773,10.8l.465-4.649A6,6,0,0,1,7.208.75h6.2a6.006,6.006,0,0,1,1.648.231l3.634,1.038a6.006,6.006,0,0,0,1.648.231h2.91"
                              style="fill: none; stroke: currentColor; stroke-linecap: round; stroke-linejoin: round; stroke-width: 1.5px;"></path>
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                        <div class="label">Nicht so wichtig</div>
                      </div>
                    </div>
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                  <path fill="currentColor" d="M26.013,10.047l1.654-2.866c-2.198-1.272-4.743-2.012-7.466-2.012h0v3.312h0 C22.32,8.481,24.301,9.057,26.013,10.047z">
                    <animateTransform attributeType="xml" attributeName="transform" type="rotate" from="0 20 20" to="360 20 20" dur="0.5s" repeatCount="indefinite"></animateTransform>
                  </path>
                </svg></div>
            </div>
            <div class="content reverse align-center">
              <div class="label-container ">
                <span class="label">Zurück</span>
              </div>
              <span class="graphic">
                <svg xmlns="http://www.w3.org/2000/svg" width="192" height="192" fill="currentColor" viewBox="0 0 256 256">
                  <rect width="256" height="256" fill="none"></rect>
                  <line x1="216" y1="128" x2="40" y2="128" fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="24"></line>
                  <polyline points="112 56 40 128 112 200" fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="24"></polyline>
                </svg>
              </span>
            </div>
          </button>
        </div>
      </div>
    </div>
    <div class="block  " style=" " data-blocktype="rich-text">
      <div class="block-content text-block align-center inner-mid" id="text-block-id-e415d6b5">
        <div class="rich-text" style="padding-top:20px; padding-bottom:20px; ">
          <h2><span style="color: var(--primary)">Anhand Ihrer Angaben</span></h2>
          <h2><span style="color: var(--primary)">können wir Ihnen nun ein Angebot erstellen.</span></h2>
        </div>
      </div>
    </div>
    <div class="block  " style=" " data-blocktype="steps">
      <div class="block-content steps-block inner-mid" id="steps-block-id-ffad632a">
        <div style="padding-top:20px; padding-bottom:20px; ">
          <div class="steps-list ">
            <div id="id-14ff0dde" class="steps-option   done">
              <div class="graphics-wrapper">
                <div class="graphics-container">
                  <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512">
                    <path
                      d="M256,0C114.84,0,0,114.84,0,256S114.84,512,256,512,512,397.16,512,256,397.16,0,256,0ZM389.23,170.2,223.82,367.13a19.71,19.71,0,0,1-14.77,7h-.34a19.67,19.67,0,0,1-14.63-6.52l-70.89-78.77a19.69,19.69,0,1,1,28.65-27c.21.23.42.45.62.68l55.74,61.94L359.08,144.87a19.69,19.69,0,0,1,30.15,25.33Z">
                    </path>
                  </svg>
                </div>
              </div>
              <div class="text-container">
                <div class="label"></div>
              </div>
            </div>
            <div id="id-0d1110ff" class="steps-option   done">
              <div class="graphics-wrapper">
                <div class="graphics-container">
                  <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512">
                    <path
                      d="M256,0C114.84,0,0,114.84,0,256S114.84,512,256,512,512,397.16,512,256,397.16,0,256,0ZM389.23,170.2,223.82,367.13a19.71,19.71,0,0,1-14.77,7h-.34a19.67,19.67,0,0,1-14.63-6.52l-70.89-78.77a19.69,19.69,0,1,1,28.65-27c.21.23.42.45.62.68l55.74,61.94L359.08,144.87a19.69,19.69,0,0,1,30.15,25.33Z">
                    </path>
                  </svg>
                </div>
              </div>
              <div class="text-container">
                <div class="label"></div>
              </div>
            </div>
            <div id="id-061e9db7" class="steps-option   done">
              <div class="graphics-wrapper">
                <div class="graphics-container">
                  <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512">
                    <path
                      d="M256,0C114.84,0,0,114.84,0,256S114.84,512,256,512,512,397.16,512,256,397.16,0,256,0ZM389.23,170.2,223.82,367.13a19.71,19.71,0,0,1-14.77,7h-.34a19.67,19.67,0,0,1-14.63-6.52l-70.89-78.77a19.69,19.69,0,1,1,28.65-27c.21.23.42.45.62.68l55.74,61.94L359.08,144.87a19.69,19.69,0,0,1,30.15,25.33Z">
                    </path>
                  </svg>
                </div>
              </div>
              <div class="text-container">
                <div class="label"></div>
              </div>
            </div>
            <div id="id-36570a2c" class="steps-option   done">
              <div class="graphics-wrapper">
                <div class="graphics-container">
                  <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512">
                    <path
                      d="M256,0C114.84,0,0,114.84,0,256S114.84,512,256,512,512,397.16,512,256,397.16,0,256,0ZM389.23,170.2,223.82,367.13a19.71,19.71,0,0,1-14.77,7h-.34a19.67,19.67,0,0,1-14.63-6.52l-70.89-78.77a19.69,19.69,0,1,1,28.65-27c.21.23.42.45.62.68l55.74,61.94L359.08,144.87a19.69,19.69,0,0,1,30.15,25.33Z">
                    </path>
                  </svg>
                </div>
              </div>
              <div class="text-container">
                <div class="label"></div>
              </div>
            </div>
            <div id="id-ae601e67" class="steps-option   done">
              <div class="graphics-wrapper">
                <div class="graphics-container">
                  <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512">
                    <path
                      d="M256,0C114.84,0,0,114.84,0,256S114.84,512,256,512,512,397.16,512,256,397.16,0,256,0ZM389.23,170.2,223.82,367.13a19.71,19.71,0,0,1-14.77,7h-.34a19.67,19.67,0,0,1-14.63-6.52l-70.89-78.77a19.69,19.69,0,1,1,28.65-27c.21.23.42.45.62.68l55.74,61.94L359.08,144.87a19.69,19.69,0,0,1,30.15,25.33Z">
                    </path>
                  </svg>
                </div>
              </div>
              <div class="text-container">
                <div class="label"></div>
              </div>
            </div>
            <div id="id-ebc2f97a" class="steps-option  current ">
              <div class="graphics-wrapper">
                <div class="graphics-container">
                  <svg data-name="Layer 1" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512">
                    <defs></defs>
                    <path d="M419,256A163,163,0,1,0,256,419,163,163,0,0,0,419,256Z"></path>
                    <path d="M494,256C494,124.6,387.4,18,256,18S18,124.6,18,256,124.6,494,256,494,494,387.4,494,256Z" style="fill: none; stroke: currentColor; stroke-miterlimit: 10; stroke-width: 32px;"></path>
                  </svg>
                </div>
              </div>
              <div class="text-container">
                <div class="label"></div>
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="block  " style=" " data-blocktype="elements-v2">
      <div class="block-content elements-container elements-v2-container inner-full" data-type="nested-blocks">
        <div class="inner-full container-style-plain" style="margin-top:10px; margin-right:10px; margin-bottom:10px; margin-left:10px; padding-top:20px; padding-bottom:20px; ">
          <div class="elements-container-inner inner-narrow" style="justify-content:normal; flex-direction:column; align-items:stretch; gap:10px;margin-left:auto;margin-right:auto;">
            <div class="block  " style=" " data-blocktype="elements-v2">
              <div class="block-content elements-container elements-v2-container inner-full" data-type="nested-blocks">
                <div class="inner-full container-style-plain" style="">
                  <div class="elements-container-inner inner-full" style="justify-content:normal;align-items:flex-start;flex-direction:row;gap:10px;margin-left:auto;margin-right:auto;">
                    <div class="block  " style=" " data-blocktype="input">
                      <div class="block-content input-box input-block inner-narrow show-error-on-nav with-floating-label floating-label-inline" id="input-e3492189-container">
                        <div style="">
                          <label for="input-e3492189">Vorname</label>
                          <div class="input  ">
                            <div class="input-inner">
                              <div style="flex:1;position:relative;">
                                <input type="text" id="input-e3492189" data-type="input" data-label="Vorname" data-variable="" data-mask="" name="input-e3492189" placeholder="Max" pattern="" maxlength="" data-trim="" data-initial-required="true"
                                  required="" class="">
                                <div class="input-floating-label">
                                  <label for="input-e3492189">Vorname</label>
                                </div>
                              </div>
                              <div class="status-indicator">
                                <div class="icon-check-mark"><svg xmlns="http://www.w3.org/2000/svg" width="40" height="40" fill="currentColor" viewBox="0 0 256 256">
                                    <path d="M128,24A104,104,0,1,0,232,128,104.11,104.11,0,0,0,128,24Zm45.66,85.66-56,56a8,8,0,0,1-11.32,0l-24-24a8,8,0,0,1,11.32-11.32L112,148.69l50.34-50.35a8,8,0,0,1,11.32,11.32Z"></path>
                                  </svg></div>
                                <div class="icon-x-mark"><svg xmlns="http://www.w3.org/2000/svg" width="40" height="40" fill="currentColor" viewBox="0 0 256 256">
                                    <path
                                      d="M128,24A104,104,0,1,0,232,128,104.11,104.11,0,0,0,128,24Zm37.66,130.34a8,8,0,0,1-11.32,11.32L128,139.31l-26.34,26.35a8,8,0,0,1-11.32-11.32L116.69,128,90.34,101.66a8,8,0,0,1,11.32-11.32L128,116.69l26.34-26.35a8,8,0,0,1,11.32,11.32L139.31,128Z">
                                    </path>
                                  </svg></div>
                                <div class="icon-spinner"><svg version="1.1" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" x="0px" y="0px" width="40px" height="40px" viewBox="0 0 40 40"
                                    enable-background="new 0 0 40 40" xml:space="preserve">
                                    <path opacity="0.3" fill="currentColor"
                                      d="M20.201,5.169c-8.254,0-14.946,6.692-14.946,14.946c0,8.255,6.692,14.946,14.946,14.946 s14.946-6.691,14.946-14.946C35.146,11.861,28.455,5.169,20.201,5.169z M20.201,31.749c-6.425,0-11.634-5.208-11.634-11.634 c0-6.425,5.209-11.634,11.634-11.634c6.425,0,11.633,5.209,11.633,11.634C31.834,26.541,26.626,31.749,20.201,31.749z">
                                    </path>
                                    <path fill="currentColor" d="M26.013,10.047l1.654-2.866c-2.198-1.272-4.743-2.012-7.466-2.012h0v3.312h0 C22.32,8.481,24.301,9.057,26.013,10.047z">
                                      <animateTransform attributeType="xml" attributeName="transform" type="rotate" from="0 20 20" to="360 20 20" dur="0.5s" repeatCount="indefinite"></animateTransform>
                                    </path>
                                  </svg></div>
                              </div>
                            </div>
                            <datalist id="datalist-input-e3492189">
                              <option>Option 1</option>
                              <option>Option 2</option>
                            </datalist>
                            <div class="error-box">
                              <svg xmlns="http://www.w3.org/2000/svg" width="192" height="192" fill="currentColor" viewBox="0 0 256 256">
                                <rect width="256" height="256" fill="none"></rect>
                                <line x1="200" y1="56" x2="56" y2="200" fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="24">
                                </line>
                                <line x1="200" y1="200" x2="56" y2="56" fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="24"></line>
                              </svg> <span class="text">Bitte gib deinen Vornamen an</span>
                            </div>
                          </div>
                        </div>
                      </div>
                    </div>
                    <div class="block  " style=" " data-blocktype="input">
                      <div class="block-content input-box input-block inner-narrow show-error-on-nav with-floating-label floating-label-inline" id="input-12645d86-container">
                        <div style="">
                          <label for="input-12645d86">Nachname</label>
                          <div class="input  ">
                            <div class="input-inner">
                              <div style="flex:1;position:relative;">
                                <input type="text" id="input-12645d86" data-type="input" data-label="Nachname" data-variable="" data-mask="" name="input-12645d86" placeholder="Muster" pattern="" maxlength="" data-trim="" data-initial-required="true"
                                  required="" class="">
                                <div class="input-floating-label">
                                  <label for="input-12645d86">Nachname</label>
                                </div>
                              </div>
                              <div class="status-indicator">
                                <div class="icon-check-mark"><svg xmlns="http://www.w3.org/2000/svg" width="40" height="40" fill="currentColor" viewBox="0 0 256 256">
                                    <path d="M128,24A104,104,0,1,0,232,128,104.11,104.11,0,0,0,128,24Zm45.66,85.66-56,56a8,8,0,0,1-11.32,0l-24-24a8,8,0,0,1,11.32-11.32L112,148.69l50.34-50.35a8,8,0,0,1,11.32,11.32Z"></path>
                                  </svg></div>
                                <div class="icon-x-mark"><svg xmlns="http://www.w3.org/2000/svg" width="40" height="40" fill="currentColor" viewBox="0 0 256 256">
                                    <path
                                      d="M128,24A104,104,0,1,0,232,128,104.11,104.11,0,0,0,128,24Zm37.66,130.34a8,8,0,0,1-11.32,11.32L128,139.31l-26.34,26.35a8,8,0,0,1-11.32-11.32L116.69,128,90.34,101.66a8,8,0,0,1,11.32-11.32L128,116.69l26.34-26.35a8,8,0,0,1,11.32,11.32L139.31,128Z">
                                    </path>
                                  </svg></div>
                                <div class="icon-spinner"><svg version="1.1" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" x="0px" y="0px" width="40px" height="40px" viewBox="0 0 40 40"
                                    enable-background="new 0 0 40 40" xml:space="preserve">
                                    <path opacity="0.3" fill="currentColor"
                                      d="M20.201,5.169c-8.254,0-14.946,6.692-14.946,14.946c0,8.255,6.692,14.946,14.946,14.946 s14.946-6.691,14.946-14.946C35.146,11.861,28.455,5.169,20.201,5.169z M20.201,31.749c-6.425,0-11.634-5.208-11.634-11.634 c0-6.425,5.209-11.634,11.634-11.634c6.425,0,11.633,5.209,11.633,11.634C31.834,26.541,26.626,31.749,20.201,31.749z">
                                    </path>
                                    <path fill="currentColor" d="M26.013,10.047l1.654-2.866c-2.198-1.272-4.743-2.012-7.466-2.012h0v3.312h0 C22.32,8.481,24.301,9.057,26.013,10.047z">
                                      <animateTransform attributeType="xml" attributeName="transform" type="rotate" from="0 20 20" to="360 20 20" dur="0.5s" repeatCount="indefinite"></animateTransform>
                                    </path>
                                  </svg></div>
                              </div>
                            </div>
                            <datalist id="datalist-input-12645d86">
                              <option>Option 1</option>
                              <option>Option 2</option>
                            </datalist>
                            <div class="error-box">
                              <svg xmlns="http://www.w3.org/2000/svg" width="192" height="192" fill="currentColor" viewBox="0 0 256 256">
                                <rect width="256" height="256" fill="none"></rect>
                                <line x1="200" y1="56" x2="56" y2="200" fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="24">
                                </line>
                                <line x1="200" y1="200" x2="56" y2="56" fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="24"></line>
                              </svg> <span class="text">Bitte gib deinen Nachnamen an</span>
                            </div>
                          </div>
                        </div>
                      </div>
                    </div>
                  </div>
                </div>
              </div>
            </div>
            <div class="block  " style=" " data-blocktype="input">
              <div class="block-content input-box input-block inner-narrow show-error-on-nav with-floating-label floating-label-inline" id="input-2581ced6-container">
                <div style="">
                  <label for="input-2581ced6">E-Mail Adresse</label>
                  <div class="input  has-prefix">
                    <div class="input-inner">
                      <div class="input-decorator input-prefix input-prefix-svg"><svg id="Raw" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 256 256">
                          <rect width="256" height="256" fill="none"></rect>
                          <polyline points="224 56 128 144 32 56" fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="16"></polyline>
                          <path d="M32,56H224a0,0,0,0,1,0,0V192a8,8,0,0,1-8,8H40a8,8,0,0,1-8-8V56A0,0,0,0,1,32,56Z" fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="16"></path>
                          <line x1="110.54541" y1="128.00013" x2="34.4668" y2="197.73926" fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="16"></line>
                          <line x1="221.53418" y1="197.73926" x2="145.45424" y2="127.99964" fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="16"></line>
                        </svg></div>
                      <div style="flex:1;position:relative;">
                        <input type="text" id="input-2581ced6" data-type="input" data-label="E-Mail Adresse" data-variable="" data-mask="" name="input-2581ced6" placeholder="email@adresse.de" pattern="^\S+@\S+\.\S+$" maxlength="" data-trim=""
                          data-initial-required="true" required="" autocomplete="email" class="">
                        <div class="input-floating-label">
                          <label for="input-2581ced6">E-Mail Adresse</label>
                        </div>
                      </div>
                      <div class="status-indicator">
                        <div class="icon-check-mark"><svg xmlns="http://www.w3.org/2000/svg" width="40" height="40" fill="currentColor" viewBox="0 0 256 256">
                            <path d="M128,24A104,104,0,1,0,232,128,104.11,104.11,0,0,0,128,24Zm45.66,85.66-56,56a8,8,0,0,1-11.32,0l-24-24a8,8,0,0,1,11.32-11.32L112,148.69l50.34-50.35a8,8,0,0,1,11.32,11.32Z"></path>
                          </svg></div>
                        <div class="icon-x-mark"><svg xmlns="http://www.w3.org/2000/svg" width="40" height="40" fill="currentColor" viewBox="0 0 256 256">
                            <path
                              d="M128,24A104,104,0,1,0,232,128,104.11,104.11,0,0,0,128,24Zm37.66,130.34a8,8,0,0,1-11.32,11.32L128,139.31l-26.34,26.35a8,8,0,0,1-11.32-11.32L116.69,128,90.34,101.66a8,8,0,0,1,11.32-11.32L128,116.69l26.34-26.35a8,8,0,0,1,11.32,11.32L139.31,128Z">
                            </path>
                          </svg></div>
                        <div class="icon-spinner"><svg version="1.1" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" x="0px" y="0px" width="40px" height="40px" viewBox="0 0 40 40" enable-background="new 0 0 40 40"
                            xml:space="preserve">
                            <path opacity="0.3" fill="currentColor"
                              d="M20.201,5.169c-8.254,0-14.946,6.692-14.946,14.946c0,8.255,6.692,14.946,14.946,14.946 s14.946-6.691,14.946-14.946C35.146,11.861,28.455,5.169,20.201,5.169z M20.201,31.749c-6.425,0-11.634-5.208-11.634-11.634 c0-6.425,5.209-11.634,11.634-11.634c6.425,0,11.633,5.209,11.633,11.634C31.834,26.541,26.626,31.749,20.201,31.749z">
                            </path>
                            <path fill="currentColor" d="M26.013,10.047l1.654-2.866c-2.198-1.272-4.743-2.012-7.466-2.012h0v3.312h0 C22.32,8.481,24.301,9.057,26.013,10.047z">
                              <animateTransform attributeType="xml" attributeName="transform" type="rotate" from="0 20 20" to="360 20 20" dur="0.5s" repeatCount="indefinite"></animateTransform>
                            </path>
                          </svg></div>
                      </div>
                    </div>
                    <datalist id="datalist-input-2581ced6">
                      <option>Option 1</option>
                      <option>Option 2</option>
                    </datalist>
                    <div class="error-box">
                      <svg xmlns="http://www.w3.org/2000/svg" width="192" height="192" fill="currentColor" viewBox="0 0 256 256">
                        <rect width="256" height="256" fill="none"></rect>
                        <line x1="200" y1="56" x2="56" y2="200" fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="24">
                        </line>
                        <line x1="200" y1="200" x2="56" y2="56" fill="none" stroke="currentColor" stroke-linecap="round" stroke-linejoin="round" stroke-width="24"></line>
                      </svg> <span class="text">Bitte gib eine korrekte E-Mail Adresse an</span>
                    </div>
                  </div>
                </div>
              </div>
            </div>
            <div class="block  " style=" " data-blocktype="phone">
              <div class="block-content input-box phone-number-block show-error-instantly inner-narrow" id="phone-number-block-phone-8f275a84">
                <div style="">
                  <hey-phone-number id="phone-8f275a84" data-async="false" data-status="invalid" network-validation-error-message="Bitte eine registrierte Nummer eingeben." default-country-code="DE" allowed-country-codes="[&quot;DE&quot;]"
                    label="Telefon" label-type="floating-inline" error-message="Bitte geben Sie eine gültige Telefonnummer ein" required="" data-initial-required="true">
                    <div class="input-box show-error-instantly with-floating-label floating-label-inline">
                      <div>
                        <div class="input has-prefix invalid" data-async="false" data-status="idle">
                          <div class="input-wrapper">
                            <div>
                              <div class="select-wrapper"><select class="select-native" id="phone-country" name="country-select-phone-8f275a84" label="🇩🇪" data-is-empty="true">
                                  <option value="DE">🇩🇪 Deutschland +49</option>
                                </select><button class="select-custom input-decorator input-prefix " aria-hidden="true">🇩🇪</button></div>
                              <div class="select-custom-options ">
                                <div class="select-custom-search-box"><input class="select-custom-search" type="text" placeholder="Search"></div><button class="select-custom-option" data-value="DE">🇩🇪 Deutschland <span
                                    class="country-calling-code">+49</span></button>
                              </div>
                            </div>
                            <div style="width: 100%; flex: 1 1 0%; position: relative;"><input class="phone-input" name="phone-input-phone-8f275a84" id="phone-8f275a84" type="tel" data-type="input" data-is-empty="true" placeholder="+49 0000 0000000">
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                            <div class="input-floating-label" style="left: 0px;"><label for="phone-8f275a84">Telefon</label></div>
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                                    <path
                                      d="M128 24a104 104 0 10104 104A104.11 104.11 0 00128 24zm37.66 130.34a8 8 0 01-11.32 11.32L128 139.31l-26.34 26.35a8 8 0 01-11.32-11.32L116.69 128l-26.35-26.34a8 8 0 0111.32-11.32L128 116.69l26.34-26.35a8 8 0 0111.32 11.32L139.31 128z">
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                            </svg><span class="text">Bitte geben Sie eine gültige Telefonnummer ein</span></div>
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                      </div>
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                      <option value="Mecklenburg-Vorpommern">Mecklenburg-Vorpommern</option>
                      <option value="Niedersachsen">Niedersachsen</option>
                      <option value="Nordrhein-Westfalen ">Nordrhein-Westfalen </option>
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                      <option value="Sachsen">Sachsen</option>
                      <option value="Sachsen-Anhalt">Sachsen-Anhalt</option>
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Text Content

WIE SIND SIE AKTUELL KRANKENVERSICHERT? 

1
list-edit
Gesetzlich

2
people-man-graduate
Privat

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WIE IST IHR AKTUELLER STATUS? 


1
people-man-graduate
Lehramtstudent

2
people-man-3
Beamtenanwärter

3
people-man-1
Lehrer

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LEGEN SIE WERT AUF HEILPRAKTIKER?


1
like
Ja, sind mir wichtig

2
dislike
Nicht so wichtig

Weiter



WIE MÖCHTEN SIE IM KRANKENHAUS BEHANDELT WERDEN?


1
professions-man-doctor-2
1-Bett-Zimmer mit Chefarzt

2
professions-man-nurse-1
2-Bett-Zimmer mit Chefarzt

3
hospital-bedroom-nurse
Mehrbett-Zimmer mit Stationsarzt

Weiter



SIND IHNEN ZAHNLEISTUNGEN WICHTIG?


1
style-three-pin-dentist
Ja, sehr wichtig

2
dislike
Nicht so wichtig

Weiter



WANN SIND SIE GEBOREN?

(DER BEITRAG RICHTET SICH U.A. NACH IHREM ALTER. FÜR DIE RICHTIGE BERECHNUNG
BENÖTIGEN WIR DAHER IHR GEBURTSDATUM.)


Bitte wähle ein Datum
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