equilli.com
Open in
urlscan Pro
83.217.70.251
Public Scan
Submitted URL: http://link.mta4.shspma.com/ls/click?upn=DynHAuf8U3WfpLpoYuSv882RhBjDYisgi6Q8MJov2p5n1jO-2FE5caQGmnbgoxgA-2F5SJxD-2BYmXNBRkM...
Effective URL: https://equilli.com/be/maak-een-afspraak/?utm=nieuwsbrief&utm_medium=email&utm_source=sharpspring&sslid=Mzc3AUIjQwtL...
Submission: On February 01 via api from BE — Scanned from DE
Effective URL: https://equilli.com/be/maak-een-afspraak/?utm=nieuwsbrief&utm_medium=email&utm_source=sharpspring&sslid=Mzc3AUIjQwtL...
Submission: On February 01 via api from BE — Scanned from DE
Form analysis 5 forms found in the DOM
POST /be/maak-een-afspraak/?utm=nieuwsbrief&utm_medium=email&utm_source=sharpspring&sslid=Mzc3AUIjQwtLEzMA&sseid=MzK2MDQxtDQ1MgIA&jobid=ffa8b967-fec5-4b66-a5a6-1529832999bd
<form method="post" enctype="multipart/form-data" id="gform_2" class="winkels_formulier gform_legacy_markup"
action="/be/maak-een-afspraak/?utm=nieuwsbrief&utm_medium=email&utm_source=sharpspring&sslid=Mzc3AUIjQwtLEzMA&sseid=MzK2MDQxtDQ1MgIA&jobid=ffa8b967-fec5-4b66-a5a6-1529832999bd">
<input type="hidden" class="gforms-pum" value="{"closepopup":false,"closedelay":0,"openpopup":false,"openpopup_id":0}">
<div class="gform_body gform-body">
<ul id="gform_fields_2" class="gform_fields left_label form_sublabel_below description_below">
<li id="field_2_8" class="gfield gfield--width-full gform_hidden field_sublabel_below field_description_below gfield_visibility_visible">
<div class="ginput_container ginput_container_text"><input name="input_8" id="input_2_8" type="hidden" class="gform_hidden" aria-invalid="false"
value="https://app-3QNND20RAY.marketingautomation.services/webforms/receivePostback/MzawMLEwNjE1BQA/"></div>
</li>
<li id="field_2_9" class="gfield gfield--width-full gform_hidden field_sublabel_below field_description_below gfield_visibility_visible">
<div class="ginput_container ginput_container_text"><input name="input_9" id="input_2_9" type="hidden" class="gform_hidden" aria-invalid="false" value="fcd6c267-dd49-4ff6-a15b-a4bafb9eb812"></div>
</li>
<li id="field_2_1" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_2_1">Naam<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_1" id="input_2_1" type="text" value="" class="medium" aria-required="true" aria-invalid="false"></div>
</li>
<li id="field_2_2" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_2_2">Voornaam<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_2" id="input_2_2" type="text" value="" class="medium" aria-required="true" aria-invalid="false"></div>
</li>
<li id="field_2_3" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_2_3">Email<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_3" id="input_2_3" type="text" value="" class="medium" aria-required="true" aria-invalid="false"></div>
</li>
<li id="field_2_4" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_2_4">Winkelpunt<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_4" id="input_2_4" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="" class="gf_placeholder">Kies een winkelpunt</option>
<option value="Leuven">Leuven</option>
<option value="Boortmeerbeek">Boortmeerbeek</option>
<option value="Kortrijk">Kortrijk</option>
<option value="Rumst">Rumst</option>
<option value="Belsele">Belsele</option>
<option value="Beringen">Beringen</option>
<option value="Diest">Diest</option>
<option value="Hasselt">Hasselt</option>
<option value="Dendermonde">Dendermonde</option>
<option value="Wommelgem">Wommelgem</option>
<option value="Zaventem">Zaventem</option>
<option value="Veurne">Veurne</option>
<option value="Meise">Meise</option>
<option value="Assen">Assen</option>
<option value="Haren">Haren</option>
<option value="Amstelveen">Amstelveen</option>
<option value="Zaandam">Zaandam</option>
<option value="Amersfoort">Amersfoort</option>
<option value="Eindhoven">Eindhoven</option>
<option value="Zevenhuizen">Zevenhuizen</option>
<option value="Overijse">Overijse</option>
<option value="Leeuwarden">Leeuwarden</option>
<option value="Gent">Gent</option>
<option value="Linkebeek">Linkebeek</option>
<option value="Ternat">Ternat</option>
<option value="Ninove">Ninove</option>
</select></div>
</li>
<li id="field_2_5" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_2_5">Tel<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_5" id="input_2_5" type="text" value="" class="medium" aria-required="true" aria-invalid="false"></div>
</li>
<li id="field_2_6" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_2_6">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_6" id="input_2_6" class="textarea medium" aria-required="true" aria-invalid="false" rows="10"
cols="50">Contacteer mij om een afspraak te maken voor een vrijblijvende Sleep Scan.</textarea></div>
</li>
<li id="field_2_7" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label screen-reader-text" for="input_2_7"></label>
<div id="input_2_7" class="ginput_container ginput_recaptcha gform-initialized" data-sitekey="6Le-cCkTAAAAAKGg5xuHh9UDUe6W2hS0OlzL4NN7" data-theme="light" data-tabindex="0" data-badge="">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6Le-cCkTAAAAAKGg5xuHh9UDUe6W2hS0OlzL4NN7&co=aHR0cHM6Ly9lcXVpbGxpLmNvbTo0NDM.&hl=nl&v=dPctOHA2ifhWm5WzFM_B5TjT&theme=light&size=normal&cb=rqblewa9zwob"
width="304" height="78" role="presentation" name="a-uh8gifmx7wyj" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox"></iframe></div><textarea id="g-recaptcha-response" name="g-recaptcha-response"
class="g-recaptcha-response" style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div>
</div>
</li>
<li id="field_2_10" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_2_10">Comments</label>
<div class="ginput_container"><input name="input_10" id="input_2_10" type="text" value=""></div>
<div class="gfield_description" id="gfield_description_2_10">This field is for validation purposes and should be left unchanged.</div>
</li>
</ul>
</div>
<div class="gform_footer left_label"> <input type="submit" id="gform_submit_button_2" class="gform_button button" value="Verstuur" onclick="if(window["gf_submitting_2"]){return false;} window["gf_submitting_2"]=true; "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_2"]){return false;} window["gf_submitting_2"]=true; jQuery("#gform_2").trigger("submit",[true]); }">
<input type="hidden" class="gform_hidden" name="is_submit_2" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="2">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_2" value="WyJbXSIsIjQzODkxOWNmZjhhY2M2ZDdhZTBlYjM3M2ExYWU2MzMzIl0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_2" id="gform_target_page_number_2" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_2" id="gform_source_page_number_2" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
</form>POST /be/maak-een-afspraak/?utm=nieuwsbrief&utm_medium=email&utm_source=sharpspring&sslid=Mzc3AUIjQwtLEzMA&sseid=MzK2MDQxtDQ1MgIA&jobid=ffa8b967-fec5-4b66-a5a6-1529832999bd
<form method="post" enctype="multipart/form-data" id="gform_1"
action="/be/maak-een-afspraak/?utm=nieuwsbrief&utm_medium=email&utm_source=sharpspring&sslid=Mzc3AUIjQwtLEzMA&sseid=MzK2MDQxtDQ1MgIA&jobid=ffa8b967-fec5-4b66-a5a6-1529832999bd">
<input type="hidden" class="gforms-pum" value="{"closepopup":false,"closedelay":0,"openpopup":false,"openpopup_id":0}">
<div class="gform_body gform-body">
<ul id="gform_fields_1" class="gform_fields top_label form_sublabel_below description_below">
<li id="field_1_4" class="gfield gfield--width-full gform_hidden field_sublabel_below field_description_below gfield_visibility_visible">
<div class="ginput_container ginput_container_text"><input name="input_4" id="input_1_4" type="hidden" class="gform_hidden" aria-invalid="false"
value="https://app-3QNND20RAY.marketingautomation.services/webforms/receivePostback/MzawMLEwNjE1BQA/"></div>
</li>
<li id="field_1_5" class="gfield gfield--width-full gform_hidden field_sublabel_below field_description_below gfield_visibility_visible">
<div class="ginput_container ginput_container_text"><input name="input_5" id="input_1_5" type="hidden" class="gform_hidden" aria-invalid="false" value="c850127d-07b2-4758-9706-0e8dfeaa29b6"></div>
</li>
<li id="field_1_1" class="gfield form_email field_sublabel_below field_description_below hidden_label gfield_visibility_visible"><label class="gfield_label" for="input_1_1">E-mailadres</label>
<div class="ginput_container ginput_container_email">
<input name="input_1" id="input_1_1" type="text" value="" class="medium" placeholder="Uw e-mailadres" aria-invalid="false">
</div>
</li>
<li id="field_1_2" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_2">CAPTCHA</label>
<div id="input_1_2" class="ginput_container ginput_recaptcha gform-initialized" data-sitekey="6Le-cCkTAAAAAKGg5xuHh9UDUe6W2hS0OlzL4NN7" data-theme="light" data-tabindex="0" data-badge="">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6Le-cCkTAAAAAKGg5xuHh9UDUe6W2hS0OlzL4NN7&co=aHR0cHM6Ly9lcXVpbGxpLmNvbTo0NDM.&hl=nl&v=dPctOHA2ifhWm5WzFM_B5TjT&theme=light&size=normal&cb=ipva3zpgpz4r"
width="304" height="78" role="presentation" name="a-6nnpl9tylxis" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox"></iframe></div><textarea id="g-recaptcha-response-1" name="g-recaptcha-response"
class="g-recaptcha-response" style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
</li>
<li id="field_1_3" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible">
<script>
var __ss_noform = __ss_noform || [];
__ss_noform.push(['baseURI', 'https://app-3QNND20RAY.marketingautomation.services/webforms/receivePostback/MzawMLEwNjE1BQA/']);
__ss_noform.push(['endpoint', 'c850127d-07b2-4758-9706-0e8dfeaa29b6']);
</script>
<script src="https://koi-3QNND20RAY.marketingautomation.services/client/noform.js?ver=1.24"></script>
</li>
<li id="field_1_6" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_6">Email</label>
<div class="ginput_container"><input name="input_6" id="input_1_6" type="text" value=""></div>
<div class="gfield_description" id="gfield_description_1_6">This field is for validation purposes and should be left unchanged.</div>
</li>
</ul>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_1" class="gform_button button" value="Verstuur" onclick="if(window["gf_submitting_1"]){return false;} window["gf_submitting_1"]=true; "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_1"]){return false;} window["gf_submitting_1"]=true; jQuery("#gform_1").trigger("submit",[true]); }">
<input type="hidden" class="gform_hidden" name="is_submit_1" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="1">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_1" value="WyJbXSIsIjQzODkxOWNmZjhhY2M2ZDdhZTBlYjM3M2ExYWU2MzMzIl0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_1" id="gform_target_page_number_1" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_1" id="gform_source_page_number_1" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
</form>POST /be/maak-een-afspraak/?utm=nieuwsbrief&utm_medium=email&utm_source=sharpspring&sslid=Mzc3AUIjQwtLEzMA&sseid=MzK2MDQxtDQ1MgIA&jobid=ffa8b967-fec5-4b66-a5a6-1529832999bd#gf_23
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_23" id="gform_23"
action="/be/maak-een-afspraak/?utm=nieuwsbrief&utm_medium=email&utm_source=sharpspring&sslid=Mzc3AUIjQwtLEzMA&sseid=MzK2MDQxtDQ1MgIA&jobid=ffa8b967-fec5-4b66-a5a6-1529832999bd#gf_23">
<input type="hidden" class="gforms-pum" value="{"closepopup":false,"closedelay":0,"openpopup":false,"openpopup_id":0}">
<div class="gform_body gform-body">
<div id="gform_fields_23" class="gform_fields top_label form_sublabel_below description_below">
<div id="field_23_1" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_23_1">Voornaam *</label>
<div class="ginput_container ginput_container_text"><input name="input_1" id="input_23_1" type="text" value="" class="large" aria-invalid="false"></div>
</div>
<div id="field_23_2" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_23_2">Achternaam *</label>
<div class="ginput_container ginput_container_text"><input name="input_2" id="input_23_2" type="text" value="" class="large" aria-invalid="false"></div>
</div>
<div id="field_23_3" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_23_3">Email *</label>
<div class="ginput_container ginput_container_text"><input name="input_3" id="input_23_3" type="text" value="" class="large" aria-invalid="false"></div>
</div>
<div id="field_23_4" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_23_4">Postcode *</label>
<div class="ginput_container ginput_container_text"><input name="input_4" id="input_23_4" type="text" value="" class="large" aria-invalid="false"></div>
</div>
<fieldset id="field_23_5" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible">
<legend class="gfield_label gfield_label_before_complex">Ik woon in.. *<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></legend>
<div class="ginput_container ginput_container_checkbox">
<div class="gfield_checkbox" id="input_23_5">
<div class="gchoice gchoice_23_5_1">
<input class="gfield-choice-input" name="input_5.1" type="checkbox" value="BE" id="choice_23_5_1">
<label for="choice_23_5_1" id="label_23_5_1">BE</label>
</div>
<div class="gchoice gchoice_23_5_2">
<input class="gfield-choice-input" name="input_5.2" type="checkbox" value="NL" id="choice_23_5_2">
<label for="choice_23_5_2" id="label_23_5_2">NL</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_23" class="gform_button button" value="Verzenden" onclick="if(window["gf_submitting_23"]){return false;} window["gf_submitting_23"]=true; "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_23"]){return false;} window["gf_submitting_23"]=true; jQuery("#gform_23").trigger("submit",[true]); }"> <input type="hidden"
name="gform_ajax" value="form_id=23&title=&description=&tabindex=0">
<input type="hidden" class="gform_hidden" name="is_submit_23" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="23">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_23" value="WyJbXSIsIjQzODkxOWNmZjhhY2M2ZDdhZTBlYjM3M2ExYWU2MzMzIl0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_23" id="gform_target_page_number_23" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_23" id="gform_source_page_number_23" value="1">
<input type="hidden" name="gform_field_values" value="">
</div><input type="hidden" name="pum_form_popup_id" value="8082">
</form>POST /be/maak-een-afspraak/?utm=nieuwsbrief&utm_medium=email&utm_source=sharpspring&sslid=Mzc3AUIjQwtLEzMA&sseid=MzK2MDQxtDQ1MgIA&jobid=ffa8b967-fec5-4b66-a5a6-1529832999bd
<form method="post" enctype="multipart/form-data" id="gform_24"
action="/be/maak-een-afspraak/?utm=nieuwsbrief&utm_medium=email&utm_source=sharpspring&sslid=Mzc3AUIjQwtLEzMA&sseid=MzK2MDQxtDQ1MgIA&jobid=ffa8b967-fec5-4b66-a5a6-1529832999bd">
<input type="hidden" class="gforms-pum" value="{"closepopup":false,"closedelay":0,"openpopup":false,"openpopup_id":0}">
<div class="gform_body gform-body">
<div id="gform_fields_24" class="gform_fields top_label form_sublabel_below description_below">
<div id="field_24_1" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_24_1">Voornaam *</label>
<div class="ginput_container ginput_container_text"><input name="input_1" id="input_24_1" type="text" value="" class="large" aria-invalid="false"></div>
</div>
<div id="field_24_2" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_24_2">Achternaam *</label>
<div class="ginput_container ginput_container_text"><input name="input_2" id="input_24_2" type="text" value="" class="large" aria-invalid="false"></div>
</div>
<div id="field_24_3" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_24_3">Email *</label>
<div class="ginput_container ginput_container_text"><input name="input_3" id="input_24_3" type="text" value="" class="large" aria-invalid="false"></div>
</div>
<div id="field_24_4" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_24_4">Postcode *</label>
<div class="ginput_container ginput_container_text"><input name="input_4" id="input_24_4" type="text" value="" class="large" aria-invalid="false"></div>
</div>
<fieldset id="field_24_5" class="gfield field_sublabel_below field_description_below gfield_visibility_visible">
<legend class="gfield_label gfield_label_before_complex">Ik woon in.. *</legend>
<div class="ginput_container ginput_container_checkbox">
<div class="gfield_checkbox" id="input_24_5">
<div class="gchoice gchoice_24_5_1">
<input class="gfield-choice-input" name="input_5.1" type="checkbox" value="BE" id="choice_24_5_1">
<label for="choice_24_5_1" id="label_24_5_1">BE</label>
</div>
<div class="gchoice gchoice_24_5_2">
<input class="gfield-choice-input" name="input_5.2" type="checkbox" value="NL" id="choice_24_5_2">
<label for="choice_24_5_2" id="label_24_5_2">NL</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_24" class="gform_button button" value="Verzenden" onclick="if(window["gf_submitting_24"]){return false;} window["gf_submitting_24"]=true; "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_24"]){return false;} window["gf_submitting_24"]=true; jQuery("#gform_24").trigger("submit",[true]); }">
<input type="hidden" class="gform_hidden" name="is_submit_24" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="24">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_24" value="WyJbXSIsIjQzODkxOWNmZjhhY2M2ZDdhZTBlYjM3M2ExYWU2MzMzIl0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_24" id="gform_target_page_number_24" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_24" id="gform_source_page_number_24" value="1">
<input type="hidden" name="gform_field_values" value="">
</div><input type="hidden" name="pum_form_popup_id" value="8158">
</form>POST /be/maak-een-afspraak/?utm=nieuwsbrief&utm_medium=email&utm_source=sharpspring&sslid=Mzc3AUIjQwtLEzMA&sseid=MzK2MDQxtDQ1MgIA&jobid=ffa8b967-fec5-4b66-a5a6-1529832999bd
<form method="post" enctype="multipart/form-data" id="gform_25"
action="/be/maak-een-afspraak/?utm=nieuwsbrief&utm_medium=email&utm_source=sharpspring&sslid=Mzc3AUIjQwtLEzMA&sseid=MzK2MDQxtDQ1MgIA&jobid=ffa8b967-fec5-4b66-a5a6-1529832999bd">
<input type="hidden" class="gforms-pum" value="{"closepopup":false,"closedelay":0,"openpopup":false,"openpopup_id":0}">
<div class="gform_body gform-body">
<div id="gform_fields_25" class="gform_fields top_label form_sublabel_below description_below">
<div id="field_25_1" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_25_1">Voornaam *</label>
<div class="ginput_container ginput_container_text"><input name="input_1" id="input_25_1" type="text" value="" class="large" aria-invalid="false"></div>
</div>
<div id="field_25_2" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_25_2">Achternaam *</label>
<div class="ginput_container ginput_container_text"><input name="input_2" id="input_25_2" type="text" value="" class="large" aria-invalid="false"></div>
</div>
<div id="field_25_3" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_25_3">Email *</label>
<div class="ginput_container ginput_container_text"><input name="input_3" id="input_25_3" type="text" value="" class="large" aria-invalid="false"></div>
</div>
<div id="field_25_4" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_25_4">Postcode *</label>
<div class="ginput_container ginput_container_text"><input name="input_4" id="input_25_4" type="text" value="" class="large" aria-invalid="false"></div>
</div>
<fieldset id="field_25_5" class="gfield field_sublabel_below field_description_below gfield_visibility_visible">
<legend class="gfield_label gfield_label_before_complex">Ik woon in.. *</legend>
<div class="ginput_container ginput_container_checkbox">
<div class="gfield_checkbox" id="input_25_5">
<div class="gchoice gchoice_25_5_1">
<input class="gfield-choice-input" name="input_5.1" type="checkbox" value="BE" id="choice_25_5_1">
<label for="choice_25_5_1" id="label_25_5_1">BE</label>
</div>
<div class="gchoice gchoice_25_5_2">
<input class="gfield-choice-input" name="input_5.2" type="checkbox" value="NL" id="choice_25_5_2">
<label for="choice_25_5_2" id="label_25_5_2">NL</label>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_25" class="gform_button button" value="Verzenden" onclick="if(window["gf_submitting_25"]){return false;} window["gf_submitting_25"]=true; "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_25"]){return false;} window["gf_submitting_25"]=true; jQuery("#gform_25").trigger("submit",[true]); }">
<input type="hidden" class="gform_hidden" name="is_submit_25" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="25">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_25" value="WyJbXSIsIjQzODkxOWNmZjhhY2M2ZDdhZTBlYjM3M2ExYWU2MzMzIl0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_25" id="gform_target_page_number_25" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_25" id="gform_source_page_number_25" value="1">
<input type="hidden" name="gform_field_values" value="">
</div><input type="hidden" name="pum_form_popup_id" value="8160">
</form>Text Content
Skip to content * NL * FR I TEL. +32 16 79 53 08 | info@equilli.com Equilli Menu * Wetenschap * Ontdek onze wetenschap * Ontdek ons verhaal * Ergonomie op maat * Ergonomische matras * Slaap Scan meting * Slaapcontract * Veilig winkelen * Blog * Matrassen * Support matras * Support + matras * Support Flex matras * Nightro reistopper * Kussens * Latex * Dons * Koudschuim * Visco * Boxsprings * Bedden * Less * Pure lattenbodem vrijstaand * Pure inleg lattenbodem Vind je winkel MAAK VRIJBLIJVEND EEN AFSPRAAK * * * Naam* * Voornaam* * Email* * Winkelpunt* Kies een winkelpuntLeuvenBoortmeerbeekKortrijkRumstBelseleBeringenDiestHasseltDendermondeWommelgemZaventemVeurneMeiseAssenHarenAmstelveenZaandamAmersfoortEindhovenZevenhuizenOverijseLeeuwardenGentLinkebeekTernatNinove * Tel* * Bericht* Contacteer mij om een afspraak te maken voor een vrijblijvende Sleep Scan. * * Comments This field is for validation purposes and should be left unchanged. IN 3 STAPPEN NAAR UW UNIEKE MATRAS 1. PERSOONLIJK GESPREK Onze goed opgeleide slaapadviseurs gaan eerst met u in gesprek om u zo goed mogelijk verder te kunnen helpen. 2. SLEEP SCAN De Personal Sleep Scan meet uw indrukkingsprofiel en berekent welke ondersteuning u nodig heeft ter hoogte van schouders, taille en heup. 3. PROEFLIGGEN EN ADVIES Uw slaapadviseur stelt ter plekke uw matras samen, zodat u uitgebreid kan testliggen en zelf de verschillende comfortopties uitproberen. VEILIG WINKELEN BIJ EQUILLI Omdat slaapadvies op maat een rustige en veilige omgeving vereist hebben al onze verkooppunten de nodige voorzorgsmaatregelen genomen ter bescherming tegen het coronavirus. Klik hieronder voor meer info. Lees meer over onze maatregelen Equilli NV Loobeekstraat 6 3190 Boortmeerbeek E-mail: info@equilli.com * Facebook * LinkedIn * Twitter * Onderhoud * Garantie * Disclaimer * Veelgestelde vragen * Dossier ergonomisch slapen * Blog SCHRIJF JE IN OP ONZE NIEUWSBRIEF * * * E-mailadres * CAPTCHA * * Email This field is for validation purposes and should be left unchanged. Voornaam * Achternaam * Email * Postcode * Ik woon in.. *(Required) BE NL × DOWNLOAD ASSET - GEZONDSLAPEN 10 tips om gezond te slapen downloads Voornaam * Achternaam * Email * Postcode * Ik woon in.. * BE NL × DOWNLOAD ASSET - ERGONOMIEGIDS 10 tips om gezond te slapen downloads Voornaam * Achternaam * Email * Postcode * Ik woon in.. * BE NL × Notificaties