www.pfizer.nl
Open in
urlscan Pro
2606:4700:4400::ac40:91dc
Public Scan
Submitted URL: https://herkenamyloidose.pfizerpro.nl/
Effective URL: https://www.pfizer.nl/herkenamyloidose
Submission: On February 24 via api from US — Scanned from US
Effective URL: https://www.pfizer.nl/herkenamyloidose
Submission: On February 24 via api from US — Scanned from US
Form analysis 11 forms found in the DOM
POST /herkenamyloidose
<form
class="webform-submission-form webform-submission-add-form webform-submission-magazine-borstkanker-form webform-submission-magazine-borstkanker-add-form webform-submission-magazine-borstkanker-paragraph-136481-form webform-submission-magazine-borstkanker-paragraph-136481-add-form js-webform-details-toggle webform-details-toggle"
data-drupal-selector="webform-submission-magazine-borstkanker-paragraph-136481-add-form" action="/herkenamyloidose" method="post" id="webform-submission-magazine-borstkanker-paragraph-136481-add-form" accept-charset="UTF-8"
data-once="form-updated webform-details-toggle"
data-drupal-form-fields="edit-initialen,edit-achternaam,edit-adres,edit-postcode,edit-instellingsnaam,edit-persoonlijk-e-mailadres,edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma-1,edit-ja-ik-geef-toestemming-1,edit-actions-submit,edit-url">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-initialen js-form-item-initialen">
<label for="edit-initialen" class="js-form-required form-required">Initialen</label>
<input data-drupal-selector="edit-initialen" data-msg-required="Initialen field is required." data-msg-maxlength="Initialen field has a maximum length of 255." type="text" id="edit-initialen" name="initialen" value="" size="60" maxlength="255"
class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-achternaam js-form-item-achternaam">
<label for="edit-achternaam" class="js-form-required form-required">Achternaam</label>
<input data-drupal-selector="edit-achternaam" data-msg-required="Achternaam field is required." data-msg-maxlength="Achternaam field has a maximum length of 255." type="text" id="edit-achternaam" name="achternaam" value="" size="60"
maxlength="255" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres js-form-item-adres">
<label for="edit-adres" class="js-form-required form-required">Adres</label>
<input data-drupal-selector="edit-adres" data-msg-required="Adres field is required." data-msg-maxlength="Adres field has a maximum length of 255." type="text" id="edit-adres" name="adres" value="" size="60" maxlength="255"
class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-postcode js-form-item-postcode">
<label for="edit-postcode" class="js-form-required form-required">Postcode en plaats</label>
<input data-drupal-selector="edit-postcode" data-msg-required="Postcode en plaats field is required." data-msg-maxlength="Postcode en plaats field has a maximum length of 255." type="text" id="edit-postcode" name="postcode" value="" size="60"
maxlength="255" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-instellingsnaam js-form-item-instellingsnaam">
<label for="edit-instellingsnaam" class="js-form-required form-required">Instellingsnaam / ziekenhuis</label>
<input data-drupal-selector="edit-instellingsnaam" data-msg-required="Instellingsnaam / ziekenhuis field is required." data-msg-maxlength="Instellingsnaam / ziekenhuis field has a maximum length of 255." type="text" id="edit-instellingsnaam"
name="instellingsnaam" value="" size="60" maxlength="255" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-email form-item-persoonlijk-e-mailadres js-form-item-persoonlijk-e-mailadres">
<label for="edit-persoonlijk-e-mailadres" class="js-form-required form-required">Persoonlijk e-mailadres</label>
<input data-drupal-selector="edit-persoonlijk-e-mailadres" data-msg-required="Persoonlijk e-mailadres field is required." data-msg-email="Persoonlijk e-mailadres does not contain a valid email."
data-msg-maxlength="Persoonlijk e-mailadres field has a maximum length of 254." type="email" id="edit-persoonlijk-e-mailadres" name="persoonlijk_e_mailadres" value="" size="60" maxlength="254" class="form-email required" required="required"
aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<fieldset data-drupal-selector="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma" id="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma--wrapper"
class="radios--wrapper fieldgroup form-composite webform-composite-hidden-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper" data-once="webform-radios-required">
<legend id="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma--wrapper-legend">
<span class="visually-hidden fieldset-legend">Ik meld mij tevens aan voor het Roze Olifant programma</span>
</legend>
<div class="fieldset-wrapper">
<div id="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma" class="js-webform-radios webform-options-display-one-column">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-radio form-item-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma js-form-item-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma">
<input data-drupal-selector="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma-1" type="radio" id="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma-1" name="ik_meld_mij_tevens_aan_voor_het_roze_olifant_programma"
value="1" class="form-radio" data-hj-suppress="">
<label for="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma-1" class="option">Ik meld mij tevens aan voor het Roze Olifant programma</label>
</div>
</div>
</div>
</fieldset>
<fieldset data-drupal-selector="edit-ja-ik-geef-toestemming-" id="edit-ja-ik-geef-toestemming---wrapper"
class="radios--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper" data-once="webform-radios-required">
<legend id="edit-ja-ik-geef-toestemming---wrapper-legend">
<span class="fieldset-legend">Indien ik dit nog niet heb gedaan, geef ik Pfizer toestemming om mijn e-mailadres te gebruiken om mij waardevolle informatie over evenementen en wetenschappelijke en gezondheidsgerelateerde informatie op basis van
mijn specialiteit en belangen toe te sturen. Meer informatie over het gebruik van uw gegevens vind u in onze
<a href="https://privacycenter.pfizer.com/nl/netherlands" target="_blank" class="ext" data-extlink="" rel="noopener" data-pfa-listener-click="1" sc:linkname="content|navigation|privacy verklaring(externe link)">Privacy verklaring<svg focusable="false" class="ext" role="img" aria-label="(externe link)" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 80 40"><metadata><sfw xmlns="http://ns.adobe.com/SaveForWeb/1.0/"><slicesourcebounds y="-8160" x="-8165" width="16389" height="16384" bottomleftorigin="true"></slicesourcebounds><optimizationsettings><targetsettings targetsettingsid="0" fileformat="PNG24Format"><png24format transparency="true" filtered="false" interlaced="false" nomattecolor="false" mattecolor="#FFFFFF"></png24format></targetsettings></optimizationsettings></sfw></metadata><title>(externe link)</title><path d="M48 26c-1.1 0-2 0.9-2 2v26H10V18h26c1.1 0 2-0.9 2-2s-0.9-2-2-2H8c-1.1 0-2 0.9-2 2v40c0 1.1 0.9 2 2 2h40c1.1 0 2-0.9 2-2V28C50 26.9 49.1 26 48 26z"></path><path d="M56 6H44c-1.1 0-2 0.9-2 2s0.9 2 2 2h7.2L30.6 30.6c-0.8 0.8-0.8 2 0 2.8C31 33.8 31.5 34 32 34s1-0.2 1.4-0.6L54 12.8V20c0 1.1 0.9 2 2 2s2-0.9 2-2V8C58 6.9 57.1 6 56 6z"></path></svg></a>.</span>
</legend>
<div class="fieldset-wrapper">
<div id="edit-ja-ik-geef-toestemming-" class="js-webform-radios webform-options-display-one-column">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-radio form-item-ja-ik-geef-toestemming- js-form-item-ja-ik-geef-toestemming-">
<input data-drupal-selector="edit-ja-ik-geef-toestemming-1" type="radio" id="edit-ja-ik-geef-toestemming-1" name="ja_ik_geef_toestemming_" value="1" class="form-radio" data-hj-suppress="">
<label for="edit-ja-ik-geef-toestemming-1" class="option">ja, ik geef toestemming.</label>
</div>
</div>
</div>
</fieldset>
<div data-drupal-selector="edit-captcha" class="captcha captcha-type-challenge--recaptcha">
<div class="captcha__element">
<input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="670905919" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="dlDiXIiXk1gzA23mkdj7w69jIXucfH5QJlDWDQG4z-I" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" data-hj-suppress="">
<div class="g-recaptcha" data-sitekey="6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0" data-theme="light" data-type="image">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-sfx9iwqp6hpd" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0&co=aHR0cHM6Ly93d3cucGZpemVyLm5sOjQ0Mw..&hl=nl&type=image&v=1kRDYC3bfA-o6-tsWzIBvp7k&theme=light&size=normal&cb=juoqtj5vepf4"></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><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" data-hj-suppress="">
</div>
<div class="captcha__description description">Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen.</div>
</div>
<div data-drupal-selector="edit-actions" class="form-actions webform-actions js-form-wrapper form-wrapper" id="edit-actions"><input class="webform-button--submit button button--primary js-form-submit form-submit"
data-drupal-selector="edit-actions-submit" type="submit" id="edit-actions-submit" name="op" value="Verzenden" data-hj-suppress="" data-pfa-listener-click="1">
</div>
<input autocomplete="off" data-drupal-selector="form-ohet-mndetfloicdoz-o0o18n7zvpel0dax2-zdo4vm" type="hidden" name="form_build_id" value="form-OHEt_mNdeTFloicdoZ-O0O18n7zVPEl0daX2_zDo4VM" data-hj-suppress="">
<input data-drupal-selector="edit-webform-submission-magazine-borstkanker-paragraph-136481-add-form" type="hidden" name="form_id" value="webform_submission_magazine_borstkanker_paragraph_136481_add_form" data-hj-suppress="">
<div class="url-textfield js-form-wrapper form-wrapper" style="display: none !important;">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-url js-form-item-url">
<label for="edit-url">Leave this field blank</label>
<input autocomplete="off" data-drupal-selector="edit-url" data-msg-maxlength="Leave this field blank field has a maximum length of 128." type="text" id="edit-url" name="url" value="" size="20" maxlength="128" class="form-text"
data-hj-suppress="">
</div>
</div>
</form>POST /herkenamyloidose
<form
class="webform-submission-form webform-submission-add-form webform-submission-toolbox-and-program-form webform-submission-toolbox-and-program-add-form webform-submission-toolbox-and-program-paragraph-136506-form webform-submission-toolbox-and-program-paragraph-136506-add-form js-webform-details-toggle webform-details-toggle"
data-drupal-selector="webform-submission-toolbox-and-program-paragraph-136506-add-form" action="/herkenamyloidose" method="post" id="webform-submission-toolbox-and-program-paragraph-136506-add-form" accept-charset="UTF-8"
data-once="form-updated webform-details-toggle"
data-drupal-form-fields="edit-initialen--2,edit-achternaam--2,edit-adres--2,edit-postcode--2,edit-instellingsnaam--2,edit-persoonlijk-e-mailadres--2,edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn,edit-persoonlijk-werkboekje-roze-olifant,edit-werkmap-roze-olifant,edit-visitekaartjes-deherontdekkingvanhaarzelf-nl,edit-setje-conversatiestarters,edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma-1--2,edit-ja-ik-geef-toestemming-1--2,edit-actions-submit--2,edit-url--2">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-initialen js-form-item-initialen">
<label for="edit-initialen--2" class="js-form-required form-required">Initialen</label>
<input data-drupal-selector="edit-initialen" data-msg-required="Initialen field is required." data-msg-maxlength="Initialen field has a maximum length of 255." type="text" id="edit-initialen--2" name="initialen" value="" size="60" maxlength="255"
class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-achternaam js-form-item-achternaam">
<label for="edit-achternaam--2" class="js-form-required form-required">Achternaam</label>
<input data-drupal-selector="edit-achternaam" data-msg-required="Achternaam field is required." data-msg-maxlength="Achternaam field has a maximum length of 255." type="text" id="edit-achternaam--2" name="achternaam" value="" size="60"
maxlength="255" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres js-form-item-adres">
<label for="edit-adres--2" class="js-form-required form-required">Adres</label>
<input data-drupal-selector="edit-adres" data-msg-required="Adres field is required." data-msg-maxlength="Adres field has a maximum length of 255." type="text" id="edit-adres--2" name="adres" value="" size="60" maxlength="255"
class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-postcode js-form-item-postcode">
<label for="edit-postcode--2" class="js-form-required form-required">Postcode en plaats</label>
<input data-drupal-selector="edit-postcode" data-msg-required="Postcode en plaats field is required." data-msg-maxlength="Postcode en plaats field has a maximum length of 255." type="text" id="edit-postcode--2" name="postcode" value="" size="60"
maxlength="255" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-instellingsnaam js-form-item-instellingsnaam">
<label for="edit-instellingsnaam--2" class="js-form-required form-required">Instellingsnaam / ziekenhuis</label>
<input data-drupal-selector="edit-instellingsnaam" data-msg-required="Instellingsnaam / ziekenhuis field is required." data-msg-maxlength="Instellingsnaam / ziekenhuis field has a maximum length of 255." type="text" id="edit-instellingsnaam--2"
name="instellingsnaam" value="" size="60" maxlength="255" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-email form-item-persoonlijk-e-mailadres js-form-item-persoonlijk-e-mailadres">
<label for="edit-persoonlijk-e-mailadres--2" class="js-form-required form-required">Persoonlijk e-mailadres</label>
<input data-drupal-selector="edit-persoonlijk-e-mailadres" data-msg-required="Persoonlijk e-mailadres field is required." data-msg-email="Persoonlijk e-mailadres does not contain a valid email."
data-msg-maxlength="Persoonlijk e-mailadres field has a maximum length of 254." type="email" id="edit-persoonlijk-e-mailadres--2" name="persoonlijk_e_mailadres" value="" size="60" maxlength="254" class="form-email required" required="required"
aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-select form-item-brochure-seksualiteit-bij-borstkanker-van-de-bvn js-form-item-brochure-seksualiteit-bij-borstkanker-van-de-bvn">
<label for="edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn">Brochure seksualiteit bij borstkanker van de BVN</label>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="js-webform-choices webform-choices form-select choices__input" data-drupal-selector="edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn" id="edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn"
name="brochure_seksualiteit_bij_borstkanker_van_de_bvn" data-once="webform-choices" hidden="" tabindex="-1" data-choice="active">
<option value="">- Geen -</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">- Geen -</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="- Geen -" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice=""
data-id="1" data-value="" data-select-text="Press to select" data-choice-selectable="" aria-selected="true">- Geen -</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="1"
data-select-text="Press to select" data-choice-selectable="">1</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="2"
data-select-text="Press to select" data-choice-selectable="">2</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="3"
data-select-text="Press to select" data-choice-selectable="">3</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="4"
data-select-text="Press to select" data-choice-selectable="">4</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="5"
data-select-text="Press to select" data-choice-selectable="">5</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="6"
data-select-text="Press to select" data-choice-selectable="">6</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="7"
data-select-text="Press to select" data-choice-selectable="">7</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="8"
data-select-text="Press to select" data-choice-selectable="">8</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="9"
data-select-text="Press to select" data-choice-selectable="">9</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="10"
data-select-text="Press to select" data-choice-selectable="">10</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-12" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="12" data-value="11"
data-select-text="Press to select" data-choice-selectable="">11</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-13" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="13" data-value="12"
data-select-text="Press to select" data-choice-selectable="">12</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-14" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="14" data-value="13"
data-select-text="Press to select" data-choice-selectable="">13</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-15" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="15" data-value="14"
data-select-text="Press to select" data-choice-selectable="">14</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-16" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="16" data-value="15"
data-select-text="Press to select" data-choice-selectable="">15</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-17" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="17" data-value="16"
data-select-text="Press to select" data-choice-selectable="">16</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-18" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="18" data-value="17"
data-select-text="Press to select" data-choice-selectable="">17</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-19" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="19" data-value="18"
data-select-text="Press to select" data-choice-selectable="">18</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-20" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="20" data-value="19"
data-select-text="Press to select" data-choice-selectable="">19</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn-item-choice-21" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="21" data-value="20"
data-select-text="Press to select" data-choice-selectable="">20</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-select form-item-persoonlijk-werkboekje-roze-olifant js-form-item-persoonlijk-werkboekje-roze-olifant">
<label for="edit-persoonlijk-werkboekje-roze-olifant">Persoonlijk werkboekje Roze Olifant</label>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="js-webform-choices webform-choices form-select choices__input" data-drupal-selector="edit-persoonlijk-werkboekje-roze-olifant" id="edit-persoonlijk-werkboekje-roze-olifant"
name="persoonlijk_werkboekje_roze_olifant" data-once="webform-choices" hidden="" tabindex="-1" data-choice="active">
<option value="">- Geen -</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">- Geen -</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="- Geen -" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1"
data-value="" data-select-text="Press to select" data-choice-selectable="" aria-selected="true">- Geen -</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="1" data-select-text="Press to select"
data-choice-selectable="">1</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="2" data-select-text="Press to select"
data-choice-selectable="">2</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="3" data-select-text="Press to select"
data-choice-selectable="">3</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="4" data-select-text="Press to select"
data-choice-selectable="">4</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="5" data-select-text="Press to select"
data-choice-selectable="">5</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="6" data-select-text="Press to select"
data-choice-selectable="">6</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="7" data-select-text="Press to select"
data-choice-selectable="">7</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="8" data-select-text="Press to select"
data-choice-selectable="">8</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="9" data-select-text="Press to select"
data-choice-selectable="">9</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="10" data-select-text="Press to select"
data-choice-selectable="">10</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-12" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="12" data-value="11" data-select-text="Press to select"
data-choice-selectable="">11</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-13" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="13" data-value="12" data-select-text="Press to select"
data-choice-selectable="">12</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-14" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="14" data-value="13" data-select-text="Press to select"
data-choice-selectable="">13</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-15" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="15" data-value="14" data-select-text="Press to select"
data-choice-selectable="">14</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-16" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="16" data-value="15" data-select-text="Press to select"
data-choice-selectable="">15</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-17" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="17" data-value="16" data-select-text="Press to select"
data-choice-selectable="">16</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-18" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="18" data-value="17" data-select-text="Press to select"
data-choice-selectable="">17</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-19" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="19" data-value="18" data-select-text="Press to select"
data-choice-selectable="">18</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-20" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="20" data-value="19" data-select-text="Press to select"
data-choice-selectable="">19</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant-item-choice-21" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="21" data-value="20" data-select-text="Press to select"
data-choice-selectable="">20</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-select form-item-werkmap-roze-olifant js-form-item-werkmap-roze-olifant">
<label for="edit-werkmap-roze-olifant">Werkmap Roze Olifant</label>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="js-webform-choices webform-choices form-select choices__input" data-drupal-selector="edit-werkmap-roze-olifant" id="edit-werkmap-roze-olifant" name="werkmap_roze_olifant" data-once="webform-choices"
hidden="" tabindex="-1" data-choice="active">
<option value="">- Geen -</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">- Geen -</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="- Geen -" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--edit-werkmap-roze-olifant-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1" data-value=""
data-select-text="Press to select" data-choice-selectable="" aria-selected="true">- Geen -</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="1" data-select-text="Press to select"
data-choice-selectable="">1</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="2" data-select-text="Press to select"
data-choice-selectable="">2</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="3" data-select-text="Press to select"
data-choice-selectable="">3</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="4" data-select-text="Press to select"
data-choice-selectable="">4</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="5" data-select-text="Press to select"
data-choice-selectable="">5</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="6" data-select-text="Press to select"
data-choice-selectable="">6</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="7" data-select-text="Press to select"
data-choice-selectable="">7</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="8" data-select-text="Press to select"
data-choice-selectable="">8</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="9" data-select-text="Press to select"
data-choice-selectable="">9</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="10" data-select-text="Press to select"
data-choice-selectable="">10</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-12" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="12" data-value="11" data-select-text="Press to select"
data-choice-selectable="">11</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-13" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="13" data-value="12" data-select-text="Press to select"
data-choice-selectable="">12</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-14" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="14" data-value="13" data-select-text="Press to select"
data-choice-selectable="">13</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-15" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="15" data-value="14" data-select-text="Press to select"
data-choice-selectable="">14</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-16" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="16" data-value="15" data-select-text="Press to select"
data-choice-selectable="">15</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-17" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="17" data-value="16" data-select-text="Press to select"
data-choice-selectable="">16</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-18" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="18" data-value="17" data-select-text="Press to select"
data-choice-selectable="">17</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-19" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="19" data-value="18" data-select-text="Press to select"
data-choice-selectable="">18</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-20" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="20" data-value="19" data-select-text="Press to select"
data-choice-selectable="">19</div>
<div id="choices--edit-werkmap-roze-olifant-item-choice-21" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="21" data-value="20" data-select-text="Press to select"
data-choice-selectable="">20</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-select form-item-visitekaartjes-deherontdekkingvanhaarzelf-nl js-form-item-visitekaartjes-deherontdekkingvanhaarzelf-nl">
<label for="edit-visitekaartjes-deherontdekkingvanhaarzelf-nl">Visitekaartjes deherontdekkingvanhaarzelf.nl</label>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="js-webform-choices webform-choices form-select choices__input" data-drupal-selector="edit-visitekaartjes-deherontdekkingvanhaarzelf-nl" id="edit-visitekaartjes-deherontdekkingvanhaarzelf-nl"
name="visitekaartjes_deherontdekkingvanhaarzelf_nl" data-once="webform-choices" hidden="" tabindex="-1" data-choice="active">
<option value="">- Geen -</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">- Geen -</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="- Geen -" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice=""
data-id="1" data-value="" data-select-text="Press to select" data-choice-selectable="" aria-selected="true">- Geen -</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="1"
data-select-text="Press to select" data-choice-selectable="">1</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="2"
data-select-text="Press to select" data-choice-selectable="">2</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="3"
data-select-text="Press to select" data-choice-selectable="">3</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="4"
data-select-text="Press to select" data-choice-selectable="">4</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="5"
data-select-text="Press to select" data-choice-selectable="">5</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="6"
data-select-text="Press to select" data-choice-selectable="">6</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="7"
data-select-text="Press to select" data-choice-selectable="">7</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="8"
data-select-text="Press to select" data-choice-selectable="">8</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="9"
data-select-text="Press to select" data-choice-selectable="">9</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="10"
data-select-text="Press to select" data-choice-selectable="">10</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-12" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="12" data-value="11"
data-select-text="Press to select" data-choice-selectable="">11</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-13" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="13" data-value="12"
data-select-text="Press to select" data-choice-selectable="">12</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-14" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="14" data-value="13"
data-select-text="Press to select" data-choice-selectable="">13</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-15" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="15" data-value="14"
data-select-text="Press to select" data-choice-selectable="">14</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-16" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="16" data-value="15"
data-select-text="Press to select" data-choice-selectable="">15</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-17" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="17" data-value="16"
data-select-text="Press to select" data-choice-selectable="">16</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-18" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="18" data-value="17"
data-select-text="Press to select" data-choice-selectable="">17</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-19" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="19" data-value="18"
data-select-text="Press to select" data-choice-selectable="">18</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-20" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="20" data-value="19"
data-select-text="Press to select" data-choice-selectable="">19</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl-item-choice-21" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="21" data-value="20"
data-select-text="Press to select" data-choice-selectable="">20</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-select form-item-setje-conversatiestarters js-form-item-setje-conversatiestarters">
<label for="edit-setje-conversatiestarters">Setje conversatiestarters</label>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="js-webform-choices webform-choices form-select choices__input" data-drupal-selector="edit-setje-conversatiestarters" id="edit-setje-conversatiestarters" name="setje_conversatiestarters"
data-once="webform-choices" hidden="" tabindex="-1" data-choice="active">
<option value="">- Geen -</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">- Geen -</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="- Geen -" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--edit-setje-conversatiestarters-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1" data-value=""
data-select-text="Press to select" data-choice-selectable="" aria-selected="true">- Geen -</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="1" data-select-text="Press to select"
data-choice-selectable="">1</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="2" data-select-text="Press to select"
data-choice-selectable="">2</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="3" data-select-text="Press to select"
data-choice-selectable="">3</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="4" data-select-text="Press to select"
data-choice-selectable="">4</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="5" data-select-text="Press to select"
data-choice-selectable="">5</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="6" data-select-text="Press to select"
data-choice-selectable="">6</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="7" data-select-text="Press to select"
data-choice-selectable="">7</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="8" data-select-text="Press to select"
data-choice-selectable="">8</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="9" data-select-text="Press to select"
data-choice-selectable="">9</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="10" data-select-text="Press to select"
data-choice-selectable="">10</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-12" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="12" data-value="11" data-select-text="Press to select"
data-choice-selectable="">11</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-13" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="13" data-value="12" data-select-text="Press to select"
data-choice-selectable="">12</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-14" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="14" data-value="13" data-select-text="Press to select"
data-choice-selectable="">13</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-15" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="15" data-value="14" data-select-text="Press to select"
data-choice-selectable="">14</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-16" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="16" data-value="15" data-select-text="Press to select"
data-choice-selectable="">15</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-17" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="17" data-value="16" data-select-text="Press to select"
data-choice-selectable="">16</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-18" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="18" data-value="17" data-select-text="Press to select"
data-choice-selectable="">17</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-19" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="19" data-value="18" data-select-text="Press to select"
data-choice-selectable="">18</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-20" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="20" data-value="19" data-select-text="Press to select"
data-choice-selectable="">19</div>
<div id="choices--edit-setje-conversatiestarters-item-choice-21" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="21" data-value="20" data-select-text="Press to select"
data-choice-selectable="">20</div>
</div>
</div>
</div>
</div>
<fieldset data-drupal-selector="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma" id="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma--2--wrapper"
class="radios--wrapper fieldgroup form-composite webform-composite-hidden-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper" data-once="webform-radios-required">
<legend id="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma--2--wrapper-legend">
<span class="visually-hidden fieldset-legend">Ik meld mij tevens aan voor het Roze Olifant programma</span>
</legend>
<div class="fieldset-wrapper">
<div id="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma--2" class="js-webform-radios webform-options-display-one-column">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-radio form-item-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma js-form-item-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma">
<input data-drupal-selector="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma-1-2" type="radio" id="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma-1--2" name="ik_meld_mij_tevens_aan_voor_het_roze_olifant_programma"
value="1" class="form-radio" data-hj-suppress="">
<label for="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma-1--2" class="option">Ik meld mij tevens aan voor het Roze Olifant programma</label>
</div>
</div>
</div>
</fieldset>
<fieldset data-drupal-selector="edit-ja-ik-geef-toestemming-" id="edit-ja-ik-geef-toestemming---2--wrapper"
class="radios--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper" data-once="webform-radios-required">
<legend id="edit-ja-ik-geef-toestemming---2--wrapper-legend">
<span class="fieldset-legend">Indien ik dit nog niet heb gedaan, geef ik Pfizer toestemming om mijn e-mailadres te gebruiken om mij waardevolle informatie over evenementen en wetenschappelijke en gezondheidsgerelateerde informatie op basis van
mijn specialiteit en belangen toe te sturen. Meer informatie over het gebruik van uw gegevens vind u in onze
<a href="https://privacycenter.pfizer.com/nl/netherlands" target="_blank" class="ext" data-extlink="" rel="noopener" data-pfa-listener-click="1" sc:linkname="content|navigation|privacy verklaring(externe link)">Privacy verklaring<svg focusable="false" class="ext" role="img" aria-label="(externe link)" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 80 40"><metadata><sfw xmlns="http://ns.adobe.com/SaveForWeb/1.0/"><slicesourcebounds y="-8160" x="-8165" width="16389" height="16384" bottomleftorigin="true"></slicesourcebounds><optimizationsettings><targetsettings targetsettingsid="0" fileformat="PNG24Format"><png24format transparency="true" filtered="false" interlaced="false" nomattecolor="false" mattecolor="#FFFFFF"></png24format></targetsettings></optimizationsettings></sfw></metadata><title>(externe link)</title><path d="M48 26c-1.1 0-2 0.9-2 2v26H10V18h26c1.1 0 2-0.9 2-2s-0.9-2-2-2H8c-1.1 0-2 0.9-2 2v40c0 1.1 0.9 2 2 2h40c1.1 0 2-0.9 2-2V28C50 26.9 49.1 26 48 26z"></path><path d="M56 6H44c-1.1 0-2 0.9-2 2s0.9 2 2 2h7.2L30.6 30.6c-0.8 0.8-0.8 2 0 2.8C31 33.8 31.5 34 32 34s1-0.2 1.4-0.6L54 12.8V20c0 1.1 0.9 2 2 2s2-0.9 2-2V8C58 6.9 57.1 6 56 6z"></path></svg></a>.</span>
</legend>
<div class="fieldset-wrapper">
<div id="edit-ja-ik-geef-toestemming---2" class="js-webform-radios webform-options-display-one-column">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-radio form-item-ja-ik-geef-toestemming- js-form-item-ja-ik-geef-toestemming-">
<input data-drupal-selector="edit-ja-ik-geef-toestemming-1-2" type="radio" id="edit-ja-ik-geef-toestemming-1--2" name="ja_ik_geef_toestemming_" value="1" class="form-radio" data-hj-suppress="">
<label for="edit-ja-ik-geef-toestemming-1--2" class="option">ja, ik geef toestemming.</label>
</div>
</div>
</div>
</fieldset>
<div data-drupal-selector="edit-captcha" class="captcha captcha-type-challenge--recaptcha">
<div class="captcha__element">
<input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="670905920" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="ikzjrmd6A02lhITEzn5nrrVONSCz5mjf0RNmPSUKzd4" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" data-hj-suppress="">
<div class="g-recaptcha" data-sitekey="6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0" data-theme="light" data-type="image">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-vl5ejl75x5ge" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0&co=aHR0cHM6Ly93d3cucGZpemVyLm5sOjQ0Mw..&hl=nl&type=image&v=1kRDYC3bfA-o6-tsWzIBvp7k&theme=light&size=normal&cb=khgs92q8ijcu"></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>
</div><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" data-hj-suppress="">
</div>
<div class="captcha__description description">Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen.</div>
</div>
<div data-drupal-selector="edit-actions" class="form-actions webform-actions js-form-wrapper form-wrapper" id="edit-actions--3"><input class="webform-button--submit button button--primary js-form-submit form-submit"
data-drupal-selector="edit-actions-submit-2" type="submit" id="edit-actions-submit--2" name="op" value="Verzenden" data-hj-suppress="" data-pfa-listener-click="1">
</div>
<input autocomplete="off" data-drupal-selector="form-uwar5tmekw2fk0wz4gw3qqzury2mefz3fc8eyk-pzxg" type="hidden" name="form_build_id" value="form-uwAr5TmEkw2FK0Wz4gw3qQzuRy2MEfZ3fC8EYk_PZxg" data-hj-suppress="">
<input data-drupal-selector="edit-webform-submission-toolbox-and-program-paragraph-136506-add-form" type="hidden" name="form_id" value="webform_submission_toolbox_and_program_paragraph_136506_add_form" data-hj-suppress="">
<div class="url-textfield js-form-wrapper form-wrapper" style="display: none !important;">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-url js-form-item-url">
<label for="edit-url--2">Leave this field blank</label>
<input autocomplete="off" data-drupal-selector="edit-url" data-msg-maxlength="Leave this field blank field has a maximum length of 128." type="text" id="edit-url--2" name="url" value="" size="20" maxlength="128" class="form-text"
data-hj-suppress="">
</div>
</div>
</form>POST /poll/131?destination=/herkenamyloidose
<form class="poll-view-form-131 poll-view-form" data-drupal-selector="poll-view-form-131" action="/poll/131?destination=/herkenamyloidose" method="post" id="poll-view-form-131" accept-charset="UTF-8" data-once="form-updated"
data-drupal-form-fields="edit-choice-386,edit-choice-391,edit-choice-396,edit-choice-401,edit-choice-406,edit-vote">
<div class="poll">
<div class="vote-form">
<h3 class="poll-question">Stelling: Angiogenese en het immuunsysteem zijn beide belangrijke pathways in RCC</h3>
<div class="poll-description">
</div>
<fieldset data-drupal-selector="edit-choice" id="edit-choice--wrapper" class="fieldgroup form-composite js-form-item form-item js-form-wrapper form-wrapper">
<legend>
<span class="visually-hidden fieldset-legend">Choices</span>
</legend>
<div class="fieldset-wrapper">
<div id="edit-choice">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-radio form-item-choice js-form-item-choice">
<input data-drupal-selector="edit-choice-386" type="radio" id="edit-choice-386" name="choice" value="386" class="form-radio" data-hj-suppress="">
<label for="edit-choice-386" class="option">Geheel mee eens</label>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-radio form-item-choice js-form-item-choice">
<input data-drupal-selector="edit-choice-391" type="radio" id="edit-choice-391" name="choice" value="391" class="form-radio" data-hj-suppress="">
<label for="edit-choice-391" class="option">Gedeeltelijk mee eens, angiogenese is belangrijker dan het immuunsysteem</label>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-radio form-item-choice js-form-item-choice">
<input data-drupal-selector="edit-choice-396" type="radio" id="edit-choice-396" name="choice" value="396" class="form-radio" data-hj-suppress="">
<label for="edit-choice-396" class="option">Gedeeltelijk mee eens, het immuunsysteem is belangrijker dan angiogenese</label>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-radio form-item-choice js-form-item-choice">
<input data-drupal-selector="edit-choice-401" type="radio" id="edit-choice-401" name="choice" value="401" class="form-radio" data-hj-suppress="">
<label for="edit-choice-401" class="option">Gedeeltelijk mee eens, het verschilt per patiënt welk proces het belangrijkste is</label>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-radio form-item-choice js-form-item-choice">
<input data-drupal-selector="edit-choice-406" type="radio" id="edit-choice-406" name="choice" value="406" class="form-radio" data-hj-suppress="">
<label for="edit-choice-406" class="option">Oneens, er zijn nog veel meer pathways die net zo belangrijk zijn</label>
</div>
</div>
</div>
</fieldset>
<div data-drupal-selector="edit-actions" class="form-actions js-form-wrapper form-wrapper" id="edit-actions--19"><input data-drupal-selector="edit-vote" type="submit" id="edit-vote" name="op" value="Stem"
class="button button--primary js-form-submit form-submit" data-hj-suppress="" data-once="drupal-ajax" data-pfa-listener-click="1">
</div>
</div>
<input autocomplete="off" data-drupal-selector="form-5osefvxvtakuy6a4vjgeuqb3skzwzdmln9mn2wu9eja" type="hidden" name="form_build_id" value="form-5OSeFVXvTAKuy6A4VJGEUqb3SKzwzDMln9Mn2wu9EjA" data-hj-suppress="">
<input data-drupal-selector="edit-poll-view-form-131" type="hidden" name="form_id" value="poll_view_form_131" data-hj-suppress="">
</div>
</form>POST /herkenamyloidose
<form
class="webform-submission-form webform-submission-add-form webform-submission-workshop-vermoeidheid-bij-kanker-form webform-submission-workshop-vermoeidheid-bij-kanker-add-form webform-submission-workshop-vermoeidheid-bij-kanker-paragraph-148266-form webform-submission-workshop-vermoeidheid-bij-kanker-paragraph-148266-add-form js-webform-details-toggle webform-details-toggle"
autocomplete="off" data-drupal-selector="webform-submission-workshop-vermoeidheid-bij-kanker-paragraph-148266-add-form" action="/herkenamyloidose" method="post" id="webform-submission-workshop-vermoeidheid-bij-kanker-paragraph-148266-add-form"
accept-charset="UTF-8" data-once="form-updated webform-details-toggle"
data-drupal-form-fields="edit-voorletter-s-,edit-achternaam--3,edit-instellingsnaam-ziekenhuis,edit-persoonlijk-e-mailadres--3,edit-telefoonnummer,edit-indien-ik-dit-nog-niet-heb-gedaan-geef-ik-pfizer-toestemming-om-1,edit-submit--3,edit-url--3">
<label data-drupal-selector="edit-algemene-gegevens" for="edit-algemene-gegevens">Algemene gegevens</label>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-voorletter-s- js-form-item-voorletter-s-">
<label for="edit-voorletter-s-" class="js-form-required form-required">Voorletter(s)</label>
<input data-drupal-selector="edit-voorletter-s-" data-msg-required="Voorletter(s) field is required." data-msg-maxlength="Voorletter(s) field has a maximum length of 255." type="text" id="edit-voorletter-s-" name="voorletter_s_" value=""
size="60" maxlength="255" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-achternaam js-form-item-achternaam">
<label for="edit-achternaam--3" class="js-form-required form-required">Achternaam</label>
<input data-drupal-selector="edit-achternaam" data-msg-required="Achternaam field is required." data-msg-maxlength="Achternaam field has a maximum length of 255." type="text" id="edit-achternaam--3" name="achternaam" value="" size="60"
maxlength="255" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-instellingsnaam-ziekenhuis js-form-item-instellingsnaam-ziekenhuis">
<label for="edit-instellingsnaam-ziekenhuis" class="js-form-required form-required">Instellingsnaam / ziekenhuis</label>
<input data-drupal-selector="edit-instellingsnaam-ziekenhuis" data-msg-required="Instellingsnaam / ziekenhuis field is required." data-msg-maxlength="Instellingsnaam / ziekenhuis field has a maximum length of 255." type="text"
id="edit-instellingsnaam-ziekenhuis" name="instellingsnaam_ziekenhuis" value="" size="60" maxlength="255" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-email form-item-persoonlijk-e-mailadres js-form-item-persoonlijk-e-mailadres">
<label for="edit-persoonlijk-e-mailadres--3" class="js-form-required form-required">Persoonlijk e-mailadres</label>
<input data-drupal-selector="edit-persoonlijk-e-mailadres" data-msg-required="Persoonlijk e-mailadres field is required." data-msg-email="Persoonlijk e-mailadres does not contain a valid email."
data-msg-maxlength="Persoonlijk e-mailadres field has a maximum length of 254." type="email" id="edit-persoonlijk-e-mailadres--3" name="persoonlijk_e_mailadres" value="" size="60" maxlength="254" class="form-email required" required="required"
aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-telefoonnummer js-form-item-telefoonnummer">
<label for="edit-telefoonnummer">Telefoonnummer</label>
<input data-drupal-selector="edit-telefoonnummer" data-msg-maxlength="Telefoonnummer field has a maximum length of 255." type="text" id="edit-telefoonnummer" name="telefoonnummer" value="" size="60" maxlength="255" class="form-text"
autocomplete="off" data-hj-suppress="">
</div>
<fieldset data-drupal-selector="edit-indien-ik-dit-nog-niet-heb-gedaan-geef-ik-pfizer-toestemming-om-" id="edit-indien-ik-dit-nog-niet-heb-gedaan-geef-ik-pfizer-toestemming-om---wrapper"
class="radios--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper" data-once="webform-radios-required">
<legend id="edit-indien-ik-dit-nog-niet-heb-gedaan-geef-ik-pfizer-toestemming-om---wrapper-legend">
<span class="fieldset-legend">Indien ik dit nog niet heb gedaan, geef ik Pfizer toestemming om mijn e-mailadres te gebruiken om mij waardevolle informatie over evenementen en wetenschappelijke en gezondheidsgerelateerde informatie op basis van
mijn specialiteit en belangen toe te sturen. Meer informatie over het gebruik van uw gegevens vind u in onze
<a href="https://privacycenter.pfizer.com/nl/netherlands" class="ext" data-extlink="" target="_blank" rel="noopener" data-pfa-listener-click="1" sc:linkname="content|navigation|privacy verklaring(externe link)">Privacy verklaring<svg focusable="false" class="ext" role="img" aria-label="(externe link)" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 80 40"><metadata><sfw xmlns="http://ns.adobe.com/SaveForWeb/1.0/"><slicesourcebounds y="-8160" x="-8165" width="16389" height="16384" bottomleftorigin="true"></slicesourcebounds><optimizationsettings><targetsettings targetsettingsid="0" fileformat="PNG24Format"><png24format transparency="true" filtered="false" interlaced="false" nomattecolor="false" mattecolor="#FFFFFF"></png24format></targetsettings></optimizationsettings></sfw></metadata><title>(externe link)</title><path d="M48 26c-1.1 0-2 0.9-2 2v26H10V18h26c1.1 0 2-0.9 2-2s-0.9-2-2-2H8c-1.1 0-2 0.9-2 2v40c0 1.1 0.9 2 2 2h40c1.1 0 2-0.9 2-2V28C50 26.9 49.1 26 48 26z"></path><path d="M56 6H44c-1.1 0-2 0.9-2 2s0.9 2 2 2h7.2L30.6 30.6c-0.8 0.8-0.8 2 0 2.8C31 33.8 31.5 34 32 34s1-0.2 1.4-0.6L54 12.8V20c0 1.1 0.9 2 2 2s2-0.9 2-2V8C58 6.9 57.1 6 56 6z"></path></svg></a>.</span>
</legend>
<div class="fieldset-wrapper">
<div id="edit-indien-ik-dit-nog-niet-heb-gedaan-geef-ik-pfizer-toestemming-om-" class="js-webform-radios webform-options-display-one-column">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-radio form-item-indien-ik-dit-nog-niet-heb-gedaan-geef-ik-pfizer-toestemming-om- js-form-item-indien-ik-dit-nog-niet-heb-gedaan-geef-ik-pfizer-toestemming-om-">
<input data-drupal-selector="edit-indien-ik-dit-nog-niet-heb-gedaan-geef-ik-pfizer-toestemming-om-1" type="radio" id="edit-indien-ik-dit-nog-niet-heb-gedaan-geef-ik-pfizer-toestemming-om-1"
name="indien_ik_dit_nog_niet_heb_gedaan_geef_ik_pfizer_toestemming_om_" value="1" class="form-radio" data-hj-suppress="">
<label for="edit-indien-ik-dit-nog-niet-heb-gedaan-geef-ik-pfizer-toestemming-om-1" class="option">ja, ik geef toestemming.</label>
</div>
</div>
</div>
</fieldset>
<div data-drupal-selector="edit-captcha" class="captcha captcha-type-challenge--recaptcha">
<div class="captcha__element">
<input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="670905921" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="BJA_opTnzaYZ6Zw7-MLPQEMMQVOD8AcHx_2vPKmQFaQ" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" data-hj-suppress="">
<div class="g-recaptcha" data-sitekey="6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0" data-theme="light" data-type="image">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-7h9l546l1clq" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0&co=aHR0cHM6Ly93d3cucGZpemVyLm5sOjQ0Mw..&hl=nl&type=image&v=1kRDYC3bfA-o6-tsWzIBvp7k&theme=light&size=normal&cb=pjovdzigdmx8"></iframe>
</div><textarea id="g-recaptcha-response-2" 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><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" data-hj-suppress="">
</div>
<div class="captcha__description description">Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen.</div>
</div>
<input autocomplete="off" data-drupal-selector="form-soqmshtlkz6u01kbztgsj-y4tpaooctyhaa-bftwcoc" type="hidden" name="form_build_id" value="form-SOQMsHTlkz6u01KBztGsj_y4tpaoOctYhAa_bftwcoc" data-hj-suppress="">
<input data-drupal-selector="edit-webform-submission-workshop-vermoeidheid-bij-kanker-paragraph-148266-add-form" type="hidden" name="form_id" value="webform_submission_workshop_vermoeidheid_bij_kanker_paragraph_148266_add_form" data-hj-suppress="">
<div data-drupal-selector="edit-actions" class="form-actions js-form-wrapper form-wrapper" id="edit-actions--5"><input class="webform-button--submit button button--primary js-form-submit form-submit" data-drupal-selector="edit-submit" type="submit"
id="edit-submit--3" name="op" value="Indienen" data-hj-suppress="" data-pfa-listener-click="1">
</div>
<div class="url-textfield js-form-wrapper form-wrapper" style="display: none !important;">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-url js-form-item-url">
<label for="edit-url--3">Leave this field blank</label>
<input autocomplete="off" data-drupal-selector="edit-url" data-msg-maxlength="Leave this field blank field has a maximum length of 128." type="text" id="edit-url--3" name="url" value="" size="20" maxlength="128" class="form-text"
data-hj-suppress="">
</div>
</div>
</form>POST /herkenamyloidose
<form
class="webform-submission-form webform-submission-add-form webform-submission-eczeem-magazine-form webform-submission-eczeem-magazine-add-form webform-submission-eczeem-magazine-paragraph-148381-form webform-submission-eczeem-magazine-paragraph-148381-add-form js-webform-details-toggle webform-details-toggle"
autocomplete="off" data-drupal-selector="webform-submission-eczeem-magazine-paragraph-148381-add-form" action="/herkenamyloidose" method="post" id="webform-submission-eczeem-magazine-paragraph-148381-add-form" accept-charset="UTF-8"
data-once="form-updated webform-details-toggle"
data-drupal-form-fields="edit-last-name,edit-achternaam--4,edit-applicant-age,edit-street-name-and-house-number,edit-postal-code,edit-venue,edit-country,edit-applicant-s-personal-email-address,edit-hoe-bent-u-bekend-geraakt-met-deze-actie-,edit-submit--4,edit-url--4">
<label data-drupal-selector="edit-general-information-applicant" for="edit-general-information-applicant">Algemene gegevens aanvrager</label>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-last-name js-form-item-last-name">
<label for="edit-last-name" class="js-form-required form-required">Voorletter(s)</label>
<input data-drupal-selector="edit-last-name" data-msg-required="Voorletter(s) field is required." data-msg-maxlength="Voorletter(s) field has a maximum length of 255." type="text" id="edit-last-name" name="last_name" value="" size="60"
maxlength="255" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-achternaam js-form-item-achternaam">
<label for="edit-achternaam--4" class="js-form-required form-required">Achternaam</label>
<input data-drupal-selector="edit-achternaam" data-msg-required="Achternaam field is required." data-msg-maxlength="Achternaam field has a maximum length of 255." type="text" id="edit-achternaam--4" name="achternaam" value="" size="60"
maxlength="255" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-applicant-age js-form-item-applicant-age">
<label for="edit-applicant-age">Leeftijd aanvrager</label>
<input data-drupal-selector="edit-applicant-age" data-msg-maxlength="Leeftijd aanvrager field has a maximum length of 255." type="text" id="edit-applicant-age" name="applicant_age" value="" size="60" maxlength="255" class="form-text"
autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-street-name-and-house-number js-form-item-street-name-and-house-number">
<label for="edit-street-name-and-house-number" class="js-form-required form-required">Straatnaam en huisnummer</label>
<input data-drupal-selector="edit-street-name-and-house-number" data-msg-required="Straatnaam en huisnummer field is required." data-msg-maxlength="Straatnaam en huisnummer field has a maximum length of 255." type="text"
id="edit-street-name-and-house-number" name="street_name_and_house_number" value="" size="60" maxlength="255" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-postal-code js-form-item-postal-code">
<label for="edit-postal-code" class="js-form-required form-required">Postcode</label>
<input data-drupal-selector="edit-postal-code" data-msg-required="Postcode field is required." data-msg-maxlength="Postcode field has a maximum length of 255." type="text" id="edit-postal-code" name="postal_code" value="" size="60"
maxlength="255" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-venue js-form-item-venue">
<label for="edit-venue" class="js-form-required form-required">Plaats</label>
<input data-drupal-selector="edit-venue" data-msg-required="Plaats field is required." data-msg-maxlength="Plaats field has a maximum length of 255." type="text" id="edit-venue" name="venue" value="" size="60" maxlength="255"
class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-country js-form-item-country">
<label for="edit-country" class="js-form-required form-required">Land</label>
<input data-drupal-selector="edit-country" data-msg-required="Land field is required." data-msg-maxlength="Land field has a maximum length of 255." type="text" id="edit-country" name="country" value="" size="60" maxlength="255"
class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-email form-item-applicant-s-personal-email-address js-form-item-applicant-s-personal-email-address">
<label for="edit-applicant-s-personal-email-address" class="js-form-required form-required">Persoonlijk e-mailadres aanvrager</label>
<input data-drupal-selector="edit-applicant-s-personal-email-address" data-msg-required="Persoonlijk e-mailadres aanvrager field is required." data-msg-email="Persoonlijk e-mailadres aanvrager does not contain a valid email."
data-msg-maxlength="Persoonlijk e-mailadres aanvrager field has a maximum length of 254." type="email" id="edit-applicant-s-personal-email-address" name="applicant_s_personal_email_address" value="" size="60" maxlength="254"
class="form-email required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-select form-item-hoe-bent-u-bekend-geraakt-met-deze-actie- js-form-item-hoe-bent-u-bekend-geraakt-met-deze-actie-">
<label for="edit-hoe-bent-u-bekend-geraakt-met-deze-actie-">Hoe bent u bekend geraakt met deze actie?</label>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="js-webform-choices webform-choices form-select choices__input" data-drupal-selector="edit-hoe-bent-u-bekend-geraakt-met-deze-actie-" id="edit-hoe-bent-u-bekend-geraakt-met-deze-actie-"
name="hoe_bent_u_bekend_geraakt_met_deze_actie_" data-once="webform-choices" hidden="" tabindex="-1" data-choice="active">
<option value="">- Geen -</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">- Geen -</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="- Geen -" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--edit-hoe-bent-u-bekend-geraakt-met-deze-actie--item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1"
data-value="" data-select-text="Press to select" data-choice-selectable="" aria-selected="true">- Geen -</div>
<div id="choices--edit-hoe-bent-u-bekend-geraakt-met-deze-actie--item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="Via Social Media"
data-select-text="Press to select" data-choice-selectable="">Via Social Media</div>
<div id="choices--edit-hoe-bent-u-bekend-geraakt-met-deze-actie--item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="Via Dermatoloog"
data-select-text="Press to select" data-choice-selectable="">Via Dermatoloog</div>
<div id="choices--edit-hoe-bent-u-bekend-geraakt-met-deze-actie--item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="Via Verpleegkundig Specialist"
data-select-text="Press to select" data-choice-selectable="">Via Verpleegkundig Specialist</div>
<div id="choices--edit-hoe-bent-u-bekend-geraakt-met-deze-actie--item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="Via Pfizer.nl"
data-select-text="Press to select" data-choice-selectable="">Via Pfizer.nl</div>
<div id="choices--edit-hoe-bent-u-bekend-geraakt-met-deze-actie--item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="Via Vrienden en Familie"
data-select-text="Press to select" data-choice-selectable="">Via Vrienden en Familie</div>
</div>
</div>
</div>
</div>
<div data-drupal-selector="edit-captcha" class="captcha captcha-type-challenge--recaptcha">
<div class="captcha__element">
<input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="670905922" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="a3DZK4eb3ZXQX0FC3ARYtn5phYoZqMHGWT_Es-bBccQ" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" data-hj-suppress="">
<div class="g-recaptcha" data-sitekey="6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0" data-theme="light" data-type="image">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-bbg261resy3p" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0&co=aHR0cHM6Ly93d3cucGZpemVyLm5sOjQ0Mw..&hl=nl&type=image&v=1kRDYC3bfA-o6-tsWzIBvp7k&theme=light&size=normal&cb=mb64xdqswlio"></iframe>
</div><textarea id="g-recaptcha-response-3" 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><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" data-hj-suppress="">
</div>
<div class="captcha__description description">Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen.</div>
</div>
<input autocomplete="off" data-drupal-selector="form-7wvb9yppvjadxvtjrtnv3vn8pddda78jvplbhf8n-bg" type="hidden" name="form_build_id" value="form-7wvb9ypPvJadXvtJRtNV3VN8PDDDA78JVplBHf8N-Bg" data-hj-suppress="">
<input data-drupal-selector="edit-webform-submission-eczeem-magazine-paragraph-148381-add-form" type="hidden" name="form_id" value="webform_submission_eczeem_magazine_paragraph_148381_add_form" data-hj-suppress="">
<div data-drupal-selector="edit-actions" class="form-actions js-form-wrapper form-wrapper" id="edit-actions--6"><input class="webform-button--submit button button--primary js-form-submit form-submit" data-drupal-selector="edit-submit" type="submit"
id="edit-submit--4" name="op" value="Indienen" data-hj-suppress="" data-pfa-listener-click="1">
</div>
<div class="url-textfield js-form-wrapper form-wrapper" style="display: none !important;">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-url js-form-item-url">
<label for="edit-url--4">Leave this field blank</label>
<input autocomplete="off" data-drupal-selector="edit-url" data-msg-maxlength="Leave this field blank field has a maximum length of 128." type="text" id="edit-url--4" name="url" value="" size="20" maxlength="128" class="form-text"
data-hj-suppress="">
</div>
</div>
</form>POST /herkenamyloidose
<form
class="webform-submission-form webform-submission-add-form webform-submission-materialen-bestellen-form webform-submission-materialen-bestellen-add-form webform-submission-materialen-bestellen-paragraph-155001-form webform-submission-materialen-bestellen-paragraph-155001-add-form js-webform-details-toggle webform-details-toggle"
data-drupal-selector="webform-submission-materialen-bestellen-paragraph-155001-add-form" action="/herkenamyloidose" method="post" id="webform-submission-materialen-bestellen-paragraph-155001-add-form" accept-charset="UTF-8"
data-once="form-updated webform-details-toggle"
data-drupal-form-fields="edit-naam-first,edit-naam-last,edit-adres-address,edit-adres-city,edit-adres-postal-code,edit-instellingsnaam--3,edit-aantal,edit-e-mailadres,edit-terms-of-service,edit-actions-submit--3,edit-url--5">
<div id="edit-title" data-hj-suppress="" class="js-form-item form-item js-form-type-webform-markup form-item-title js-form-item-title form-no-label">
<h3>Materialen bestellen</h3>
</div>
<div class="two-colum-wrapper js-form-wrapper form-wrapper" data-drupal-selector="edit-container-wrapper" id="edit-container-wrapper">
<div class="form-text-item js-form-wrapper form-wrapper" data-drupal-selector="edit-container-data" id="edit-container-data">
<div data-drupal-selector="edit-naam" id="edit-naam--wrapper" class="webform-name--wrapper fieldgroup form-composite js-form-wrapper form-wrapper">
<div class="webform-name">
<div class="webform-flexbox">
<div class="webform-flex webform-flex--3 webform-name__first">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-naam-first js-form-item-naam-first">
<label for="edit-naam-first" class="js-form-required form-required">Initialen</label>
<input data-drupal-selector="edit-naam-first" data-msg-required="Initialen field is required." data-msg-maxlength="Initialen field has a maximum length of 255." type="text" id="edit-naam-first" name="naam[first]" value="" size="60"
maxlength="255" placeholder="Initialen" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
<div class="webform-flex webform-flex--3 webform-name__last">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-naam-last js-form-item-naam-last">
<label for="edit-naam-last" class="js-form-required form-required">Achternaam</label>
<input data-drupal-selector="edit-naam-last" data-msg-required="Achternaam field is required." data-msg-maxlength="Achternaam field has a maximum length of 255." type="text" id="edit-naam-last" name="naam[last]" value="" size="60"
maxlength="255" placeholder="Achternaam" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
</div>
</div>
</div>
<div data-drupal-selector="edit-adres" data-msg-required="adres field is required." id="edit-adres--3--wrapper" class="webform-address--wrapper fieldgroup form-composite js-form-wrapper form-wrapper">
<div class="webform-address">
<div class="webform-flexbox webform-address__row-1">
<div class="webform-flex webform-flex--1 webform-address__address">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres-address js-form-item-adres-address">
<label for="edit-adres-address" class="js-form-required form-required">Adres</label>
<input data-drupal-selector="edit-adres-address" data-msg-required="Adres field is required." data-msg-maxlength="Adres field has a maximum length of 255." type="text" id="edit-adres-address" name="adres[address]" value="" size="60"
maxlength="255" placeholder="Straatnaam en nummer" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
</div>
<div class="webform-flexbox webform-address__row-3">
<div class="webform-flex webform-flex--1 webform-address__city">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres-city js-form-item-adres-city">
<label for="edit-adres-city" class="js-form-required form-required">Plaats</label>
<input data-drupal-selector="edit-adres-city" data-msg-required="Plaats field is required." data-msg-maxlength="Plaats field has a maximum length of 255." type="text" id="edit-adres-city" name="adres[city]" value="" size="60"
maxlength="255" placeholder="Plaatsnaam" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
<div class="webform-flex webform-flex--1 webform-address__postal-code">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres-postal-code js-form-item-adres-postal-code">
<label for="edit-adres-postal-code" class="js-form-required form-required">Postcode</label>
<input data-drupal-selector="edit-adres-postal-code" data-msg-required="Postcode field is required." data-msg-maxlength="Postcode field has a maximum length of 255." type="text" id="edit-adres-postal-code" name="adres[postal_code]"
value="" size="60" maxlength="255" placeholder="0000 XX" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-instellingsnaam js-form-item-instellingsnaam">
<label for="edit-instellingsnaam--3" class="js-form-required form-required">Instellingsnaam / ziekenhuis</label>
<input data-drupal-selector="edit-instellingsnaam" data-msg-required="Instellingsnaam / ziekenhuis field is required." data-msg-maxlength="Instellingsnaam / ziekenhuis field has a maximum length of 255." type="text"
id="edit-instellingsnaam--3" name="instellingsnaam" value="" size="60" maxlength="255" placeholder="V.b. Ziekenhuis of gezondheidcentrum" class="form-text required" required="required" aria-required="true" autocomplete="off"
data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-select form-item-aantal js-form-item-aantal">
<label for="edit-aantal" class="js-form-required form-required">Aantal</label>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="js-webform-choices webform-choices form-select required choices__input" data-drupal-selector="edit-aantal" data-msg-required="Aantal field is required." id="edit-aantal" name="aantal"
data-once="webform-choices" hidden="" tabindex="-1" data-choice="active">
<option value="">- Selecteren -</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">- Selecteren -</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="- Selecteren -" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--edit-aantal-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1" data-value=""
data-select-text="Press to select" data-choice-selectable="" aria-selected="true">- Selecteren -</div>
<div id="choices--edit-aantal-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="1" data-select-text="Press to select" data-choice-selectable="">1
</div>
<div id="choices--edit-aantal-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="2" data-select-text="Press to select" data-choice-selectable="">2
</div>
<div id="choices--edit-aantal-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="3" data-select-text="Press to select" data-choice-selectable="">3
</div>
<div id="choices--edit-aantal-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="4" data-select-text="Press to select" data-choice-selectable="">4
</div>
<div id="choices--edit-aantal-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="5" data-select-text="Press to select" data-choice-selectable="">5
</div>
<div id="choices--edit-aantal-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="6" data-select-text="Press to select" data-choice-selectable="">6
</div>
<div id="choices--edit-aantal-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="7" data-select-text="Press to select" data-choice-selectable="">7
</div>
<div id="choices--edit-aantal-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="8" data-select-text="Press to select" data-choice-selectable="">8
</div>
<div id="choices--edit-aantal-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="9" data-select-text="Press to select" data-choice-selectable="">9
</div>
<div id="choices--edit-aantal-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="10" data-select-text="Press to select" data-choice-selectable="">
10</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-email form-item-e-mailadres js-form-item-e-mailadres">
<label for="edit-e-mailadres" class="js-form-required form-required">Persoonlijk e-mailadres</label>
<input data-drupal-selector="edit-e-mailadres" data-msg-required="Persoonlijk e-mailadres field is required." data-msg-email="Persoonlijk e-mailadres does not contain a valid email."
data-msg-maxlength="Persoonlijk e-mailadres field has a maximum length of 254." type="email" id="edit-e-mailadres" name="e_mailadres" value="" size="60" maxlength="254" placeholder="adres@mail.nl" class="form-email required"
required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
<div class="form-checkboxes form-checkboxes-narrow js-form-wrapper form-wrapper" data-drupal-selector="edit-container-confirmation" id="edit-container-confirmation">
<div id="edit-confirmation-top-text" data-hj-suppress="" class="js-form-item form-item js-form-type-processed-text form-item- js-form-item- form-no-label">
<p>Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over het gebruik van je gegevens vind je in onze
<a href="https://privacycenter.pfizer.com/nl/netherlands" title="https://privacycenter.pfizer.com/nl/netherlands" class="ext" data-extlink="" target="_blank" rel="noopener" data-pfa-listener-click="1" sc:linkname="content|navigation|privacy verklaring(externe link)">Privacy verklaring<svg focusable="false" class="ext" role="img" aria-label="(externe link)" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 80 40"><metadata><sfw xmlns="http://ns.adobe.com/SaveForWeb/1.0/"><slicesourcebounds y="-8160" x="-8165" width="16389" height="16384" bottomleftorigin="true"></slicesourcebounds><optimizationsettings><targetsettings targetsettingsid="0" fileformat="PNG24Format"><png24format transparency="true" filtered="false" interlaced="false" nomattecolor="false" mattecolor="#FFFFFF"></png24format></targetsettings></optimizationsettings></sfw></metadata><title>(externe link)</title><path d="M48 26c-1.1 0-2 0.9-2 2v26H10V18h26c1.1 0 2-0.9 2-2s-0.9-2-2-2H8c-1.1 0-2 0.9-2 2v40c0 1.1 0.9 2 2 2h40c1.1 0 2-0.9 2-2V28C50 26.9 49.1 26 48 26z"></path><path d="M56 6H44c-1.1 0-2 0.9-2 2s0.9 2 2 2h7.2L30.6 30.6c-0.8 0.8-0.8 2 0 2.8C31 33.8 31.5 34 32 34s1-0.2 1.4-0.6L54 12.8V20c0 1.1 0.9 2 2 2s2-0.9 2-2V8C58 6.9 57.1 6 56 6z"></path></svg></a>.
</p>
</div>
<div data-webform-terms-of-service-type="slideout" class="form-type-webform-terms-of-service js-form-type-webform-terms-of-service js-form-item form-item js-form-type-checkbox form-item-terms-of-service js-form-item-terms-of-service"
data-hj-suppress="" data-once="webform-terms-of-service">
<input data-drupal-selector="edit-terms-of-service" type="checkbox" id="edit-terms-of-service" name="terms_of_service" value="" class="form-checkbox" data-hj-suppress="">
<label for="edit-terms-of-service" class="option">Ja, ik geef Pfizer toestemming</label>
<div class="description">
<div id="edit-terms-of-service--description" class="webform-element-description">
<div id="webform-terms-of-service-terms_of_service--description" class="webform-terms-of-service-details js-hide">
<div class="webform-terms-of-service-details--title">Ja, ik geef Pfizer toestemming</div>
<div class="webform-terms-of-service-details--content">Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over
het gebruik van je gegevens vind je in onze
<a href="https://privacycenter.pfizer.com/nl/netherlands" title="https://privacycenter.pfizer.com/nl/netherlands" class="ext" data-extlink="" target="_blank" rel="noopener" data-pfa-listener-click="1" sc:linkname="content|navigation|privacy verklaring(externe link)">Privacy verklaring<svg focusable="false" class="ext" role="img" aria-label="(externe link)" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 80 40"><metadata><sfw xmlns="http://ns.adobe.com/SaveForWeb/1.0/"><slicesourcebounds y="-8160" x="-8165" width="16389" height="16384" bottomleftorigin="true"></slicesourcebounds><optimizationsettings><targetsettings targetsettingsid="0" fileformat="PNG24Format"><png24format transparency="true" filtered="false" interlaced="false" nomattecolor="false" mattecolor="#FFFFFF"></png24format></targetsettings></optimizationsettings></sfw></metadata><title>(externe link)</title><path d="M48 26c-1.1 0-2 0.9-2 2v26H10V18h26c1.1 0 2-0.9 2-2s-0.9-2-2-2H8c-1.1 0-2 0.9-2 2v40c0 1.1 0.9 2 2 2h40c1.1 0 2-0.9 2-2V28C50 26.9 49.1 26 48 26z"></path><path d="M56 6H44c-1.1 0-2 0.9-2 2s0.9 2 2 2h7.2L30.6 30.6c-0.8 0.8-0.8 2 0 2.8C31 33.8 31.5 34 32 34s1-0.2 1.4-0.6L54 12.8V20c0 1.1 0.9 2 2 2s2-0.9 2-2V8C58 6.9 57.1 6 56 6z"></path></svg></a>.
</div>
</div>
</div>
</div>
</div>
<div class="small-lh js-form-item form-item js-form-type-processed-text form-item- js-form-item- form-no-label" id="edit-confirmation-bottom-text" data-hj-suppress="">
<p><span style="font-size:09px;">Pfizer, inclusief moeder-, dochter- en zusterondernemingen en gelieerde partijen, respecteert de vertrouwelijkheid van persoonlijke informatie. Alleen Pfizer, of organisaties die namens Pfizer handelen, hebben
toegang tot uw informatie. U hebt te allen tijde het recht uw informatie in te zien of te laten aanpassen. Voor meer informatie over de privacy policy die Pfizer hanteert, verwijzen wij u naar pfizer.nl.</span></p>
<p><span style="font-size:09px;">Mocht u medische vragen hebben over Pfizer geneesmiddelen, neem dan contact op met Pfizer Medische Informatie via 0800-633 4636. Wilt u een bijwerking melden, neem dan contact op met Pfizer Drug Safety via
info@pfizer.nl of bel met 010-4064290.</span></p>
</div>
</div>
</div>
<div data-drupal-selector="edit-captcha" class="captcha captcha-type-challenge--recaptcha">
<div class="captcha__element">
<input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="670905923" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="gMtdSixioXvccyIx3muuBnJHQl6Mb4YwUq3ctb_z9SI" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" data-hj-suppress="">
<div class="g-recaptcha" data-sitekey="6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0" data-theme="light" data-type="image">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-8dxh5xuuk3v" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0&co=aHR0cHM6Ly93d3cucGZpemVyLm5sOjQ0Mw..&hl=nl&type=image&v=1kRDYC3bfA-o6-tsWzIBvp7k&theme=light&size=normal&cb=q5lqrn7jourv"></iframe>
</div><textarea id="g-recaptcha-response-4" 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><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" data-hj-suppress="">
</div>
<div class="captcha__description description">Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen.</div>
</div>
<div data-drupal-selector="edit-actions" class="form-actions webform-actions js-form-wrapper form-wrapper" id="edit-actions--7"><input class="webform-button--submit button button--primary js-form-submit form-submit"
data-drupal-selector="edit-actions-submit-3" type="submit" id="edit-actions-submit--3" name="op" value="Bestellen" data-hj-suppress="" data-pfa-listener-click="1">
</div>
<input autocomplete="off" data-drupal-selector="form-sreeyo17-soeb2ffh73hjkztpaltfctqlgpymqr9i-8" type="hidden" name="form_build_id" value="form-SreEYO17_soEB2Ffh73HJkzTpaLTfcTqLgPyMQR9i_8" data-hj-suppress="">
<input data-drupal-selector="edit-webform-submission-materialen-bestellen-paragraph-155001-add-form" type="hidden" name="form_id" value="webform_submission_materialen_bestellen_paragraph_155001_add_form" data-hj-suppress="">
<div class="url-textfield js-form-wrapper form-wrapper" style="display: none !important;">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-url js-form-item-url">
<label for="edit-url--5">Leave this field blank</label>
<input autocomplete="off" data-drupal-selector="edit-url" data-msg-maxlength="Leave this field blank field has a maximum length of 128." type="text" id="edit-url--5" name="url" value="" size="20" maxlength="128" class="form-text"
data-hj-suppress="">
</div>
</div>
</form>POST /herkenamyloidose
<form
class="webform-submission-form webform-submission-add-form webform-submission-materialen-bestellen-form webform-submission-materialen-bestellen-add-form webform-submission-materialen-bestellen-paragraph-155081-form webform-submission-materialen-bestellen-paragraph-155081-add-form js-webform-details-toggle webform-details-toggle"
data-drupal-selector="webform-submission-materialen-bestellen-paragraph-155081-add-form" action="/herkenamyloidose" method="post" id="webform-submission-materialen-bestellen-paragraph-155081-add-form" accept-charset="UTF-8"
data-once="form-updated webform-details-toggle"
data-drupal-form-fields="edit-naam-first--2,edit-naam-last--2,edit-adres-address--2,edit-adres-city--2,edit-adres-postal-code--2,edit-instellingsnaam--4,edit-aantal--2,edit-e-mailadres--2,edit-terms-of-service--2,edit-actions-submit--4,edit-url--6">
<div id="edit-title--2" data-hj-suppress="" class="js-form-item form-item js-form-type-webform-markup form-item-title js-form-item-title form-no-label">
<h3>Materialen bestellen</h3>
</div>
<div class="two-colum-wrapper js-form-wrapper form-wrapper" data-drupal-selector="edit-container-wrapper" id="edit-container-wrapper--2">
<div class="form-text-item js-form-wrapper form-wrapper" data-drupal-selector="edit-container-data" id="edit-container-data--2">
<div data-drupal-selector="edit-naam" id="edit-naam--2--wrapper" class="webform-name--wrapper fieldgroup form-composite js-form-wrapper form-wrapper">
<div class="webform-name">
<div class="webform-flexbox">
<div class="webform-flex webform-flex--3 webform-name__first">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-naam-first js-form-item-naam-first">
<label for="edit-naam-first--2" class="js-form-required form-required">Initialen</label>
<input data-drupal-selector="edit-naam-first" data-msg-required="Initialen field is required." data-msg-maxlength="Initialen field has a maximum length of 255." type="text" id="edit-naam-first--2" name="naam[first]" value=""
size="60" maxlength="255" placeholder="Initialen" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
<div class="webform-flex webform-flex--3 webform-name__last">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-naam-last js-form-item-naam-last">
<label for="edit-naam-last--2" class="js-form-required form-required">Achternaam</label>
<input data-drupal-selector="edit-naam-last" data-msg-required="Achternaam field is required." data-msg-maxlength="Achternaam field has a maximum length of 255." type="text" id="edit-naam-last--2" name="naam[last]" value=""
size="60" maxlength="255" placeholder="Achternaam" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
</div>
</div>
</div>
<div data-drupal-selector="edit-adres" data-msg-required="adres field is required." id="edit-adres--4--wrapper" class="webform-address--wrapper fieldgroup form-composite js-form-wrapper form-wrapper">
<div class="webform-address">
<div class="webform-flexbox webform-address__row-1">
<div class="webform-flex webform-flex--1 webform-address__address">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres-address js-form-item-adres-address">
<label for="edit-adres-address--2" class="js-form-required form-required">Adres</label>
<input data-drupal-selector="edit-adres-address" data-msg-required="Adres field is required." data-msg-maxlength="Adres field has a maximum length of 255." type="text" id="edit-adres-address--2" name="adres[address]" value=""
size="60" maxlength="255" placeholder="Straatnaam en nummer" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
</div>
<div class="webform-flexbox webform-address__row-3">
<div class="webform-flex webform-flex--1 webform-address__city">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres-city js-form-item-adres-city">
<label for="edit-adres-city--2" class="js-form-required form-required">Plaats</label>
<input data-drupal-selector="edit-adres-city" data-msg-required="Plaats field is required." data-msg-maxlength="Plaats field has a maximum length of 255." type="text" id="edit-adres-city--2" name="adres[city]" value="" size="60"
maxlength="255" placeholder="Plaatsnaam" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
<div class="webform-flex webform-flex--1 webform-address__postal-code">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres-postal-code js-form-item-adres-postal-code">
<label for="edit-adres-postal-code--2" class="js-form-required form-required">Postcode</label>
<input data-drupal-selector="edit-adres-postal-code" data-msg-required="Postcode field is required." data-msg-maxlength="Postcode field has a maximum length of 255." type="text" id="edit-adres-postal-code--2"
name="adres[postal_code]" value="" size="60" maxlength="255" placeholder="0000 XX" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-instellingsnaam js-form-item-instellingsnaam">
<label for="edit-instellingsnaam--4" class="js-form-required form-required">Instellingsnaam / ziekenhuis</label>
<input data-drupal-selector="edit-instellingsnaam" data-msg-required="Instellingsnaam / ziekenhuis field is required." data-msg-maxlength="Instellingsnaam / ziekenhuis field has a maximum length of 255." type="text"
id="edit-instellingsnaam--4" name="instellingsnaam" value="" size="60" maxlength="255" placeholder="V.b. Ziekenhuis of gezondheidcentrum" class="form-text required" required="required" aria-required="true" autocomplete="off"
data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-select form-item-aantal js-form-item-aantal">
<label for="edit-aantal--2" class="js-form-required form-required">Aantal</label>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="js-webform-choices webform-choices form-select required choices__input" data-drupal-selector="edit-aantal" data-msg-required="Aantal field is required." id="edit-aantal--2" name="aantal"
data-once="webform-choices" hidden="" tabindex="-1" data-choice="active">
<option value="">- Selecteren -</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">- Selecteren -</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="- Selecteren -" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--edit-aantal--2-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1" data-value=""
data-select-text="Press to select" data-choice-selectable="" aria-selected="true">- Selecteren -</div>
<div id="choices--edit-aantal--2-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="1" data-select-text="Press to select" data-choice-selectable="">1
</div>
<div id="choices--edit-aantal--2-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="2" data-select-text="Press to select" data-choice-selectable="">2
</div>
<div id="choices--edit-aantal--2-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="3" data-select-text="Press to select" data-choice-selectable="">3
</div>
<div id="choices--edit-aantal--2-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="4" data-select-text="Press to select" data-choice-selectable="">4
</div>
<div id="choices--edit-aantal--2-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="5" data-select-text="Press to select" data-choice-selectable="">5
</div>
<div id="choices--edit-aantal--2-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="6" data-select-text="Press to select" data-choice-selectable="">6
</div>
<div id="choices--edit-aantal--2-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="7" data-select-text="Press to select" data-choice-selectable="">7
</div>
<div id="choices--edit-aantal--2-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="8" data-select-text="Press to select" data-choice-selectable="">8
</div>
<div id="choices--edit-aantal--2-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="9" data-select-text="Press to select"
data-choice-selectable="">9</div>
<div id="choices--edit-aantal--2-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="10" data-select-text="Press to select"
data-choice-selectable="">10</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-email form-item-e-mailadres js-form-item-e-mailadres">
<label for="edit-e-mailadres--2" class="js-form-required form-required">Persoonlijk e-mailadres</label>
<input data-drupal-selector="edit-e-mailadres" data-msg-required="Persoonlijk e-mailadres field is required." data-msg-email="Persoonlijk e-mailadres does not contain a valid email."
data-msg-maxlength="Persoonlijk e-mailadres field has a maximum length of 254." type="email" id="edit-e-mailadres--2" name="e_mailadres" value="" size="60" maxlength="254" placeholder="adres@mail.nl" class="form-email required"
required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
<div class="form-checkboxes form-checkboxes-narrow js-form-wrapper form-wrapper" data-drupal-selector="edit-container-confirmation" id="edit-container-confirmation--2">
<div id="edit-confirmation-top-text--2" data-hj-suppress="" class="js-form-item form-item js-form-type-processed-text form-item- js-form-item- form-no-label">
<p>Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over het gebruik van je gegevens vind je in onze
<a href="https://privacycenter.pfizer.com/nl/netherlands" title="https://privacycenter.pfizer.com/nl/netherlands" class="ext" data-extlink="" target="_blank" rel="noopener" data-pfa-listener-click="1" sc:linkname="content|navigation|privacy verklaring(externe link)">Privacy verklaring<svg focusable="false" class="ext" role="img" aria-label="(externe link)" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 80 40"><metadata><sfw xmlns="http://ns.adobe.com/SaveForWeb/1.0/"><slicesourcebounds y="-8160" x="-8165" width="16389" height="16384" bottomleftorigin="true"></slicesourcebounds><optimizationsettings><targetsettings targetsettingsid="0" fileformat="PNG24Format"><png24format transparency="true" filtered="false" interlaced="false" nomattecolor="false" mattecolor="#FFFFFF"></png24format></targetsettings></optimizationsettings></sfw></metadata><title>(externe link)</title><path d="M48 26c-1.1 0-2 0.9-2 2v26H10V18h26c1.1 0 2-0.9 2-2s-0.9-2-2-2H8c-1.1 0-2 0.9-2 2v40c0 1.1 0.9 2 2 2h40c1.1 0 2-0.9 2-2V28C50 26.9 49.1 26 48 26z"></path><path d="M56 6H44c-1.1 0-2 0.9-2 2s0.9 2 2 2h7.2L30.6 30.6c-0.8 0.8-0.8 2 0 2.8C31 33.8 31.5 34 32 34s1-0.2 1.4-0.6L54 12.8V20c0 1.1 0.9 2 2 2s2-0.9 2-2V8C58 6.9 57.1 6 56 6z"></path></svg></a>.
</p>
</div>
<div data-webform-terms-of-service-type="slideout" class="form-type-webform-terms-of-service js-form-type-webform-terms-of-service js-form-item form-item js-form-type-checkbox form-item-terms-of-service js-form-item-terms-of-service"
data-hj-suppress="" data-once="webform-terms-of-service">
<input data-drupal-selector="edit-terms-of-service" type="checkbox" id="edit-terms-of-service--2" name="terms_of_service" value="" class="form-checkbox" data-hj-suppress="">
<label for="edit-terms-of-service--2" class="option">Ja, ik geef Pfizer toestemming</label>
<div class="description">
<div id="edit-terms-of-service--2--description" class="webform-element-description">
<div id="webform-terms-of-service-terms_of_service--description" class="webform-terms-of-service-details js-hide">
<div class="webform-terms-of-service-details--title">Ja, ik geef Pfizer toestemming</div>
<div class="webform-terms-of-service-details--content">Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over
het gebruik van je gegevens vind je in onze
<a href="https://privacycenter.pfizer.com/nl/netherlands" title="https://privacycenter.pfizer.com/nl/netherlands" class="ext" data-extlink="" target="_blank" rel="noopener" data-pfa-listener-click="1" sc:linkname="content|navigation|privacy verklaring(externe link)">Privacy verklaring<svg focusable="false" class="ext" role="img" aria-label="(externe link)" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 80 40"><metadata><sfw xmlns="http://ns.adobe.com/SaveForWeb/1.0/"><slicesourcebounds y="-8160" x="-8165" width="16389" height="16384" bottomleftorigin="true"></slicesourcebounds><optimizationsettings><targetsettings targetsettingsid="0" fileformat="PNG24Format"><png24format transparency="true" filtered="false" interlaced="false" nomattecolor="false" mattecolor="#FFFFFF"></png24format></targetsettings></optimizationsettings></sfw></metadata><title>(externe link)</title><path d="M48 26c-1.1 0-2 0.9-2 2v26H10V18h26c1.1 0 2-0.9 2-2s-0.9-2-2-2H8c-1.1 0-2 0.9-2 2v40c0 1.1 0.9 2 2 2h40c1.1 0 2-0.9 2-2V28C50 26.9 49.1 26 48 26z"></path><path d="M56 6H44c-1.1 0-2 0.9-2 2s0.9 2 2 2h7.2L30.6 30.6c-0.8 0.8-0.8 2 0 2.8C31 33.8 31.5 34 32 34s1-0.2 1.4-0.6L54 12.8V20c0 1.1 0.9 2 2 2s2-0.9 2-2V8C58 6.9 57.1 6 56 6z"></path></svg></a>.
</div>
</div>
</div>
</div>
</div>
<div class="small-lh js-form-item form-item js-form-type-processed-text form-item- js-form-item- form-no-label" id="edit-confirmation-bottom-text--2" data-hj-suppress="">
<p><span style="font-size:09px;">Pfizer, inclusief moeder-, dochter- en zusterondernemingen en gelieerde partijen, respecteert de vertrouwelijkheid van persoonlijke informatie. Alleen Pfizer, of organisaties die namens Pfizer handelen, hebben
toegang tot uw informatie. U hebt te allen tijde het recht uw informatie in te zien of te laten aanpassen. Voor meer informatie over de privacy policy die Pfizer hanteert, verwijzen wij u naar pfizer.nl.</span></p>
<p><span style="font-size:09px;">Mocht u medische vragen hebben over Pfizer geneesmiddelen, neem dan contact op met Pfizer Medische Informatie via 0800-633 4636. Wilt u een bijwerking melden, neem dan contact op met Pfizer Drug Safety via
info@pfizer.nl of bel met 010-4064290.</span></p>
</div>
</div>
</div>
<div data-drupal-selector="edit-captcha" class="captcha captcha-type-challenge--recaptcha">
<div class="captcha__element">
<input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="670905924" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="q8jtN7LBkKrfRLXe4ps9JOeWQWC5VzfxJjZcWljotBY" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" data-hj-suppress="">
<div class="g-recaptcha" data-sitekey="6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0" data-theme="light" data-type="image">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-8elfq27e553f" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0&co=aHR0cHM6Ly93d3cucGZpemVyLm5sOjQ0Mw..&hl=nl&type=image&v=1kRDYC3bfA-o6-tsWzIBvp7k&theme=light&size=normal&cb=3j476d5an19u"></iframe>
</div><textarea id="g-recaptcha-response-5" 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><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" data-hj-suppress="">
</div>
<div class="captcha__description description">Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen.</div>
</div>
<div data-drupal-selector="edit-actions" class="form-actions webform-actions js-form-wrapper form-wrapper" id="edit-actions--9"><input class="webform-button--submit button button--primary js-form-submit form-submit"
data-drupal-selector="edit-actions-submit-4" type="submit" id="edit-actions-submit--4" name="op" value="Bestellen" data-hj-suppress="" data-pfa-listener-click="1">
</div>
<input autocomplete="off" data-drupal-selector="form-6y5avyktdcda-5u2px4v4gfqrazrzrq37jfxb-wfiuo" type="hidden" name="form_build_id" value="form-6Y5AVYKtdCDA_5u2pX4V4GFqraZrZrq37jfXb_wfIuo" data-hj-suppress="">
<input data-drupal-selector="edit-webform-submission-materialen-bestellen-paragraph-155081-add-form" type="hidden" name="form_id" value="webform_submission_materialen_bestellen_paragraph_155081_add_form" data-hj-suppress="">
<div class="url-textfield js-form-wrapper form-wrapper" style="display: none !important;">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-url js-form-item-url">
<label for="edit-url--6">Leave this field blank</label>
<input autocomplete="off" data-drupal-selector="edit-url" data-msg-maxlength="Leave this field blank field has a maximum length of 128." type="text" id="edit-url--6" name="url" value="" size="20" maxlength="128" class="form-text"
data-hj-suppress="">
</div>
</div>
</form>POST /herkenamyloidose
<form
class="webform-submission-form webform-submission-add-form webform-submission-materialen-bestellen-form webform-submission-materialen-bestellen-add-form webform-submission-materialen-bestellen-paragraph-155961-form webform-submission-materialen-bestellen-paragraph-155961-add-form js-webform-details-toggle webform-details-toggle"
data-drupal-selector="webform-submission-materialen-bestellen-paragraph-155961-add-form" action="/herkenamyloidose" method="post" id="webform-submission-materialen-bestellen-paragraph-155961-add-form" accept-charset="UTF-8"
data-once="form-updated webform-details-toggle"
data-drupal-form-fields="edit-naam-first--3,edit-naam-last--3,edit-adres-address--3,edit-adres-city--3,edit-adres-postal-code--3,edit-instellingsnaam--5,edit-aantal--3,edit-e-mailadres--3,edit-terms-of-service--3,edit-actions-submit--5,edit-url--7">
<div id="edit-title--3" data-hj-suppress="" class="js-form-item form-item js-form-type-webform-markup form-item-title js-form-item-title form-no-label">
<h3>Materialen bestellen</h3>
</div>
<div class="two-colum-wrapper js-form-wrapper form-wrapper" data-drupal-selector="edit-container-wrapper" id="edit-container-wrapper--3">
<div class="form-text-item js-form-wrapper form-wrapper" data-drupal-selector="edit-container-data" id="edit-container-data--3">
<div data-drupal-selector="edit-naam" id="edit-naam--3--wrapper" class="webform-name--wrapper fieldgroup form-composite js-form-wrapper form-wrapper">
<div class="webform-name">
<div class="webform-flexbox">
<div class="webform-flex webform-flex--3 webform-name__first">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-naam-first js-form-item-naam-first">
<label for="edit-naam-first--3" class="js-form-required form-required">Initialen</label>
<input data-drupal-selector="edit-naam-first" data-msg-required="Initialen field is required." data-msg-maxlength="Initialen field has a maximum length of 255." type="text" id="edit-naam-first--3" name="naam[first]" value=""
size="60" maxlength="255" placeholder="Initialen" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
<div class="webform-flex webform-flex--3 webform-name__last">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-naam-last js-form-item-naam-last">
<label for="edit-naam-last--3" class="js-form-required form-required">Achternaam</label>
<input data-drupal-selector="edit-naam-last" data-msg-required="Achternaam field is required." data-msg-maxlength="Achternaam field has a maximum length of 255." type="text" id="edit-naam-last--3" name="naam[last]" value=""
size="60" maxlength="255" placeholder="Achternaam" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
</div>
</div>
</div>
<div data-drupal-selector="edit-adres" data-msg-required="adres field is required." id="edit-adres--5--wrapper" class="webform-address--wrapper fieldgroup form-composite js-form-wrapper form-wrapper">
<div class="webform-address">
<div class="webform-flexbox webform-address__row-1">
<div class="webform-flex webform-flex--1 webform-address__address">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres-address js-form-item-adres-address">
<label for="edit-adres-address--3" class="js-form-required form-required">Adres</label>
<input data-drupal-selector="edit-adres-address" data-msg-required="Adres field is required." data-msg-maxlength="Adres field has a maximum length of 255." type="text" id="edit-adres-address--3" name="adres[address]" value=""
size="60" maxlength="255" placeholder="Straatnaam en nummer" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
</div>
<div class="webform-flexbox webform-address__row-3">
<div class="webform-flex webform-flex--1 webform-address__city">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres-city js-form-item-adres-city">
<label for="edit-adres-city--3" class="js-form-required form-required">Plaats</label>
<input data-drupal-selector="edit-adres-city" data-msg-required="Plaats field is required." data-msg-maxlength="Plaats field has a maximum length of 255." type="text" id="edit-adres-city--3" name="adres[city]" value="" size="60"
maxlength="255" placeholder="Plaatsnaam" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
<div class="webform-flex webform-flex--1 webform-address__postal-code">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres-postal-code js-form-item-adres-postal-code">
<label for="edit-adres-postal-code--3" class="js-form-required form-required">Postcode</label>
<input data-drupal-selector="edit-adres-postal-code" data-msg-required="Postcode field is required." data-msg-maxlength="Postcode field has a maximum length of 255." type="text" id="edit-adres-postal-code--3"
name="adres[postal_code]" value="" size="60" maxlength="255" placeholder="0000 XX" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-instellingsnaam js-form-item-instellingsnaam">
<label for="edit-instellingsnaam--5" class="js-form-required form-required">Instellingsnaam / ziekenhuis</label>
<input data-drupal-selector="edit-instellingsnaam" data-msg-required="Instellingsnaam / ziekenhuis field is required." data-msg-maxlength="Instellingsnaam / ziekenhuis field has a maximum length of 255." type="text"
id="edit-instellingsnaam--5" name="instellingsnaam" value="" size="60" maxlength="255" placeholder="V.b. Ziekenhuis of gezondheidcentrum" class="form-text required" required="required" aria-required="true" autocomplete="off"
data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-select form-item-aantal js-form-item-aantal">
<label for="edit-aantal--3" class="js-form-required form-required">Aantal</label>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="js-webform-choices webform-choices form-select required choices__input" data-drupal-selector="edit-aantal" data-msg-required="Aantal field is required." id="edit-aantal--3" name="aantal"
data-once="webform-choices" hidden="" tabindex="-1" data-choice="active">
<option value="">- Selecteren -</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">- Selecteren -</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="- Selecteren -" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--edit-aantal--3-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1" data-value=""
data-select-text="Press to select" data-choice-selectable="" aria-selected="true">- Selecteren -</div>
<div id="choices--edit-aantal--3-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="1" data-select-text="Press to select" data-choice-selectable="">1
</div>
<div id="choices--edit-aantal--3-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="2" data-select-text="Press to select" data-choice-selectable="">2
</div>
<div id="choices--edit-aantal--3-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="3" data-select-text="Press to select" data-choice-selectable="">3
</div>
<div id="choices--edit-aantal--3-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="4" data-select-text="Press to select" data-choice-selectable="">4
</div>
<div id="choices--edit-aantal--3-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="5" data-select-text="Press to select" data-choice-selectable="">5
</div>
<div id="choices--edit-aantal--3-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="6" data-select-text="Press to select" data-choice-selectable="">6
</div>
<div id="choices--edit-aantal--3-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="7" data-select-text="Press to select" data-choice-selectable="">7
</div>
<div id="choices--edit-aantal--3-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="8" data-select-text="Press to select" data-choice-selectable="">8
</div>
<div id="choices--edit-aantal--3-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="9" data-select-text="Press to select"
data-choice-selectable="">9</div>
<div id="choices--edit-aantal--3-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="10" data-select-text="Press to select"
data-choice-selectable="">10</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-email form-item-e-mailadres js-form-item-e-mailadres">
<label for="edit-e-mailadres--3" class="js-form-required form-required">Persoonlijk e-mailadres</label>
<input data-drupal-selector="edit-e-mailadres" data-msg-required="Persoonlijk e-mailadres field is required." data-msg-email="Persoonlijk e-mailadres does not contain a valid email."
data-msg-maxlength="Persoonlijk e-mailadres field has a maximum length of 254." type="email" id="edit-e-mailadres--3" name="e_mailadres" value="" size="60" maxlength="254" placeholder="adres@mail.nl" class="form-email required"
required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
<div class="form-checkboxes form-checkboxes-narrow js-form-wrapper form-wrapper" data-drupal-selector="edit-container-confirmation" id="edit-container-confirmation--3">
<div id="edit-confirmation-top-text--3" data-hj-suppress="" class="js-form-item form-item js-form-type-processed-text form-item- js-form-item- form-no-label">
<p>Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over het gebruik van je gegevens vind je in onze
<a href="https://privacycenter.pfizer.com/nl/netherlands" title="https://privacycenter.pfizer.com/nl/netherlands" class="ext" data-extlink="" target="_blank" rel="noopener" data-pfa-listener-click="1" sc:linkname="content|navigation|privacy verklaring(externe link)">Privacy verklaring<svg focusable="false" class="ext" role="img" aria-label="(externe link)" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 80 40"><metadata><sfw xmlns="http://ns.adobe.com/SaveForWeb/1.0/"><slicesourcebounds y="-8160" x="-8165" width="16389" height="16384" bottomleftorigin="true"></slicesourcebounds><optimizationsettings><targetsettings targetsettingsid="0" fileformat="PNG24Format"><png24format transparency="true" filtered="false" interlaced="false" nomattecolor="false" mattecolor="#FFFFFF"></png24format></targetsettings></optimizationsettings></sfw></metadata><title>(externe link)</title><path d="M48 26c-1.1 0-2 0.9-2 2v26H10V18h26c1.1 0 2-0.9 2-2s-0.9-2-2-2H8c-1.1 0-2 0.9-2 2v40c0 1.1 0.9 2 2 2h40c1.1 0 2-0.9 2-2V28C50 26.9 49.1 26 48 26z"></path><path d="M56 6H44c-1.1 0-2 0.9-2 2s0.9 2 2 2h7.2L30.6 30.6c-0.8 0.8-0.8 2 0 2.8C31 33.8 31.5 34 32 34s1-0.2 1.4-0.6L54 12.8V20c0 1.1 0.9 2 2 2s2-0.9 2-2V8C58 6.9 57.1 6 56 6z"></path></svg></a>.
</p>
</div>
<div data-webform-terms-of-service-type="slideout" class="form-type-webform-terms-of-service js-form-type-webform-terms-of-service js-form-item form-item js-form-type-checkbox form-item-terms-of-service js-form-item-terms-of-service"
data-hj-suppress="" data-once="webform-terms-of-service">
<input data-drupal-selector="edit-terms-of-service" type="checkbox" id="edit-terms-of-service--3" name="terms_of_service" value="" class="form-checkbox" data-hj-suppress="">
<label for="edit-terms-of-service--3" class="option">Ja, ik geef Pfizer toestemming</label>
<div class="description">
<div id="edit-terms-of-service--3--description" class="webform-element-description">
<div id="webform-terms-of-service-terms_of_service--description" class="webform-terms-of-service-details js-hide">
<div class="webform-terms-of-service-details--title">Ja, ik geef Pfizer toestemming</div>
<div class="webform-terms-of-service-details--content">Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over
het gebruik van je gegevens vind je in onze
<a href="https://privacycenter.pfizer.com/nl/netherlands" title="https://privacycenter.pfizer.com/nl/netherlands" class="ext" data-extlink="" target="_blank" rel="noopener" data-pfa-listener-click="1" sc:linkname="content|navigation|privacy verklaring(externe link)">Privacy verklaring<svg focusable="false" class="ext" role="img" aria-label="(externe link)" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 80 40"><metadata><sfw xmlns="http://ns.adobe.com/SaveForWeb/1.0/"><slicesourcebounds y="-8160" x="-8165" width="16389" height="16384" bottomleftorigin="true"></slicesourcebounds><optimizationsettings><targetsettings targetsettingsid="0" fileformat="PNG24Format"><png24format transparency="true" filtered="false" interlaced="false" nomattecolor="false" mattecolor="#FFFFFF"></png24format></targetsettings></optimizationsettings></sfw></metadata><title>(externe link)</title><path d="M48 26c-1.1 0-2 0.9-2 2v26H10V18h26c1.1 0 2-0.9 2-2s-0.9-2-2-2H8c-1.1 0-2 0.9-2 2v40c0 1.1 0.9 2 2 2h40c1.1 0 2-0.9 2-2V28C50 26.9 49.1 26 48 26z"></path><path d="M56 6H44c-1.1 0-2 0.9-2 2s0.9 2 2 2h7.2L30.6 30.6c-0.8 0.8-0.8 2 0 2.8C31 33.8 31.5 34 32 34s1-0.2 1.4-0.6L54 12.8V20c0 1.1 0.9 2 2 2s2-0.9 2-2V8C58 6.9 57.1 6 56 6z"></path></svg></a>.
</div>
</div>
</div>
</div>
</div>
<div class="small-lh js-form-item form-item js-form-type-processed-text form-item- js-form-item- form-no-label" id="edit-confirmation-bottom-text--3" data-hj-suppress="">
<p><span style="font-size:09px;">Pfizer, inclusief moeder-, dochter- en zusterondernemingen en gelieerde partijen, respecteert de vertrouwelijkheid van persoonlijke informatie. Alleen Pfizer, of organisaties die namens Pfizer handelen, hebben
toegang tot uw informatie. U hebt te allen tijde het recht uw informatie in te zien of te laten aanpassen. Voor meer informatie over de privacy policy die Pfizer hanteert, verwijzen wij u naar pfizer.nl.</span></p>
<p><span style="font-size:09px;">Mocht u medische vragen hebben over Pfizer geneesmiddelen, neem dan contact op met Pfizer Medische Informatie via 0800-633 4636. Wilt u een bijwerking melden, neem dan contact op met Pfizer Drug Safety via
info@pfizer.nl of bel met 010-4064290.</span></p>
</div>
</div>
</div>
<div data-drupal-selector="edit-captcha" class="captcha captcha-type-challenge--recaptcha">
<div class="captcha__element">
<input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="670905925" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="frJvM_flj8VwybXNeuMnGiBTc30mBRvPBk0qWaveBPU" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" data-hj-suppress="">
<div class="g-recaptcha" data-sitekey="6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0" data-theme="light" data-type="image">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-vvbuytg535im" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0&co=aHR0cHM6Ly93d3cucGZpemVyLm5sOjQ0Mw..&hl=nl&type=image&v=1kRDYC3bfA-o6-tsWzIBvp7k&theme=light&size=normal&cb=4rbppyxslh8y"></iframe>
</div><textarea id="g-recaptcha-response-6" 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><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" data-hj-suppress="">
</div>
<div class="captcha__description description">Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen.</div>
</div>
<div data-drupal-selector="edit-actions" class="form-actions webform-actions js-form-wrapper form-wrapper" id="edit-actions--11"><input class="webform-button--submit button button--primary js-form-submit form-submit"
data-drupal-selector="edit-actions-submit-5" type="submit" id="edit-actions-submit--5" name="op" value="Bestellen" data-hj-suppress="" data-pfa-listener-click="1">
</div>
<input autocomplete="off" data-drupal-selector="form-wb9m-ztpqv8orpruvlqih2fwktizcr0eknz6zvdmsjq" type="hidden" name="form_build_id" value="form-WB9M_ZTpqV8OrprUVlQIh2FWktizCr0EKnz6zvdMSjQ" data-hj-suppress="">
<input data-drupal-selector="edit-webform-submission-materialen-bestellen-paragraph-155961-add-form" type="hidden" name="form_id" value="webform_submission_materialen_bestellen_paragraph_155961_add_form" data-hj-suppress="">
<div class="url-textfield js-form-wrapper form-wrapper" style="display: none !important;">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-url js-form-item-url">
<label for="edit-url--7">Leave this field blank</label>
<input autocomplete="off" data-drupal-selector="edit-url" data-msg-maxlength="Leave this field blank field has a maximum length of 128." type="text" id="edit-url--7" name="url" value="" size="20" maxlength="128" class="form-text"
data-hj-suppress="">
</div>
</div>
</form>POST /herkenamyloidose
<form
class="webform-submission-form webform-submission-add-form webform-submission-materialen-bestellen-form webform-submission-materialen-bestellen-add-form webform-submission-materialen-bestellen-paragraph-156491-form webform-submission-materialen-bestellen-paragraph-156491-add-form js-webform-details-toggle webform-details-toggle"
data-drupal-selector="webform-submission-materialen-bestellen-paragraph-156491-add-form" action="/herkenamyloidose" method="post" id="webform-submission-materialen-bestellen-paragraph-156491-add-form" accept-charset="UTF-8"
data-once="form-updated webform-details-toggle"
data-drupal-form-fields="edit-naam-first--4,edit-naam-last--4,edit-adres-address--4,edit-adres-city--4,edit-adres-postal-code--4,edit-instellingsnaam--6,edit-aantal--4,edit-e-mailadres--4,edit-terms-of-service--4,edit-actions-submit--6,edit-url--8">
<div id="edit-title--4" data-hj-suppress="" class="js-form-item form-item js-form-type-webform-markup form-item-title js-form-item-title form-no-label">
<h3>Materialen bestellen</h3>
</div>
<div class="two-colum-wrapper js-form-wrapper form-wrapper" data-drupal-selector="edit-container-wrapper" id="edit-container-wrapper--4">
<div class="form-text-item js-form-wrapper form-wrapper" data-drupal-selector="edit-container-data" id="edit-container-data--4">
<div data-drupal-selector="edit-naam" id="edit-naam--4--wrapper" class="webform-name--wrapper fieldgroup form-composite js-form-wrapper form-wrapper">
<div class="webform-name">
<div class="webform-flexbox">
<div class="webform-flex webform-flex--3 webform-name__first">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-naam-first js-form-item-naam-first">
<label for="edit-naam-first--4" class="js-form-required form-required">Initialen</label>
<input data-drupal-selector="edit-naam-first" data-msg-required="Initialen field is required." data-msg-maxlength="Initialen field has a maximum length of 255." type="text" id="edit-naam-first--4" name="naam[first]" value=""
size="60" maxlength="255" placeholder="Initialen" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
<div class="webform-flex webform-flex--3 webform-name__last">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-naam-last js-form-item-naam-last">
<label for="edit-naam-last--4" class="js-form-required form-required">Achternaam</label>
<input data-drupal-selector="edit-naam-last" data-msg-required="Achternaam field is required." data-msg-maxlength="Achternaam field has a maximum length of 255." type="text" id="edit-naam-last--4" name="naam[last]" value=""
size="60" maxlength="255" placeholder="Achternaam" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
</div>
</div>
</div>
<div data-drupal-selector="edit-adres" data-msg-required="adres field is required." id="edit-adres--6--wrapper" class="webform-address--wrapper fieldgroup form-composite js-form-wrapper form-wrapper">
<div class="webform-address">
<div class="webform-flexbox webform-address__row-1">
<div class="webform-flex webform-flex--1 webform-address__address">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres-address js-form-item-adres-address">
<label for="edit-adres-address--4" class="js-form-required form-required">Adres</label>
<input data-drupal-selector="edit-adres-address" data-msg-required="Adres field is required." data-msg-maxlength="Adres field has a maximum length of 255." type="text" id="edit-adres-address--4" name="adres[address]" value=""
size="60" maxlength="255" placeholder="Straatnaam en nummer" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
</div>
<div class="webform-flexbox webform-address__row-3">
<div class="webform-flex webform-flex--1 webform-address__city">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres-city js-form-item-adres-city">
<label for="edit-adres-city--4" class="js-form-required form-required">Plaats</label>
<input data-drupal-selector="edit-adres-city" data-msg-required="Plaats field is required." data-msg-maxlength="Plaats field has a maximum length of 255." type="text" id="edit-adres-city--4" name="adres[city]" value="" size="60"
maxlength="255" placeholder="Plaatsnaam" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
<div class="webform-flex webform-flex--1 webform-address__postal-code">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres-postal-code js-form-item-adres-postal-code">
<label for="edit-adres-postal-code--4" class="js-form-required form-required">Postcode</label>
<input data-drupal-selector="edit-adres-postal-code" data-msg-required="Postcode field is required." data-msg-maxlength="Postcode field has a maximum length of 255." type="text" id="edit-adres-postal-code--4"
name="adres[postal_code]" value="" size="60" maxlength="255" placeholder="0000 XX" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-instellingsnaam js-form-item-instellingsnaam">
<label for="edit-instellingsnaam--6" class="js-form-required form-required">Instellingsnaam / ziekenhuis</label>
<input data-drupal-selector="edit-instellingsnaam" data-msg-required="Instellingsnaam / ziekenhuis field is required." data-msg-maxlength="Instellingsnaam / ziekenhuis field has a maximum length of 255." type="text"
id="edit-instellingsnaam--6" name="instellingsnaam" value="" size="60" maxlength="255" placeholder="V.b. Ziekenhuis of gezondheidcentrum" class="form-text required" required="required" aria-required="true" autocomplete="off"
data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-select form-item-aantal js-form-item-aantal">
<label for="edit-aantal--4" class="js-form-required form-required">Aantal</label>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="js-webform-choices webform-choices form-select required choices__input" data-drupal-selector="edit-aantal" data-msg-required="Aantal field is required." id="edit-aantal--4" name="aantal"
data-once="webform-choices" hidden="" tabindex="-1" data-choice="active">
<option value="">- Selecteren -</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">- Selecteren -</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="- Selecteren -" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--edit-aantal--4-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1" data-value=""
data-select-text="Press to select" data-choice-selectable="" aria-selected="true">- Selecteren -</div>
<div id="choices--edit-aantal--4-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="1" data-select-text="Press to select" data-choice-selectable="">1
</div>
<div id="choices--edit-aantal--4-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="2" data-select-text="Press to select" data-choice-selectable="">2
</div>
<div id="choices--edit-aantal--4-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="3" data-select-text="Press to select" data-choice-selectable="">3
</div>
<div id="choices--edit-aantal--4-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="4" data-select-text="Press to select" data-choice-selectable="">4
</div>
<div id="choices--edit-aantal--4-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="5" data-select-text="Press to select" data-choice-selectable="">5
</div>
<div id="choices--edit-aantal--4-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="6" data-select-text="Press to select" data-choice-selectable="">6
</div>
<div id="choices--edit-aantal--4-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="7" data-select-text="Press to select" data-choice-selectable="">7
</div>
<div id="choices--edit-aantal--4-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="8" data-select-text="Press to select" data-choice-selectable="">8
</div>
<div id="choices--edit-aantal--4-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="9" data-select-text="Press to select"
data-choice-selectable="">9</div>
<div id="choices--edit-aantal--4-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="10" data-select-text="Press to select"
data-choice-selectable="">10</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-email form-item-e-mailadres js-form-item-e-mailadres">
<label for="edit-e-mailadres--4" class="js-form-required form-required">Persoonlijk e-mailadres</label>
<input data-drupal-selector="edit-e-mailadres" data-msg-required="Persoonlijk e-mailadres field is required." data-msg-email="Persoonlijk e-mailadres does not contain a valid email."
data-msg-maxlength="Persoonlijk e-mailadres field has a maximum length of 254." type="email" id="edit-e-mailadres--4" name="e_mailadres" value="" size="60" maxlength="254" placeholder="adres@mail.nl" class="form-email required"
required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
<div class="form-checkboxes form-checkboxes-narrow js-form-wrapper form-wrapper" data-drupal-selector="edit-container-confirmation" id="edit-container-confirmation--4">
<div id="edit-confirmation-top-text--4" data-hj-suppress="" class="js-form-item form-item js-form-type-processed-text form-item- js-form-item- form-no-label">
<p>Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over het gebruik van je gegevens vind je in onze
<a href="https://privacycenter.pfizer.com/nl/netherlands" title="https://privacycenter.pfizer.com/nl/netherlands" class="ext" data-extlink="" target="_blank" rel="noopener" data-pfa-listener-click="1" sc:linkname="content|navigation|privacy verklaring(externe link)">Privacy verklaring<svg focusable="false" class="ext" role="img" aria-label="(externe link)" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 80 40"><metadata><sfw xmlns="http://ns.adobe.com/SaveForWeb/1.0/"><slicesourcebounds y="-8160" x="-8165" width="16389" height="16384" bottomleftorigin="true"></slicesourcebounds><optimizationsettings><targetsettings targetsettingsid="0" fileformat="PNG24Format"><png24format transparency="true" filtered="false" interlaced="false" nomattecolor="false" mattecolor="#FFFFFF"></png24format></targetsettings></optimizationsettings></sfw></metadata><title>(externe link)</title><path d="M48 26c-1.1 0-2 0.9-2 2v26H10V18h26c1.1 0 2-0.9 2-2s-0.9-2-2-2H8c-1.1 0-2 0.9-2 2v40c0 1.1 0.9 2 2 2h40c1.1 0 2-0.9 2-2V28C50 26.9 49.1 26 48 26z"></path><path d="M56 6H44c-1.1 0-2 0.9-2 2s0.9 2 2 2h7.2L30.6 30.6c-0.8 0.8-0.8 2 0 2.8C31 33.8 31.5 34 32 34s1-0.2 1.4-0.6L54 12.8V20c0 1.1 0.9 2 2 2s2-0.9 2-2V8C58 6.9 57.1 6 56 6z"></path></svg></a>.
</p>
</div>
<div data-webform-terms-of-service-type="slideout" class="form-type-webform-terms-of-service js-form-type-webform-terms-of-service js-form-item form-item js-form-type-checkbox form-item-terms-of-service js-form-item-terms-of-service"
data-hj-suppress="" data-once="webform-terms-of-service">
<input data-drupal-selector="edit-terms-of-service" type="checkbox" id="edit-terms-of-service--4" name="terms_of_service" value="" class="form-checkbox" data-hj-suppress="">
<label for="edit-terms-of-service--4" class="option">Ja, ik geef Pfizer toestemming</label>
<div class="description">
<div id="edit-terms-of-service--4--description" class="webform-element-description">
<div id="webform-terms-of-service-terms_of_service--description" class="webform-terms-of-service-details js-hide">
<div class="webform-terms-of-service-details--title">Ja, ik geef Pfizer toestemming</div>
<div class="webform-terms-of-service-details--content">Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over
het gebruik van je gegevens vind je in onze
<a href="https://privacycenter.pfizer.com/nl/netherlands" title="https://privacycenter.pfizer.com/nl/netherlands" class="ext" data-extlink="" target="_blank" rel="noopener" data-pfa-listener-click="1" sc:linkname="content|navigation|privacy verklaring(externe link)">Privacy verklaring<svg focusable="false" class="ext" role="img" aria-label="(externe link)" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 80 40"><metadata><sfw xmlns="http://ns.adobe.com/SaveForWeb/1.0/"><slicesourcebounds y="-8160" x="-8165" width="16389" height="16384" bottomleftorigin="true"></slicesourcebounds><optimizationsettings><targetsettings targetsettingsid="0" fileformat="PNG24Format"><png24format transparency="true" filtered="false" interlaced="false" nomattecolor="false" mattecolor="#FFFFFF"></png24format></targetsettings></optimizationsettings></sfw></metadata><title>(externe link)</title><path d="M48 26c-1.1 0-2 0.9-2 2v26H10V18h26c1.1 0 2-0.9 2-2s-0.9-2-2-2H8c-1.1 0-2 0.9-2 2v40c0 1.1 0.9 2 2 2h40c1.1 0 2-0.9 2-2V28C50 26.9 49.1 26 48 26z"></path><path d="M56 6H44c-1.1 0-2 0.9-2 2s0.9 2 2 2h7.2L30.6 30.6c-0.8 0.8-0.8 2 0 2.8C31 33.8 31.5 34 32 34s1-0.2 1.4-0.6L54 12.8V20c0 1.1 0.9 2 2 2s2-0.9 2-2V8C58 6.9 57.1 6 56 6z"></path></svg></a>.
</div>
</div>
</div>
</div>
</div>
<div class="small-lh js-form-item form-item js-form-type-processed-text form-item- js-form-item- form-no-label" id="edit-confirmation-bottom-text--4" data-hj-suppress="">
<p><span style="font-size:09px;">Pfizer, inclusief moeder-, dochter- en zusterondernemingen en gelieerde partijen, respecteert de vertrouwelijkheid van persoonlijke informatie. Alleen Pfizer, of organisaties die namens Pfizer handelen, hebben
toegang tot uw informatie. U hebt te allen tijde het recht uw informatie in te zien of te laten aanpassen. Voor meer informatie over de privacy policy die Pfizer hanteert, verwijzen wij u naar pfizer.nl.</span></p>
<p><span style="font-size:09px;">Mocht u medische vragen hebben over Pfizer geneesmiddelen, neem dan contact op met Pfizer Medische Informatie via 0800-633 4636. Wilt u een bijwerking melden, neem dan contact op met Pfizer Drug Safety via
info@pfizer.nl of bel met 010-4064290.</span></p>
</div>
</div>
</div>
<div data-drupal-selector="edit-captcha" class="captcha captcha-type-challenge--recaptcha">
<div class="captcha__element">
<input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="670905926" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="u-jn6Gp3tF52k_n0By9tF2QUhLgafo1-Y0KzBsGEzmg" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" data-hj-suppress="">
<div class="g-recaptcha" data-sitekey="6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0" data-theme="light" data-type="image">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-oank13ajzvd9" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0&co=aHR0cHM6Ly93d3cucGZpemVyLm5sOjQ0Mw..&hl=nl&type=image&v=1kRDYC3bfA-o6-tsWzIBvp7k&theme=light&size=normal&cb=r536g5mug2rl"></iframe>
</div><textarea id="g-recaptcha-response-7" 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><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" data-hj-suppress="">
</div>
<div class="captcha__description description">Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen.</div>
</div>
<div data-drupal-selector="edit-actions" class="form-actions webform-actions js-form-wrapper form-wrapper" id="edit-actions--13"><input class="webform-button--submit button button--primary js-form-submit form-submit"
data-drupal-selector="edit-actions-submit-6" type="submit" id="edit-actions-submit--6" name="op" value="Bestellen" data-hj-suppress="" data-pfa-listener-click="1">
</div>
<input autocomplete="off" data-drupal-selector="form-nzaccmcwlg1uqb-qocgastik2yqln1pnatxmenuo4ug" type="hidden" name="form_build_id" value="form-nZAcCmCwlg1UqB_qoCgaStiK2YqLn1pnAtXMeNuO4Ug" data-hj-suppress="">
<input data-drupal-selector="edit-webform-submission-materialen-bestellen-paragraph-156491-add-form" type="hidden" name="form_id" value="webform_submission_materialen_bestellen_paragraph_156491_add_form" data-hj-suppress="">
<div class="url-textfield js-form-wrapper form-wrapper" style="display: none !important;">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-url js-form-item-url">
<label for="edit-url--8">Leave this field blank</label>
<input autocomplete="off" data-drupal-selector="edit-url" data-msg-maxlength="Leave this field blank field has a maximum length of 128." type="text" id="edit-url--8" name="url" value="" size="20" maxlength="128" class="form-text"
data-hj-suppress="">
</div>
</div>
</form>POST /herkenamyloidose
<form
class="webform-submission-form webform-submission-add-form webform-submission-materialen-bestellen-form webform-submission-materialen-bestellen-add-form webform-submission-materialen-bestellen-paragraph-156506-form webform-submission-materialen-bestellen-paragraph-156506-add-form js-webform-details-toggle webform-details-toggle"
data-drupal-selector="webform-submission-materialen-bestellen-paragraph-156506-add-form" action="/herkenamyloidose" method="post" id="webform-submission-materialen-bestellen-paragraph-156506-add-form" accept-charset="UTF-8"
data-once="form-updated webform-details-toggle"
data-drupal-form-fields="edit-naam-first--5,edit-naam-last--5,edit-adres-address--5,edit-adres-city--5,edit-adres-postal-code--5,edit-instellingsnaam--7,edit-aantal--5,edit-e-mailadres--5,edit-terms-of-service--5,edit-actions-submit--7,edit-url--9">
<div id="edit-title--5" data-hj-suppress="" class="js-form-item form-item js-form-type-webform-markup form-item-title js-form-item-title form-no-label">
<h3>Materialen bestellen</h3>
</div>
<div class="two-colum-wrapper js-form-wrapper form-wrapper" data-drupal-selector="edit-container-wrapper" id="edit-container-wrapper--5">
<div class="form-text-item js-form-wrapper form-wrapper" data-drupal-selector="edit-container-data" id="edit-container-data--5">
<div data-drupal-selector="edit-naam" id="edit-naam--5--wrapper" class="webform-name--wrapper fieldgroup form-composite js-form-wrapper form-wrapper">
<div class="webform-name">
<div class="webform-flexbox">
<div class="webform-flex webform-flex--3 webform-name__first">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-naam-first js-form-item-naam-first">
<label for="edit-naam-first--5" class="js-form-required form-required">Initialen</label>
<input data-drupal-selector="edit-naam-first" data-msg-required="Initialen field is required." data-msg-maxlength="Initialen field has a maximum length of 255." type="text" id="edit-naam-first--5" name="naam[first]" value=""
size="60" maxlength="255" placeholder="Initialen" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
<div class="webform-flex webform-flex--3 webform-name__last">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-naam-last js-form-item-naam-last">
<label for="edit-naam-last--5" class="js-form-required form-required">Achternaam</label>
<input data-drupal-selector="edit-naam-last" data-msg-required="Achternaam field is required." data-msg-maxlength="Achternaam field has a maximum length of 255." type="text" id="edit-naam-last--5" name="naam[last]" value=""
size="60" maxlength="255" placeholder="Achternaam" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
</div>
</div>
</div>
<div data-drupal-selector="edit-adres" data-msg-required="adres field is required." id="edit-adres--7--wrapper" class="webform-address--wrapper fieldgroup form-composite js-form-wrapper form-wrapper">
<div class="webform-address">
<div class="webform-flexbox webform-address__row-1">
<div class="webform-flex webform-flex--1 webform-address__address">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres-address js-form-item-adres-address">
<label for="edit-adres-address--5" class="js-form-required form-required">Adres</label>
<input data-drupal-selector="edit-adres-address" data-msg-required="Adres field is required." data-msg-maxlength="Adres field has a maximum length of 255." type="text" id="edit-adres-address--5" name="adres[address]" value=""
size="60" maxlength="255" placeholder="Straatnaam en nummer" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
</div>
<div class="webform-flexbox webform-address__row-3">
<div class="webform-flex webform-flex--1 webform-address__city">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres-city js-form-item-adres-city">
<label for="edit-adres-city--5" class="js-form-required form-required">Plaats</label>
<input data-drupal-selector="edit-adres-city" data-msg-required="Plaats field is required." data-msg-maxlength="Plaats field has a maximum length of 255." type="text" id="edit-adres-city--5" name="adres[city]" value="" size="60"
maxlength="255" placeholder="Plaatsnaam" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
<div class="webform-flex webform-flex--1 webform-address__postal-code">
<div class="webform-flex--container">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres-postal-code js-form-item-adres-postal-code">
<label for="edit-adres-postal-code--5" class="js-form-required form-required">Postcode</label>
<input data-drupal-selector="edit-adres-postal-code" data-msg-required="Postcode field is required." data-msg-maxlength="Postcode field has a maximum length of 255." type="text" id="edit-adres-postal-code--5"
name="adres[postal_code]" value="" size="60" maxlength="255" placeholder="0000 XX" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-instellingsnaam js-form-item-instellingsnaam">
<label for="edit-instellingsnaam--7" class="js-form-required form-required">Instellingsnaam / ziekenhuis</label>
<input data-drupal-selector="edit-instellingsnaam" data-msg-required="Instellingsnaam / ziekenhuis field is required." data-msg-maxlength="Instellingsnaam / ziekenhuis field has a maximum length of 255." type="text"
id="edit-instellingsnaam--7" name="instellingsnaam" value="" size="60" maxlength="255" placeholder="V.b. Ziekenhuis of gezondheidcentrum" class="form-text required" required="required" aria-required="true" autocomplete="off"
data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-select form-item-aantal js-form-item-aantal">
<label for="edit-aantal--5" class="js-form-required form-required">Aantal</label>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="js-webform-choices webform-choices form-select required choices__input" data-drupal-selector="edit-aantal" data-msg-required="Aantal field is required." id="edit-aantal--5" name="aantal"
data-once="webform-choices" hidden="" tabindex="-1" data-choice="active">
<option value="">- Selecteren -</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">- Selecteren -</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="- Selecteren -" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--edit-aantal--5-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1" data-value=""
data-select-text="Press to select" data-choice-selectable="" aria-selected="true">- Selecteren -</div>
<div id="choices--edit-aantal--5-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="1" data-select-text="Press to select" data-choice-selectable="">1
</div>
<div id="choices--edit-aantal--5-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="2" data-select-text="Press to select" data-choice-selectable="">2
</div>
<div id="choices--edit-aantal--5-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="3" data-select-text="Press to select" data-choice-selectable="">3
</div>
<div id="choices--edit-aantal--5-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="4" data-select-text="Press to select" data-choice-selectable="">4
</div>
<div id="choices--edit-aantal--5-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="5" data-select-text="Press to select" data-choice-selectable="">5
</div>
<div id="choices--edit-aantal--5-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="6" data-select-text="Press to select" data-choice-selectable="">6
</div>
<div id="choices--edit-aantal--5-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="7" data-select-text="Press to select" data-choice-selectable="">7
</div>
<div id="choices--edit-aantal--5-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="8" data-select-text="Press to select" data-choice-selectable="">8
</div>
<div id="choices--edit-aantal--5-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="9" data-select-text="Press to select"
data-choice-selectable="">9</div>
<div id="choices--edit-aantal--5-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="10" data-select-text="Press to select"
data-choice-selectable="">10</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-email form-item-e-mailadres js-form-item-e-mailadres">
<label for="edit-e-mailadres--5" class="js-form-required form-required">Persoonlijk e-mailadres</label>
<input data-drupal-selector="edit-e-mailadres" data-msg-required="Persoonlijk e-mailadres field is required." data-msg-email="Persoonlijk e-mailadres does not contain a valid email."
data-msg-maxlength="Persoonlijk e-mailadres field has a maximum length of 254." type="email" id="edit-e-mailadres--5" name="e_mailadres" value="" size="60" maxlength="254" placeholder="adres@mail.nl" class="form-email required"
required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
</div>
<div class="form-checkboxes form-checkboxes-narrow js-form-wrapper form-wrapper" data-drupal-selector="edit-container-confirmation" id="edit-container-confirmation--5">
<div id="edit-confirmation-top-text--5" data-hj-suppress="" class="js-form-item form-item js-form-type-processed-text form-item- js-form-item- form-no-label">
<p>Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over het gebruik van je gegevens vind je in onze
<a href="https://privacycenter.pfizer.com/nl/netherlands" title="https://privacycenter.pfizer.com/nl/netherlands" class="ext" data-extlink="" target="_blank" rel="noopener" data-pfa-listener-click="1" sc:linkname="content|navigation|privacy verklaring(externe link)">Privacy verklaring<svg focusable="false" class="ext" role="img" aria-label="(externe link)" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 80 40"><metadata><sfw xmlns="http://ns.adobe.com/SaveForWeb/1.0/"><slicesourcebounds y="-8160" x="-8165" width="16389" height="16384" bottomleftorigin="true"></slicesourcebounds><optimizationsettings><targetsettings targetsettingsid="0" fileformat="PNG24Format"><png24format transparency="true" filtered="false" interlaced="false" nomattecolor="false" mattecolor="#FFFFFF"></png24format></targetsettings></optimizationsettings></sfw></metadata><title>(externe link)</title><path d="M48 26c-1.1 0-2 0.9-2 2v26H10V18h26c1.1 0 2-0.9 2-2s-0.9-2-2-2H8c-1.1 0-2 0.9-2 2v40c0 1.1 0.9 2 2 2h40c1.1 0 2-0.9 2-2V28C50 26.9 49.1 26 48 26z"></path><path d="M56 6H44c-1.1 0-2 0.9-2 2s0.9 2 2 2h7.2L30.6 30.6c-0.8 0.8-0.8 2 0 2.8C31 33.8 31.5 34 32 34s1-0.2 1.4-0.6L54 12.8V20c0 1.1 0.9 2 2 2s2-0.9 2-2V8C58 6.9 57.1 6 56 6z"></path></svg></a>.
</p>
</div>
<div data-webform-terms-of-service-type="slideout" class="form-type-webform-terms-of-service js-form-type-webform-terms-of-service js-form-item form-item js-form-type-checkbox form-item-terms-of-service js-form-item-terms-of-service"
data-hj-suppress="" data-once="webform-terms-of-service">
<input data-drupal-selector="edit-terms-of-service" type="checkbox" id="edit-terms-of-service--5" name="terms_of_service" value="" class="form-checkbox" data-hj-suppress="">
<label for="edit-terms-of-service--5" class="option">Ja, ik geef Pfizer toestemming</label>
<div class="description">
<div id="edit-terms-of-service--5--description" class="webform-element-description">
<div id="webform-terms-of-service-terms_of_service--description" class="webform-terms-of-service-details js-hide">
<div class="webform-terms-of-service-details--title">Ja, ik geef Pfizer toestemming</div>
<div class="webform-terms-of-service-details--content">Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over
het gebruik van je gegevens vind je in onze
<a href="https://privacycenter.pfizer.com/nl/netherlands" title="https://privacycenter.pfizer.com/nl/netherlands" class="ext" data-extlink="" target="_blank" rel="noopener" data-pfa-listener-click="1" sc:linkname="content|navigation|privacy verklaring(externe link)">Privacy verklaring<svg focusable="false" class="ext" role="img" aria-label="(externe link)" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 80 40"><metadata><sfw xmlns="http://ns.adobe.com/SaveForWeb/1.0/"><slicesourcebounds y="-8160" x="-8165" width="16389" height="16384" bottomleftorigin="true"></slicesourcebounds><optimizationsettings><targetsettings targetsettingsid="0" fileformat="PNG24Format"><png24format transparency="true" filtered="false" interlaced="false" nomattecolor="false" mattecolor="#FFFFFF"></png24format></targetsettings></optimizationsettings></sfw></metadata><title>(externe link)</title><path d="M48 26c-1.1 0-2 0.9-2 2v26H10V18h26c1.1 0 2-0.9 2-2s-0.9-2-2-2H8c-1.1 0-2 0.9-2 2v40c0 1.1 0.9 2 2 2h40c1.1 0 2-0.9 2-2V28C50 26.9 49.1 26 48 26z"></path><path d="M56 6H44c-1.1 0-2 0.9-2 2s0.9 2 2 2h7.2L30.6 30.6c-0.8 0.8-0.8 2 0 2.8C31 33.8 31.5 34 32 34s1-0.2 1.4-0.6L54 12.8V20c0 1.1 0.9 2 2 2s2-0.9 2-2V8C58 6.9 57.1 6 56 6z"></path></svg></a>.
</div>
</div>
</div>
</div>
</div>
<div class="small-lh js-form-item form-item js-form-type-processed-text form-item- js-form-item- form-no-label" id="edit-confirmation-bottom-text--5" data-hj-suppress="">
<p><span style="font-size:09px;">Pfizer, inclusief moeder-, dochter- en zusterondernemingen en gelieerde partijen, respecteert de vertrouwelijkheid van persoonlijke informatie. Alleen Pfizer, of organisaties die namens Pfizer handelen, hebben
toegang tot uw informatie. U hebt te allen tijde het recht uw informatie in te zien of te laten aanpassen. Voor meer informatie over de privacy policy die Pfizer hanteert, verwijzen wij u naar pfizer.nl.</span></p>
<p><span style="font-size:09px;">Mocht u medische vragen hebben over Pfizer geneesmiddelen, neem dan contact op met Pfizer Medische Informatie via 0800-633 4636. Wilt u een bijwerking melden, neem dan contact op met Pfizer Drug Safety via
info@pfizer.nl of bel met 010-4064290.</span></p>
</div>
</div>
</div>
<div data-drupal-selector="edit-captcha" class="captcha captcha-type-challenge--recaptcha">
<div class="captcha__element">
<input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="670905927" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="W5pMmDvzkH4fa5dcYu8dY0xEcupHsgkCsftK1UQJNaM" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" data-hj-suppress="">
<div class="g-recaptcha" data-sitekey="6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0" data-theme="light" data-type="image">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-yfzymdyybzre" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0&co=aHR0cHM6Ly93d3cucGZpemVyLm5sOjQ0Mw..&hl=nl&type=image&v=1kRDYC3bfA-o6-tsWzIBvp7k&theme=light&size=normal&cb=6it1t52y0n33"></iframe>
</div><textarea id="g-recaptcha-response-8" 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><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" data-hj-suppress="">
</div>
<div class="captcha__description description">Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen.</div>
</div>
<div data-drupal-selector="edit-actions" class="form-actions webform-actions js-form-wrapper form-wrapper" id="edit-actions--15"><input class="webform-button--submit button button--primary js-form-submit form-submit"
data-drupal-selector="edit-actions-submit-7" type="submit" id="edit-actions-submit--7" name="op" value="Bestellen" data-hj-suppress="" data-pfa-listener-click="1">
</div>
<input autocomplete="off" data-drupal-selector="form-9ol0bexhifl1k4mewfkw-45fghv0q99-flo4ttrb0ta" type="hidden" name="form_build_id" value="form-9oL0BeXHiFL1K4meWfKW_45Fghv0Q99_flO4TTRb0tA" data-hj-suppress="">
<input data-drupal-selector="edit-webform-submission-materialen-bestellen-paragraph-156506-add-form" type="hidden" name="form_id" value="webform_submission_materialen_bestellen_paragraph_156506_add_form" data-hj-suppress="">
<div class="url-textfield js-form-wrapper form-wrapper" style="display: none !important;">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-url js-form-item-url">
<label for="edit-url--9">Leave this field blank</label>
<input autocomplete="off" data-drupal-selector="edit-url" data-msg-maxlength="Leave this field blank field has a maximum length of 128." type="text" id="edit-url--9" name="url" value="" size="20" maxlength="128" class="form-text"
data-hj-suppress="">
</div>
</div>
</form>POST /herkenamyloidose
<form
class="webform-submission-form webform-submission-add-form webform-submission-toolbox-and-program-form webform-submission-toolbox-and-program-add-form webform-submission-toolbox-and-program-paragraph-162945-form webform-submission-toolbox-and-program-paragraph-162945-add-form js-webform-details-toggle webform-details-toggle"
data-drupal-selector="webform-submission-toolbox-and-program-paragraph-162945-add-form" action="/herkenamyloidose" method="post" id="webform-submission-toolbox-and-program-paragraph-162945-add-form" accept-charset="UTF-8"
data-once="form-updated webform-details-toggle"
data-drupal-form-fields="edit-initialen--3,edit-achternaam--5,edit-adres--8,edit-postcode--3,edit-instellingsnaam--8,edit-persoonlijk-e-mailadres--4,edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2,edit-persoonlijk-werkboekje-roze-olifant--2,edit-werkmap-roze-olifant--2,edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2,edit-setje-conversatiestarters--2,edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma-1--3,edit-ja-ik-geef-toestemming-1--3,edit-actions-submit--8,edit-url--10">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-initialen js-form-item-initialen">
<label for="edit-initialen--3" class="js-form-required form-required">Initialen</label>
<input data-drupal-selector="edit-initialen" data-msg-required="Initialen field is required." data-msg-maxlength="Initialen field has a maximum length of 255." type="text" id="edit-initialen--3" name="initialen" value="" size="60" maxlength="255"
class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-achternaam js-form-item-achternaam">
<label for="edit-achternaam--5" class="js-form-required form-required">Achternaam</label>
<input data-drupal-selector="edit-achternaam" data-msg-required="Achternaam field is required." data-msg-maxlength="Achternaam field has a maximum length of 255." type="text" id="edit-achternaam--5" name="achternaam" value="" size="60"
maxlength="255" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-adres js-form-item-adres">
<label for="edit-adres--8" class="js-form-required form-required">Adres</label>
<input data-drupal-selector="edit-adres" data-msg-required="Adres field is required." data-msg-maxlength="Adres field has a maximum length of 255." type="text" id="edit-adres--8" name="adres" value="" size="60" maxlength="255"
class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-postcode js-form-item-postcode">
<label for="edit-postcode--3" class="js-form-required form-required">Postcode en plaats</label>
<input data-drupal-selector="edit-postcode" data-msg-required="Postcode en plaats field is required." data-msg-maxlength="Postcode en plaats field has a maximum length of 255." type="text" id="edit-postcode--3" name="postcode" value="" size="60"
maxlength="255" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-instellingsnaam js-form-item-instellingsnaam">
<label for="edit-instellingsnaam--8" class="js-form-required form-required">Instellingsnaam / ziekenhuis</label>
<input data-drupal-selector="edit-instellingsnaam" data-msg-required="Instellingsnaam / ziekenhuis field is required." data-msg-maxlength="Instellingsnaam / ziekenhuis field has a maximum length of 255." type="text" id="edit-instellingsnaam--8"
name="instellingsnaam" value="" size="60" maxlength="255" class="form-text required" required="required" aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-email form-item-persoonlijk-e-mailadres js-form-item-persoonlijk-e-mailadres">
<label for="edit-persoonlijk-e-mailadres--4" class="js-form-required form-required">Persoonlijk e-mailadres</label>
<input data-drupal-selector="edit-persoonlijk-e-mailadres" data-msg-required="Persoonlijk e-mailadres field is required." data-msg-email="Persoonlijk e-mailadres does not contain a valid email."
data-msg-maxlength="Persoonlijk e-mailadres field has a maximum length of 254." type="email" id="edit-persoonlijk-e-mailadres--4" name="persoonlijk_e_mailadres" value="" size="60" maxlength="254" class="form-email required" required="required"
aria-required="true" autocomplete="off" data-hj-suppress="">
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-select form-item-brochure-seksualiteit-bij-borstkanker-van-de-bvn js-form-item-brochure-seksualiteit-bij-borstkanker-van-de-bvn">
<label for="edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2">Brochure seksualiteit bij borstkanker van de BVN</label>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="js-webform-choices webform-choices form-select choices__input" data-drupal-selector="edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn" id="edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2"
name="brochure_seksualiteit_bij_borstkanker_van_de_bvn" data-once="webform-choices" hidden="" tabindex="-1" data-choice="active">
<option value="">- Geen -</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">- Geen -</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="- Geen -" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice=""
data-id="1" data-value="" data-select-text="Press to select" data-choice-selectable="" aria-selected="true">- Geen -</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="1"
data-select-text="Press to select" data-choice-selectable="">1</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="2"
data-select-text="Press to select" data-choice-selectable="">2</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="3"
data-select-text="Press to select" data-choice-selectable="">3</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="4"
data-select-text="Press to select" data-choice-selectable="">4</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="5"
data-select-text="Press to select" data-choice-selectable="">5</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="6"
data-select-text="Press to select" data-choice-selectable="">6</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="7"
data-select-text="Press to select" data-choice-selectable="">7</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="8"
data-select-text="Press to select" data-choice-selectable="">8</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="9"
data-select-text="Press to select" data-choice-selectable="">9</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="10"
data-select-text="Press to select" data-choice-selectable="">10</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-12" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="12" data-value="11"
data-select-text="Press to select" data-choice-selectable="">11</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-13" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="13" data-value="12"
data-select-text="Press to select" data-choice-selectable="">12</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-14" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="14" data-value="13"
data-select-text="Press to select" data-choice-selectable="">13</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-15" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="15" data-value="14"
data-select-text="Press to select" data-choice-selectable="">14</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-16" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="16" data-value="15"
data-select-text="Press to select" data-choice-selectable="">15</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-17" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="17" data-value="16"
data-select-text="Press to select" data-choice-selectable="">16</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-18" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="18" data-value="17"
data-select-text="Press to select" data-choice-selectable="">17</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-19" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="19" data-value="18"
data-select-text="Press to select" data-choice-selectable="">18</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-20" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="20" data-value="19"
data-select-text="Press to select" data-choice-selectable="">19</div>
<div id="choices--edit-brochure-seksualiteit-bij-borstkanker-van-de-bvn--2-item-choice-21" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="21" data-value="20"
data-select-text="Press to select" data-choice-selectable="">20</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-select form-item-persoonlijk-werkboekje-roze-olifant js-form-item-persoonlijk-werkboekje-roze-olifant">
<label for="edit-persoonlijk-werkboekje-roze-olifant--2">Persoonlijk werkboekje Roze Olifant</label>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="js-webform-choices webform-choices form-select choices__input" data-drupal-selector="edit-persoonlijk-werkboekje-roze-olifant" id="edit-persoonlijk-werkboekje-roze-olifant--2"
name="persoonlijk_werkboekje_roze_olifant" data-once="webform-choices" hidden="" tabindex="-1" data-choice="active">
<option value="">- Geen -</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">- Geen -</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="- Geen -" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1"
data-value="" data-select-text="Press to select" data-choice-selectable="" aria-selected="true">- Geen -</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="1" data-select-text="Press to select"
data-choice-selectable="">1</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="2" data-select-text="Press to select"
data-choice-selectable="">2</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="3" data-select-text="Press to select"
data-choice-selectable="">3</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="4" data-select-text="Press to select"
data-choice-selectable="">4</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="5" data-select-text="Press to select"
data-choice-selectable="">5</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="6" data-select-text="Press to select"
data-choice-selectable="">6</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="7" data-select-text="Press to select"
data-choice-selectable="">7</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="8" data-select-text="Press to select"
data-choice-selectable="">8</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="9" data-select-text="Press to select"
data-choice-selectable="">9</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="10" data-select-text="Press to select"
data-choice-selectable="">10</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-12" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="12" data-value="11" data-select-text="Press to select"
data-choice-selectable="">11</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-13" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="13" data-value="12" data-select-text="Press to select"
data-choice-selectable="">12</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-14" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="14" data-value="13" data-select-text="Press to select"
data-choice-selectable="">13</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-15" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="15" data-value="14" data-select-text="Press to select"
data-choice-selectable="">14</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-16" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="16" data-value="15" data-select-text="Press to select"
data-choice-selectable="">15</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-17" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="17" data-value="16" data-select-text="Press to select"
data-choice-selectable="">16</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-18" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="18" data-value="17" data-select-text="Press to select"
data-choice-selectable="">17</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-19" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="19" data-value="18" data-select-text="Press to select"
data-choice-selectable="">18</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-20" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="20" data-value="19" data-select-text="Press to select"
data-choice-selectable="">19</div>
<div id="choices--edit-persoonlijk-werkboekje-roze-olifant--2-item-choice-21" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="21" data-value="20" data-select-text="Press to select"
data-choice-selectable="">20</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-select form-item-werkmap-roze-olifant js-form-item-werkmap-roze-olifant">
<label for="edit-werkmap-roze-olifant--2">Werkmap Roze Olifant</label>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="js-webform-choices webform-choices form-select choices__input" data-drupal-selector="edit-werkmap-roze-olifant" id="edit-werkmap-roze-olifant--2" name="werkmap_roze_olifant" data-once="webform-choices"
hidden="" tabindex="-1" data-choice="active">
<option value="">- Geen -</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">- Geen -</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="- Geen -" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1" data-value=""
data-select-text="Press to select" data-choice-selectable="" aria-selected="true">- Geen -</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="1" data-select-text="Press to select"
data-choice-selectable="">1</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="2" data-select-text="Press to select"
data-choice-selectable="">2</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="3" data-select-text="Press to select"
data-choice-selectable="">3</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="4" data-select-text="Press to select"
data-choice-selectable="">4</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="5" data-select-text="Press to select"
data-choice-selectable="">5</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="6" data-select-text="Press to select"
data-choice-selectable="">6</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="7" data-select-text="Press to select"
data-choice-selectable="">7</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="8" data-select-text="Press to select"
data-choice-selectable="">8</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="9" data-select-text="Press to select"
data-choice-selectable="">9</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="10" data-select-text="Press to select"
data-choice-selectable="">10</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-12" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="12" data-value="11" data-select-text="Press to select"
data-choice-selectable="">11</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-13" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="13" data-value="12" data-select-text="Press to select"
data-choice-selectable="">12</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-14" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="14" data-value="13" data-select-text="Press to select"
data-choice-selectable="">13</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-15" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="15" data-value="14" data-select-text="Press to select"
data-choice-selectable="">14</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-16" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="16" data-value="15" data-select-text="Press to select"
data-choice-selectable="">15</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-17" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="17" data-value="16" data-select-text="Press to select"
data-choice-selectable="">16</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-18" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="18" data-value="17" data-select-text="Press to select"
data-choice-selectable="">17</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-19" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="19" data-value="18" data-select-text="Press to select"
data-choice-selectable="">18</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-20" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="20" data-value="19" data-select-text="Press to select"
data-choice-selectable="">19</div>
<div id="choices--edit-werkmap-roze-olifant--2-item-choice-21" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="21" data-value="20" data-select-text="Press to select"
data-choice-selectable="">20</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-select form-item-visitekaartjes-deherontdekkingvanhaarzelf-nl js-form-item-visitekaartjes-deherontdekkingvanhaarzelf-nl">
<label for="edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2">Visitekaartjes deherontdekkingvanhaarzelf.nl</label>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="js-webform-choices webform-choices form-select choices__input" data-drupal-selector="edit-visitekaartjes-deherontdekkingvanhaarzelf-nl" id="edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2"
name="visitekaartjes_deherontdekkingvanhaarzelf_nl" data-once="webform-choices" hidden="" tabindex="-1" data-choice="active">
<option value="">- Geen -</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">- Geen -</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="- Geen -" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice=""
data-id="1" data-value="" data-select-text="Press to select" data-choice-selectable="" aria-selected="true">- Geen -</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="1"
data-select-text="Press to select" data-choice-selectable="">1</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="2"
data-select-text="Press to select" data-choice-selectable="">2</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="3"
data-select-text="Press to select" data-choice-selectable="">3</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="4"
data-select-text="Press to select" data-choice-selectable="">4</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="5"
data-select-text="Press to select" data-choice-selectable="">5</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="6"
data-select-text="Press to select" data-choice-selectable="">6</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="7"
data-select-text="Press to select" data-choice-selectable="">7</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="8"
data-select-text="Press to select" data-choice-selectable="">8</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="9"
data-select-text="Press to select" data-choice-selectable="">9</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="10"
data-select-text="Press to select" data-choice-selectable="">10</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-12" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="12" data-value="11"
data-select-text="Press to select" data-choice-selectable="">11</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-13" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="13" data-value="12"
data-select-text="Press to select" data-choice-selectable="">12</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-14" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="14" data-value="13"
data-select-text="Press to select" data-choice-selectable="">13</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-15" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="15" data-value="14"
data-select-text="Press to select" data-choice-selectable="">14</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-16" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="16" data-value="15"
data-select-text="Press to select" data-choice-selectable="">15</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-17" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="17" data-value="16"
data-select-text="Press to select" data-choice-selectable="">16</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-18" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="18" data-value="17"
data-select-text="Press to select" data-choice-selectable="">17</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-19" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="19" data-value="18"
data-select-text="Press to select" data-choice-selectable="">18</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-20" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="20" data-value="19"
data-select-text="Press to select" data-choice-selectable="">19</div>
<div id="choices--edit-visitekaartjes-deherontdekkingvanhaarzelf-nl--2-item-choice-21" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="21" data-value="20"
data-select-text="Press to select" data-choice-selectable="">20</div>
</div>
</div>
</div>
</div>
<div data-hj-suppress="" class="js-form-item form-item js-form-type-select form-item-setje-conversatiestarters js-form-item-setje-conversatiestarters">
<label for="edit-setje-conversatiestarters--2">Setje conversatiestarters</label>
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select class="js-webform-choices webform-choices form-select choices__input" data-drupal-selector="edit-setje-conversatiestarters" id="edit-setje-conversatiestarters--2" name="setje_conversatiestarters"
data-once="webform-choices" hidden="" tabindex="-1" data-choice="active">
<option value="">- Geen -</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true">- Geen -</div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
aria-label="- Geen -" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--edit-setje-conversatiestarters--2-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1" data-value=""
data-select-text="Press to select" data-choice-selectable="" aria-selected="true">- Geen -</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="1" data-select-text="Press to select"
data-choice-selectable="">1</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="2" data-select-text="Press to select"
data-choice-selectable="">2</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="3" data-select-text="Press to select"
data-choice-selectable="">3</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="4" data-select-text="Press to select"
data-choice-selectable="">4</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="5" data-select-text="Press to select"
data-choice-selectable="">5</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="6" data-select-text="Press to select"
data-choice-selectable="">6</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="7" data-select-text="Press to select"
data-choice-selectable="">7</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="8" data-select-text="Press to select"
data-choice-selectable="">8</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="9" data-select-text="Press to select"
data-choice-selectable="">9</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="10" data-select-text="Press to select"
data-choice-selectable="">10</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-12" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="12" data-value="11" data-select-text="Press to select"
data-choice-selectable="">11</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-13" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="13" data-value="12" data-select-text="Press to select"
data-choice-selectable="">12</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-14" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="14" data-value="13" data-select-text="Press to select"
data-choice-selectable="">13</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-15" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="15" data-value="14" data-select-text="Press to select"
data-choice-selectable="">14</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-16" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="16" data-value="15" data-select-text="Press to select"
data-choice-selectable="">15</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-17" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="17" data-value="16" data-select-text="Press to select"
data-choice-selectable="">16</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-18" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="18" data-value="17" data-select-text="Press to select"
data-choice-selectable="">17</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-19" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="19" data-value="18" data-select-text="Press to select"
data-choice-selectable="">18</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-20" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="20" data-value="19" data-select-text="Press to select"
data-choice-selectable="">19</div>
<div id="choices--edit-setje-conversatiestarters--2-item-choice-21" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="21" data-value="20" data-select-text="Press to select"
data-choice-selectable="">20</div>
</div>
</div>
</div>
</div>
<fieldset data-drupal-selector="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma" id="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma--3--wrapper"
class="radios--wrapper fieldgroup form-composite webform-composite-hidden-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper" data-once="webform-radios-required">
<legend id="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma--3--wrapper-legend">
<span class="visually-hidden fieldset-legend">Ik meld mij tevens aan voor het Roze Olifant programma</span>
</legend>
<div class="fieldset-wrapper">
<div id="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma--3" class="js-webform-radios webform-options-display-one-column">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-radio form-item-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma js-form-item-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma">
<input data-drupal-selector="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma-1-3" type="radio" id="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma-1--3" name="ik_meld_mij_tevens_aan_voor_het_roze_olifant_programma"
value="1" class="form-radio" data-hj-suppress="">
<label for="edit-ik-meld-mij-tevens-aan-voor-het-roze-olifant-programma-1--3" class="option">Ik meld mij tevens aan voor het Roze Olifant programma</label>
</div>
</div>
</div>
</fieldset>
<fieldset data-drupal-selector="edit-ja-ik-geef-toestemming-" id="edit-ja-ik-geef-toestemming---3--wrapper"
class="radios--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper" data-once="webform-radios-required">
<legend id="edit-ja-ik-geef-toestemming---3--wrapper-legend">
<span class="fieldset-legend">Indien ik dit nog niet heb gedaan, geef ik Pfizer toestemming om mijn e-mailadres te gebruiken om mij waardevolle informatie over evenementen en wetenschappelijke en gezondheidsgerelateerde informatie op basis van
mijn specialiteit en belangen toe te sturen. Meer informatie over het gebruik van uw gegevens vind u in onze
<a href="https://privacycenter.pfizer.com/nl/netherlands" target="_blank" class="ext" data-extlink="" rel="noopener" data-pfa-listener-click="1" sc:linkname="content|navigation|privacy verklaring(externe link)">Privacy verklaring<svg focusable="false" class="ext" role="img" aria-label="(externe link)" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 80 40"><metadata><sfw xmlns="http://ns.adobe.com/SaveForWeb/1.0/"><slicesourcebounds y="-8160" x="-8165" width="16389" height="16384" bottomleftorigin="true"></slicesourcebounds><optimizationsettings><targetsettings targetsettingsid="0" fileformat="PNG24Format"><png24format transparency="true" filtered="false" interlaced="false" nomattecolor="false" mattecolor="#FFFFFF"></png24format></targetsettings></optimizationsettings></sfw></metadata><title>(externe link)</title><path d="M48 26c-1.1 0-2 0.9-2 2v26H10V18h26c1.1 0 2-0.9 2-2s-0.9-2-2-2H8c-1.1 0-2 0.9-2 2v40c0 1.1 0.9 2 2 2h40c1.1 0 2-0.9 2-2V28C50 26.9 49.1 26 48 26z"></path><path d="M56 6H44c-1.1 0-2 0.9-2 2s0.9 2 2 2h7.2L30.6 30.6c-0.8 0.8-0.8 2 0 2.8C31 33.8 31.5 34 32 34s1-0.2 1.4-0.6L54 12.8V20c0 1.1 0.9 2 2 2s2-0.9 2-2V8C58 6.9 57.1 6 56 6z"></path></svg></a>.</span>
</legend>
<div class="fieldset-wrapper">
<div id="edit-ja-ik-geef-toestemming---3" class="js-webform-radios webform-options-display-one-column">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-radio form-item-ja-ik-geef-toestemming- js-form-item-ja-ik-geef-toestemming-">
<input data-drupal-selector="edit-ja-ik-geef-toestemming-1-3" type="radio" id="edit-ja-ik-geef-toestemming-1--3" name="ja_ik_geef_toestemming_" value="1" class="form-radio" data-hj-suppress="">
<label for="edit-ja-ik-geef-toestemming-1--3" class="option">ja, ik geef toestemming.</label>
</div>
</div>
</div>
</fieldset>
<div data-drupal-selector="edit-captcha" class="captcha captcha-type-challenge--recaptcha">
<div class="captcha__element">
<input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="670905928" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="HHQr8e0vOv_gPQHhTAplDBkiTYYrC_ApCF9gCeyca-s" data-hj-suppress="">
<input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" data-hj-suppress="">
<div class="g-recaptcha" data-sitekey="6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0" data-theme="light" data-type="image">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-rkmwqcwrv93" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LcvQTsUAAAAAOBlBYnJleKXH5qU5uKAvdsuPPu0&co=aHR0cHM6Ly93d3cucGZpemVyLm5sOjQ0Mw..&hl=nl&type=image&v=1kRDYC3bfA-o6-tsWzIBvp7k&theme=light&size=normal&cb=xd1alpz8zbkc"></iframe>
</div><textarea id="g-recaptcha-response-9" 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><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" data-hj-suppress="">
</div>
<div class="captcha__description description">Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen.</div>
</div>
<div data-drupal-selector="edit-actions" class="form-actions webform-actions js-form-wrapper form-wrapper" id="edit-actions--17"><input class="webform-button--submit button button--primary js-form-submit form-submit"
data-drupal-selector="edit-actions-submit-8" type="submit" id="edit-actions-submit--8" name="op" value="Verzenden" data-hj-suppress="" data-pfa-listener-click="1">
</div>
<input autocomplete="off" data-drupal-selector="form-9tpyr-h5jjs-vkmeox56oduubnvplteygavzxyfjwcq" type="hidden" name="form_build_id" value="form-9TPyr_h5JJS-vkMeOX56OduubNVplTEYgavZXYfjwcQ" data-hj-suppress="">
<input data-drupal-selector="edit-webform-submission-toolbox-and-program-paragraph-162945-add-form" type="hidden" name="form_id" value="webform_submission_toolbox_and_program_paragraph_162945_add_form" data-hj-suppress="">
<div class="url-textfield js-form-wrapper form-wrapper" style="display: none !important;">
<div data-hj-suppress="" class="js-form-item form-item js-form-type-textfield form-item-url js-form-item-url">
<label for="edit-url--10">Leave this field blank</label>
<input autocomplete="off" data-drupal-selector="edit-url" data-msg-maxlength="Leave this field blank field has a maximum length of 128." type="text" id="edit-url--10" name="url" value="" size="20" maxlength="128" class="form-text"
data-hj-suppress="">
</div>
</div>
</form>Text Content
Overslaan en naar de inhoud gaan * Typen amyloïdose * AL amyloïdose * Erfelijke ATTR amyloïdose * AA amyloïdose * Wild-type ATTR amyloïdose * Overige vormen Amyloïdose * Specialisme * Cardiologie * Neurologie * Urologie * Gastroenterologie * Klinische genetica * Ervaringsverhalen * Wim de Ket heeft wildtype ATTR amyloïdose * Pien heeft AL Amyloïdose * Dik Schipper heeft erfelijke ATTR Amyloïdose * Patiënt met amyloïdose moet sneller in beeld komen * Wij zijn gewend om met een amyloïdose-oog te kijken * Educatie & Nascholing * Handige materialen * Wat is de prevalentie van cardiale amyloïdose * Podcasts * Publicaties * Talkshow * Video: De diagnose van amyloïdose * Contact * Expertise centra * Contact Pfizer Toggle mobile menu HET ZIEKTEBEELD AMYLOÏDOSE Amyloïdose is de naam van een groep stapelingsziekten van verkeerd gevouwen eiwitten die zich kunnen manifesteren in allerlei organen zoals hart, nieren, lever, maag-darmkanaal en het zenuwstelsel. Amyloïdose is steeds beter behandelbaar, maar als diagnose nog steeds makkelijk gemist. Deze stapelingsziekte is vaak lastig te herkennen. Nu behandelingsmogelijkheden verbeteren, wordt diagnostiek belangrijker. Er worden verschillende vormen van amyloïdose onderscheiden: AL amyloïdose, erfelijke ATTR-amyloïdose, AA amyloïdose, Wild-type amyloïdose en overige vormen. Typen amyloïdose WAT IS DE PREVALENTIE VAN CARDIALE AMYLOÏDOSE? Amyloïdose is een ondergediagnostiseerde systeemziekte. Om dit zichtbaar te maken is op basis van beschikbare gegevens de interactieve prevalentiekaart ontwikkeld. Deze kan een voorzichtige inschatting geven van het aantal ATTR-CM patiënten in elke regio. Lees meer CARDIALE BETROKKENHEID BIJ AMYLOÏDOSE Amyloïdosepatiënten met cardiale betrokkenheid krijgen op den duur last van hun hart, omdat amyloïdfibrillen zich daar opstapelen en schade veroorzaken. Schade aan onder andere de atria, de ventrikels en de perivasculaire ruimte. Soms raken ook de hartkleppen en het geleidingssysteem van het hart aangetast. Lees meer EDUCATIE AMYLOÏDOSE Amyloïdose is een fascinerend ziektebeeld dat niet eenvoudig is om te herkennen. Tijdige herkenning is wel belangrijk, omdat er behandeling mogelijk is en de prognose van uw patiënten sterk kan verbeteren. Daarom bieden we de komende maanden een uitgebereid, hybride nascholingspakket aan waarmee u op de hoogte kunt blijven van de nieuwste diagnosemogelijkheden, behandelinzichten en onderzoeken op het gebied van de verschillende typen amyloïdose. E-LEARNING CARDIALE AMYLOÏDOSE: HERKENNING, DIAGNOSE EN BEHANDELING In deze e-learning gaat Petra van Pol, cardioloog van het OLVG in Amsterdam, in gesprek met collega cardiologen om uit te zoeken waar het nu fout gaat en hoe deze patiënten in Nederland het beste gediagnosticeerd en behandeld kunnen worden. Volg de e-learning ESCAPEROOM INTERACTIEVE SKILLSLAB Het unieke Skillslab, escaperoom Cardiale amyloïdose, vergroot je bewustwording en kennis. Een Active Learning Escaperoom waarbij je binnen 1 uur alles leert over de rode vlaggen, de presentatie en verwijsmogelijkheden. Accreditatie is toegekend voor 1 punt door NVVC, V&V, NAPA en NVNG. Meld je nu aan PODCAST PODCAST: CARDIALE AMYLOÏDOSE, HOE TE HERKENNEN EN WANNEER ER AAN TE DENKEN. Michelle Michels, cardioloog werkzaam bij het Erasmus MC met als aandachtgebieden o.a. cardiogenetica gaat in gesprek over o.a. de drie mythes rondom cardiale amyloïdose; het is zeldzaam, moeilijk te diagnosticeren en niet te behandelen…? Besluister de podcast * 1 ‘JE ZIET MENSEN MET HARTFALEN STEEDS ZIEKER WORDEN, ONDANKS DE BEHANDELING DIE ZE KRIJGEN’ Verpleegkundig specialist cardiologie Gun Verhaest van het BovenIJ ziekenhuis in Amsterdam zet zich in om meer bewustzijn en aandacht te creëren voor ATTR amyloïdose. Samen met Pfizer ontwikkelde ze het HIDDEN-zakkaartje met daarop naast een overzicht van de rode vlaggen ook een diagnostisch algoritme voor cardiale amyloïdose. Lees het verhaal van Gun ‘Ik hoop dat de HIDDEN-zakkaartjes veel worden gebruikt’ Download of bekijk hier het HIDDEN-zakkaartje. Download PRAKTISCHE INFORMATIE Handige downloads, een overzicht van de Nederlandse expertise- en behandelcentra en andere praktische informatie. PRAKTISCHE SCHEMA'S EXPERTISE- EN BEHANDELCENTRA IN NEDERLAND In Nederland bestaan verschillende expertise- en behandelcentra voor amyloïdose. Welk centrum is er bij u in de regio actief? Amyloïdose centra TOOL VOOR U SAMENGEVAT: Acht recente klinisch relevante publicaties over amyloïdose. Framingham (externe link) PFIZERPRO LOG IN VOOR DATA ATTR-ACT STUDIE(EXTERNE LINK) Deze informatie is beschikbaar voor artsen in Nederland. U kunt contact(externe link) met ons opnemen wanneer u er de voorkeur aan geeft deze informatie per e-mail te ontvangen. Inloggen Pfizerpro (externe link) * 1 WAAROM ZIEN CARDIOLOGEN MEER PATIËNTEN MET AMYLOÏDOSE DAN ANDERE SPECIALISTEN? Deel 4 van de talkshow Amyloïdose gaat over amyloïdose en cardiologie. Zo wordt onder andere de belangrijke rol van de cardioloog bij het stellen van de diagnose besproken. Talkshow amyloïdose PATIËNTENVERHALEN ‘MET TENNIS GOOIDE IK MIJN RACKET PER ONGELUK ACHTER DE BAL AAN’ Van de podotherapeut, neuroloog, reumatoloog, revalidatiearts, orthopedisch chirurg, tot internist en uroloog: Dik bezocht ze allemaal zonder de juiste diagnose te krijgen. Bij het AMC gingen de alarmbellen af toen ze hoorden dat Dik naast cardiomyopathie enkele jaren geleden carpaaltunnelsyndroom had. Lees het verhaal van Dik ‘IK SPREEK GENOEG MENSEN DIE JAREN MOESTEN WACHTEN OP EEN DIAGNOSE. DAT IS FUNEST BIJ DEZE ZIEKTE.’ Wim de Ket weet sinds kort dat hij de zeldzame aandoening transthyretine gerelateerde cardiale amyloïdose heeft. Hij prijst zichzelf gelukkig dat de diagnose binnen enkele maanden al werd gesteld. Lees het verhaal van Wim ‘IK WAS VOORAL OPGELUCHT TOEN IK DE DIAGNOSE KREEG’ Het was Peter zelf die ontdekte dat hij AL-amyloïdose heeft. Hij moest aandringen in het ziekenhuis voordat zijn vermoeden werd onderzocht én bevestigd. ‘Eindelijk wist ik wat ik had.’ Lees het verhaal van Peter * 1 * Bijwerkingen melden * Gebruiksvoorwaarden * Privacyverklaring(externe link) ©2023 Pfizer.nl, Alle Rechten voorbehouden. | PP-VYN-NLD-0288 Top Close popup Close popup VIND HULP OM TE STOPPEN MET ROKEN Zorgverleners zijn getraind om mensen van het roken af te helpen. Ze kunnen je adviseren over de meest geschikte methodes. Met de hulp van, bijvoorbeeld, je huisarts heb je tot 4 keer meer kans op een succesvolle stoppoging dan wanneer je het alleen probeert. Stoppen met roken kan lastig zijn. Een roker heeft soms meerdere pogingen nodig om succesvol te stoppen. Je huisarts of zorgverlener kan je allerlei vragen stellen als je om advies vraagt over stoppen met roken. Wanneer je alle informatie over eerdere stoppogingen deelt, kun je samen besluiten welke stopmethode voor jou de beste is. Welke vragen kun je verwachten? Behalve bij de huisarts kun je voor stoppen met roken hulp ook heel goed terecht bij: Wequit.nl(externe link) “Bij WeQuit geloven we dat het succes van onze aanpak zit in de persoonlijke begeleiding. Je hoeft het niet alleen te doen.” Sinefuma.nl(externe link) Stoppen in groepsverband zowel op locatie als online of met individuele coaching op locatie, telefonisch of online. Ikstopnu.nl(externe link) Hier kun je nog meer informatie over stoppen met roken vinden. Close popup VRAAG EEN GEDRUKT EXEMPLAAR AAN Dit magazine is alleen bedoeld voor zorgprofessionals met voorschrijfbevoegdheid. Initialen Achternaam Adres Postcode en plaats Instellingsnaam / ziekenhuis Persoonlijk e-mailadres Ik meld mij tevens aan voor het Roze Olifant programma Ik meld mij tevens aan voor het Roze Olifant programma Indien ik dit nog niet heb gedaan, geef ik Pfizer toestemming om mijn e-mailadres te gebruiken om mij waardevolle informatie over evenementen en wetenschappelijke en gezondheidsgerelateerde informatie op basis van mijn specialiteit en belangen toe te sturen. Meer informatie over het gebruik van uw gegevens vind u in onze Privacy verklaring(externe link). ja, ik geef toestemming. Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen. Leave this field blank Close popup PROGRAMMA Roze Olifant is specifiek voor artsen, verpleegkundigen, seksuologen en andere professionals geschreven om hen te begeleiden om dit onderwerp in hun ziekenhuizen verder te verbeteren. Programma Roze Olifant is tot stand gebracht door een programmacommissie gevormd door vertegenwoordigers van Borstkankervereniging Nederland (BVN), Sick & Sex, zorgverleners die passie hebben voor het onderwerp en Pfizer Oncology. Borstkanker behandeling vraagt om meer aandacht voor seksualiteit en intimiteit Voor vrouwen (en mannen) met borstkanker leek intimiteit en seksualiteit lange tijd geen issue; eerst overleven. Nu borstkanker steeds beter te behandelen is, is de kwaliteit van leven vaker onderwerp in de spreekkamer. Seksualiteit en intimiteit maken daar onmiskenbaar deel van uit. Hoe breng je iemands seksleven ter sprake als onderdeel van goede borstkanker zorg? Seksualiteit is vaak ‘de olifant in de spreekkamer’; het probleem is overduidelijk aanwezig en je weet dat je het als zorgteam, ergens in het zorgpad, bespreekbaar zou moeten maken. En toch gebeurt het niet, of niet altijd. Programma Roze Olifant ondersteunt het zorgteam (behandelaren, verpleegkundig specialisten en mammacare-verpleegkundigen) om intimiteit en seksualiteit bespreekbaar te maken. Close popup MELD JE AAN! Roze Olifant is een programma voor zorgprofessionals in ziekenhuizen om seksualiteit en intimiteit vaker bespreekbaar te maken bij vrouwen en mannen die borstkanker hebben (gehad). Interesse? Meld je aan! Initialen Achternaam Adres Postcode en plaats Instellingsnaam / ziekenhuis Persoonlijk e-mailadres Brochure seksualiteit bij borstkanker van de BVN - Geen - - Geen - - Geen - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Persoonlijk werkboekje Roze Olifant - Geen - - Geen - - Geen - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Werkmap Roze Olifant - Geen - - Geen - - Geen - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Visitekaartjes deherontdekkingvanhaarzelf.nl - Geen - - Geen - - Geen - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Setje conversatiestarters - Geen - - Geen - - Geen - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Ik meld mij tevens aan voor het Roze Olifant programma Ik meld mij tevens aan voor het Roze Olifant programma Indien ik dit nog niet heb gedaan, geef ik Pfizer toestemming om mijn e-mailadres te gebruiken om mij waardevolle informatie over evenementen en wetenschappelijke en gezondheidsgerelateerde informatie op basis van mijn specialiteit en belangen toe te sturen. Meer informatie over het gebruik van uw gegevens vind u in onze Privacy verklaring(externe link). ja, ik geef toestemming. Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen. Leave this field blank Close popup STELLING: ANGIOGENESE EN HET IMMUUNSYSTEEM ZIJN BEIDE BELANGRIJKE PATHWAYS IN RCC Choices Geheel mee eens Gedeeltelijk mee eens, angiogenese is belangrijker dan het immuunsysteem Gedeeltelijk mee eens, het immuunsysteem is belangrijker dan angiogenese Gedeeltelijk mee eens, het verschilt per patiënt welk proces het belangrijkste is Oneens, er zijn nog veel meer pathways die net zo belangrijk zijn Close popup Algemene gegevens Voorletter(s) Achternaam Instellingsnaam / ziekenhuis Persoonlijk e-mailadres Telefoonnummer Indien ik dit nog niet heb gedaan, geef ik Pfizer toestemming om mijn e-mailadres te gebruiken om mij waardevolle informatie over evenementen en wetenschappelijke en gezondheidsgerelateerde informatie op basis van mijn specialiteit en belangen toe te sturen. Meer informatie over het gebruik van uw gegevens vind u in onze Privacy verklaring(externe link). ja, ik geef toestemming. Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen. Leave this field blank Close popup Algemene gegevens aanvrager Voorletter(s) Achternaam Leeftijd aanvrager Straatnaam en huisnummer Postcode Plaats Land Persoonlijk e-mailadres aanvrager Hoe bent u bekend geraakt met deze actie? - Geen - - Geen - - Geen - Via Social Media Via Dermatoloog Via Verpleegkundig Specialist Via Pfizer.nl Via Vrienden en Familie Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen. Leave this field blank Close popup VRAAG HET BOEK "ALLES OVER BORSTKANKER' AAN Dit boek is alleen bedoeld voor zorgprofessionals met voorschrijfbevoegdheid. MATERIALEN BESTELLEN Initialen Achternaam Adres Plaats Postcode Instellingsnaam / ziekenhuis Aantal - Selecteren - - Selecteren - - Selecteren - 1 2 3 4 5 6 7 8 9 10 Persoonlijk e-mailadres Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over het gebruik van je gegevens vind je in onze Privacy verklaring(externe link). Ja, ik geef Pfizer toestemming Ja, ik geef Pfizer toestemming Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over het gebruik van je gegevens vind je in onze Privacy verklaring(externe link). Pfizer, inclusief moeder-, dochter- en zusterondernemingen en gelieerde partijen, respecteert de vertrouwelijkheid van persoonlijke informatie. Alleen Pfizer, of organisaties die namens Pfizer handelen, hebben toegang tot uw informatie. U hebt te allen tijde het recht uw informatie in te zien of te laten aanpassen. Voor meer informatie over de privacy policy die Pfizer hanteert, verwijzen wij u naar pfizer.nl. Mocht u medische vragen hebben over Pfizer geneesmiddelen, neem dan contact op met Pfizer Medische Informatie via 0800-633 4636. Wilt u een bijwerking melden, neem dan contact op met Pfizer Drug Safety via info@pfizer.nl of bel met 010-4064290. Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen. Leave this field blank Close popup VRAAG HET BOEK "ALLES OVER BORSTKANKER' AAN Dit boek is alleen bedoeld voor zorgprofessionals met voorschrijfbevoegdheid. MATERIALEN BESTELLEN Initialen Achternaam Adres Plaats Postcode Instellingsnaam / ziekenhuis Aantal - Selecteren - - Selecteren - - Selecteren - 1 2 3 4 5 6 7 8 9 10 Persoonlijk e-mailadres Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over het gebruik van je gegevens vind je in onze Privacy verklaring(externe link). Ja, ik geef Pfizer toestemming Ja, ik geef Pfizer toestemming Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over het gebruik van je gegevens vind je in onze Privacy verklaring(externe link). Pfizer, inclusief moeder-, dochter- en zusterondernemingen en gelieerde partijen, respecteert de vertrouwelijkheid van persoonlijke informatie. Alleen Pfizer, of organisaties die namens Pfizer handelen, hebben toegang tot uw informatie. U hebt te allen tijde het recht uw informatie in te zien of te laten aanpassen. Voor meer informatie over de privacy policy die Pfizer hanteert, verwijzen wij u naar pfizer.nl. Mocht u medische vragen hebben over Pfizer geneesmiddelen, neem dan contact op met Pfizer Medische Informatie via 0800-633 4636. Wilt u een bijwerking melden, neem dan contact op met Pfizer Drug Safety via info@pfizer.nl of bel met 010-4064290. Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen. Leave this field blank Close popup VRAAG HET BOEK "ALLES OVER BORSTKANKER' AAN Dit boek is alleen bedoeld voor zorgprofessionals met voorschrijfbevoegdheid. MATERIALEN BESTELLEN Initialen Achternaam Adres Plaats Postcode Instellingsnaam / ziekenhuis Aantal - Selecteren - - Selecteren - - Selecteren - 1 2 3 4 5 6 7 8 9 10 Persoonlijk e-mailadres Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over het gebruik van je gegevens vind je in onze Privacy verklaring(externe link). Ja, ik geef Pfizer toestemming Ja, ik geef Pfizer toestemming Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over het gebruik van je gegevens vind je in onze Privacy verklaring(externe link). Pfizer, inclusief moeder-, dochter- en zusterondernemingen en gelieerde partijen, respecteert de vertrouwelijkheid van persoonlijke informatie. Alleen Pfizer, of organisaties die namens Pfizer handelen, hebben toegang tot uw informatie. U hebt te allen tijde het recht uw informatie in te zien of te laten aanpassen. Voor meer informatie over de privacy policy die Pfizer hanteert, verwijzen wij u naar pfizer.nl. Mocht u medische vragen hebben over Pfizer geneesmiddelen, neem dan contact op met Pfizer Medische Informatie via 0800-633 4636. Wilt u een bijwerking melden, neem dan contact op met Pfizer Drug Safety via info@pfizer.nl of bel met 010-4064290. Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen. Leave this field blank Close popup VRAAG HET COMPENDIUM MAMMACARCINOOM AAN Als oncoloog of verpleegkundig specialist kunt u het Compendium kosteloos aanvragen. MATERIALEN BESTELLEN Initialen Achternaam Adres Plaats Postcode Instellingsnaam / ziekenhuis Aantal - Selecteren - - Selecteren - - Selecteren - 1 2 3 4 5 6 7 8 9 10 Persoonlijk e-mailadres Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over het gebruik van je gegevens vind je in onze Privacy verklaring(externe link). Ja, ik geef Pfizer toestemming Ja, ik geef Pfizer toestemming Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over het gebruik van je gegevens vind je in onze Privacy verklaring(externe link). Pfizer, inclusief moeder-, dochter- en zusterondernemingen en gelieerde partijen, respecteert de vertrouwelijkheid van persoonlijke informatie. Alleen Pfizer, of organisaties die namens Pfizer handelen, hebben toegang tot uw informatie. U hebt te allen tijde het recht uw informatie in te zien of te laten aanpassen. Voor meer informatie over de privacy policy die Pfizer hanteert, verwijzen wij u naar pfizer.nl. Mocht u medische vragen hebben over Pfizer geneesmiddelen, neem dan contact op met Pfizer Medische Informatie via 0800-633 4636. Wilt u een bijwerking melden, neem dan contact op met Pfizer Drug Safety via info@pfizer.nl of bel met 010-4064290. Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen. Leave this field blank Close popup VRAAG HET COMPENDIUM MAMMACARCINOOM AAN Als oncoloog of verpleegkundig specialist kunt u het Compendium kosteloos aanvragen. MATERIALEN BESTELLEN Initialen Achternaam Adres Plaats Postcode Instellingsnaam / ziekenhuis Aantal - Selecteren - - Selecteren - - Selecteren - 1 2 3 4 5 6 7 8 9 10 Persoonlijk e-mailadres Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over het gebruik van je gegevens vind je in onze Privacy verklaring(externe link). Ja, ik geef Pfizer toestemming Ja, ik geef Pfizer toestemming Ik geef toestemming voor gebruik van mijn e-mailadres door Pfizer om op dit adres – voor mij- relevante, waardevolle en gebalanceerde informatie te verstrekken. Meer informatie over het gebruik van je gegevens vind je in onze Privacy verklaring(externe link). Pfizer, inclusief moeder-, dochter- en zusterondernemingen en gelieerde partijen, respecteert de vertrouwelijkheid van persoonlijke informatie. Alleen Pfizer, of organisaties die namens Pfizer handelen, hebben toegang tot uw informatie. U hebt te allen tijde het recht uw informatie in te zien of te laten aanpassen. Voor meer informatie over de privacy policy die Pfizer hanteert, verwijzen wij u naar pfizer.nl. Mocht u medische vragen hebben over Pfizer geneesmiddelen, neem dan contact op met Pfizer Medische Informatie via 0800-633 4636. Wilt u een bijwerking melden, neem dan contact op met Pfizer Drug Safety via info@pfizer.nl of bel met 010-4064290. Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen. Leave this field blank Close popup VRAAG AANVULLENDE MATERIALEN AAN De toolkit Roze Olifant bevat verschillende materialen. Mocht je nog iets missen of behoefte hebben aan extra materialen, vraag deze dan hier aan. Initialen Achternaam Adres Postcode en plaats Instellingsnaam / ziekenhuis Persoonlijk e-mailadres Brochure seksualiteit bij borstkanker van de BVN - Geen - - Geen - - Geen - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Persoonlijk werkboekje Roze Olifant - Geen - - Geen - - Geen - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Werkmap Roze Olifant - Geen - - Geen - - Geen - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Visitekaartjes deherontdekkingvanhaarzelf.nl - Geen - - Geen - - Geen - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Setje conversatiestarters - Geen - - Geen - - Geen - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Ik meld mij tevens aan voor het Roze Olifant programma Ik meld mij tevens aan voor het Roze Olifant programma Indien ik dit nog niet heb gedaan, geef ik Pfizer toestemming om mijn e-mailadres te gebruiken om mij waardevolle informatie over evenementen en wetenschappelijke en gezondheidsgerelateerde informatie op basis van mijn specialiteit en belangen toe te sturen. Meer informatie over het gebruik van uw gegevens vind u in onze Privacy verklaring(externe link). ja, ik geef toestemming. Deze vraag is om te controleren dat u een mens bent, om geautomatiseerde invoer (spam) te voorkomen. Leave this field blank We need your consent to proceed We use cookies to enhance your website experience. We use necessary cookies to ensure our website functions properly and to keep it secure. These always need to be on. We use analytics cookies to measure website use, to learn what content is most useful to users and to help us improve it. We use marketing cookies to help us share content with you that you may find interesting and relevant. We use personalisation cookies to help manage your preferences and remember your settings. For more information see our Cookie Notice. To see a complete list of the companies that use these cookies and other technologies and to tell us whether they can be used on your device or not, access our Cookie Consent Tool. You will see this message only once, but you will always be able to set your preferences at any time in the Cookie Consent Tool. In addition, find more information about the use of cookies and similar technologies on this site in our Cookie Notice. When you proceed to access our site, the companies listed in the Cookie Consent Tool will use cookies and other technologies. This is further explained in our Cookie Notice. Manage PreferencesDecline AllAccept All Close ✖