{"id":5742,"date":"2025-06-19T08:06:29","date_gmt":"2025-06-19T06:06:29","guid":{"rendered":"https:\/\/app.lux-solution.de\/nj1hgv\/?page_id=5742"},"modified":"2025-06-25T11:45:18","modified_gmt":"2025-06-25T09:45:18","slug":"tumorboard-anmeldung","status":"publish","type":"page","link":"https:\/\/app.lux-solution.de\/nj1hgv\/tumorboard-anmeldung\/","title":{"rendered":"Tumorboard Anmeldung"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"5742\" class=\"elementor elementor-5742\" data-elementor-post-type=\"page\">\n\t\t\t\t<div data-dce-background-image-url=\"https:\/\/app.lux-solution.de\/nj1hgv\/wp-content\/uploads\/sites\/26\/2024\/12\/Universitaets-Notfallzentrum-2.jpg\" class=\"elementor-element elementor-element-769ce46 e-flex e-con-boxed e-con e-parent\" data-id=\"769ce46\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-caa8795 e-flex e-con-boxed e-con e-child\" data-id=\"caa8795\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-44e3258 e-flex e-con-boxed e-con e-child\" data-id=\"44e3258\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-444d8e1 elementor-widget elementor-widget-heading\" data-id=\"444d8e1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Universit\u00e4tsklinikum Freiburg<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div data-dce-title-color=\"#7A7A7A\" class=\"elementor-element elementor-element-6ddfdad elementor-widget elementor-widget-heading\" data-id=\"6ddfdad\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-heading-title elementor-size-default\">Klinik f\u00fcr Urologie<\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div data-dce-title-color=\"#7A7A7A\" class=\"elementor-element elementor-element-86bfb6d elementor-widget elementor-widget-heading\" data-id=\"86bfb6d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-heading-title elementor-size-default\"><b>Tumorboard-Management<\/b><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div data-dce-title-color=\"#7A7A7A\" class=\"elementor-element elementor-element-b339d16 elementor-widget elementor-widget-heading\" data-id=\"b339d16\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-heading-title elementor-size-default\"><a href=\"tel:+4976127028920\" target=\"_blank\">Tel.: 0761 \/ 270-28920<\/a><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div data-dce-title-color=\"#7A7A7A\" class=\"elementor-element elementor-element-c9e1adf elementor-widget elementor-widget-heading\" data-id=\"c9e1adf\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-heading-title elementor-size-default\"><a href=\"mailto:chir.sekretariat.jilg@uniklinik-freiburg.de\">chir.sekretariat.jilg@uniklinik-freiburg.de<\/a><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e6a61a8 e-flex e-con-boxed e-con e-child\" data-id=\"e6a61a8\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-fdc0fae dce_masking-none elementor-widget elementor-widget-image\" data-id=\"fdc0fae\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"628\" height=\"216\" src=\"https:\/\/app.lux-solution.de\/nj1hgv\/wp-content\/uploads\/sites\/26\/2024\/12\/universitaetsklinik-freiburg-logo-weiss.png\" class=\"attachment-large size-large wp-image-5656\" alt=\"\" srcset=\"https:\/\/app.lux-solution.de\/nj1hgv\/wp-content\/uploads\/sites\/26\/2024\/12\/universitaetsklinik-freiburg-logo-weiss.png 628w, https:\/\/app.lux-solution.de\/nj1hgv\/wp-content\/uploads\/sites\/26\/2024\/12\/universitaetsklinik-freiburg-logo-weiss-300x103.png 300w\" sizes=\"(max-width: 628px) 100vw, 628px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-fd4ba40 e-flex e-con-boxed e-con e-child\" data-id=\"fd4ba40\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div data-dce-advanced-background-color=\"#FFFFFF\" data-dce-field-description=\"{&quot;fields&quot;:[{&quot;custom_id&quot;:&quot;begleiterkrankung&quot;,&quot;position&quot;:&quot;elementor-field-label&quot;,&quot;description&quot;:&quot;Aktuelle Komorbidit\\u00e4t&quot;,&quot;description_text&quot;:&quot;Aktuelle Komorbidit\\u00e4t&quot;,&quot;tooltip&quot;:true,&quot;tooltip_position&quot;:&quot;top&quot;}]}\" class=\"elementor-element elementor-element-0dc4e4c elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"0dc4e4c\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;N\\u00e4chster&quot;,&quot;step_previous_label&quot;:&quot;Voriger&quot;,&quot;step_type&quot;:&quot;progress_bar&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;dce_confirm_dialog_enabled&quot;:&quot;no&quot;,&quot;label_icon_size&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;field_icon_size&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]}}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"dce-conditions-js-error-notice elementor-message elementor-message-danger\" style=\"display: none;\">A problem was detected in the following Form. Submitting it could result in errors. Please contact the site administrator.<\/div>\t\t\t<script>\n\t\t\tsetTimeout(function() {\n\t\t\t\tlet el = document.querySelector(\".dce-conditions-js-error-notice\");\n\t\t\t\tif (el)\n\t\t\t\t\tel.style.display = \"block\";\n\t\t\t}, 6000);\n\t\t\t<\/script>\t\t<form class=\"elementor-form\" method=\"post\" name=\"Tumorboard Anmeldung\" aria-label=\"Tumorboard Anmeldung\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"5742\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"0dc4e4c\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"UKF Tumorboard Anmeldung\" \/>\n\n\t\t\t\n\t\t\t<div data-field-conditions=\"[{&quot;id&quot;:&quot;field_2d80303&quot;,&quot;condition&quot;:&quot;(versichert==&#039;Gesetzlich&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;diagnose_wahl_andere&quot;,&quot;condition&quot;:&quot;(hauptdiagnose_wahl==&#039;Andere\\\/Sonstige&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;hodentumor_ldh&quot;,&quot;condition&quot;:&quot;(hauptdiagnose_wahl==&#039;Hodentumor&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;hodentumor_afp&quot;,&quot;condition&quot;:&quot;(hauptdiagnose_wahl==&#039;Hodentumor&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;hodentumor_hcg&quot;,&quot;condition&quot;:&quot;(hauptdiagnose_wahl==&#039;Hodentumor&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;hodentumor_plap&quot;,&quot;condition&quot;:&quot;(hauptdiagnose_wahl==&#039;Hodentumor&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;diagnose_wahl_ipsa&quot;,&quot;condition&quot;:&quot;(hauptdiagnose_wahl==&#039;Prostatakarzinom&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;diagnose_wahl_gleason&quot;,&quot;condition&quot;:&quot;(hauptdiagnose_wahl==&#039;Prostatakarzinom&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;diagnose_wahl_psa&quot;,&quot;condition&quot;:&quot;(hauptdiagnose_wahl==&#039;Prostatakarzinom&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;diagnose_wahl_systemtherapie&quot;,&quot;condition&quot;:&quot;(hauptdiagnose_wahl==&#039;Prostatakarzinom&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;nierenzell_kreatinin&quot;,&quot;condition&quot;:&quot;(hauptdiagnose_wahl==&#039;Nierenzellkarzinom&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;urothel_kreatinin&quot;,&quot;condition&quot;:&quot;(hauptdiagnose_wahl==&#039;Urothelkarzinom Harnblase&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;urothel_harntrakt_kreatinin&quot;,&quot;condition&quot;:&quot;(hauptdiagnose_wahl==&#039;Urothelkarzinom oberer Harntrakt&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;penis_kreatinin&quot;,&quot;condition&quot;:&quot;(hauptdiagnose_wahl==&#039;Peniskarzinom&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;petct_datum&quot;,&quot;condition&quot;:&quot;(bildgebung_ukf==\\&quot;JA\\&quot;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;mrt_datum&quot;,&quot;condition&quot;:&quot;(bildgebung_ukf==\\&quot;JA\\&quot;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;ct_datum&quot;,&quot;condition&quot;:&quot;(bildgebung_ukf==\\&quot;JA\\&quot;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;skelett_datum&quot;,&quot;condition&quot;:&quot;(bildgebung_ukf==\\&quot;JA\\&quot;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;extbildgebung_wahl&quot;,&quot;condition&quot;:&quot;(bildgebung_wahl==\\&quot;JA\\&quot;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;qr_code_upload&quot;,&quot;condition&quot;:&quot;(extbildgebung_wahl==&#039;QR-Code + schriftlicher Befund&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;laborwerte_pdf&quot;,&quot;condition&quot;:&quot;(laborwerte==&#039;JA&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false}]\" data-field-ids=\"[&quot;field_6bb1215&quot;,&quot;field_ba70815&quot;,&quot;field_05fbd67&quot;,&quot;field_453317f&quot;,&quot;field_22ab341&quot;,&quot;praxis&quot;,&quot;praxisemail&quot;,&quot;praxistelefon&quot;,&quot;field_bc3b062&quot;,&quot;field_ea17835&quot;,&quot;field_2d80303&quot;,&quot;geschlecht&quot;,&quot;versichert&quot;,&quot;vorname&quot;,&quot;name&quot;,&quot;geburtsdatum&quot;,&quot;strasse&quot;,&quot;plz&quot;,&quot;wohnort&quot;,&quot;telefon&quot;,&quot;email&quot;,&quot;koerpergroesse&quot;,&quot;koerpergewicht&quot;,&quot;field_5469340&quot;,&quot;hauptdiagnose_wahl&quot;,&quot;diagnose_wahl_andere&quot;,&quot;hodentumor_ldh&quot;,&quot;hodentumor_afp&quot;,&quot;hodentumor_hcg&quot;,&quot;hodentumor_plap&quot;,&quot;diagnose_wahl_ipsa&quot;,&quot;diagnose_wahl_gleason&quot;,&quot;diagnose_wahl_psa&quot;,&quot;diagnose_wahl_systemtherapie&quot;,&quot;nierenzell_kreatinin&quot;,&quot;urothel_kreatinin&quot;,&quot;urothel_harntrakt_kreatinin&quot;,&quot;penis_kreatinin&quot;,&quot;field_3658fb2&quot;,&quot;tnmstadium&quot;,&quot;patho_upload&quot;,&quot;patho_2upload&quot;,&quot;patho_3upload&quot;,&quot;field_76aaaf3&quot;,&quot;therapieverlauf&quot;,&quot;field_c4ab80d&quot;,&quot;begleiterkrankung&quot;,&quot;field_1175917&quot;,&quot;karnofsky&quot;,&quot;field_d5d0117&quot;,&quot;bildgebung_ukf&quot;,&quot;petct_datum&quot;,&quot;mrt_datum&quot;,&quot;ct_datum&quot;,&quot;skelett_datum&quot;,&quot;field_ba57fea&quot;,&quot;bildgebung_wahl&quot;,&quot;field_c00879b&quot;,&quot;extbildgebung_wahl&quot;,&quot;qr_code_upload&quot;,&quot;field_a2402ce&quot;,&quot;laborwerte&quot;,&quot;field_d889fce&quot;,&quot;laborwerte_pdf&quot;,&quot;field_ae75c6e&quot;,&quot;fragestellung&quot;,&quot;field_010e166&quot;,&quot;datenschutz&quot;,&quot;datumzeit&quot;,&quot;bmi&quot;,&quot;field_7517e35&quot;]\" class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-field_6bb1215 elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Hinweis\" data-previousButton=\"\" data-nextButton=\"zum Formular\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"&lt;svg class=&quot;e-font-icon-svg e-fas-star&quot; viewBox=&quot;0 0 576 512&quot; xmlns=&quot;http:\/\/www.w3.org\/2000\/svg&quot;&gt;&lt;path d=&quot;M259.3 17.8L194 150.2 47.9 171.5c-26.2 3.8-36.7 36.1-17.7 54.6l105.7 103-25 145.5c-4.5 26.3 23.2 46 46.4 33.7L288 439.6l130.7 68.7c23.2 12.2 50.9-7.4 46.4-33.7l-25-145.5 105.7-103c19-18.5 8.5-50.8-17.7-54.6L382 150.2 316.7 17.8c-11.7-23.6-45.6-23.9-57.4 0z&quot;&gt;&lt;\/path&gt;&lt;\/svg&gt;\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_ba70815 elementor-col-100\">\n\t\t\t\t\t<style>\n  \/* Verstecke den gesamten Inhalt der Seite standardm\u00e4\u00dfig *\/\n  body {\n    visibility: hidden;\n    opacity: 0;\n    transition: opacity 0.3s ease-in-out; \/* Sanfte \u00dcberblendung *\/\n  }\n<\/style>\n\n<script>\n  document.addEventListener(\"DOMContentLoaded\", function() {\n    \/\/ Zeigt den Inhalt der Seite, nachdem das DOM vollst\u00e4ndig geladen wurde\n    document.body.style.visibility = \"visible\";\n    document.body.style.opacity = \"1\";\n  });\n<\/script>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_05fbd67 elementor-col-100\">\n\t\t\t\t\t<center><b style=\"font-size:25px;\">TUMORBOARD-ANMELDUNG<\/b><br\/>- KLINIK F\u00dcR UROLOGIE -<br><br><br\/>\n<b style=\"background-color:#B62B30;color:#fff;padding:10px;\">Nur f\u00fcr \u00c4rzte und medizinisches Fachpersonal bestimmt.<\/b><br\/><br\/><br>\nDie Bearbeitung Ihrer Tumorboard-Anmeldung ist nur m\u00f6glich, wenn alle Pflichtfelder vollst\u00e4ndig und korrekt<br>\nausgef\u00fcllt sind. Unklare oder allgemeine Angaben k\u00f6nnen nicht ber\u00fccksichtigt werden.<br\/><br\/><\/center>\n<br\/><br\/>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_453317f elementor-col-100\">\n\t\t\t\t\t<script>\n    document.addEventListener(\"DOMContentLoaded\", function() {\n        var form = document.querySelector('.elementor-form');\n        if (form) {\n            form.setAttribute('autocomplete', 'off');\n        }\n    });\n<\/script>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-field_22ab341 elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Anfragetyp\" data-previousButton=\"zur\u00fcck\" data-nextButton=\"zum Formular\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"&lt;svg class=&quot;e-font-icon-svg e-fas-star&quot; viewBox=&quot;0 0 576 512&quot; xmlns=&quot;http:\/\/www.w3.org\/2000\/svg&quot;&gt;&lt;path d=&quot;M259.3 17.8L194 150.2 47.9 171.5c-26.2 3.8-36.7 36.1-17.7 54.6l105.7 103-25 145.5c-4.5 26.3 23.2 46 46.4 33.7L288 439.6l130.7 68.7c23.2 12.2 50.9-7.4 46.4-33.7l-25-145.5 105.7-103c19-18.5 8.5-50.8-17.7-54.6L382 150.2 316.7 17.8c-11.7-23.6-45.6-23.9-57.4 0z&quot;&gt;&lt;\/path&gt;&lt;\/svg&gt;\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-praxis elementor-col-25 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-praxis\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPraxis\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[praxis]\" id=\"form-field-praxis\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-praxisemail elementor-col-25 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-praxisemail\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tE-Mail Praxis\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[praxisemail]\" id=\"form-field-praxisemail\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-praxistelefon elementor-col-25 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-praxistelefon\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tTelefonnr. Praxis\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[praxistelefon]\" id=\"form-field-praxistelefon\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_bc3b062 elementor-col-100\">\n\t\t\t\t\t<hr>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_ea17835 elementor-col-100\">\n\t\t\t\t\t<b>Informationen zum\/zur Patient*in<\/b>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_2d80303 elementor-col-100\">\n\t\t\t\t\t <div style=\"background-color: #B62B30; color: white; font-family: Arial, sans-serif; text-align: center; padding: 10px;\">Wir ben\u00f6tigen bitte eine aktuelle \u00dcberweisung.    <\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-geschlecht elementor-col-20\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-geschlecht\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tGeschlecht\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Weiblich\" id=\"form-field-geschlecht-0\" name=\"form_fields[geschlecht]\"> <label for=\"form-field-geschlecht-0\">Weiblich<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"M\u00e4nnlich\" id=\"form-field-geschlecht-1\" name=\"form_fields[geschlecht]\"> <label for=\"form-field-geschlecht-1\">M\u00e4nnlich<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Divers\" id=\"form-field-geschlecht-2\" name=\"form_fields[geschlecht]\"> <label for=\"form-field-geschlecht-2\">Divers<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-versichert elementor-col-20\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-versichert\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tVersichert\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Gesetzlich\" id=\"form-field-versichert-0\" name=\"form_fields[versichert]\"> <label for=\"form-field-versichert-0\">Gesetzlich<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Privat\" id=\"form-field-versichert-1\" name=\"form_fields[versichert]\"> <label for=\"form-field-versichert-1\">Privat<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-vorname elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-vorname\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tVorname\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[vorname]\" id=\"form-field-vorname\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Name\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-geburtsdatum elementor-col-25 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-geburtsdatum\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tGeb.-Datum\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[geburtsdatum]\" id=\"form-field-geburtsdatum\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-strasse elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-strasse\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tStra\u00dfe\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[strasse]\" id=\"form-field-strasse\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-plz elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-plz\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPLZ\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[plz]\" id=\"form-field-plz\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-wohnort elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-wohnort\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWohnort\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[wohnort]\" id=\"form-field-wohnort\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-telefon elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-telefon\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMobil\/Tel. Nr.\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[telefon]\" id=\"form-field-telefon\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tE-Mail\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-koerpergroesse elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-koerpergroesse\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tK\u00f6rpergr\u00f6\u00dfe in cm\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[koerpergroesse]\" id=\"form-field-koerpergroesse\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-koerpergewicht elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-koerpergewicht\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tK\u00f6rpergewicht in kg\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[koerpergewicht]\" id=\"form-field-koerpergewicht\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_5469340 elementor-col-100\">\n\t\t\t\t\t<hr>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-hauptdiagnose_wahl elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-hauptdiagnose_wahl\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b>Urologische Hauptdiagnose(n)<\/b>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-eicon-caret-down\" viewBox=\"0 0 571.4 571.4\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M571 393Q571 407 561 418L311 668Q300 679 286 679T261 668L11 418Q0 407 0 393T11 368 36 357H536Q550 357 561 368T571 393Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[hauptdiagnose_wahl]\" id=\"form-field-hauptdiagnose_wahl\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"-- bitte w\u00e4hlen --\">-- bitte w\u00e4hlen --<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Prostatakarzinom\">Prostatakarzinom<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Urothelkarzinom Harnblase\">Urothelkarzinom Harnblase<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Urothelkarzinom oberer Harntrakt\">Urothelkarzinom oberer Harntrakt<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Nierenzellkarzinom\">Nierenzellkarzinom<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Hodentumor\">Hodentumor<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Peniskarzinom\">Peniskarzinom<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Andere\/Sonstige\">Andere\/Sonstige<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-diagnose_wahl_andere elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-diagnose_wahl_andere\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAndere\/Sonstige - bitte benennen\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[diagnose_wahl_andere]\" id=\"form-field-diagnose_wahl_andere\" rows=\"4\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-hodentumor_ldh elementor-col-25 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-hodentumor_ldh\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHodentumor: LDH\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[hodentumor_ldh]\" id=\"form-field-hodentumor_ldh\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"bitte tragen Sie den Wert ein\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-hodentumor_afp elementor-col-25 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-hodentumor_afp\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHodentumor: AFP\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[hodentumor_afp]\" id=\"form-field-hodentumor_afp\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"bitte tragen Sie den Wert ein\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-hodentumor_hcg elementor-col-25 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-hodentumor_hcg\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHodentumor: \u00df-HCG\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[hodentumor_hcg]\" id=\"form-field-hodentumor_hcg\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"bitte tragen Sie den Wert ein\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-hodentumor_plap elementor-col-25 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-hodentumor_plap\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHodentumor: PLAP\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[hodentumor_plap]\" id=\"form-field-hodentumor_plap\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"bitte tragen Sie den Wert ein\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-diagnose_wahl_ipsa elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-diagnose_wahl_ipsa\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tProstatakarzinom: iPSA-Wert (ng\/ml)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[diagnose_wahl_ipsa]\" id=\"form-field-diagnose_wahl_ipsa\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"bitte tragen Sie den Wert ein\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-diagnose_wahl_gleason elementor-col-30 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-diagnose_wahl_gleason\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tProstatakarzinom: Gleason-score\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[diagnose_wahl_gleason]\" id=\"form-field-diagnose_wahl_gleason\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"bitte tragen Sie den Wert ein\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-diagnose_wahl_psa elementor-col-40 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-diagnose_wahl_psa\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tProstatakarzinom: aktueller PSA-Wert (ng\/ml)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[diagnose_wahl_psa]\" id=\"form-field-diagnose_wahl_psa\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"bitte tragen Sie den Wert ein\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-diagnose_wahl_systemtherapie elementor-col-70 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-diagnose_wahl_systemtherapie\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tProstatakarzinom: Angaben zur aktuellen Systemtherapie\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[diagnose_wahl_systemtherapie]\" id=\"form-field-diagnose_wahl_systemtherapie\" rows=\"4\" placeholder=\"bitte machen Sie dazu genaue Angaben\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-nierenzell_kreatinin elementor-col-40 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-nierenzell_kreatinin\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNierenzellkarzinom: Kreatininwert\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[nierenzell_kreatinin]\" id=\"form-field-nierenzell_kreatinin\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"bitte tragen Sie den Wert ein\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-urothel_kreatinin elementor-col-40 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-urothel_kreatinin\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tUrothelkarzinom: Kreatininwert\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[urothel_kreatinin]\" id=\"form-field-urothel_kreatinin\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"bitte tragen Sie den Wert ein\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-urothel_harntrakt_kreatinin elementor-col-40 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-urothel_harntrakt_kreatinin\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tUrothelkarzinom oberer Harntrakt: Kreatininwert\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[urothel_harntrakt_kreatinin]\" id=\"form-field-urothel_harntrakt_kreatinin\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"bitte tragen Sie den Wert ein\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-penis_kreatinin elementor-col-40 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-penis_kreatinin\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPeniskarzinom: Kreatininwert\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[penis_kreatinin]\" id=\"form-field-penis_kreatinin\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"bitte tragen Sie den Wert ein\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_3658fb2 elementor-col-100\">\n\t\t\t\t\t<hr>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-tnmstadium elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-tnmstadium\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b>Aktuelles TNM-Stadium der urologischen Hauptdiagnose<\/b>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[tnmstadium]\" id=\"form-field-tnmstadium\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-patho_upload elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-patho_upload\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tUpload f\u00fcr Pathologiebefund (nur PDF; max. 15MB)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[patho_upload]\" id=\"form-field-patho_upload\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" data-maxsize=\"15\" data-maxsize-message=\"Diese Datei \u00fcbersteigt die maximale Dateigr\u00f6\u00dfe\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-patho_2upload elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-patho_2upload\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t2. Upload f\u00fcr weiteres Dokument (nur PDF; max. 15MB)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[patho_2upload]\" id=\"form-field-patho_2upload\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" data-maxsize=\"15\" data-maxsize-message=\"Diese Datei \u00fcbersteigt die maximale Dateigr\u00f6\u00dfe\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-patho_3upload elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-patho_3upload\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t3. Upload f\u00fcr weiteres Dokument (nur PDF; max. 15MB)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[patho_3upload]\" id=\"form-field-patho_3upload\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" data-maxsize=\"15\" data-maxsize-message=\"Diese Datei \u00fcbersteigt die maximale Dateigr\u00f6\u00dfe\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_76aaaf3 elementor-col-100\">\n\t\t\t\t\t<hr>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-therapieverlauf elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-therapieverlauf\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b>Therapieverlauf<\/b>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[therapieverlauf]\" id=\"form-field-therapieverlauf\" rows=\"4\" placeholder=\"Bitte tragen\/kopieren Sie den Therapieverlauf hier ein\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_c4ab80d elementor-col-100\">\n\t\t\t\t\t<hr>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-begleiterkrankung elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-begleiterkrankung\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b>Relevante Begleiterkrankung<\/b>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[begleiterkrankung]\" id=\"form-field-begleiterkrankung\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_1175917 elementor-col-100\">\n\t\t\t\t\t<hr>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-karnofsky elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-karnofsky\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b>Karnofsky Index<\/b>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-eicon-caret-down\" viewBox=\"0 0 571.4 571.4\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M571 393Q571 407 561 418L311 668Q300 679 286 679T261 668L11 418Q0 407 0 393T11 368 36 357H536Q550 357 561 368T571 393Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[karnofsky]\" id=\"form-field-karnofsky\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"-- bitte w\u00e4hlen --\">-- bitte w\u00e4hlen --<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"100% - keine Beschwerden, keine Krankheitszeichen\">100% - keine Beschwerden, keine Krankheitszeichen<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"  90% - f\u00e4hig zu normaler Aktivit\u00e4t, geringe Symptome oder Krankeitszeichen\">  90% - f\u00e4hig zu normaler Aktivit\u00e4t, geringe Symptome oder Krankeitszeichen<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"  80% - normale Aktivit\u00e4t mit einiger Anstrengung m\u00f6glich. Einige Symptome oder Krankeitszeichen\">  80% - normale Aktivit\u00e4t mit einiger Anstrengung m\u00f6glich. Einige Symptome oder Krankeitszeichen<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"  70% - sorgt f\u00fcr sich selbst, normale Aktivit\u00e4t nicht m\u00f6glich, nicht arbeitsf\u00e4hig\">  70% - sorgt f\u00fcr sich selbst, normale Aktivit\u00e4t nicht m\u00f6glich, nicht arbeitsf\u00e4hig<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"  60% - ben\u00f6tigt gelegentliche fremde Hilfe, kann die meisten persn\u00f6nlichen Angelegenheiten selbst erledigen\">  60% - ben\u00f6tigt gelegentliche fremde Hilfe, kann die meisten persn\u00f6nlichen Angelegenheiten selbst erledigen<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"  50% - ben\u00f6tigt oft Hilfe, braucht h\u00e4ufig medizinische Betreuung\">  50% - ben\u00f6tigt oft Hilfe, braucht h\u00e4ufig medizinische Betreuung<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"  40% - behindert, braucht besondere Betreuung und Hilfe\">  40% - behindert, braucht besondere Betreuung und Hilfe<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"  30% - stark behindert, station\u00e4re Behandlung erforderlich\">  30% - stark behindert, station\u00e4re Behandlung erforderlich<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"  20% - sehr krank, station\u00e4re Behandlung zur supportiven oder kausalen Therapie dringend erforderlich\">  20% - sehr krank, station\u00e4re Behandlung zur supportiven oder kausalen Therapie dringend erforderlich<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"  10% - sterbend t\u00f6dliche Erkrankung schreitet rasch voran\">  10% - sterbend t\u00f6dliche Erkrankung schreitet rasch voran<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"    0% - tot\">    0% - tot<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_d5d0117 elementor-col-100\">\n\t\t\t\t\t<hr>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-bildgebung_ukf elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-bildgebung_ukf\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b>Bildgebung hat in der Uniklinik Freiburg stattgefunden?<\/b>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"NEIN\" id=\"form-field-bildgebung_ukf-0\" name=\"form_fields[bildgebung_ukf]\"> <label for=\"form-field-bildgebung_ukf-0\">NEIN<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"JA\" id=\"form-field-bildgebung_ukf-1\" name=\"form_fields[bildgebung_ukf]\"> <label for=\"form-field-bildgebung_ukf-1\">JA<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-petct_datum elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-petct_datum\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPet\/CT\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[petct_datum]\" id=\"form-field-petct_datum\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Datum\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-mrt_datum elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-mrt_datum\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMRT\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[mrt_datum]\" id=\"form-field-mrt_datum\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Datum\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-ct_datum elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-ct_datum\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCT\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[ct_datum]\" id=\"form-field-ct_datum\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Datum\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-skelett_datum elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-skelett_datum\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSkelettszintigraphie\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[skelett_datum]\" id=\"form-field-skelett_datum\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Datum\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_ba57fea elementor-col-100\">\n\t\t\t\t\t<hr>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-bildgebung_wahl elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-bildgebung_wahl\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b>Eine externe Bildgebung liegt vor und wird verschickt als:<\/b>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"NEIN\" id=\"form-field-bildgebung_wahl-0\" name=\"form_fields[bildgebung_wahl]\"> <label for=\"form-field-bildgebung_wahl-0\">NEIN<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"JA\" id=\"form-field-bildgebung_wahl-1\" name=\"form_fields[bildgebung_wahl]\"> <label for=\"form-field-bildgebung_wahl-1\">JA<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_c00879b elementor-col-50\">\n\t\t\t\t\t<b>Adresse f\u00fcr den Versand \/ E-Mail<\/b><br>\nUNIVERSIT\u00c4TSKLINIKUM FREIBURG <br>\nKlinik f\u00fcr Urologie <br>\nSekretariat Frau Prof. Dr. C. Jilg <br>\nHugstetter Stra\u00dfe 55, 79106 Freiburg <br>\n<br>\nE-Mail: <a href=\"mailto:chir.sekretariat.jilg@uniklinik-freiburg.de\">chir.sekretariat.jilg@uniklinik-freiburg.de<\/a>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-extbildgebung_wahl elementor-col-40\">\n\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-eicon-caret-down\" viewBox=\"0 0 571.4 571.4\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M571 393Q571 407 561 418L311 668Q300 679 286 679T261 668L11 418Q0 407 0 393T11 368 36 357H536Q550 357 561 368T571 393Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[extbildgebung_wahl]\" id=\"form-field-extbildgebung_wahl\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"--- bitte w\u00e4hlen ---\">--- bitte w\u00e4hlen ---<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"CD + schriftlicher Befund\">CD + schriftlicher Befund<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"QR-Code + schriftlicher Befund\">QR-Code + schriftlicher Befund<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-qr_code_upload elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-qr_code_upload\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tQR-Code hochladen (nur PDF, JPG, PNG; max. 2MB)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[qr_code_upload]\" id=\"form-field-qr_code_upload\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" data-maxsize=\"2\" data-maxsize-message=\"Diese Datei \u00fcbersteigt die maximale Dateigr\u00f6\u00dfe\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_a2402ce elementor-col-100\">\n\t\t\t\t\t<hr>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-laborwerte elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-laborwerte\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b>Liegen Laborwerte vor?<\/b>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"NEIN\" id=\"form-field-laborwerte-0\" name=\"form_fields[laborwerte]\"> <label for=\"form-field-laborwerte-0\">NEIN<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"JA\" id=\"form-field-laborwerte-1\" name=\"form_fields[laborwerte]\"> <label for=\"form-field-laborwerte-1\">JA<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_d889fce elementor-col-50\">\n\t\t\t\t\t<b>Relevante Laborparameter: <\/b><br>\nProstatakarzinom: iPSA, PSA-Verlauf, aktueller PSA-Wert bei <br>\nAnmeldung zum Tumorboard<br> \nNierenzellkarzinom: Kreatininwert <br>\nUrothelkarzinom: Kreatininwert <br>\nHodenkarzinom: LDH, AFP, \u00df-HCG, PLAP <br>\nPeniskarzinom: Kreatininwert<br>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-laborwerte_pdf elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-laborwerte_pdf\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tUpload Laborwerte (nur PDF; max. 15MB)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[laborwerte_pdf]\" id=\"form-field-laborwerte_pdf\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" data-maxsize=\"15\" data-maxsize-message=\"Diese Datei \u00fcbersteigt die maximale Dateigr\u00f6\u00dfe\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_ae75c6e elementor-col-100\">\n\t\t\t\t\t<hr>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-fragestellung elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-fragestellung\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b> Fragestellung f\u00fcr die Tumorboardvorstellung<\/b>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[fragestellung]\" id=\"form-field-fragestellung\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_010e166 elementor-col-100\">\n\t\t\t\t\t<hr>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-datenschutz elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-datenschutz\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b>Datenschutz<\/b>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[datenschutz]\" id=\"form-field-datenschutz\" class=\"elementor-field elementor-size-sm  elementor-acceptance-field\" required=\"required\">\n\t\t\t\t<label for=\"form-field-datenschutz\">Ich best\u00e4tige hiermit, dass ich das Einverst\u00e4ndnis des\/der Patient*in zur \u00dcbermittlung seiner Daten per E-Mail zum Klinikum eingeholt und ihn \u00fcber die damit verbundenen Sicherheitsrisiken aufgekl\u00e4rt habe. Diese \u00dcbermittlung erfolgt auf ausdr\u00fccklichen Wunsch des\/der Patient*in.<\/label>\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-hidden elementor-field-group elementor-column elementor-field-group-datumzeit elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"hidden\" name=\"form_fields[datumzeit]\" id=\"form-field-datumzeit\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" value=\"17\/04\/2026 11:50\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-amount elementor-field-group elementor-column elementor-field-group-bmi elementor-col-100\">\n\t\t\t\t\t<input type=\"hidden\" name=\"form_fields[bmi]\" id=\"form-field-bmi\" class=\"elementor-field elementor-size-sm  dce-amount-hidden\" data-hide=\"yes\" data-field-expression=\" getField(&quot;koerpergewicht&quot;)  \/ (( getField(&quot;koerpergroesse&quot;)  \/ 100)^2)\" data-text-before=\"\" data-text-after=\"\" data-should-round=\"yes\" data-round-precision=\"1\" data-refresh-on=\"input\" data-should-format=\"\" data-format-precision=\"\" style=\"display: none;\"><input size=\"1\"type=\"text\" class=\"dce-amount-visible elementor-field-textual\" readonly=\"\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-recaptcha_v3 elementor-field-group elementor-column elementor-field-group-field_7517e35 elementor-col-100 recaptcha_v3-bottomright\">\n\t\t\t\t\t<div class=\"elementor-field\" id=\"form-field-field_7517e35\"><div class=\"elementor-g-recaptcha\" data-sitekey=\"6LcoSegqAAAAAO65scPLEdS8_eAibNDeV-gZLYY7\" data-type=\"v3\" data-action=\"Form\" data-badge=\"bottomright\" data-size=\"invisible\"><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Formular absenden<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t<style>.elementor-element.elementor-element-0dc4e4c .elementor-field-group { align-self: flex-start; }<\/style>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-87e3415 e-flex e-con-boxed e-con e-parent\" data-id=\"87e3415\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-27ed6bc elementor-widget elementor-widget-shortcode\" data-id=\"27ed6bc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">\t\t<div data-elementor-type=\"container\" data-elementor-id=\"786\" class=\"elementor elementor-786\" data-elementor-post-type=\"elementor_library\">\n\t\t\t\t<div class=\"elementor-element elementor-element-329d47f1 e-flex e-con-boxed e-con e-parent\" data-id=\"329d47f1\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-642dbe9 elementor-icon-list--layout-inline elementor-align-center elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"642dbe9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items elementor-inline-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-inline-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.uniklinik-freiburg.de\/footernavigation\/impressum.html\" target=\"_blank\">\n\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Impressum<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-inline-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.uniklinik-freiburg.de\/footernavigation\/datenschutz.html\" target=\"_blank\">\n\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Datenschutz<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div data-dce-title-color=\"#7A7A7A\" class=\"elementor-element elementor-element-39528007 elementor-widget elementor-widget-heading\" data-id=\"39528007\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"><a href=\"https:\/\/lux-digitalepraxis.de\" target=\"_blank\">\u00a9 2026 LUX Digitale Praxis<\/a><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Tumorboard-Management Tel.: 0761 \/ 270-28920 chir.sekretariat.jilg@uniklinik-freiburg.de<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-5742","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/app.lux-solution.de\/nj1hgv\/wp-json\/wp\/v2\/pages\/5742","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/app.lux-solution.de\/nj1hgv\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/app.lux-solution.de\/nj1hgv\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/app.lux-solution.de\/nj1hgv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/app.lux-solution.de\/nj1hgv\/wp-json\/wp\/v2\/comments?post=5742"}],"version-history":[{"count":104,"href":"https:\/\/app.lux-solution.de\/nj1hgv\/wp-json\/wp\/v2\/pages\/5742\/revisions"}],"predecessor-version":[{"id":5867,"href":"https:\/\/app.lux-solution.de\/nj1hgv\/wp-json\/wp\/v2\/pages\/5742\/revisions\/5867"}],"wp:attachment":[{"href":"https:\/\/app.lux-solution.de\/nj1hgv\/wp-json\/wp\/v2\/media?parent=5742"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}