{"id":4110,"date":"2024-06-06T17:07:22","date_gmt":"2024-06-06T15:07:22","guid":{"rendered":"https:\/\/app.lux-solution.de\/opwb73t\/?page_id=4110"},"modified":"2025-04-30T09:18:31","modified_gmt":"2025-04-30T07:18:31","slug":"befundanforderung-stationaer","status":"publish","type":"page","link":"https:\/\/app.lux-solution.de\/opwb73t\/befundanforderung-stationaer\/","title":{"rendered":"Befundanforderung station\u00e4r"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"4110\" class=\"elementor elementor-4110\" data-elementor-post-type=\"page\">\n\t\t\t\t<header data-dce-background-image-url=\"https:\/\/app.lux-solution.de\/pplzjlfd\/wp-content\/uploads\/sites\/12\/2023\/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-846bbb5 elementor-widget elementor-widget-heading\" data-id=\"846bbb5\" 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\">Hugstetter Str. 55<\/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\">79106 Freiburg i. Br.<\/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:0761 270-28910<\/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=\"\">sekretariat.urologie@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 decoding=\"async\" width=\"400\" height=\"100\" src=\"https:\/\/app.lux-solution.de\/opwb73t\/wp-content\/uploads\/sites\/13\/2024\/07\/universitaetsklinikum-freiburg-urologie-logo-bg-weiss.jpg\" class=\"attachment-large size-large wp-image-4404\" alt=\"Logo der Klinik f\u00fcr Urologie des Universit\u00e4tsklinikums Freiburg\" srcset=\"https:\/\/app.lux-solution.de\/opwb73t\/wp-content\/uploads\/sites\/13\/2024\/07\/universitaetsklinikum-freiburg-urologie-logo-bg-weiss.jpg 400w, https:\/\/app.lux-solution.de\/opwb73t\/wp-content\/uploads\/sites\/13\/2024\/07\/universitaetsklinikum-freiburg-urologie-logo-bg-weiss-300x75.jpg 300w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/>\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<main 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-inline-align=\"{&quot;fields&quot;:[{&quot;custom_id&quot;:&quot;handelnder&quot;,&quot;field_id&quot;:&quot;f0aacde&quot;}]}\" data-dce-field-description=\"{&quot;fields&quot;:[{&quot;custom_id&quot;:&quot;zusendung&quot;,&quot;position&quot;:&quot;elementor-field-label&quot;,&quot;description&quot;:&quot;Aus Datenschutzgr\\u00fcnden muss Ihre Email-Adresse bereits in unserem Kliniksystem vorhanden sein. Falls nicht, senden wir Ihnen Ihre Dokumente per Post.&quot;,&quot;description_text&quot;:&quot;Aus Datenschutzgr\\u00fcnden muss Ihre Email-Adresse bereits in unserem Kliniksystem vorhanden sein. 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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=\"Befundanforderung stationaer\" aria-label=\"Befundanforderung stationaer\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"4110\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"0dc4e4c\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Klinik f\u00fcr Urologie | UKF\" \/>\n\n\t\t\t\n\t\t\t<div data-field-conditions=\"[{&quot;id&quot;:&quot;piz&quot;,&quot;condition&quot;:&quot;(auswahl_piz==&#039;Ja, ich kenne die PIZ (Patienten-Identifikationsziffer)&#039;)&quot;,&quot;mode&quot;:&quot;show&quot;,&quot;disableOnly&quot;:false},{&quot;id&quot;:&quot;geschlecht&quot;,&quot;condition&quot;:&quot;(auswahl_piz==&#039;Nein, ich gebe die 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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_ea17835 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>\n\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_6411927 elementor-col-100\">\n\t\t\t\t\t<center><b style=\"font-size:25px;\">BEFUNDANFORDERUNG<\/b><br\/>- STATION\u00c4R -<br><br><br\/>\n<b style=\"background-color:#B62B30;color:#fff;padding:10px;\">Wichtige Hinweise zu Befunden und Arztbriefen<\/b><br\/><br\/><br\/><\/center>\n<div style=\"display: flex;\n      justify-content: center;\">\n<div style=\"text-align:left;\">\n<b>\u00b7 Histologischer Befund:<\/b> Die Erstellung dauert in der Regel etwa 2 Wochen.<br>\n<b>\u00b7 Endg\u00fcltiger Arztbrief:<\/b> Dieser wird nach ca. 6 Wochen fertiggestellt.<br\/>\nWeitere Informationen finden Sie im vorl\u00e4ufigen Arztbrief.\n<\/div><\/div><br\/><br\/>\n\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_a3ff3bf 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-radio elementor-field-group elementor-column elementor-field-group-handelnder elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-handelnder\" 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elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-auswahl_piz\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAuswahl\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=\"Ja, ich kenne die PIZ (Patienten-Identifikationsziffer)\" id=\"form-field-auswahl_piz-0\" name=\"form_fields[auswahl_piz]\" required=\"required\"> <label for=\"form-field-auswahl_piz-0\">Ja, ich kenne die PIZ (Patienten-Identifikationsziffer)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Nein, ich gebe die Anschrift manuell ein\" id=\"form-field-auswahl_piz-1\" name=\"form_fields[auswahl_piz]\" required=\"required\"> <label for=\"form-field-auswahl_piz-1\">Nein, ich gebe die Anschrift manuell ein<\/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-piz elementor-col-25 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-piz\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMeine PIZ\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[piz]\" id=\"form-field-piz\" 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-radio elementor-field-group elementor-column elementor-field-group-geschlecht elementor-col-25 elementor-field-required\">\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]\" required=\"required\"> <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]\" required=\"required\"> <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]\" required=\"required\"> <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-text elementor-field-group elementor-column elementor-field-group-vorname elementor-col-25 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-25 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\" 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 elementor-field-required\">\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\" 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-plz elementor-col-25 elementor-field-required\">\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\" 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-wohnort elementor-col-25 elementor-field-required\">\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\" 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-telefon elementor-col-25 elementor-field-required\">\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\" 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-email elementor-field-group elementor-column elementor-field-group-email elementor-col-25 elementor-field-required\">\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\" 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-step elementor-field-group elementor-column elementor-field-group-field_86eafa6 elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"Information Patient:in\" 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-checkbox elementor-field-group elementor-column elementor-field-group-befundwahl elementor-col-60\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-befundwahl\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWelchen Befund ben\u00f6tigen Sie?\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=\"checkbox\" value=\"endg\u00fcltiger Arztbrief\" id=\"form-field-befundwahl-0\" name=\"form_fields[befundwahl][]\"> <label for=\"form-field-befundwahl-0\">endg\u00fcltiger Arztbrief<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"histologische Befunde\" id=\"form-field-befundwahl-1\" name=\"form_fields[befundwahl][]\"> <label for=\"form-field-befundwahl-1\">histologische Befunde<\/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_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-radio elementor-field-group elementor-column elementor-field-group-zusendung elementor-col-70 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-zusendung\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tZusendung der Befunde:\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=\"per Post an meine hinterlegte Adresse\" id=\"form-field-zusendung-0\" name=\"form_fields[zusendung]\" required=\"required\"> <label for=\"form-field-zusendung-0\">per Post an meine hinterlegte Adresse<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"an meine - in der Patientenakte - hinterlegte Email Adresse\" id=\"form-field-zusendung-1\" name=\"form_fields[zusendung]\" required=\"required\"> <label for=\"form-field-zusendung-1\">an meine - in der Patientenakte - hinterlegte Email Adresse<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"an meinen Hausarzt \/ Klinik\" id=\"form-field-zusendung-2\" name=\"form_fields[zusendung]\" required=\"required\"> <label for=\"form-field-zusendung-2\">an meinen Hausarzt \/ Klinik<\/label><\/span><\/div>\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-adresseklinik elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-adresseklinik\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAdresse des Arztes \/ Klinik\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[adresseklinik]\" id=\"form-field-adresseklinik\" rows=\"4\" placeholder=\"Vollst\u00e4ndige Adresse und Email Adresse\" required=\"required\"><\/textarea>\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-praxisadresse elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-praxisadresse\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAdresse der Arztpraxis \/ Klinik\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[praxisadresse]\" id=\"form-field-praxisadresse\" rows=\"4\" placeholder=\"Vollst\u00e4ndige Adresse und Email Adresse\" required=\"required\"><\/textarea>\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-entbindung elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-entbindung\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tLaden Sie bitte die Entbindung der Schweigepflicht des Patienten hoch (Dateiformat PDF, Dateigr\u00f6\u00dfe max. 5MB)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[entbindung]\" id=\"form-field-entbindung\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" required=\"required\" data-maxsize=\"5\" 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_b1371ca 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-nachricht elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-nachricht\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b>Ihre Nachricht an uns<\/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[nachricht]\" id=\"form-field-nachricht\" rows=\"4\"><\/textarea>\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\">Ihre Privatsph\u00e4re ist uns wichtig. Die von Ihnen in diesem Formular eingegebenen Daten werden streng vertraulich behandelt und nur f\u00fcr die Bearbeitung Ihrer Rezeptanforderung verwendet. Ihre pers\u00f6nlichen Informationen werden gem\u00e4\u00df den geltenden <a href=\"https:\/\/uniklinik-freiburg.de\/footernavigation\/datenschutz.html\" target=\"_blank\">Datenschutzerkl\u00e4rung.<\/a> sicher verarbeitet.<br\/><\/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=\"10\/05\/2026 18:55\">\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-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; 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