{"id":190,"date":"2023-10-12T16:50:55","date_gmt":"2023-10-12T14:50:55","guid":{"rendered":"http:\/\/praxisgundheim.de\/home\/?page_id=190"},"modified":"2023-10-12T17:11:08","modified_gmt":"2023-10-12T15:11:08","slug":"rezept","status":"publish","type":"page","link":"http:\/\/praxisgundheim.de\/home\/?page_id=190","title":{"rendered":"Rezept"},"content":{"rendered":"<div id=\"sp-page\" class=\"spBgfull sp-content-1\" style=\"background-color: rgb(255, 255, 255); font-family: Inter, sans-serif; font-weight: 400;\">\n<section id=\"sp-whzd4t7ldl59\" data-mobile-visibility=\"#sp-whzd4t7ldl59|false\" data-desktop-visibility=\"#sp-whzd4t7ldl59|false\" class=\"sp-el-section  spBgcoverscroll\" style=\"position: relative; background-image: url('http:\/\/praxisgundheim.de\/wp-content\/uploads\/2022\/04\/MedicalBanner.jpg'); background-color: rgb(242, 241, 239); width: 100%; max-width: 100%; padding: 0px;\">\n<div id=\"sp-kghgt1\" data-mobile-visibility=\"#sp-kghgt1|false\" data-desktop-visibility=\"#sp-kghgt1|false\" class=\"sp-el-row sm:sp-flex sp-w-full  sp-m-auto sp-justify-between\" style=\"width: auto; max-width: 940px;\">\n<div id=\"sp-l3it03\" data-mobile-visibility=\"#sp-l3it03|false\" data-desktop-visibility=\"#sp-l3it03|false\" class=\"sp-el-col  sp-w-full\" style=\"width: calc(33.3333% - 3px);\">\n<div class=\"sp-button-wrapper sp-el-block\" style=\"margin: 0px; text-align: center;\"><a href=\"https:\/\/maps.app.goo.gl\/U3oaxptnvtn3TJjH7\" id=\"sp-wyeesz\" data-mobile-css=\"\" data-mobile-visibility=\".sp-button-wyeesz|false\" data-desktop-visibility=\".sp-button-wyeesz|false\" target=\"_blank\" rel=\"noopener\" class=\"sp-button sp-css-target sp-text-center sp-inline-block sp-leading-none sp-button-wyeesz\" style=\"text-shadow: rgba(0, 0, 0, 0.5) 1px 1px 3px; font-size: 18px; background: rgb(30, 136, 229); color: rgb(255, 255, 255); width: auto; padding: 12px 16px; border-radius: 4px;\"><i class=\"sp-mr-2 fas fa-map-marked-alt\"><\/i><span>Greifenklaustr. 31<\/span><\/a><\/div>\n<\/div>\n<div id=\"sp-hz4b3e\" data-mobile-visibility=\"#sp-hz4b3e|false\" data-desktop-visibility=\"#sp-hz4b3e|false\" class=\"sp-el-col  sp-w-full\" style=\"width: calc(33.3333% - 3px);\">\n<div class=\"sp-button-wrapper sp-el-block\" style=\"margin: 0px; text-align: center;\"><a href=\"mailto:praxis.cernovski@t-online.de\" id=\"sp-b65ms2\" data-mobile-css=\"\" data-mobile-visibility=\".sp-button-b65ms2|false\" data-desktop-visibility=\".sp-button-b65ms2|false\" target=\"_blank\" rel=\"noopener\" class=\"sp-button sp-css-target sp-text-center sp-inline-block sp-leading-none sp-button-b65ms2\" style=\"text-shadow: rgba(0, 0, 0, 0.5) 1px 1px 3px; font-size: 18px; background: rgb(30, 136, 229); color: rgb(255, 255, 255); width: auto; padding: 12px 16px; border-radius: 4px;\"><i class=\"sp-mr-2 fas fa-envelope\"><\/i><span>Kontakt<\/span><\/a><\/div>\n<\/div>\n<div id=\"sp-zm54h3\" data-mobile-visibility=\"#sp-zm54h3|false\" data-desktop-visibility=\"#sp-zm54h3|false\" class=\"sp-el-col  sp-w-full\" style=\"width: calc(33.3333% - 3px);\">\n<div class=\"sp-button-wrapper sp-el-block\" style=\"margin: 0px; text-align: center;\"><a href=\"tel:+496244905072\" id=\"sp-soqmy8\" data-mobile-css=\"\" data-mobile-visibility=\".sp-button-soqmy8|false\" data-desktop-visibility=\".sp-button-soqmy8|false\" target=\"\" rel=\"noopener\" class=\"sp-button sp-css-target sp-text-center sp-inline-block sp-leading-none sp-button-soqmy8\" style=\"text-shadow: rgba(0, 0, 0, 0.5) 1px 1px 3px; font-size: 18px; background: rgb(30, 136, 229); color: rgb(255, 255, 255); width: auto; padding: 12px 16px; border-radius: 4px;\"><i class=\"sp-mr-2 fas fa-phone-alt\"><\/i><span>06244\/905072<\/span><\/a><\/div>\n<\/div>\n<\/div>\n<div id=\"sp-b11h6uppgumco\" data-mobile-visibility=\"#sp-b11h6uppgumco|false\" data-desktop-visibility=\"#sp-b11h6uppgumco|false\" class=\"sp-el-row sm:sp-flex sp-w-full  sp-m-auto spBgcontainscroll sp-justify-between\" style=\"padding: 0px; background-image: url('http:\/\/praxisgundheim.de\/wp-content\/uploads\/2023\/10\/Wappen_von_Gundheim-removebg-preview.png'); background-color: rgba(0, 0, 0, 0); width: auto; max-width: 850px;\">\n<div id=\"sp-ezounguzatwo\" data-mobile-visibility=\"#sp-ezounguzatwo|false\" data-desktop-visibility=\"#sp-ezounguzatwo|false\" class=\"sp-el-col  spBgcover sp-w-full\" style=\"width: calc(100% - 0px);\">\n<style type=\"text\/css\">\n        #sp-ezounguzatwo .sp-col-top .seedprod-shape-fill {fill: undefined;} #sp-ezounguzatwo .sp-col-top svg {width: undefined%;height: undefinedpx;transform: translateX(-50%);} #sp-ezounguzatwo .sp-col-bottom .seedprod-shape-fill {fill: undefined;} #sp-ezounguzatwo .sp-col-bottom svg {width: undefined%;height: undefinedpx;transform: translateX(-50%);}\n      <\/style>\n<div class=\"sp-col-shape sp-col-top\" style=\"z-index: 0;\">\n<div><\/div>\n<\/div>\n<div class=\"sp-col-shape sp-col-bottom\" style=\"z-index: 0;\">\n<div><\/div>\n<\/div>\n<div id=\"sp-nvl6h56pokj8\" class=\"sp-spacer\" style=\"height: 0px;\"><\/div>\n<div id=\"sp-sxbr9q\" class=\"sp-spacer\" style=\"height: 176px;\"><\/div>\n<\/div>\n<\/div>\n<div id=\"sp-kacp1i\" data-mobile-visibility=\"#sp-kacp1i|false\" data-desktop-visibility=\"#sp-kacp1i|false\" class=\"sp-el-row sm:sp-flex sp-w-full  sp-m-auto sp-justify-between\">\n<div id=\"sp-ymes5x\" data-mobile-visibility=\"#sp-ymes5x|false\" data-desktop-visibility=\"#sp-ymes5x|false\" class=\"sp-el-col  sp-w-full\" style=\"width: calc(100% - 0px);\">\n<h3 id=\"sp-pqu6yw\" data-mobile-css=\"\" data-mobile-visibility=\".sp-headline-block-pqu6yw|false\" data-desktop-visibility=\".sp-headline-block-pqu6yw|false\" class=\"sp-css-target sp-el-block sp-headline-block-pqu6yw sp-type-header\" style=\"font-size: 60px; color: rgb(255, 255, 255); text-shadow: rgba(0, 0, 0, 0.5) 1px 1px 3px; text-align: center; padding: 0px; margin: 0px;\">Online Rezept Bestellen<\/h3>\n<\/div>\n<\/div>\n<div id=\"sp-ziludbz8q53j\" data-mobile-visibility=\"#sp-ziludbz8q53j|false\" data-desktop-visibility=\"#sp-ziludbz8q53j|false\" class=\"sp-el-row sm:sp-flex sp-w-full  sp-m-auto spBgcover sp-justify-between\" style=\"padding: 0px; width: auto; max-width: 1000px;\">\n<div id=\"sp-azf0dexkeszs\" data-mobile-visibility=\"#sp-azf0dexkeszs|false\" data-desktop-visibility=\"#sp-azf0dexkeszs|false\" class=\"sp-el-col  spBgcover sp-w-full\" style=\"width: calc(100% - 0px);\">\n<style type=\"text\/css\">\n        #sp-azf0dexkeszs .sp-col-top .seedprod-shape-fill {fill: undefined;} #sp-azf0dexkeszs .sp-col-top svg {width: undefined%;height: undefinedpx;transform: translateX(-50%);} #sp-azf0dexkeszs .sp-col-bottom .seedprod-shape-fill {fill: undefined;} #sp-azf0dexkeszs .sp-col-bottom svg {width: undefined%;height: undefinedpx;transform: translateX(-50%);}\n      <\/style>\n<div class=\"sp-col-shape sp-col-top\" style=\"z-index: 0;\">\n<div><\/div>\n<\/div>\n<div class=\"sp-col-shape sp-col-bottom\" style=\"z-index: 0;\">\n<div><\/div>\n<\/div>\n<div id=\"sp-qrf8arlrzcep\" class=\"sp-spacer\" style=\"height: 56px;\"><\/div>\n<\/div>\n<\/div>\n<\/section>\n<section id=\"sp-xvhssrvns5v\" data-mobile-visibility=\"#sp-xvhssrvns5v|false\" data-desktop-visibility=\"#sp-xvhssrvns5v|false\" class=\"sp-el-section  spBgcover\" style=\"background-image: linear-gradient(rgb(255, 255, 255) 50%, rgb(204, 204, 204) 100%); width: 100%; max-width: 100%; padding: 10px;\">\n<div id=\"sp-gesnuoho4phd\" data-mobile-visibility=\"#sp-gesnuoho4phd|false\" data-desktop-visibility=\"#sp-gesnuoho4phd|false\" class=\"sp-el-row sm:sp-flex sp-w-full  sp-m-auto spBgcover sp-justify-between\" style=\"padding: 0px; width: auto; max-width: 1000px;\">\n<div id=\"sp-lgtr0q2q7ws\" data-mobile-visibility=\"#sp-lgtr0q2q7ws|false\" data-desktop-visibility=\"#sp-lgtr0q2q7ws|false\" class=\"sp-el-col  spBgcover sp-w-full\" style=\"width: calc(100% - 0px);\">\n<style type=\"text\/css\">\n        #sp-lgtr0q2q7ws .sp-col-top .seedprod-shape-fill {fill: undefined;} #sp-lgtr0q2q7ws .sp-col-top svg {width: undefined%;height: undefinedpx;transform: translateX(-50%);} #sp-lgtr0q2q7ws .sp-col-bottom .seedprod-shape-fill {fill: undefined;} #sp-lgtr0q2q7ws .sp-col-bottom svg {width: undefined%;height: undefinedpx;transform: translateX(-50%);}\n      <\/style>\n<div class=\"sp-col-shape sp-col-top\" style=\"z-index: 0;\">\n<div><\/div>\n<\/div>\n<div class=\"sp-col-shape sp-col-bottom\" style=\"z-index: 0;\">\n<div><\/div>\n<\/div>\n<div id=\"tiny-vue_37086756961697123461036\" data-mobile-css=\"\" data-mobile-visibility=\".sp-text-wrapper-fyuhdk|false\" data-desktop-visibility=\".sp-text-wrapper-fyuhdk|false\" class=\"sp-css-target sp-text-wrapper sp-el-block sp-text-wrapper-fyuhdk mce-content-body html4-captions\" style=\"margin: 0px; text-align: center; position: relative;\"  >\n<p>Mit dieser Anfrage k\u00f6nnen Sie ganz bequem und zuverl\u00e4ssig von zuhause oder unterwegs Ihr Rezept bei uns beantragen. Innerhalb von 24 Stunden k\u00f6nnen Sie es dann in der Praxis vor Ort abholen oder zu der Apotheke Ihrer Wahl verschicken lassen.<\/p>\n<\/div>\n<div id=\"sp-w8jru6\" data-mobile-css=\"\" data-mobile-visibility=\".sp-form-block-w8jru6|false\" data-desktop-visibility=\".sp-form-block-w8jru6|false\" class=\"sp-form-wrapper sp-el-block sp-has-form sp-form-block-w8jru6\" style=\"margin: 0px; text-align: left;\">\n<div>\n<div class=\"\">\n        <div class=\"wpforms-container wpforms-container-full wpforms-render-modern\" id=\"wpforms-116\"><form id=\"wpforms-form-116\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"116\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/home\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F190\" data-token=\"d2f9b30c0a761f311d389a6a71135304\"><noscript class=\"wpforms-error-noscript\">Bitte aktiviere JavaScript in deinem Browser, um dieses Formular fertigzustellen.<\/noscript><div class=\"wpforms-hidden\" id=\"wpforms-error-noscript\">Bitte aktiviere JavaScript in deinem Browser, um dieses Formular fertigzustellen.<\/div><div class=\"wpforms-page-indicator progress\" data-indicator=\"progress\" data-indicator-color=\"#066aab\" data-scroll=\"1\" role=\"progressbar\" aria-valuenow=\"1\" aria-valuemin=\"1\" aria-valuemax=\"2\" tabindex=\"-1\"><span class=\"wpforms-page-indicator-page-title\" ><\/span><span class=\"wpforms-page-indicator-page-title-sep\" style=\"display:none;\"> - <\/span><span class=\"wpforms-page-indicator-steps\">Schritt <span class=\"wpforms-page-indicator-steps-current\">1<\/span> von 2<\/span><div class=\"wpforms-page-indicator-page-progress-wrap\"><div class=\"wpforms-page-indicator-page-progress\" style=\"width:50%;background-color:#066aab\"><\/div><\/div><\/div><div class=\"wpforms-field-container\"><div class=\"wpforms-page wpforms-page-1 \" data-page=\"1\"><div id=\"wpforms-116-field_20-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"20\"><\/div><div id=\"wpforms-116-field_7-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"7\"><fieldset><legend class=\"wpforms-field-label\">Patienten Name: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-116-field_7\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][7][first]\" aria-errormessage=\"wpforms-116-field_7-error\" aria-describedby=\"wpforms-116-field_7-description\" required><label for=\"wpforms-116-field_7\" class=\"wpforms-field-sublabel after \">Vorname<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-116-field_7-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][7][last]\" aria-errormessage=\"wpforms-116-field_7-last-error\" aria-describedby=\"wpforms-116-field_7-description\" required><label for=\"wpforms-116-field_7-last\" class=\"wpforms-field-sublabel after \">Nachname<\/label><\/div><\/div><div id=\"wpforms-116-field_7-description\" class=\"wpforms-field-description\">Bitte geben Sie hier Ihren Vor- und Nachnamen ein, wie er auf Ihrer Krankenversichertenkarte aufgef\u00fchrt ist.<\/div><\/fieldset><\/div><div id=\"wpforms-116-field_23-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-id=\"23\"><fieldset><legend class=\"wpforms-field-label\">Geburtsdatum: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-date-dropdown-wrap wpforms-field-medium\"><select name=\"wpforms[fields][23][date][d]\" id=\"wpforms-116-field_23-day\" class=\"wpforms-field-date-time-date-day wpforms-field-required\" aria-label=\"Tag\"  required><option value=\"\" class=\"placeholder\" selected disabled>TT<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><option value=\"13\" >13<\/option><option value=\"14\" >14<\/option><option value=\"15\" >15<\/option><option value=\"16\" >16<\/option><option value=\"17\" >17<\/option><option value=\"18\" >18<\/option><option value=\"19\" >19<\/option><option value=\"20\" >20<\/option><option value=\"21\" >21<\/option><option value=\"22\" >22<\/option><option value=\"23\" >23<\/option><option value=\"24\" >24<\/option><option value=\"25\" >25<\/option><option value=\"26\" >26<\/option><option value=\"27\" >27<\/option><option value=\"28\" >28<\/option><option value=\"29\" >29<\/option><option value=\"30\" >30<\/option><option value=\"31\" >31<\/option><\/select><select name=\"wpforms[fields][23][date][m]\" id=\"wpforms-116-field_23-month\" class=\"wpforms-field-date-time-date-month wpforms-field-required\" aria-label=\"Monat\"  required><option value=\"\" class=\"placeholder\" selected disabled>MM<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><\/select><select name=\"wpforms[fields][23][date][y]\" id=\"wpforms-116-field_23-year\" class=\"wpforms-field-date-time-date-year wpforms-field-required\" aria-label=\"Jahr\"  required><option value=\"\" class=\"placeholder\" selected disabled>JJJJ<\/option><option value=\"2027\" >2027<\/option><option value=\"2026\" >2026<\/option><option value=\"2025\" >2025<\/option><option value=\"2024\" >2024<\/option><option value=\"2023\" >2023<\/option><option value=\"2022\" >2022<\/option><option value=\"2021\" >2021<\/option><option value=\"2020\" >2020<\/option><option value=\"2019\" >2019<\/option><option value=\"2018\" >2018<\/option><option value=\"2017\" >2017<\/option><option value=\"2016\" >2016<\/option><option value=\"2015\" >2015<\/option><option value=\"2014\" >2014<\/option><option value=\"2013\" >2013<\/option><option value=\"2012\" >2012<\/option><option value=\"2011\" >2011<\/option><option value=\"2010\" >2010<\/option><option value=\"2009\" >2009<\/option><option value=\"2008\" >2008<\/option><option value=\"2007\" >2007<\/option><option value=\"2006\" >2006<\/option><option value=\"2005\" >2005<\/option><option value=\"2004\" >2004<\/option><option value=\"2003\" >2003<\/option><option value=\"2002\" >2002<\/option><option value=\"2001\" >2001<\/option><option value=\"2000\" >2000<\/option><option value=\"1999\" >1999<\/option><option value=\"1998\" >1998<\/option><option value=\"1997\" >1997<\/option><option value=\"1996\" >1996<\/option><option value=\"1995\" >1995<\/option><option value=\"1994\" >1994<\/option><option value=\"1993\" >1993<\/option><option value=\"1992\" >1992<\/option><option value=\"1991\" >1991<\/option><option value=\"1990\" >1990<\/option><option value=\"1989\" >1989<\/option><option value=\"1988\" >1988<\/option><option value=\"1987\" >1987<\/option><option value=\"1986\" >1986<\/option><option value=\"1985\" >1985<\/option><option value=\"1984\" >1984<\/option><option value=\"1983\" >1983<\/option><option value=\"1982\" >1982<\/option><option value=\"1981\" >1981<\/option><option value=\"1980\" >1980<\/option><option value=\"1979\" >1979<\/option><option value=\"1978\" >1978<\/option><option value=\"1977\" >1977<\/option><option value=\"1976\" >1976<\/option><option value=\"1975\" >1975<\/option><option value=\"1974\" >1974<\/option><option value=\"1973\" >1973<\/option><option value=\"1972\" >1972<\/option><option value=\"1971\" >1971<\/option><option value=\"1970\" >1970<\/option><option value=\"1969\" >1969<\/option><option value=\"1968\" >1968<\/option><option value=\"1967\" >1967<\/option><option value=\"1966\" >1966<\/option><option value=\"1965\" >1965<\/option><option value=\"1964\" >1964<\/option><option value=\"1963\" >1963<\/option><option value=\"1962\" >1962<\/option><option value=\"1961\" >1961<\/option><option value=\"1960\" >1960<\/option><option value=\"1959\" >1959<\/option><option value=\"1958\" >1958<\/option><option value=\"1957\" >1957<\/option><option value=\"1956\" >1956<\/option><option value=\"1955\" >1955<\/option><option value=\"1954\" >1954<\/option><option value=\"1953\" >1953<\/option><option value=\"1952\" >1952<\/option><option value=\"1951\" >1951<\/option><option value=\"1950\" >1950<\/option><option value=\"1949\" >1949<\/option><option value=\"1948\" >1948<\/option><option value=\"1947\" >1947<\/option><option value=\"1946\" >1946<\/option><option value=\"1945\" >1945<\/option><option value=\"1944\" >1944<\/option><option value=\"1943\" >1943<\/option><option value=\"1942\" >1942<\/option><option value=\"1941\" >1941<\/option><option value=\"1940\" >1940<\/option><option value=\"1939\" >1939<\/option><option value=\"1938\" >1938<\/option><option value=\"1937\" >1937<\/option><option value=\"1936\" >1936<\/option><option value=\"1935\" >1935<\/option><option value=\"1934\" >1934<\/option><option value=\"1933\" >1933<\/option><option value=\"1932\" >1932<\/option><option value=\"1931\" >1931<\/option><option value=\"1930\" >1930<\/option><option value=\"1929\" >1929<\/option><option value=\"1928\" >1928<\/option><option value=\"1927\" >1927<\/option><option value=\"1926\" >1926<\/option><option value=\"1925\" >1925<\/option><option value=\"1924\" >1924<\/option><option value=\"1923\" >1923<\/option><option value=\"1922\" >1922<\/option><option value=\"1921\" >1921<\/option><option value=\"1920\" >1920<\/option><\/select><\/div><\/fieldset><\/div><div id=\"wpforms-116-field_8-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-116-field_8\">E-Mail: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-116-field_8\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][8]\" spellcheck=\"false\" aria-errormessage=\"wpforms-116-field_8-error\" aria-describedby=\"wpforms-116-field_8-description\" required><div id=\"wpforms-116-field_8-description\" class=\"wpforms-field-description\">Bitte geben Sie hier Ihre E-Mail an, damit wir Sie im Falle von Nachfragen erreichen k\u00f6nnen.<\/div><\/div><div id=\"wpforms-116-field_18-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-116-field_18\">Telefonnummer: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-116-field_18\" class=\"wpforms-field-medium wpforms-field-required wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][18]\" aria-errormessage=\"wpforms-116-field_18-error\" aria-describedby=\"wpforms-116-field_18-description\" required><div id=\"wpforms-116-field_18-description\" class=\"wpforms-field-description\">Bitte geben Sie hier Ihre Telefonnummer an, damit wir Sie im Falle von Nachfragen erreichen k\u00f6nnen.<\/div><\/div><div id=\"wpforms-116-field_15-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-116-field_15\">Medikament #1: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-116-field_15\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][15]\" aria-errormessage=\"wpforms-116-field_15-error\" aria-describedby=\"wpforms-116-field_15-description\" required><div id=\"wpforms-116-field_15-description\" class=\"wpforms-field-description\">Bitte geben Sie hier den Namen des Medikaments, die Dosierung und die Anzahl der Tabletten ein. Wenn Sie mehr als drei Medikamente anfragen m\u00f6chten, senden Sie bitte eine zus\u00e4tzliche Anfrage.<\/div><\/div><div id=\"wpforms-116-field_11-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-116-field_11\">Medikament #2:<\/label><input type=\"text\" id=\"wpforms-116-field_11\" class=\"wpforms-field-medium\" name=\"wpforms[fields][11]\" aria-errormessage=\"wpforms-116-field_11-error\" aria-describedby=\"wpforms-116-field_11-description\" ><div id=\"wpforms-116-field_11-description\" class=\"wpforms-field-description\">Bitte geben Sie hier den Namen des Medikaments, die Dosierung und die Anzahl der Tabletten ein. Wenn Sie mehr als drei Medikamente anfragen m\u00f6chten, senden Sie bitte eine zus\u00e4tzliche Anfrage.<\/div><\/div><div id=\"wpforms-116-field_16-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-116-field_16\">Medikament #3:<\/label><input type=\"text\" id=\"wpforms-116-field_16\" class=\"wpforms-field-medium\" name=\"wpforms[fields][16]\" aria-errormessage=\"wpforms-116-field_16-error\" aria-describedby=\"wpforms-116-field_16-description\" ><div id=\"wpforms-116-field_16-description\" class=\"wpforms-field-description\">Bitte geben Sie hier den Namen des Medikaments, die Dosierung und die Anzahl der Tabletten ein. Wenn Sie mehr als drei Medikamente anfragen m\u00f6chten, senden Sie bitte eine zus\u00e4tzliche Anfrage.<\/div><\/div><div id=\"wpforms-116-field_17-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-116-field_17\">Abholort: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-116-field_17\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][17]\" required=\"required\"><option value=\"Pers\u00f6nlich in der Praxis Gundheim abholen.\" >Pers\u00f6nlich in der Praxis Gundheim abholen.<\/option><option value=\"Sonnen-Apotheke (Fl\u00f6rsheim-Dalsheim)\" >Sonnen-Apotheke (Fl\u00f6rsheim-Dalsheim)<\/option><option value=\"Rheinberg-Apotheke (Osthofen)\" >Rheinberg-Apotheke (Osthofen)<\/option><option value=\"Seebach-Apotheke (Westhofen)\" >Seebach-Apotheke (Westhofen)<\/option><option value=\"Dalberg-Apotheke (Worms-Pfeddersheim)\" >Dalberg-Apotheke (Worms-Pfeddersheim)<\/option><option value=\"L\u00f6wen-Apotheke (Worms-Pfeddersheim)\" >L\u00f6wen-Apotheke (Worms-Pfeddersheim)<\/option><\/select><\/div><div id=\"wpforms-116-field_10-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"10\"><label class=\"wpforms-field-label\" for=\"wpforms-116-field_10\">Zus\u00e4tzliche Angaben:<\/label><textarea id=\"wpforms-116-field_10\" class=\"wpforms-field-medium\" name=\"wpforms[fields][10]\" aria-errormessage=\"wpforms-116-field_10-error\" aria-describedby=\"wpforms-116-field_10-description\" ><\/textarea><div id=\"wpforms-116-field_10-description\" class=\"wpforms-field-description\">Hier k\u00f6nnen Sie zus\u00e4tzliche Angaben und\/oder Informationen mitteilen.<\/div><\/div><div id=\"wpforms-116-field_19-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"19\"><div class=\"wpforms-clear wpforms-pagebreak-left\"><button class=\"wpforms-page-button wpforms-page-next wpforms-disabled\"\n\t\t\t\t\tdata-action=\"next\" data-page=\"1\" data-formid=\"116\" aria-disabled=\"true\" aria-describedby=\"wpforms-error-noscript\">Weiter<\/button><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-2 last \" data-page=\"2\" style=\"display:none;\"><div id=\"wpforms-116-field_22-container\" class=\"wpforms-field wpforms-field-entry-preview\" data-field-id=\"22\"><div class=\"wpforms-entry-preview-updating-message\">Vorschau aktualisieren...<\/div><div class=\"wpforms-entry-preview-notice\" style=\"display: none;\"><strong>Dies ist eine Vorschau deiner \u00dcbermittlung. 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