{"url":"\/home","form_action_on_submit":"display_text","form_action_on_submit_text":"Vielen Dank f\u00fcr Ihre Tertminanfrage. Wir melden uns schnellstm\u00f6glich bei Ihnen.<br \/>\n<br \/>\nIhr Logop\u00e4die Team Grathwohl","form_include_text_fields_in_notification_emails":"1","rows":[{"columns":[{"columnWidth":null,"fields":[{"field_id":"3e9b99fb-2955-4fda-872e-07e3f0a4eff9-field-2","field_name":"Terminanfrage Name","field_type":"input_text","field_label":"Vor- und Nachname (Patient:in)","field_placeholder":"Namen eingeben ...","field_required":null,"field_label_required_error":"","field_hidden":null},{"field_id":"3e9b99fb-2955-4fda-872e-07e3f0a4eff9-field-3","field_name":"Terminanfrage Geburtsdatum","field_type":"input_date","field_label":"Geburtsdatum (Patient:in)","field_placeholder":"","field_required":null,"field_label_required_error":"","field_hidden":null},{"field_id":"3e9b99fb-2955-4fda-872e-07e3f0a4eff9-field-18","field_name":"E-Mail","field_type":"email","field_label":"* E-Mail","field_placeholder":"E-Mail eingeben ...","clientField":"email","field_required":"1","field_label_required_error":"","field_hidden":null},{"field_id":"3e9b99fb-2955-4fda-872e-07e3f0a4eff9-field-26","field_name":"Telefon","field_type":"phone","field_label":"Telefon\/Mobil","field_placeholder":"Telefon\/Mobil eingeben ...","clientField":"phone","field_required":null,"field_label_required_error":"","field_hidden":null},{"field_id":"3e9b99fb-2955-4fda-872e-07e3f0a4eff9-field-6","field_name":"Terminanfrage Terminwunsch","field_type":"textarea","field_label":"M\u00f6gliche Tage und Uhrzeiten","field_placeholder":"z.B. Mo.-Mi. flexibel, Do. vormittags, Fr. ab 13 Uhr","field_required":null,"field_label_required_error":"","field_hidden":null},{"field_id":"3e9b99fb-2955-4fda-872e-07e3f0a4eff9-field-7","field_name":"3e9b99fb-2955-4fda-872e-07e3f0a4eff9-field-7","field_type":"text","text":"<p>Flexible Termine m\u00f6glich (W\u00e4hlen Sie diese Option, wenn Sie zeitlich flexibel sind, und auch L\u00fccken f\u00fcllen k\u00f6nnen, die durch Ausf\u00e4lle entstehen. Die Wartezeit kann sich dadurch verk\u00fcrzen.)<\/p>"},{"field_id":"3e9b99fb-2955-4fda-872e-07e3f0a4eff9-field-8","field_name":"Terminanfrage Diagnose","field_type":"textarea","field_label":"Diagnose \/ St\u00f6rungsbild \/ Kurzbescheibung","field_placeholder":"Grund der Vorstellung","field_required":null,"field_label_required_error":"","field_hidden":null},{"field_id":"3e9b99fb-2955-4fda-872e-07e3f0a4eff9-field-9","field_name":"Terminanfrage Krankenkasse","field_type":"input_text","field_label":"Krankenkasse Patient:in","field_placeholder":"z.B. AOK","field_required":null,"field_label_required_error":"","field_hidden":null},{"field_id":"3e9b99fb-2955-4fda-872e-07e3f0a4eff9-field-11","field_name":"3e9b99fb-2955-4fda-872e-07e3f0a4eff9-field-11","field_type":"text","text":"<p><strong>Felder, die mit * markiert sind, sind Pflichtfelder !<\/strong><\/p>"},{"field_id":"3e9b99fb-2955-4fda-872e-07e3f0a4eff9-field-12","field_name":"Terminanfrage Checkbox","field_type":"checkbox","field_label":"Bitte anklicken","field_placeholder":"","field_required":"1","field_label_required_error":"","field_hidden":null,"field_select_multiple":null,"field_label_no_option":"","options":[{"option_label":"* Ich bin einverstanden, dass die angegeben Daten zur Kontaktaufnahme genutzt werden.","option_value":"","option_selected":false}]},{"field_id":"3e9b99fb-2955-4fda-872e-07e3f0a4eff9-field-1","field_name":"3e9b99fb-2955-4fda-872e-07e3f0a4eff9-field-1","field_type":"button","field_label":"Absenden","buttonClasses":"wsw-block-button-default wsw-button-solid wsw-button-rounded wsw-button-meduim"}]}]}]}

{"no_option":"Keine Option","subscribe_to_newsletter":"Newsletter abonnieren","subscribe_to_newsletter_yes":"Ja","subscribe_to_newsletter_no":"Nein","send_form_to_me_label":"Kopie an mich senden","choose_file":"Datei ausw\u00e4hlen","invalid_email":"E-Mail ist nicht korrekt","email_does_not_match":"E-Mail stimmt nicht \u00fcberein","password_does_not_match":"Passwort stimmt nicht \u00fcberein","captcha_failed":"Captcha-Verifikation fehlgeschlagen. Bitte versuchen Sie es erneut.","field_required":"Dieses Feld ist notwendig","unknown_error":"Unbekannter Error. Bitte neu laden","on_submit_text":"Vielen Dank f\u00fcr das Einreichen des Formulars."}