{"id":123,"date":"2021-09-01T13:20:46","date_gmt":"2021-09-01T13:20:46","guid":{"rendered":"https:\/\/kokmetselen.nl\/veilig\/?page_id=123"},"modified":"2022-02-14T06:57:00","modified_gmt":"2022-02-14T06:57:00","slug":"meldingen","status":"publish","type":"page","link":"https:\/\/kokmetselen.nl\/veilig\/meldingen\/","title":{"rendered":"Meldingen"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"123\" class=\"elementor elementor-123\" data-elementor-settings=\"[]\">\n\t\t\t\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a83c356 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a83c356\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-f9fb5c4\" data-id=\"f9fb5c4\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c10be12 elementor-widget elementor-widget-shortcode\" data-id=\"c10be12\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-shortcode\"><div class=\"forminator-ui forminator-custom-form forminator-custom-form-174 forminator-design--default  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-174\"><br\/><\/div><form\r\n\t\t\t\tid=\"forminator-module-174\"\r\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-174 forminator-design--default  forminator_ajax\"\r\n\t\t\t\tmethod=\"post\"\r\n\t\t\t\tdata-forminator-render=\"0\"\r\n\t\t\t\tdata-form-id=\"174\"\r\n\t\t\t\t\r\n\t\t\t\tdata-design=\"default\"\r\n\t\t\t\t\r\n\t\t\t\t\r\n\t\t\t\t\r\n\t\t\t\tdata-grid=\"open\"\r\n\t\t\t\t\r\n\t\t\t\t\r\n\t\t\t\tstyle=\"display: none;\"\r\n\t\t\t><div class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"section-6\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h2 class=\"forminator-title\">Melding incident<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-21\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-21\" class=\"forminator-label\">Datum incident<\/label><input type=\"text\" name=\"text-21\" value=\"\" placeholder=\"\" id=\"forminator-field-text-21\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"text-2\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-2\" class=\"forminator-label\">Tijdstip incident<\/label><input type=\"text\" name=\"text-2\" value=\"\" placeholder=\"Bijv: 08:30 uur\" id=\"forminator-field-text-2\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-3\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-3\" class=\"forminator-label\">Plaats<\/label><input type=\"text\" name=\"text-3\" value=\"\" placeholder=\"\" id=\"forminator-field-text-3\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"checkbox-1\" class=\"forminator-col forminator-col-6 \"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-6a2a4402cb89e-label\"><h4 id=\"forminator-checkbox-group-6a2a4402cb89e-label\" class=\"forminator-label\">Betreft<\/h4><label for=\"forminator-field-checkbox-1-1-6a2a4402cb89e\" class=\"forminator-checkbox\" title=\"Persoonlijk letsel\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"persoonlijk-letsel\" id=\"forminator-field-checkbox-1-1-6a2a4402cb89e\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Persoonlijk letsel<\/span><\/label><label for=\"forminator-field-checkbox-1-2-6a2a4402cb89e\" class=\"forminator-checkbox\" title=\"Incident\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"incident\" id=\"forminator-field-checkbox-1-2-6a2a4402cb89e\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Incident<\/span><\/label><label for=\"forminator-field-checkbox-1-3-6a2a4402cb89e\" class=\"forminator-checkbox\" title=\"Materi\u00eble schade\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"materi\u00eble-schade\" id=\"forminator-field-checkbox-1-3-6a2a4402cb89e\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Materi\u00eble schade<\/span><\/label><label for=\"forminator-field-checkbox-1-4-6a2a4402cb89e\" class=\"forminator-checkbox\" title=\"Anders\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"anders\" id=\"forminator-field-checkbox-1-4-6a2a4402cb89e\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Anders<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-1\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-1\" class=\"forminator-label\">Namelijk:<\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"\" id=\"forminator-field-text-1\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-1\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h2 class=\"forminator-title\">Gegevens betrokkene<\/h2><hr class=\"forminator-border\" style=\"border: 1px dashed 1;\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-4\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-4\" class=\"forminator-label\">Naam<\/label><input type=\"text\" name=\"text-4\" value=\"\" placeholder=\"\" id=\"forminator-field-text-4\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"text-5\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-5\" class=\"forminator-label\">Geboortedatum<\/label><input type=\"text\" name=\"text-5\" value=\"\" placeholder=\"\" id=\"forminator-field-text-5\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-6\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-6\" class=\"forminator-label\">Adres:<\/label><input type=\"text\" name=\"text-6\" value=\"\" placeholder=\"\" id=\"forminator-field-text-6\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"text-7\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-7\" class=\"forminator-label\">Postcode\/woonplaats<\/label><input type=\"text\" name=\"text-7\" value=\"\" placeholder=\"\" id=\"forminator-field-text-7\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-2\" class=\"forminator-col forminator-col-12 \"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-6a2a4402cb9b7-label\"><h4 id=\"forminator-checkbox-group-6a2a4402cb9b7-label\" class=\"forminator-label\">Betreft<\/h4><label for=\"forminator-field-checkbox-2-1-6a2a4402cb9b7\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Eigen werknemer\"><input type=\"checkbox\" name=\"checkbox-2[]\" value=\"eigen-werknemer\" id=\"forminator-field-checkbox-2-1-6a2a4402cb9b7\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Eigen werknemer<\/span><\/label><label for=\"forminator-field-checkbox-2-2-6a2a4402cb9b7\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Inleenkracht\"><input type=\"checkbox\" name=\"checkbox-2[]\" value=\"inleenkracht\" id=\"forminator-field-checkbox-2-2-6a2a4402cb9b7\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Inleenkracht<\/span><\/label><label for=\"forminator-field-checkbox-2-3-6a2a4402cb9b7\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Werknemer derde\"><input type=\"checkbox\" name=\"checkbox-2[]\" value=\"werknemer-derde\" id=\"forminator-field-checkbox-2-3-6a2a4402cb9b7\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Werknemer derde<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-8\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-8\" class=\"forminator-label\">Firma:<\/label><input type=\"text\" name=\"text-8\" value=\"\" placeholder=\"\" id=\"forminator-field-text-8\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-2\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h2 class=\"forminator-title\">Gegevens van het ongeval \/ incident<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-9\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-9\" class=\"forminator-label\">Letsel<\/label><input type=\"text\" name=\"text-9\" value=\"\" placeholder=\"\" id=\"forminator-field-text-9\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-3\" class=\"forminator-col forminator-col-12 \"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-6a2a4402cba53-label\"><h4 id=\"forminator-checkbox-group-6a2a4402cba53-label\" class=\"forminator-label\">Aard verwonding<\/h4><label for=\"forminator-field-checkbox-3-1-6a2a4402cba53\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Schaafwond\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"schaafwond\" id=\"forminator-field-checkbox-3-1-6a2a4402cba53\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Schaafwond<\/span><\/label><label for=\"forminator-field-checkbox-3-2-6a2a4402cba53\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Kneuzing\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"kneuzing\" id=\"forminator-field-checkbox-3-2-6a2a4402cba53\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Kneuzing<\/span><\/label><label for=\"forminator-field-checkbox-3-3-6a2a4402cba53\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Botbreuk\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"botbreuk\" id=\"forminator-field-checkbox-3-3-6a2a4402cba53\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Botbreuk<\/span><\/label><label for=\"forminator-field-checkbox-3-4-6a2a4402cba53\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Snijwond\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"snijwond\" id=\"forminator-field-checkbox-3-4-6a2a4402cba53\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Snijwond<\/span><\/label><label for=\"forminator-field-checkbox-3-5-6a2a4402cba53\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Verstuiking\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"verstuiking\" id=\"forminator-field-checkbox-3-5-6a2a4402cba53\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Verstuiking<\/span><\/label><label for=\"forminator-field-checkbox-3-6-6a2a4402cba53\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Bedwelming\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"bedwelming\" id=\"forminator-field-checkbox-3-6-6a2a4402cba53\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Bedwelming<\/span><\/label><label for=\"forminator-field-checkbox-3-7-6a2a4402cba53\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Prikwond\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"prikwond\" id=\"forminator-field-checkbox-3-7-6a2a4402cba53\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Prikwond<\/span><\/label><label for=\"forminator-field-checkbox-3-8-6a2a4402cba53\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Vergiftiging\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"vergiftiging\" id=\"forminator-field-checkbox-3-8-6a2a4402cba53\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Vergiftiging<\/span><\/label><label for=\"forminator-field-checkbox-3-9-6a2a4402cba53\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Brandwond\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"brandwond\" id=\"forminator-field-checkbox-3-9-6a2a4402cba53\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Brandwond<\/span><\/label><label for=\"forminator-field-checkbox-3-10-6a2a4402cba53\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Anders\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"anders\" id=\"forminator-field-checkbox-3-10-6a2a4402cba53\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Anders<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-10\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-10\" class=\"forminator-label\">Anders<\/label><input type=\"text\" name=\"text-10\" value=\"\" placeholder=\"\" id=\"forminator-field-text-10\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-11\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-11\" class=\"forminator-label\">Plaats verwonding<\/label><input type=\"text\" name=\"text-11\" value=\"\" placeholder=\"\" id=\"forminator-field-text-11\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-4\" class=\"forminator-col forminator-col-12 \"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-6a2a4402cbb09-label\"><h4 id=\"forminator-checkbox-group-6a2a4402cbb09-label\" class=\"forminator-label\">EHBO verleend door<\/h4><label for=\"forminator-field-checkbox-4-1-6a2a4402cbb09\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"EHBO\/BHV-er\"><input type=\"checkbox\" name=\"checkbox-4[]\" value=\"ehbo-bhv-er\" id=\"forminator-field-checkbox-4-1-6a2a4402cbb09\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">EHBO\/BHV-er<\/span><\/label><label for=\"forminator-field-checkbox-4-2-6a2a4402cbb09\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Huisarts\"><input type=\"checkbox\" name=\"checkbox-4[]\" value=\"huisarts\" id=\"forminator-field-checkbox-4-2-6a2a4402cbb09\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Huisarts<\/span><\/label><label for=\"forminator-field-checkbox-4-3-6a2a4402cbb09\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Ziekenhuis\"><input type=\"checkbox\" name=\"checkbox-4[]\" value=\"ziekenhuis\" id=\"forminator-field-checkbox-4-3-6a2a4402cbb09\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Ziekenhuis<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-12\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-12\" class=\"forminator-label\">Behandeling<\/label><input type=\"text\" name=\"text-12\" value=\"\" placeholder=\"\" id=\"forminator-field-text-12\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-5\" class=\"forminator-col forminator-col-12 \"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-6a2a4402cbb56-label\"><h4 id=\"forminator-checkbox-group-6a2a4402cbb56-label\" class=\"forminator-label\">Werk hervat na behandeling<\/h4><label for=\"forminator-field-checkbox-5-1-6a2a4402cbb56\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Ja\"><input type=\"checkbox\" name=\"checkbox-5[]\" value=\"ja\" id=\"forminator-field-checkbox-5-1-6a2a4402cbb56\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Ja<\/span><\/label><label for=\"forminator-field-checkbox-5-2-6a2a4402cbb56\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Aangepast werk\"><input type=\"checkbox\" name=\"checkbox-5[]\" value=\"aangepast-werk\" id=\"forminator-field-checkbox-5-2-6a2a4402cbb56\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Aangepast werk<\/span><\/label><label for=\"forminator-field-checkbox-5-3-6a2a4402cbb56\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Nee\"><input type=\"checkbox\" name=\"checkbox-5[]\" value=\"nee\" id=\"forminator-field-checkbox-5-3-6a2a4402cbb56\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Nee<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-13\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-13\" class=\"forminator-label\">Namelijk<\/label><input type=\"text\" name=\"text-13\" value=\"\" placeholder=\"\" id=\"forminator-field-text-13\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-3\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h2 class=\"forminator-title\">Materi\u00eble schade<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-14\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-14\" class=\"forminator-label\">Betrokken materieel<\/label><input type=\"text\" name=\"text-14\" value=\"\" placeholder=\"\" id=\"forminator-field-text-14\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-15\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-15\" class=\"forminator-label\">Aard van de schade<\/label><input type=\"text\" name=\"text-15\" value=\"\" placeholder=\"\" id=\"forminator-field-text-15\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-16\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-16\" class=\"forminator-label\">Geschatte kosten<\/label><input type=\"text\" name=\"text-16\" value=\"\" placeholder=\"\u20ac\" id=\"forminator-field-text-16\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-17\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-17\" class=\"forminator-label\">Oorzaak van de schade<\/label><input type=\"text\" name=\"text-17\" value=\"\" placeholder=\"\" id=\"forminator-field-text-17\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-6\" class=\"forminator-col forminator-col-12 \"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-6a2a4402cbc72-label\"><h4 id=\"forminator-checkbox-group-6a2a4402cbc72-label\" class=\"forminator-label\">(weers)omstandigheden<\/h4><label for=\"forminator-field-checkbox-6-1-6a2a4402cbc72\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Droog\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"droog\" id=\"forminator-field-checkbox-6-1-6a2a4402cbc72\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Droog<\/span><\/label><label for=\"forminator-field-checkbox-6-2-6a2a4402cbc72\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Regen\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"regen\" id=\"forminator-field-checkbox-6-2-6a2a4402cbc72\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Regen<\/span><\/label><label for=\"forminator-field-checkbox-6-3-6a2a4402cbc72\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Sneeuw\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"sneeuw\" id=\"forminator-field-checkbox-6-3-6a2a4402cbc72\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Sneeuw<\/span><\/label><label for=\"forminator-field-checkbox-6-4-6a2a4402cbc72\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"IJzel\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"ijzel\" id=\"forminator-field-checkbox-6-4-6a2a4402cbc72\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">IJzel<\/span><\/label><label for=\"forminator-field-checkbox-6-5-6a2a4402cbc72\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Mistig\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"mistig\" id=\"forminator-field-checkbox-6-5-6a2a4402cbc72\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Mistig<\/span><\/label><label for=\"forminator-field-checkbox-6-6-6a2a4402cbc72\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Helder\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"helder\" id=\"forminator-field-checkbox-6-6-6a2a4402cbc72\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Helder<\/span><\/label><label for=\"forminator-field-checkbox-6-7-6a2a4402cbc72\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Schemer\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"schemer\" id=\"forminator-field-checkbox-6-7-6a2a4402cbc72\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Schemer<\/span><\/label><label for=\"forminator-field-checkbox-6-8-6a2a4402cbc72\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Donker\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"donker\" id=\"forminator-field-checkbox-6-8-6a2a4402cbc72\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Donker<\/span><\/label><label for=\"forminator-field-checkbox-6-9-6a2a4402cbc72\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Kunstlicht\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"kunstlicht\" id=\"forminator-field-checkbox-6-9-6a2a4402cbc72\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Kunstlicht<\/span><\/label><label for=\"forminator-field-checkbox-6-10-6a2a4402cbc72\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Daglicht\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"daglicht\" id=\"forminator-field-checkbox-6-10-6a2a4402cbc72\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Daglicht<\/span><\/label><label for=\"forminator-field-checkbox-6-11-6a2a4402cbc72\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Hitte\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"hitte\" id=\"forminator-field-checkbox-6-11-6a2a4402cbc72\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Hitte<\/span><\/label><label for=\"forminator-field-checkbox-6-12-6a2a4402cbc72\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Vorst\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"vorst\" id=\"forminator-field-checkbox-6-12-6a2a4402cbc72\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Vorst<\/span><\/label><label for=\"forminator-field-checkbox-6-13-6a2a4402cbc72\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Storm\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"storm\" id=\"forminator-field-checkbox-6-13-6a2a4402cbc72\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Storm<\/span><\/label><label for=\"forminator-field-checkbox-6-14-6a2a4402cbc72\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Onweer\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"onweer\" id=\"forminator-field-checkbox-6-14-6a2a4402cbc72\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Onweer<\/span><\/label><label for=\"forminator-field-checkbox-6-15-6a2a4402cbc72\" class=\"forminator-checkbox forminator-checkbox-inline\" title=\"Anders\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"anders\" id=\"forminator-field-checkbox-6-15-6a2a4402cbc72\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Anders<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-18\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-18\" class=\"forminator-label\">Namelijk<\/label><input type=\"text\" name=\"text-18\" value=\"\" placeholder=\"\" id=\"forminator-field-text-18\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-1\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-1\" class=\"forminator-label\">Omschrijving van het ongeval \/ incident<\/label><textarea name=\"textarea-1\" placeholder=\"\" id=\"forminator-field-textarea-1\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-2\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-2\" class=\"forminator-label\">Mogelijke oorzaak van het ongeval \/ incident<\/label><textarea name=\"textarea-2\" placeholder=\"\" id=\"forminator-field-textarea-2\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-3\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-3\" class=\"forminator-label\">Direct genomen actie<\/label><textarea name=\"textarea-3\" placeholder=\"\" id=\"forminator-field-textarea-3\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-4\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-4\" class=\"forminator-label\">Voorgestelde verbetering<\/label><textarea name=\"textarea-4\" placeholder=\"\" id=\"forminator-field-textarea-4\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-5\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-5\" class=\"forminator-label\">Bijzonderheden<\/label><textarea name=\"textarea-5\" placeholder=\"\" id=\"forminator-field-textarea-5\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-4\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h2 class=\"forminator-title\">Getuigen<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-19\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-19\" class=\"forminator-label\">Naam<\/label><input type=\"text\" name=\"text-19\" value=\"\" placeholder=\"\" id=\"forminator-field-text-19\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"phone-1\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1\" class=\"forminator-label\">Telefoonnummer<\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-1\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" \/><\/div><\/div><div id=\"text-20\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-20\" class=\"forminator-label\">Afdeling\/firma<\/label><input type=\"text\" name=\"text-20\" value=\"\" placeholder=\"\" id=\"forminator-field-text-20\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-22\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-22\" class=\"forminator-label\">Naam<\/label><input type=\"text\" name=\"text-22\" value=\"\" placeholder=\"\" id=\"forminator-field-text-22\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"text-23\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-23\" class=\"forminator-label\">Afdeling\/firma<\/label><input type=\"text\" name=\"text-23\" value=\"\" placeholder=\"\" id=\"forminator-field-text-23\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"phone-2\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-2\" class=\"forminator-label\">Telefoonnummer<\/label><input type=\"text\" name=\"phone-2\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-2\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-25\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-25\" class=\"forminator-label\">Naam<\/label><input type=\"text\" name=\"text-25\" value=\"\" placeholder=\"\" id=\"forminator-field-text-25\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"phone-3\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-3\" class=\"forminator-label\">Telefoonnummer<\/label><input type=\"text\" name=\"phone-3\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-3\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" \/><\/div><\/div><div id=\"text-24\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-24\" class=\"forminator-label\">Afdeling\/firma<\/label><input type=\"text\" name=\"text-24\" value=\"\" placeholder=\"\" id=\"forminator-field-text-24\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-5\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h2 class=\"forminator-title\">Opgesteld door<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-col forminator-col-3 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-1\" class=\"forminator-label\">Naam<\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"\" id=\"forminator-field-name-1\" class=\"forminator-input forminator-name--field\" aria-required=\"false\" \/><\/div><\/div><div id=\"text-26\" class=\"forminator-col forminator-col-3 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-26\" class=\"forminator-label\">Functie<\/label><input type=\"text\" name=\"text-26\" value=\"\" placeholder=\"\" id=\"forminator-field-text-26\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"text-27\" class=\"forminator-col forminator-col-3 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-27\" class=\"forminator-label\">Afdeling<\/label><input type=\"text\" name=\"text-27\" value=\"\" placeholder=\"\" id=\"forminator-field-text-27\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"phone-4\" class=\"forminator-col forminator-col-3 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-4\" class=\"forminator-label\">Telefoonnummer<\/label><input type=\"text\" name=\"phone-4\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-4\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"signature-1\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field forminator-field-signature\"><label class=\"forminator-label\">Handtekening<\/label><div class=\"forminator-signature\" data-elementheight=\"180\"><span id=\"ctlSignature6a2a4402cbffd_placeholder\" class=\"forminator-signature--placeholder\" aria-hidden=\"true\"><\/span><div id=\"ctlSignature6a2a4402cbffd_Container\" class=\"forminator-signature--container\"><canvas id=\"ctlSignature6a2a4402cbffd\" class=\"forminator-signature-canvas\" height=\"180\" tabindex=\"-1\"><p>Your browser does not support e-Signature field.<\/p><\/canvas><\/div><\/div><input type=\"hidden\" name=\"field-signature-1\" value=\"6a2a4402cbffd\" class=\"signature-prefix\"><\/div><\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div class=\"forminator-row forminator-row-last\"><div class=\"forminator-col\"><div class=\"forminator-field\"><button class=\"forminator-button forminator-button-submit\">Bericht Verzenden<\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"766527aac4\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/veilig\/wp-json\/wp\/v2\/pages\/123\" \/><input type=\"hidden\" name=\"form_id\" value=\"174\"><input type=\"hidden\" name=\"page_id\" value=\"123\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/kokmetselen.nl\/veilig\/wp-json\/wp\/v2\/pages\/123\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><\/form><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-123","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/kokmetselen.nl\/veilig\/wp-json\/wp\/v2\/pages\/123","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kokmetselen.nl\/veilig\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/kokmetselen.nl\/veilig\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/kokmetselen.nl\/veilig\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kokmetselen.nl\/veilig\/wp-json\/wp\/v2\/comments?post=123"}],"version-history":[{"count":10,"href":"https:\/\/kokmetselen.nl\/veilig\/wp-json\/wp\/v2\/pages\/123\/revisions"}],"predecessor-version":[{"id":254,"href":"https:\/\/kokmetselen.nl\/veilig\/wp-json\/wp\/v2\/pages\/123\/revisions\/254"}],"wp:attachment":[{"href":"https:\/\/kokmetselen.nl\/veilig\/wp-json\/wp\/v2\/media?parent=123"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}