{"id":5495,"date":"2022-06-30T16:00:28","date_gmt":"2022-06-30T14:00:28","guid":{"rendered":"https:\/\/support.mrdm.com\/?post_type=account&#038;p=5495"},"modified":"2022-07-01T10:44:26","modified_gmt":"2022-07-01T08:44:26","slug":"request-an-account","status":"publish","type":"account","link":"https:\/\/support.mrdm.com\/en\/account\/account\/request-an-account\/","title":{"rendered":"Request an account"},"content":{"rendered":"\n<div style=\"height:30px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f5494-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"5494\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/account\/5495#wpcf7-f5494-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"5494\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f5494-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\" \/><input type=\"hidden\" name=\"_wpcf7cf_options\" value=\"{&quot;form_id&quot;:5494,&quot;conditions&quot;:[{&quot;then_field&quot;:&quot;requestor-is-not-contact&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;contactpersoon&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;I&#039;m not a contact person&quot;}]},{&quot;then_field&quot;:&quot;requestor-is-contact&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;contactpersoon&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;I&#039;m a Contact Person&quot;}]},{&quot;then_field&quot;:&quot;unknown-contact&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;contactpersoon&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;I do not know&quot;}]},{&quot;then_field&quot;:&quot;known-contact&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;contactpersoon&quot;,&quot;operator&quot;:&quot;not equals&quot;,&quot;if_value&quot;:&quot;I do not know&quot;}]},{&quot;then_field&quot;:&quot;deelnemer-1&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;dn-1-naam&quot;,&quot;operator&quot;:&quot;not equals&quot;,&quot;if_value&quot;:&quot;&quot;}]},{&quot;then_field&quot;:&quot;deelnemer-2&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;dn-2-naam&quot;,&quot;operator&quot;:&quot;not equals&quot;,&quot;if_value&quot;:&quot;&quot;}]},{&quot;then_field&quot;:&quot;deelnemer-3&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;dn-3-naam&quot;,&quot;operator&quot;:&quot;not equals&quot;,&quot;if_value&quot;:&quot;&quot;}]},{&quot;then_field&quot;:&quot;deelnemer-4&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;dn-4-naam&quot;,&quot;operator&quot;:&quot;not equals&quot;,&quot;if_value&quot;:&quot;&quot;}]},{&quot;then_field&quot;:&quot;group-dn-1-functie-anders&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;dn-1-functie&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Other&quot;}]},{&quot;then_field&quot;:&quot;group-dn-2-functie-anders&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;dn-2-functie&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Other&quot;}]},{&quot;then_field&quot;:&quot;group-dn-3-functie-anders&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;dn-3-functie&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Other&quot;}]},{&quot;then_field&quot;:&quot;group-dn-4-functie-anders&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;dn-4-functie&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Other&quot;}]}],&quot;settings&quot;:{&quot;animation&quot;:&quot;no&quot;,&quot;animation_intime&quot;:&quot;200&quot;,&quot;animation_outtime&quot;:&quot;200&quot;,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:&quot;&quot;,&quot;notice_dismissed_rollback-cf7-5.5.6&quot;:true,&quot;notice_dismissed_rollback-cf7-5.6&quot;:true,&quot;notice_dismissed_rollback-cf7-5.6.4&quot;:true,&quot;notice_dismissed_rollback-cf7-5.7.4&quot;:true,&quot;notice_dismissed_rollback-cf7-5.8.6&quot;:true,&quot;notice_dismissed_rollback-cf7-5.9.7&quot;:true}}\" \/>\n<\/fieldset>\n<div class=\"block\">\n<div class=\"inner\">\n\n  <h3>Registry<\/h3>\n  <div class=\"field\">\n    <label>For which registry would you like to request accounts?<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"registratie\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"registratie\"><option value=\"\">Select a registry<\/option><option value=\"account,survey,batch,codman,breast-cancer,ichom\">Breast cancer<\/option><option value=\"sign-up,account,downloads,survey,codman,epsa,ernica\">EPSA<\/option><\/select><\/span>\n  <\/div>\n\n<\/div>\n<\/div>\n\n<!-- Aanvrager -->\n<div class=\"block\">\n<div class=\"inner\">\n\n  <h3>Your details<\/h3>\n\n  <div class=\"field\">\n    <label>Your Name<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"aanvragen-naam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Name\" value=\"\" type=\"text\" name=\"aanvragen-naam\" \/><\/span>\n  <\/div>\n\n  <div class=\"field\">\n    <label>Your email address<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"aanvrager-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email light\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Email address\" value=\"\" type=\"email\" name=\"aanvrager-email\" \/><\/span>\n  <\/div>\n\n<\/div>\n<\/div>\n<!-- Aanvrager -->\n\n\n<!-- Contactpersoon -->\n<div class=\"block\">\n<div class=\"inner\">\n\n  <h3>Contact person<\/h3>\n  <p>For each registry, an organization has a contact person. The contact person is the person responsible for the whole registry and has the rights to request an account for other users.<\/p>\n\n  <div class=\"field radio horizontal\">\n    <label>Contact person<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"contactpersoon\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"contactpersoon\" value=\"I&#039;m a contact person\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">I&#039;m a contact person<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"contactpersoon\" value=\"I&#039;m not a contact person\" \/><span class=\"wpcf7-list-item-label\">I&#039;m not a contact person<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"contactpersoon\" value=\"I do not know\" \/><span class=\"wpcf7-list-item-label\">I do not know<\/span><\/label><\/span><\/span><\/span>\n  <\/div>\n\n<div data-id=\"requestor-is-not-contact\" data-orig_data_id=\"requestor-is-not-contact\"  class=\"\" data-class=\"wpcf7cf_group\">\n  <div class=\"field\">\n    <label>Name of contact person *<\/label>\n    <label>Your name *<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"contactpersoon-naam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Name\" value=\"\" type=\"text\" name=\"contactpersoon-naam\" \/><\/span>\n  <\/div>\n\n  <div class=\"field\">\n    <label>Email address contact person *<\/label>\n    <label>Your email address *<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"contactpersoon-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email light\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Email address\" value=\"\" type=\"email\" name=\"contactpersoon-email\" \/><\/span>\n  <\/div>\n<\/div>\n<div data-id=\"requestor-is-contact\" data-orig_data_id=\"requestor-is-contact\"  class=\"\" data-class=\"wpcf7cf_group\"><\/div>\n<div data-id=\"unknown-contact\" data-orig_data_id=\"unknown-contact\"  class=\"\" data-class=\"wpcf7cf_group\">\n<p>If you do not know who the contact person is for your selected registry please contact the service desk: <a href=\"mailto:servicedesk@mrdm.nl\">servicedesk@mrdm.nl<\/a><\/p>\n<\/div>\n<\/div>\n<\/div>\n<!-- Contactpersoon -->\n\n\n<div data-id=\"known-contact\" data-orig_data_id=\"known-contact\"  class=\"\" data-class=\"wpcf7cf_group\">\n<!-- Organisatie -->\n<div class=\"block\">\n<div class=\"inner\">\n\n  <h3>Organization<\/h3>\n\n  <div class=\"field\">\n  <label>Your organization *<br>(If there are multiple locations, please specify for which location)<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"instelling\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Your organization\" value=\"\" type=\"text\" name=\"instelling\" \/><\/span>\n  <\/div>\n\n  <div class=\"field col-2\">\n  <label>Street name<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"straatnaam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Street name\" value=\"\" type=\"text\" name=\"straatnaam\" \/><\/span>\n  <\/div>\n\n  <div class=\"field col-2 last\">\n  <label>Number<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"nummer\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Number\" value=\"\" type=\"text\" name=\"nummer\" \/><\/span>\n  <\/div>\n\n  <div class=\"field col-2\">\n  <label>Postal code<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"postcode\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Postal code\" value=\"\" type=\"text\" name=\"postcode\" \/><\/span>\n  <\/div>\n\n  <div class=\"field col-2 last\">\n  <label>City<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"plaats\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"City\" value=\"\" type=\"text\" name=\"plaats\" \/><\/span>\n  <\/div>\n\n  <div class=\"field\">\n  <label>AGB-code (when applicable)<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"agb-code\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"AGB-code\" value=\"\" type=\"text\" name=\"agb-code\" \/><\/span>\n  <\/div>\n\n<\/div>\n<\/div>\n<!-- Organisatie -->\n\n\n<!-- Deelnemers -->\n\n<div class=\"block\">\n<div class=\"inner\">\n\n  <h3>Participants<\/h3>\n  <p>Please add the participants here for whom you want to request an account.<\/p>\n\n<\/div>\n\n<!-- Deelnemer 1 -->\n<div data-id=\"deelnemer-1\" data-orig_data_id=\"deelnemer-1\"  class=\"\" data-class=\"wpcf7cf_group\"><\/div>\n<div class=\"inner block\">\n\n  <div class=\"field col-2\">\n  <label>First name *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-1-naam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"First name\" value=\"\" type=\"text\" name=\"dn-1-naam\" \/><\/span>\n  <\/div>\n\n<div class=\"field col-2 last\">\n  <label>Last name *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-1-achternaam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Last name\" value=\"\" type=\"text\" name=\"dn-1-achternaam\" \/><\/span>\n  <\/div>\n\n<div class=\"field radio horizontal\">\n  <label>Male\/Female<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-1-man-vrouw\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"dn-1-man-vrouw\" value=\"Male\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Male<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"dn-1-man-vrouw\" value=\"Female\" \/><span class=\"wpcf7-list-item-label\">Female<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"dn-1-man-vrouw\" value=\"Neutral\" \/><span class=\"wpcf7-list-item-label\">Neutral<\/span><\/label><\/span><\/span><\/span>\n  <\/div>\n\n  <div class=\"field\">\n  <label>Position *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-1-functie\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"dn-1-functie\"><option value=\"Analyst\">Analyst<\/option><option value=\"Doctor\">Doctor<\/option><option value=\"Quality employee\">Quality employee<\/option><option value=\"Management\">Management<\/option><option value=\"Supporting staff\">Supporting staff<\/option><option value=\"Paramedic\">Paramedic<\/option><option value=\"Nurse\">Nurse<\/option><option value=\"Other\">Other<\/option><\/select><\/span>\n  <div data-id=\"group-dn-1-functie-anders\" data-orig_data_id=\"group-dn-1-functie-anders\"  class=\"\" data-class=\"wpcf7cf_group\"><span class=\"wpcf7-form-control-wrap\" data-name=\"dn-1-functie-anders\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Position\" value=\"\" type=\"text\" name=\"dn-1-functie-anders\" \/><\/span><\/div>\n  <\/div>\n\n\n  <div class=\"field col-2\">\n  <label>Telephone number *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-1-telefoon\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Telephone number\" value=\"\" type=\"text\" name=\"dn-1-telefoon\" \/><\/span>\n  <\/div>\n\n<div class=\"field col-2 last\">\n  <label>Email address *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-1-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Email address\" value=\"\" type=\"text\" name=\"dn-1-email\" \/><\/span>\n  <\/div>\n\n<div class=\"field checkbox horizontal\">\n  <label>Account for<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-1-type-dataentry\"><span class=\"wpcf7-form-control wpcf7-checkbox conditional set-has-survey\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"dn-1-type-dataentry[]\" value=\"DataEntry\" \/><span class=\"wpcf7-list-item-label\">DataEntry<\/span><\/label><\/span><\/span><\/span>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-1-type-batch\"><span class=\"wpcf7-form-control wpcf7-checkbox conditional set-has-batch\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"dn-1-type-batch[]\" value=\"Data Connect (Batch)\" \/><span class=\"wpcf7-list-item-label\">Data Connect (Batch)<\/span><\/label><\/span><\/span><\/span>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-1-type-codman\"><span class=\"wpcf7-form-control wpcf7-checkbox conditional set-has-codman\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"dn-1-type-codman[]\" value=\"Codman\" \/><span class=\"wpcf7-list-item-label\">Codman<\/span><\/label><\/span><\/span><\/span>\n  <\/div>\n\n <div class=\"field checkbox horizontal\">\n  <label>Contact Person<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-1-contactpersoon\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"dn-1-contactpersoon[]\" value=\"Sign-up as contact person\" \/><span class=\"wpcf7-list-item-label\">Sign-up as contact person<\/span><\/label><\/span><\/span><\/span>\n  <\/div>\n\n\n<\/div>\n\n\n\n\n<!-- Deelnemer 2 -->\n<div data-id=\"deelnemer-2\" data-orig_data_id=\"deelnemer-2\"  class=\"\" data-class=\"wpcf7cf_group\"><\/div>\n<div class=\"inner block hidden\">\n\n  <div class=\"field col-2\">\n  <label>First Name *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-2-naam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"First Name\" value=\"\" type=\"text\" name=\"dn-2-naam\" \/><\/span>\n  <\/div>\n\n<div class=\"field col-2 last\">\n  <label>Last name *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-2-achternaam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Last name\" value=\"\" type=\"text\" name=\"dn-2-achternaam\" \/><\/span>\n  <\/div>\n\n<div class=\"field radio horizontal\">\n  <label>Male\/Female<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-2-man-vrouw\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"dn-2-man-vrouw\" value=\"Male\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Male<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"dn-2-man-vrouw\" value=\"Female\" \/><span class=\"wpcf7-list-item-label\">Female<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"dn-2-man-vrouw\" value=\"Neutral\" \/><span class=\"wpcf7-list-item-label\">Neutral<\/span><\/label><\/span><\/span><\/span>\n  <\/div>\n\n  <div class=\"field\">\n  <label>Function *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-2-functie\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"dn-2-functie\"><option value=\"Analyst\">Analyst<\/option><option value=\"Doctor\">Doctor<\/option><option value=\"Quality employee\">Quality employee<\/option><option value=\"Management\">Management<\/option><option value=\"Supporting staff\">Supporting staff<\/option><option value=\"Paramedic\">Paramedic<\/option><option value=\"Nurse\">Nurse<\/option><option value=\"Other\">Other<\/option><\/select><\/span>\n  <div data-id=\"group-dn-2-functie-anders\" data-orig_data_id=\"group-dn-2-functie-anders\"  class=\"\" data-class=\"wpcf7cf_group\"><span class=\"wpcf7-form-control-wrap\" data-name=\"dn-2-functie-anders\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Position\" value=\"\" type=\"text\" name=\"dn-2-functie-anders\" \/><\/span><\/div>\n  <\/div>\n\n  <div class=\"field col-2\">\n  <label>Phone number *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-2-telefoon\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Telephone number\" value=\"\" type=\"text\" name=\"dn-2-telefoon\" \/><\/span>\n  <\/div>\n\n<div class=\"field col-2 last\">\n  <label>Email address *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-2-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Email address\" value=\"\" type=\"text\" name=\"dn-2-email\" \/><\/span>\n  <\/div>\n\n<div class=\"field checkbox horizontal\">\n  <label>Account for<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-2-type-dataentry\"><span class=\"wpcf7-form-control wpcf7-checkbox conditional set-has-survey\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"dn-2-type-dataentry[]\" value=\"DataEntry\" \/><span class=\"wpcf7-list-item-label\">DataEntry<\/span><\/label><\/span><\/span><\/span>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-2-type-batch\"><span class=\"wpcf7-form-control wpcf7-checkbox conditional set-has-batch\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"dn-2-type-batch[]\" value=\"Data Connect (Batch)\" \/><span class=\"wpcf7-list-item-label\">Data Connect (Batch)<\/span><\/label><\/span><\/span><\/span>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-2-type-codman\"><span class=\"wpcf7-form-control wpcf7-checkbox conditional set-has-codman\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"dn-2-type-codman[]\" value=\"Codman\" \/><span class=\"wpcf7-list-item-label\">Codman<\/span><\/label><\/span><\/span><\/span>\n  <\/div>\n\n <div class=\"field checkbox horizontal\">\n  <label>Contact Person<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-2-contactpersoon\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"dn-2-contactpersoon[]\" value=\"Sign-up as contact person\" \/><span class=\"wpcf7-list-item-label\">Sign-up as contact person<\/span><\/label><\/span><\/span><\/span>\n  <\/div>\n\n<\/div>\n\n<!-- Deelnemer 3 -->\n<div data-id=\"deelnemer-3\" data-orig_data_id=\"deelnemer-3\"  class=\"\" data-class=\"wpcf7cf_group\"><\/div>\n<div class=\"inner block hidden\">\n\n  <div class=\"field col-2\">\n  <label>First Name *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-3-naam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Voornaam\/voorletters\" value=\"\" type=\"text\" name=\"dn-3-naam\" \/><\/span>\n  <\/div>\n\n<div class=\"field col-2 last\">\n  <label>Last name *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-3-achternaam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Achternaam\" value=\"\" type=\"text\" name=\"dn-3-achternaam\" \/><\/span>\n  <\/div>\n\n<div class=\"field radio horizontal\">\n  <label>Male\/Female<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-3-man-vrouw\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"dn-3-man-vrouw\" value=\"Male\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Male<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"dn-3-man-vrouw\" value=\"Female\" \/><span class=\"wpcf7-list-item-label\">Female<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"dn-3-man-vrouw\" value=\"Neutral\" \/><span class=\"wpcf7-list-item-label\">Neutral<\/span><\/label><\/span><\/span><\/span>\n  <\/div>\n\n  <div class=\"field\">\n  <label>Function *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-3-functie\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"dn-3-functie\"><option value=\"Analyst\">Analyst<\/option><option value=\"Doctor\">Doctor<\/option><option value=\"Quality employee\">Quality employee<\/option><option value=\"Management\">Management<\/option><option value=\"Supporting staff\">Supporting staff<\/option><option value=\"Paramedic\">Paramedic<\/option><option value=\"Nurse\">Nurse<\/option><option value=\"Other\">Other<\/option><\/select><\/span>\n  <div data-id=\"group-dn-3-functie-anders\" data-orig_data_id=\"group-dn-3-functie-anders\"  class=\"\" data-class=\"wpcf7cf_group\"><span class=\"wpcf7-form-control-wrap\" data-name=\"dn-3-functie-anders\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Position\" value=\"\" type=\"text\" name=\"dn-3-functie-anders\" \/><\/span><\/div>\n  <\/div>\n\n  <div class=\"field col-2\">\n  <label>Phone number *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-3-telefoon\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Telephone number\" value=\"\" type=\"text\" name=\"dn-3-telefoon\" \/><\/span>\n  <\/div>\n\n<div class=\"field col-2 last\">\n  <label>Email address *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-3-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Email address\" value=\"\" type=\"text\" name=\"dn-3-email\" \/><\/span>\n  <\/div>\n\n<div class=\"field checkbox horizontal\">\n  <label>Account for<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-3-type-dataentry\"><span class=\"wpcf7-form-control wpcf7-checkbox conditional set-has-survey\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"dn-3-type-dataentry[]\" value=\"Dataentry\" \/><span class=\"wpcf7-list-item-label\">Dataentry<\/span><\/label><\/span><\/span><\/span>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-3-type-batch\"><span class=\"wpcf7-form-control wpcf7-checkbox conditional set-has-batch\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"dn-3-type-batch[]\" value=\"Data Connect (Batch)\" \/><span class=\"wpcf7-list-item-label\">Data Connect (Batch)<\/span><\/label><\/span><\/span><\/span>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-3-type-codman\"><span class=\"wpcf7-form-control wpcf7-checkbox conditional set-has-codman\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"dn-3-type-codman[]\" value=\"Codman\" \/><span class=\"wpcf7-list-item-label\">Codman<\/span><\/label><\/span><\/span><\/span>\n  <\/div>\n\n <div class=\"field checkbox horizontal\">\n  <label>Contact Person<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-3-contactpersoon\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"dn-3-contactpersoon[]\" value=\"Sign-up as contact person\" \/><span class=\"wpcf7-list-item-label\">Sign-up as contact person<\/span><\/label><\/span><\/span><\/span>\n  <\/div>\n\n<\/div>\n\n\n\n\n<!-- Deelnemer 4 -->\n<div data-id=\"deelnemer-4\" data-orig_data_id=\"deelnemer-4\"  class=\"\" data-class=\"wpcf7cf_group\"><\/div>\n<div class=\"inner block hidden\">\n\n  <div class=\"field col-2\">\n  <label>First Name *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-4-naam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Voornaam\/voorletters\" value=\"\" type=\"text\" name=\"dn-4-naam\" \/><\/span>\n  <\/div>\n\n<div class=\"field col-2 last\">\n  <label>Last name *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-4-achternaam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Achternaam\" value=\"\" type=\"text\" name=\"dn-4-achternaam\" \/><\/span>\n  <\/div>\n\n<div class=\"field radio horizontal\">\n  <label>Male\/Female<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-4-man-vrouw\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"dn-4-man-vrouw\" value=\"Male\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Male<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"dn-4-man-vrouw\" value=\"Female\" \/><span class=\"wpcf7-list-item-label\">Female<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"dn-4-man-vrouw\" value=\"Neutral\" \/><span class=\"wpcf7-list-item-label\">Neutral<\/span><\/label><\/span><\/span><\/span>\n  <\/div>\n\n  <div class=\"field\">\n  <label>Function *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-4-functie\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"dn-4-functie\"><option value=\"Analyst\">Analyst<\/option><option value=\"Doctor\">Doctor<\/option><option value=\"Quality employee\">Quality employee<\/option><option value=\"Management\">Management<\/option><option value=\"Supporting staff\">Supporting staff<\/option><option value=\"Paramedic\">Paramedic<\/option><option value=\"Nurse\">Nurse<\/option><option value=\"Other\">Other<\/option><\/select><\/span>\n  <div data-id=\"group-dn-4-functie-anders\" data-orig_data_id=\"group-dn-4-functie-anders\"  class=\"\" data-class=\"wpcf7cf_group\"><span class=\"wpcf7-form-control-wrap\" data-name=\"dn-4-functie-anders\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Position\" value=\"\" type=\"text\" name=\"dn-4-functie-anders\" \/><\/span><\/div>\n  <\/div>\n\n  <div class=\"field col-2\">\n  <label>Phone number *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-4-telefoon\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Telephone number\" value=\"\" type=\"text\" name=\"dn-4-telefoon\" \/><\/span>\n  <\/div>\n\n<div class=\"field col-2 last\">\n  <label>Email address *<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-4-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Email address\" value=\"\" type=\"text\" name=\"dn-4-email\" \/><\/span>\n  <\/div>\n\n<div class=\"field checkbox horizontal\">\n  <label>Account for<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-4-type-dataentry\"><span class=\"wpcf7-form-control wpcf7-checkbox conditional set-has-survey\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"dn-4-type-dataentry[]\" value=\"Dataentry\" \/><span class=\"wpcf7-list-item-label\">Dataentry<\/span><\/label><\/span><\/span><\/span>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-4-type-batch\"><span class=\"wpcf7-form-control wpcf7-checkbox conditional set-has-batch\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"dn-4-type-batch[]\" value=\"Data Connect (Batch)\" \/><span class=\"wpcf7-list-item-label\">Data Connect (Batch)<\/span><\/label><\/span><\/span><\/span>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-4-type-codman\"><span class=\"wpcf7-form-control wpcf7-checkbox conditional set-has-codman\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"dn-4-type-codman[]\" value=\"Codman\" \/><span class=\"wpcf7-list-item-label\">Codman<\/span><\/label><\/span><\/span><\/span>\n  <\/div>\n\n <div class=\"field checkbox horizontal\">\n  <label>Contact Person<\/label>\n  <span class=\"wpcf7-form-control-wrap\" data-name=\"dn-4-contactpersoon\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"dn-4-contactpersoon[]\" value=\"Sign-up as contact person\" \/><span class=\"wpcf7-list-item-label\">Sign-up as contact person<\/span><\/label><\/span><\/span><\/span>\n  <\/div>\n\n<\/div>\n\n<div class=\"inner block add-block\">\n<span class=\"icon\">add_circle<\/span>\nAdd participant\n <\/div>\n<\/div>\n\n\n<!-- Info -->\n<div class=\"block\">\n<div class=\"inner\">\n<ul>\n<li>By completing and returning this form, you consent to the use of this account information data by MRDM. <span class=\"conditional set-has-dica\">.<\/span><\/li>\n<li>The purpose for using this account information is limited to communication around participation in the ICHOM Global Benchmark for which there is a legal agreement between your organization and MRDM.<\/li> \n<li>The persons known through this document can at any time submit a request to the Service Desk for rectification, deletion and retrieval of the account information known to us.<\/li>\n<li>The information you find in the benchmarking dashboard is confidential and only for internal usage. MRDM is not liable for any users sharing data outside of the benchmarking dashboard.<\/li>\n<li>MRDM is ISO 27001:2013 and NEN 7510:2011 certified and thus guarantees the secure processing of personal data.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n\n<span class=\"wpcf7-form-control-wrap\" data-name=\"hcap-cf7\">\t\t<input\n\t\t\t\ttype=\"hidden\"\n\t\t\t\tclass=\"hcaptcha-widget-id\"\n\t\t\t\tname=\"hcaptcha-widget-id\"\n\t\t\t\tvalue=\"eyJzb3VyY2UiOlsiY29udGFjdC1mb3JtLTdcL3dwLWNvbnRhY3QtZm9ybS03LnBocCJdLCJmb3JtX2lkIjoyNzk5fQ==-dad60bd3196084f1859e2ac6a75d0194\">\n\t\t\t\t<span id=\"hcap_cf7-69f3e8d982edd4.91029824\" class=\"wpcf7-form-control h-captcha \"\n\t\t\tdata-sitekey=\"16310c4e-78ea-428a-97c4-0237baf70ce2\"\n\t\t\tdata-theme=\"light\"\n\t\t\tdata-size=\"normal\"\n\t\t\tdata-auto=\"false\"\n\t\t\tdata-ajax=\"false\"\n\t\t\tdata-force=\"false\">\n\t\t<\/span>\n\t\t<input type=\"hidden\" id=\"_wpnonce\" name=\"_wpnonce\" value=\"6ec2067cbb\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/en\/wp-json\/wp\/v2\/account\/5495\" \/><\/span><input class=\"wpcf7-form-control wpcf7-submit has-spinner bg-color-primary bg-hover txt-color-white\" type=\"submit\" value=\"Send\" \/>\n<\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"parent":1417,"menu_order":0,"template":"","class_list":["post-5495","account","type-account","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/support.mrdm.com\/en\/wp-json\/wp\/v2\/account\/5495","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/support.mrdm.com\/en\/wp-json\/wp\/v2\/account"}],"about":[{"href":"https:\/\/support.mrdm.com\/en\/wp-json\/wp\/v2\/types\/account"}],"version-history":[{"count":4,"href":"https:\/\/support.mrdm.com\/en\/wp-json\/wp\/v2\/account\/5495\/revisions"}],"predecessor-version":[{"id":5499,"href":"https:\/\/support.mrdm.com\/en\/wp-json\/wp\/v2\/account\/5495\/revisions\/5499"}],"up":[{"embeddable":true,"href":"https:\/\/support.mrdm.com\/en\/wp-json\/wp\/v2\/account\/1417"}],"wp:attachment":[{"href":"https:\/\/support.mrdm.com\/en\/wp-json\/wp\/v2\/media?parent=5495"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}