{"id":12227,"date":"2026-03-17T15:50:00","date_gmt":"2026-03-17T14:50:00","guid":{"rendered":"https:\/\/support.mrdm.com\/?page_id=12227"},"modified":"2026-03-17T16:03:56","modified_gmt":"2026-03-17T15:03:56","slug":"test","status":"publish","type":"page","link":"https:\/\/support.mrdm.com\/nl\/test\/","title":{"rendered":"Test formulier"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">hello<\/p>\n\n\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f12226-o1\" lang=\"nl-NL\" dir=\"ltr\" data-wpcf7-id=\"12226\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/nl\/wp-json\/wp\/v2\/pages\/12227#wpcf7-f12226-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contactformulier\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"12226\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"nl_NL\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f12226-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;:12226,&quot;conditions&quot;:[{&quot;then_field&quot;:&quot;-1&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;-1&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Anders&quot;}]},{&quot;then_field&quot;:&quot;-1&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;-1&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Codman Indicatoren&quot;}]},{&quot;then_field&quot;:&quot;-1&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;-1&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Codman Exploratief&quot;}]},{&quot;then_field&quot;:&quot;-1&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;-1&quot;,&quot;operator&quot;:&quot;not empty&quot;,&quot;if_value&quot;:&quot;show-afwijkingen&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;repeater_remove_button&quot;:&quot;bottom&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<!-- Instelling -->\n<div class=\"block\">\n<div class=\"inner\">\n\n  <h4>Gegevens instelling<\/h4>\n\n  <div class=\"field\">\n    <label>Naam instelling *<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"instelling-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=\"Naam instelling\" value=\"\" type=\"text\" name=\"instelling-naam\" \/><\/span>\n  <\/div>\n\n  <div class=\"field\">\n    <label>Adres *<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"instelling-adres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Adres\" value=\"\" type=\"text\" name=\"instelling-adres\" \/><\/span>\n  <\/div>\n\n  <div class=\"field\">\n    <label>Decentraal pathologie laboratorium<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"pathologie-lab\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Naam pathologie laboratorium\" value=\"\" type=\"text\" name=\"pathologie-lab\" \/><\/span>\n  <\/div>\n\n<\/div>\n<\/div>\n<!-- Instelling -->\n\n\n<!-- Registraties -->\n<div class=\"block\">\n<div class=\"inner\">\n\n  <h4>Benodigde gegevens<\/h4>\n\n  <div class=\"field checkbox\">\n    <label>Selecteer voor welke registraties u de PALGA-koppeling wilt activeren *<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"registraties\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"registraties[]\" value=\"DCRA\" \/><span class=\"wpcf7-list-item-label\">DCRA<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"registraties[]\" value=\"DGEA\" \/><span class=\"wpcf7-list-item-label\">DGEA<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"registraties[]\" value=\"DUCA\" \/><span class=\"wpcf7-list-item-label\">DUCA<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"registraties[]\" value=\"DMTR\" \/><span class=\"wpcf7-list-item-label\">DMTR<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"registraties[]\" value=\"DPCA\" \/><span class=\"wpcf7-list-item-label\">DPCA<\/span><\/label><\/span><\/span><\/span>\n  <\/div>\n\n<\/div>\n<\/div>\n<!-- Registraties -->\n\n\n<!-- Contactpersoon contract -->\n<div class=\"block\">\n<div class=\"inner\">\n\n  <h4>Contactpersoon voor Pathologie-Connect contract<\/h4>\n  <p>Om gebruik te kunnen maken van de PALGA-koppeling, dient er een Pathologie-Connect contract ondertekend te worden. Graag vernemen wij wie binnen uw instelling het contract mag ontvangen. Het betreft hier een contract zonder kosten voor het ziekenhuis.<\/p>\n\n  <div class=\"field\">\n    <label>Naam *<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"contract-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=\"Naam\" value=\"\" type=\"text\" name=\"contract-naam\" \/><\/span>\n  <\/div>\n\n  <div class=\"field\">\n    <label>E-mailadres *<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"contract-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=\"naam@organisatie.nl\" value=\"\" type=\"email\" name=\"contract-email\" \/><\/span>\n  <\/div>\n\n  <div class=\"field\">\n    <label>Telefoonnummer<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"contract-telefoon\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Telefoonnummer\" value=\"\" type=\"tel\" name=\"contract-telefoon\" \/><\/span>\n  <\/div>\n\n  <div class=\"field\">\n    <label>Functie<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"contract-functie\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Functie\" value=\"\" type=\"text\" name=\"contract-functie\" \/><\/span>\n  <\/div>\n\n<\/div>\n<\/div>\n<!-- Contactpersoon contract -->\n\n\n<!-- Contactpersonen vragen -->\n<div class=\"block\">\n<div class=\"inner\">\n\n  <h4>Contactpersonen voor vragen<\/h4>\n  <p>Het kan voorkomen dat er vragen zijn omtrent de PALGA-koppeling die door de organisatie beantwoord moeten worden. Graag vernemen wij wie de contactpersonen zijn die wij kunnen benaderen.<\/p>\n\n  <h6>Contactpersoon 1<\/h6>\n\n  <div class=\"field\">\n    <label>Naam *<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"contact1-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=\"Naam\" value=\"\" type=\"text\" name=\"contact1-naam\" \/><\/span>\n  <\/div>\n\n  <div class=\"field\">\n    <label>E-mailadres *<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"contact1-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=\"naam@organisatie.nl\" value=\"\" type=\"email\" name=\"contact1-email\" \/><\/span>\n  <\/div>\n\n  <div class=\"field\">\n    <label>Telefoonnummer<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"contact1-telefoon\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Telefoonnummer\" value=\"\" type=\"tel\" name=\"contact1-telefoon\" \/><\/span>\n  <\/div>\n\n  <div class=\"field\">\n    <label>Functie<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"contact1-functie\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Functie\" value=\"\" type=\"text\" name=\"contact1-functie\" \/><\/span>\n  <\/div>\n\n  <h6>Contactpersoon 2 (optioneel)<\/h6>\n\n  <div class=\"field\">\n    <label>Naam<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"contact2-naam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Naam\" value=\"\" type=\"text\" name=\"contact2-naam\" \/><\/span>\n  <\/div>\n\n  <div class=\"field\">\n    <label>E-mailadres<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"contact2-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-text wpcf7-validates-as-email light\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"naam@organisatie.nl\" value=\"\" type=\"email\" name=\"contact2-email\" \/><\/span>\n  <\/div>\n\n  <div class=\"field\">\n    <label>Telefoonnummer<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"contact2-telefoon\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Telefoonnummer\" value=\"\" type=\"tel\" name=\"contact2-telefoon\" \/><\/span>\n  <\/div>\n\n  <div class=\"field\">\n    <label>Functie<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"contact2-functie\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" autocomplete=\"off\" aria-invalid=\"false\" placeholder=\"Functie\" value=\"\" type=\"text\" name=\"contact2-functie\" \/><\/span>\n  <\/div>\n\n<\/div>\n<\/div>\n<!-- Contactpersonen vragen -->\n\n\n<!-- Toestemming -->\n<div class=\"block\">\n<div class=\"inner\">\n\n  <h4>Toestemming PALGA-koppeling<\/h4>\n  <p>Hierbij gaat de zorginstelling, bij naam van ondergetekende, akkoord met het verwerken door MRDM van PALGA pathologiegegevens voor de op dit formulier aangegeven registraties.<\/p>\n\n  <div class=\"field\">\n    <label>Naam instelling *<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"toestemming-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=\"Naam instelling\" value=\"\" type=\"text\" name=\"toestemming-instelling\" \/><\/span>\n  <\/div>\n\n  <div class=\"field\">\n    <label>Naam ondertekenende *<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"toestemming-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=\"Naam ondertekenende\" value=\"\" type=\"text\" name=\"toestemming-naam\" \/><\/span>\n  <\/div>\n\n  <div class=\"field\">\n    <label>Datum *<\/label>\n    <span class=\"wpcf7-form-control-wrap\" data-name=\"toestemming-datum\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"toestemming-datum\" \/><\/span>\n  <\/div>\n\n<\/div>\n<\/div>\n<!-- Toestemming -->\n\n\n<!-- Info -->\n<div class=\"block\">\n<div class=\"inner\">\n<ul>\n<li>Door het invullen van dit formulier geeft u toestemming voor het gebruik van deze gegevens door MRDM.<\/li>\n<li>De doeleinden voor het gebruik van deze gegevens beperken zich tot communicatie rondom de deelname aan de registratie(s) waarvoor de PALGA-koppeling wordt geactiveerd.<\/li>\n<li>De via dit document bekende personen kunnen te allen tijde een verzoek indienen bij de Servicedesk voor rectificatie, verwijdering en opvraag van de bij ons bekende gegevens.<\/li>\n<li>De gegevens worden niet verder verspreid naar derden en worden opgeslagen bij MRDM voor zover er een samenwerkingsverband bestaat tussen uw organisatie en MRDM.<\/li>\n<li>MRDM is ISO 27001:2013 en NEN 7510:2011 gecertificeerd en waarborgt daarmee de veilige verwerking van persoonsgegevens.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n\n<span class=\"wpcf7-form-control-wrap\" 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aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>hello<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"page-category":[],"class_list":["post-12227","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/support.mrdm.com\/nl\/wp-json\/wp\/v2\/pages\/12227","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/support.mrdm.com\/nl\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/support.mrdm.com\/nl\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/support.mrdm.com\/nl\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/support.mrdm.com\/nl\/wp-json\/wp\/v2\/comments?post=12227"}],"version-history":[{"count":2,"href":"https:\/\/support.mrdm.com\/nl\/wp-json\/wp\/v2\/pages\/12227\/revisions"}],"predecessor-version":[{"id":12229,"href":"https:\/\/support.mrdm.com\/nl\/wp-json\/wp\/v2\/pages\/12227\/revisions\/12229"}],"wp:attachment":[{"href":"https:\/\/support.mrdm.com\/nl\/wp-json\/wp\/v2\/media?parent=12227"}],"wp:term":[{"taxonomy":"page-category","embeddable":true,"href":"https:\/\/support.mrdm.com\/nl\/wp-json\/wp\/v2\/page-category?post=12227"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}