{"id":11445,"date":"2026-09-08T11:28:45","date_gmt":"2026-09-08T11:28:45","guid":{"rendered":"https:\/\/4balance.ch\/?page_id=11445"},"modified":"2026-09-08T11:28:45","modified_gmt":"2026-09-08T11:28:45","slug":"kinderphysiotherapie-formular","status":"publish","type":"page","link":"https:\/\/4balance.ch\/en\/kinderphysiotherapie-formular\/","title":{"rendered":"Kinderphysiotherapie Formular"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form fusion-form-builder fusion-form-form-wrapper fusion-form-11443\" style=\"--awb-tooltip-text-color:#ffffff;--awb-tooltip-background-color:#333333;\" data-form-id=\"11443\" data-config=\"{&quot;form_id&quot;:11443,&quot;form_post_id&quot;:11443,&quot;post_id&quot;:11445,&quot;form_type&quot;:&quot;ajax&quot;,&quot;confirmation_type&quot;:&quot;message&quot;,&quot;redirect_url&quot;:&quot;&quot;,&quot;redirect_timeout&quot;:&quot;0&quot;,&quot;field_labels&quot;:{&quot;name&quot;:&quot;Name&quot;,&quot;vorname&quot;:&quot;Vorname&quot;,&quot;datum&quot;:&quot;Geburtsdatum&quot;,&quot;geschlecht&quot;:&quot;Geschlecht&quot;,&quot;adresse&quot;:&quot;Adresse&quot;,&quot;krankenkasse_versicherungsnummer&quot;:&quot;Krankenkasse \\\/ Versicherungsnummer&quot;,&quot;name_u_tel_des_gestzlichen_vertreters&quot;:&quot;Name u. Tel. des gesetzlichen Vertreters:&quot;,&quot;bezugpersonen_im_alltag&quot;:&quot;Bezugspersonen im Alltag (wer betreut das Kind haupts\\u00e4chlich)&quot;,&quot;lebenssituation_der_familie&quot;:&quot;Lebenssituation der Familie (z.B. zusammenlebend, getrennt, alleinerziehend, Mehrfamilienhaushalt\\u2026)&quot;,&quot;geschwisterkinder&quot;:&quot;Geschwisterkinder (Name, Alter, Besonderheiten)&quot;,&quot;externe_unterstuetzung_im_alltag&quot;:&quot;Externe Unterst\\u00fctzung im Alltag (z.B. Grosseltern, Pflegepersonal, Integrationshilfe)&quot;,&quot;diagnose_krankheitsbild&quot;:&quot;Diagnose \\\/ Krankheitsbild&quot;,&quot;bishergie_sowie_aktuell_noch_andere_therapien&quot;:&quot;Bisherige sowie aktuell noch andere Therapien (Physio \\\/ Ergo \\\/ Logop\\u00e4die etc.)&quot;,&quot;medikamente&quot;:&quot;Medikamente&quot;,&quot;allergien_unvertraeglichkeiten&quot;:&quot;Allergien \\\/ Unvertr\\u00e4glichkeiten&quot;,&quot;hilfsmittel_rollstuhl_orthesen&quot;:&quot;Hilfsmittel \\\/ Rollstuhl \\\/ Orthesen&quot;,&quot;aerztliche_betreuung&quot;:&quot;\\u00c4rztliche Betreuung (Kontaktdaten)&quot;,&quot;hat_ihr_kind&quot;:&quot;Hat ihr Kind&quot;,&quot;lieblingsspielzeug&quot;:&quot;Lieblingsspielzeug \\\/ -musik \\\/ -b\\u00fccher&quot;,&quot;besondere_interessen&quot;:&quot;Besondere Interessen (Fahrzeuge, Tiere, Musik\\u2026)&quot;,&quot;was_macht_ihr_kind_besonders_gerne&quot;:&quot;Was macht ihr Kind besonders gerne?&quot;,&quot;womit_koennen_wir_ihr_kind_besonders_gut_motivieren&quot;:&quot;Womit k\\u00f6nnen wir Ihr Kind besonders gut motivieren?&quot;,&quot;was_mag_ihr_kind_absolut_nicht&quot;:&quot;Was mag ihr Kind absolut nicht?&quot;,&quot;reagiert_ihr_kind_empfindlich_auf_bestimmte_dinge&quot;:&quot;Reagiert ihr Kind empfindlich auf bestimmte Dinge (z.B. Ger\\u00e4usche, Licht, Ber\\u00fchrung\\u2026)&quot;,&quot;wie_reagier_ihr_kind_wenn_es_freude_zeigt&quot;:&quot;Wie reagiert ihr Kind, wenn es Freude zeigt, wie wenn es \\u00fcberfordert oder gestresst ist?&quot;,&quot;no_gos&quot;:&quot;Hier ist Platz f\\u00fcr Situationen, die bei Ihrem Kind stress ausl\\u00f6sen sowie andere No Gos&quot;,&quot;was_sind_ihre_wichtigsten_ziele_fuer_die_physiotherapie&quot;:&quot;Was sind Ihre wichtigsten Ziele f\\u00fcr die Physiotherapie?&quot;,&quot;welche_alltagssituationen_duerfen_sich_verbessern&quot;:&quot;Welche Alltagssituationen d\\u00fcrfen sich verbessern?&quot;,&quot;sonst_noch_mitteilen&quot;:&quot;Hier ist noch Platz f\\u00fcr das, was Sie den Therapeuten sonst noch mitteilen, m\\u00f6chten.&quot;,&quot;email&quot;:&quot;E-Mail&quot;},&quot;field_logics&quot;:{&quot;notice_1&quot;:&quot;&quot;,&quot;name&quot;:&quot;&quot;,&quot;vorname&quot;:&quot;&quot;,&quot;datum&quot;:&quot;&quot;,&quot;geschlecht&quot;:&quot;&quot;,&quot;adresse&quot;:&quot;&quot;,&quot;krankenkasse_versicherungsnummer&quot;:&quot;&quot;,&quot;name_u_tel_des_gestzlichen_vertreters&quot;:&quot;&quot;,&quot;bezugpersonen_im_alltag&quot;:&quot;&quot;,&quot;lebenssituation_der_familie&quot;:&quot;&quot;,&quot;geschwisterkinder&quot;:&quot;&quot;,&quot;externe_unterstuetzung_im_alltag&quot;:&quot;&quot;,&quot;diagnose_krankheitsbild&quot;:&quot;&quot;,&quot;bishergie_sowie_aktuell_noch_andere_therapien&quot;:&quot;&quot;,&quot;medikamente&quot;:&quot;&quot;,&quot;allergien_unvertraeglichkeiten&quot;:&quot;&quot;,&quot;hilfsmittel_rollstuhl_orthesen&quot;:&quot;&quot;,&quot;aerztliche_betreuung&quot;:&quot;&quot;,&quot;hat_ihr_kind&quot;:&quot;&quot;,&quot;lieblingsspielzeug&quot;:&quot;&quot;,&quot;besondere_interessen&quot;:&quot;&quot;,&quot;was_macht_ihr_kind_besonders_gerne&quot;:&quot;&quot;,&quot;womit_koennen_wir_ihr_kind_besonders_gut_motivieren&quot;:&quot;&quot;,&quot;was_mag_ihr_kind_absolut_nicht&quot;:&quot;&quot;,&quot;reagiert_ihr_kind_empfindlich_auf_bestimmte_dinge&quot;:&quot;&quot;,&quot;wie_reagier_ihr_kind_wenn_es_freude_zeigt&quot;:&quot;&quot;,&quot;no_gos&quot;:&quot;&quot;,&quot;was_sind_ihre_wichtigsten_ziele_fuer_die_physiotherapie&quot;:&quot;&quot;,&quot;welche_alltagssituationen_duerfen_sich_verbessern&quot;:&quot;&quot;,&quot;sonst_noch_mitteilen&quot;:&quot;&quot;,&quot;email&quot;:&quot;&quot;,&quot;submit_1&quot;:&quot;&quot;},&quot;field_types&quot;:{&quot;notice_1&quot;:&quot;notice&quot;,&quot;name&quot;:&quot;text&quot;,&quot;vorname&quot;:&quot;text&quot;,&quot;datum&quot;:&quot;date&quot;,&quot;geschlecht&quot;:&quot;text&quot;,&quot;adresse&quot;:&quot;text&quot;,&quot;krankenkasse_versicherungsnummer&quot;:&quot;text&quot;,&quot;name_u_tel_des_gestzlichen_vertreters&quot;:&quot;text&quot;,&quot;bezugpersonen_im_alltag&quot;:&quot;text&quot;,&quot;lebenssituation_der_familie&quot;:&quot;text&quot;,&quot;geschwisterkinder&quot;:&quot;text&quot;,&quot;externe_unterstuetzung_im_alltag&quot;:&quot;text&quot;,&quot;diagnose_krankheitsbild&quot;:&quot;text&quot;,&quot;bishergie_sowie_aktuell_noch_andere_therapien&quot;:&quot;text&quot;,&quot;medikamente&quot;:&quot;text&quot;,&quot;allergien_unvertraeglichkeiten&quot;:&quot;text&quot;,&quot;hilfsmittel_rollstuhl_orthesen&quot;:&quot;text&quot;,&quot;aerztliche_betreuung&quot;:&quot;text&quot;,&quot;hat_ihr_kind&quot;:&quot;checkbox&quot;,&quot;lieblingsspielzeug&quot;:&quot;text&quot;,&quot;besondere_interessen&quot;:&quot;text&quot;,&quot;was_macht_ihr_kind_besonders_gerne&quot;:&quot;text&quot;,&quot;womit_koennen_wir_ihr_kind_besonders_gut_motivieren&quot;:&quot;text&quot;,&quot;was_mag_ihr_kind_absolut_nicht&quot;:&quot;text&quot;,&quot;reagiert_ihr_kind_empfindlich_auf_bestimmte_dinge&quot;:&quot;text&quot;,&quot;wie_reagier_ihr_kind_wenn_es_freude_zeigt&quot;:&quot;text&quot;,&quot;no_gos&quot;:&quot;text&quot;,&quot;was_sind_ihre_wichtigsten_ziele_fuer_die_physiotherapie&quot;:&quot;text&quot;,&quot;welche_alltagssituationen_duerfen_sich_verbessern&quot;:&quot;text&quot;,&quot;sonst_noch_mitteilen&quot;:&quot;text&quot;,&quot;email&quot;:&quot;text&quot;,&quot;submit_1&quot;:&quot;submit&quot;},&quot;nonce_method&quot;:&quot;ajax&quot;,&quot;form_views&quot;:&quot;&quot;,&quot;form_views_counting&quot;:&quot;&quot;}\"><form action=\"https:\/\/4balance.ch\/en\/kinderphysiotherapie-formular\/\" target=\"_self\" method=\"post\" class=\"fusion-form fusion-form-11443\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"form-submission-notices data-notice_1\" id=\"fusion-notices-1\" data-instance=\"1\"><div class=\"fusion-alert alert success alert-success fusion-alert-center fusion-form-response fusion-form-response-success awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"alert-icon\"><i class=\"awb-icon-check-circle\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-alert-content\">Vielen Dank f\u00fcr Ihre Nachricht. Sie wurde abgeschickt.<\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">&times;<\/button><\/div><div class=\"fusion-alert alert error alert-danger fusion-alert-center fusion-form-response fusion-form-response-error awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"alert-icon\"><i class=\"awb-icon-exclamation-triangle\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-alert-content\">Beim Senden Ihrer Nachricht ist ein Fehler aufgetreten. Bitte versuchen Sie es sp\u00e4ter noch einmal.<\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">&times;<\/button><\/div><\/div><div class=\"fusion-text fusion-text-1\"><p>Liebe Eltern, liebe Bezugspersonen,<\/p>\n<p>Damit wir Ihr Kind bestm\u00f6glich und individuell in der Physiotherapie unterst\u00fctzen k\u00f6nnen, bitten wir Sie, diesen Bogen so vollst\u00e4ndig wie m\u00f6glich auszuf\u00fcllen. Ihre Angaben helfen uns, die Therapie auf die Bed\u00fcrfnisse, St\u00e4rken und Besonderheiten Ihres Kindes abzustimmen. Selbstverst\u00e4ndlich unterliegen alle Informationen der Schweigepflicht.<\/p>\n<p>Bitte f\u00fcllen Sie den Bogen vor dem ersten Termin aus und senden Ihn uns via E-Mail im Voraus zur\u00fcck. Bei Fragen helfen wir Ihnen gerne weiter.<\/p>\n<\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:30px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-2 fusion-text-no-margin\" style=\"--awb-font-size:20px;--awb-margin-bottom:0px;\"><p><strong>Angaben zum Kind<\/strong><\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"name\">Name<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"name\" id=\"name\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"vorname\">Vorname<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"vorname\" id=\"vorname\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-date-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><label for=\"datum\">Geburtsdatum<\/label><input autocomplete=\"off\" type=\"date\" data-first-day=\"1\"  data-format=\"d.m.Y\" tabindex=\"\" id=\"datum\" name=\"datum\" data-type=\"custom\" value=\"\" data-holds-private-data=\"false\" class=\"fusion-form-input\"autocomplete=\"no\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"geschlecht\">Geschlecht<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"geschlecht\" id=\"geschlecht\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"adresse\">Adresse<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"adresse\" id=\"adresse\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-7 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"krankenkasse_versicherungsnummer\">Krankenkasse \/ Versicherungsnummer<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"krankenkasse_versicherungsnummer\" id=\"krankenkasse_versicherungsnummer\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-8 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"name_u_tel_des_gestzlichen_vertreters\">Name u. Tel. des gesetzlichen Vertreters:<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"name_u_tel_des_gestzlichen_vertreters\" id=\"name_u_tel_des_gestzlichen_vertreters\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-9 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"bezugpersonen_im_alltag\">Bezugspersonen im Alltag (wer betreut das Kind haupts\u00e4chlich)<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"bezugpersonen_im_alltag\" id=\"bezugpersonen_im_alltag\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-10 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:30px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-3 fusion-text-no-margin\" style=\"--awb-font-size:20px;--awb-margin-bottom:0px;\"><p><strong>Famili\u00e4re Situation<\/strong><\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-11 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"lebenssituation_der_familie\">Lebenssituation der Familie (z.B. zusammenlebend, getrennt, alleinerziehend, Mehrfamilienhaushalt\u2026)<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"lebenssituation_der_familie\" id=\"lebenssituation_der_familie\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-12 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"geschwisterkinder\">Geschwisterkinder (Name, Alter, Besonderheiten)<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"geschwisterkinder\" id=\"geschwisterkinder\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-13 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"externe_unterstuetzung_im_alltag\">Externe Unterst\u00fctzung im Alltag (z.B. Grosseltern, Pflegepersonal, Integrationshilfe)<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"externe_unterstuetzung_im_alltag\" id=\"externe_unterstuetzung_im_alltag\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-14 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:30px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-4 fusion-text-no-margin\" style=\"--awb-font-size:20px;--awb-margin-bottom:0px;\"><p><strong>Krankheitsbild und medizinische Vorgeschichte<\/strong><\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-15 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"diagnose_krankheitsbild\">Diagnose \/ Krankheitsbild<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"diagnose_krankheitsbild\" id=\"diagnose_krankheitsbild\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-16 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"bishergie_sowie_aktuell_noch_andere_therapien\">Bisherige sowie aktuell noch andere Therapien (Physio \/ Ergo \/ Logop\u00e4die etc.)<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"bishergie_sowie_aktuell_noch_andere_therapien\" id=\"bishergie_sowie_aktuell_noch_andere_therapien\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-17 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"medikamente\">Medikamente<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"medikamente\" id=\"medikamente\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-18 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"allergien_unvertraeglichkeiten\">Allergien \/ Unvertr\u00e4glichkeiten<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"allergien_unvertraeglichkeiten\" id=\"allergien_unvertraeglichkeiten\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-19 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"hilfsmittel_rollstuhl_orthesen\">Hilfsmittel \/ Rollstuhl \/ Orthesen<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"hilfsmittel_rollstuhl_orthesen\" id=\"hilfsmittel_rollstuhl_orthesen\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-20 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"aerztliche_betreuung\">\u00c4rztliche Betreuung (Kontaktdaten)<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"aerztliche_betreuung\" id=\"aerztliche_betreuung\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-21 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:30px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-5 fusion-text-no-margin\" style=\"--awb-font-size:20px;--awb-margin-bottom:0px;\"><p><strong>Kontraindikationen und Besonderheiten<\/strong><\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-22 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-checkbox-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><fieldset><legend class=\"fusion-form-label-wrapper\"><span class=\"label\">Hat ihr Kind<\/span><\/legend><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-hat_ihr_kind-1-0\" type=\"checkbox\" value=\"Akute Infekte\" name=\"hat_ihr_kind[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-hat_ihr_kind-1-0\">Akute Infekte<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-hat_ihr_kind-1-1\" type=\"checkbox\" value=\"Epilepsie \/ Krampfanf\u00e4lle\" name=\"hat_ihr_kind[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-hat_ihr_kind-1-1\">Epilepsie \/ Krampfanf\u00e4lle<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-hat_ihr_kind-1-2\" type=\"checkbox\" value=\"Herz-Kreislauf Probleme\" name=\"hat_ihr_kind[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-hat_ihr_kind-1-2\">Herz-Kreislauf Probleme<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-hat_ihr_kind-1-3\" type=\"checkbox\" value=\"Schmerzempfinden (wo, wann u. wie stark)\" name=\"hat_ihr_kind[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-hat_ihr_kind-1-3\">Schmerzempfinden (wo, wann u. wie stark)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-hat_ihr_kind-1-4\" type=\"checkbox\" value=\"Andere medizinische Einschr\u00e4nkungen\" name=\"hat_ihr_kind[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-hat_ihr_kind-1-4\">Andere medizinische Einschr\u00e4nkungen<\/label><\/div><\/fieldset><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-23 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-6 fusion-text-no-margin\" style=\"--awb-font-size:20px;--awb-margin-bottom:0px;\"><p><strong>Vorlieben \/ Motivation Ihres Kindes<\/strong><\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-24 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"lieblingsspielzeug\">Lieblingsspielzeug \/ -musik \/ -b\u00fccher<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"lieblingsspielzeug\" id=\"lieblingsspielzeug\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-25 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"besondere_interessen\">Besondere Interessen (Fahrzeuge, Tiere, Musik\u2026)<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"besondere_interessen\" id=\"besondere_interessen\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-26 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"was_macht_ihr_kind_besonders_gerne\">Was macht ihr Kind besonders gerne?<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"was_macht_ihr_kind_besonders_gerne\" id=\"was_macht_ihr_kind_besonders_gerne\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-27 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"womit_koennen_wir_ihr_kind_besonders_gut_motivieren\">Womit k\u00f6nnen wir Ihr Kind besonders gut motivieren?<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"womit_koennen_wir_ihr_kind_besonders_gut_motivieren\" id=\"womit_koennen_wir_ihr_kind_besonders_gut_motivieren\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-28 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"was_mag_ihr_kind_absolut_nicht\">Was mag ihr Kind absolut nicht?<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"was_mag_ihr_kind_absolut_nicht\" id=\"was_mag_ihr_kind_absolut_nicht\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-29 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"reagiert_ihr_kind_empfindlich_auf_bestimmte_dinge\">Reagiert ihr Kind empfindlich auf bestimmte Dinge (z.B. Ger\u00e4usche, Licht, Ber\u00fchrung\u2026)<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"reagiert_ihr_kind_empfindlich_auf_bestimmte_dinge\" id=\"reagiert_ihr_kind_empfindlich_auf_bestimmte_dinge\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-30 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"wie_reagier_ihr_kind_wenn_es_freude_zeigt\">Wie reagiert ihr Kind, wenn es Freude zeigt, wie wenn es \u00fcberfordert oder gestresst ist?<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"wie_reagier_ihr_kind_wenn_es_freude_zeigt\" id=\"wie_reagier_ihr_kind_wenn_es_freude_zeigt\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-31 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"no_gos\">Hier ist Platz f\u00fcr Situationen, die bei Ihrem Kind stress ausl\u00f6sen sowie andere No Gos<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"no_gos\" id=\"no_gos\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-32 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-7 fusion-text-no-margin\" style=\"--awb-font-size:20px;--awb-margin-bottom:0px;\"><p><strong>Therapieziele und Erwartungen<\/strong><\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-33 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"was_sind_ihre_wichtigsten_ziele_fuer_die_physiotherapie\">Was sind Ihre wichtigsten Ziele f\u00fcr die Physiotherapie?<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"was_sind_ihre_wichtigsten_ziele_fuer_die_physiotherapie\" id=\"was_sind_ihre_wichtigsten_ziele_fuer_die_physiotherapie\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-34 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"welche_alltagssituationen_duerfen_sich_verbessern\">Welche Alltagssituationen d\u00fcrfen sich verbessern?<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"welche_alltagssituationen_duerfen_sich_verbessern\" id=\"welche_alltagssituationen_duerfen_sich_verbessern\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-35 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"sonst_noch_mitteilen\">Hier ist noch Platz f\u00fcr das, was Sie den Therapeuten sonst noch mitteilen, m\u00f6chten.<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"sonst_noch_mitteilen\" id=\"sonst_noch_mitteilen\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-36 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div class=\"fusion-form-label-wrapper\"><label for=\"email\">E-Mail <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"email\" id=\"email\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-37 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:30px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-8\"><p>Vielen Dank f\u00fcr Ihre Mithilfe! Wir freuen uns auf die Zusammenarbeit mit Ihnen und Ihrem Kind!<\/p>\n<p>Mit freundlichen Gr\u00fcssen<\/p>\n<\/div>\n<\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-38 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-submit-field fusion-form-label-above\" style=\"\" data-form-id=\"11443\"><div ><button type=\"submit\" class=\"fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-1 fusion-button-default-span  button-default form-form-submit\" data-form-number=\"11443\" tabindex=\"\"><span class=\"fusion-button-text awb-button__text awb-button__text--default\">Absenden<\/span><\/button><\/div><\/div><\/div><\/div><\/div><\/div><\/form><\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":4,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-11445","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/4balance.ch\/en\/wp-json\/wp\/v2\/pages\/11445","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/4balance.ch\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/4balance.ch\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/4balance.ch\/en\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/4balance.ch\/en\/wp-json\/wp\/v2\/comments?post=11445"}],"version-history":[{"count":2,"href":"https:\/\/4balance.ch\/en\/wp-json\/wp\/v2\/pages\/11445\/revisions"}],"predecessor-version":[{"id":11447,"href":"https:\/\/4balance.ch\/en\/wp-json\/wp\/v2\/pages\/11445\/revisions\/11447"}],"wp:attachment":[{"href":"https:\/\/4balance.ch\/en\/wp-json\/wp\/v2\/media?parent=11445"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}