{"id":1288,"date":"2023-02-07T13:09:00","date_gmt":"2023-02-07T13:09:00","guid":{"rendered":"https:\/\/nlelysee-zelende.savviihq.com\/?page_id=1288"},"modified":"2023-04-06T14:51:12","modified_gmt":"2023-04-06T14:51:12","slug":"begroting-aanvragen","status":"publish","type":"page","link":"https:\/\/elysee-dental.fi\/nl\/contacteer-ons\/begroting-aanvragen\/","title":{"rendered":"Begroting aanvragen"},"content":{"rendered":"\n\n<section class=\"block block__simple-text block--left block--full\">\n    <div class=\"container\">\n\n        \n        \n        <div class=\"simple-text--content\">\n            <div class=\"acf-innerblocks-container\">\n\n<h1 class=\"wp-block-heading\">Begroting aanvragen<\/h1>\n\n\n\n<p>Bent u op zoek naar de beste prijs-kwaliteitverhouding voor uw behandelplan? Dan is het aanvragen van een begroting de eerste stap in de goede richting. Ons team staat klaar om een begroting op maat voor u te maken. Vul onderstaand formulier en de daarop volgende vragen zo volledig mogelijk in, zodat wij u een kloppende begroting kunnen sturen.<\/p>\n\n<\/div>\n        <\/div>\n    <\/div>\n<\/section>\n\n\n\n<section class=\"block forms-menu\">\n    <div class=\"container\">\n        <h2 class=\"forms-menu__title\">\n            \n        <\/h2>\n\n        <p class=\"forms-menu__description\">\n            \n        <\/p>\n\n        <div class=\"forms-menu__select-outer-wrapper\">\n            <div class=\"forms-menu__select-wrapper forms-menu__select-wrapper--is-mobile\">\n                <label class=\"forms-menu__select-label\" for=\"forms-category\">\n                    Choose a subject\n                <\/label>\n\n                <div class=\"forms-menu__select-inner-wrapper\">\n                    <select class=\"forms-menu__select\" name=\"forms-category\" id=\"forms-category\">\n                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                <option class=\"forms-menu__category-option\"\n                                    value=\"https:\/\/elysee-dental.fi\/nl\/contacteer-ons\/technische-vraag-stellen\/\"\n                                >\n                                    Overleg met onze tandtechnische adviseurs\n                                <\/option>\n                                                                                                                                                                                                                                                                            <option class=\"forms-menu__category-option\"\n                                    value=\"https:\/\/elysee-dental.fi\/nl\/contacteer-ons\/vraag-een-levering-aan\/\"\n                                >\n                                    Vraag een levering aan\n                                <\/option>\n                                                                                                                <option class=\"forms-menu__category-option\"\n                                    value=\"https:\/\/elysee-dental.fi\/nl\/contacteer-ons\/maak-een-afspraak\/\"\n                                >\n                                    Maak een afspraak\n                                <\/option>\n                                                                                                                <option class=\"forms-menu__category-option\"\n                                    value=\"https:\/\/elysee-dental.fi\/nl\/contacteer-ons\/begroting-aanvragen\/\"\n                                >\n                                    Begroting aanvragen\n                                <\/option>\n                                                                                                                <option class=\"forms-menu__category-option\"\n                                    value=\"https:\/\/elysee-dental.fi\/nl\/contacteer-ons\/productcatalogus-aanvragen\/\"\n                                >\n                                    Digitale productcatalogus aanvragen\n                                <\/option>\n                                                                                                                <option class=\"forms-menu__category-option\"\n                                    value=\"https:\/\/elysee-dental.fi\/nl\/contacteer-ons\/\"\n                                >\n                                    Contacteer ons\n                                <\/option>\n                                                                                                                                                                                                                                    <\/select>\n\n                    <div class=\"icon forms-menu__select-icon-wrapper\">\n    <svg viewBox=\"0 0 100 50\" class=\"icon__svg \">\n    <polygon points=\"100,0 0,0 50,50\" \/>\n<\/svg>\n<\/div>\n                <\/div>\n            <\/div>\n\n            <div class=\"forms-menu__hover-categories-wrapper forms-menu__hover-categories-wrapper--is-desktop\">\n                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        <div class=\"forms-menu__category-row \">\n                            <div class=\"forms-menu__category-icon\"><\/div>\n                            <a href=\"https:\/\/elysee-dental.fi\/nl\/contacteer-ons\/technische-vraag-stellen\/\">\n                                Overleg met onze tandtechnische adviseurs\n                            <\/a>\n                        <\/div>\n                                                                                                                                                                                            <div class=\"forms-menu__category-row \">\n                            <div class=\"forms-menu__category-icon\"><\/div>\n                            <a href=\"https:\/\/elysee-dental.fi\/nl\/contacteer-ons\/vraag-een-levering-aan\/\">\n                                Vraag een levering aan\n                            <\/a>\n                        <\/div>\n                                                                                <div class=\"forms-menu__category-row \">\n                            <div class=\"forms-menu__category-icon\"><\/div>\n                            <a href=\"https:\/\/elysee-dental.fi\/nl\/contacteer-ons\/maak-een-afspraak\/\">\n                                Maak een afspraak\n                            <\/a>\n                        <\/div>\n                                                                                <div class=\"forms-menu__category-row is-active\">\n                            <div class=\"forms-menu__category-icon\"><\/div>\n                            <a href=\"https:\/\/elysee-dental.fi\/nl\/contacteer-ons\/begroting-aanvragen\/\">\n                                Begroting aanvragen\n                            <\/a>\n                        <\/div>\n                                                                                <div class=\"forms-menu__category-row \">\n                            <div class=\"forms-menu__category-icon\"><\/div>\n                            <a href=\"https:\/\/elysee-dental.fi\/nl\/contacteer-ons\/productcatalogus-aanvragen\/\">\n                                Digitale productcatalogus aanvragen\n                            <\/a>\n                        <\/div>\n                                                                                <div class=\"forms-menu__category-row \">\n                            <div class=\"forms-menu__category-icon\"><\/div>\n                            <a href=\"https:\/\/elysee-dental.fi\/nl\/contacteer-ons\/\">\n                                Contacteer ons\n                            <\/a>\n                        <\/div>\n                                                                                                                                                            <\/div>\n\n            <div class=\"forms-menu__search-results-wrapper\">\n                <h5 class=\"forms-menu__active-category-name\">\n                    \n                <\/h5>\n\n                <div class=\"forms-menu__active-category-form\">\n                    <div data-category=\"Begroting aanvragen\" class=\"forms-menu__form-card gravity-form\">\n                                                    <script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 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d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_9' style='display:none'><div id='gf_9' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Begroting aanvragen<\/h2>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_9'  action='\/nl\/wp-json\/wp\/v2\/pages\/1288#gf_9' data-formid='9' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_page_9_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_9_196\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Algemeen<\/h3><\/div><div id=\"field_9_4\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Vul uw gegevens zo volledig mogelijk in en we bezorgen u zo snel mogelijk uw begroting.<\/div><div id=\"field_9_6\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_6'>Naam praktijk<\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_9_6' type='text' value='' class='large'    placeholder='Naam praktijk *'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_7\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_7'>Naam aanvrager<\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_9_7' type='text' value='' class='large'    placeholder='Naam aanvrager *'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_8\" class=\"gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_8'>Telefoonnummer<\/label><div class='ginput_container ginput_container_phone'><input name='input_8' id='input_9_8' type='tel' value='' class='large'  placeholder='Telefoonnummer'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_9\" class=\"gfield gfield--type-email field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_9'>E-mail<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_9' id='input_9_9' type='email' value='' class='large'   placeholder='E-mail **'  aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_9_10\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_10'>Acroniem of nummercode pati\u00ebnt<\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_9_10' type='text' value='' class='large'    placeholder='Acroniem of nummercode pati\u00ebnt *'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_12\" class=\"gfield gfield--type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_12'>Geslacht<\/label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_9_12' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Geslacht<\/option><option value='Man' >Man<\/option><option value='Vrouw' >Vrouw<\/option><\/select><\/div><\/div><div id=\"field_9_13\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_13'>Geboortedatum<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_13' id='input_9_13' type='text' value='' class='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'   placeholder='Geboortedatum' aria-describedby=\"input_9_13_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_9_13_date_format' class='screen-reader-text'>DD slash MM slash JJJJ<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_9_13' class='gform_hidden' value='https:\/\/elysee-dental.fi\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_9_14\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_14'>Klantnummer (indien bekend)<\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_9_14' type='text' value='' class='large'    placeholder='Klantnummer (indien bekend)'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_15\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Ik ga akkoord met het privacybeleid.<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_15'><div class='gchoice gchoice_9_15_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.1' type='checkbox'  value='Ik ga akkoord met het privacybeleid. *'  id='choice_9_15_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_15_1' id='label_9_15_1' class='gform-field-label gform-field-label--type-inline'>Ik ga akkoord met het privacybeleid. *<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_9_17' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_2' class='gform_page' data-js='page-field-id-17' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_9_22\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Geef de verschillende onderdelen aan waarvoor u een begroting wenst. In de volgende schermen kunt u elk onderdeel specificeren. Op het einde krijgt u een overzicht van alle ingevulde gegevens ter controle.<\/div><fieldset id=\"field_9_21\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Ik wil een offerte voor<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_21'><div class='gchoice gchoice_9_21_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.1' type='checkbox'  value='Kroon- en brugwerk'  id='choice_9_21_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_21_1' id='label_9_21_1' class='gform-field-label gform-field-label--type-inline'>Kroon- en brugwerk<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_21_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.2' type='checkbox'  value='Prothese werk'  id='choice_9_21_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_21_2' id='label_9_21_2' class='gform-field-label gform-field-label--type-inline'>Prothese werk<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_21_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.3' type='checkbox'  value='Frame werk'  id='choice_9_21_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_21_3' id='label_9_21_3' class='gform-field-label gform-field-label--type-inline'>Frame werk<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_21_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.4' type='checkbox'  value='Implantologie'  id='choice_9_21_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_21_4' id='label_9_21_4' class='gform-field-label gform-field-label--type-inline'>Implantologie<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_21_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.5' type='checkbox'  value='Diverse'  id='choice_9_21_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_21_5' id='label_9_21_5' class='gform-field-label gform-field-label--type-inline'>Diverse<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_38' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_9_38' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_3' class='gform_page' data-js='page-field-id-38' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_9_197\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Kroon- &amp; brugwerk<\/h3><\/div><fieldset id=\"field_9_39\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Ik wil een offerte voor een<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_39'><div class='gchoice gchoice_9_39_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.1' type='checkbox'  value='Kroon'  id='choice_9_39_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_39_1' id='label_9_39_1' class='gform-field-label gform-field-label--type-inline'>Kroon<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_39_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.2' type='checkbox'  value='Brug'  id='choice_9_39_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_39_2' id='label_9_39_2' class='gform-field-label gform-field-label--type-inline'>Brug<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_39_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.3' type='checkbox'  value='Etsburg'  id='choice_9_39_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_39_3' id='label_9_39_3' class='gform-field-label gform-field-label--type-inline'>Etsburg<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_39_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.4' type='checkbox'  value='Telescoop kronen (binnen + buitenkroon)'  id='choice_9_39_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_39_4' id='label_9_39_4' class='gform-field-label gform-field-label--type-inline'>Telescoop kronen (binnen + buitenkroon)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_39_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.5' type='checkbox'  value='Stiftopbouw'  id='choice_9_39_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_39_5' id='label_9_39_5' class='gform-field-label gform-field-label--type-inline'>Stiftopbouw<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_39_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.6' type='checkbox'  value='Facings'  id='choice_9_39_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_39_6' id='label_9_39_6' class='gform-field-label gform-field-label--type-inline'>Facings<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_39_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.7' type='checkbox'  value='Noodkroon- \/ brug maken'  id='choice_9_39_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_39_7' id='label_9_39_7' class='gform-field-label gform-field-label--type-inline'>Noodkroon- \/ brug maken<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_23' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_9_23' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_4' class='gform_page' data-js='page-field-id-23' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_9_200\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Kroon<\/h3><\/div><div id=\"field_9_53\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Kroon<\/div><div id=\"field_9_24\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_24'>Aantal elementen<\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_9_24' type='text' value='' class='large'    placeholder='Aantal elementen'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_26\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Type<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_26'>\n\t\t\t<div class='gchoice gchoice_9_26_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Volledig metaal'  id='choice_9_26_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_26_0' id='label_9_26_0' class='gform-field-label gform-field-label--type-inline'>Volledig metaal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_26_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Metaal porselein (VMK)'  id='choice_9_26_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_26_1' id='label_9_26_1' class='gform-field-label gform-field-label--type-inline'>Metaal porselein (VMK)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_26_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Metaalvrij'  id='choice_9_26_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_26_2' id='label_9_26_2' class='gform-field-label gform-field-label--type-inline'>Metaalvrij<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_27\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Volledig metaal<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_27'>\n\t\t\t<div class='gchoice gchoice_9_27_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Hoogedel (opbaklegering)'  id='choice_9_27_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_27_0' id='label_9_27_0' class='gform-field-label gform-field-label--type-inline'>Hoogedel (opbaklegering)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_27_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Edel (lichtgeel - geelgoud)'  id='choice_9_27_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_27_1' id='label_9_27_1' class='gform-field-label gform-field-label--type-inline'>Edel (lichtgeel &#8211; geelgoud)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_27_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Edel (witgoud)'  id='choice_9_27_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_27_2' id='label_9_27_2' class='gform-field-label gform-field-label--type-inline'>Edel (witgoud)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_27_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Spaarlegering'  id='choice_9_27_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_27_3' id='label_9_27_3' class='gform-field-label gform-field-label--type-inline'>Spaarlegering<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_27_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Hoogedel (standaard)'  id='choice_9_27_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_27_4' id='label_9_27_4' class='gform-field-label gform-field-label--type-inline'>Hoogedel (standaard)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_27_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Titanium'  id='choice_9_27_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_27_5' id='label_9_27_5' class='gform-field-label gform-field-label--type-inline'>Titanium<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_27_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Onedel'  id='choice_9_27_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_27_6' id='label_9_27_6' class='gform-field-label gform-field-label--type-inline'>Onedel<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_35\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Metaal porselein (VMK)<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_35'>\n\t\t\t<div class='gchoice gchoice_9_35_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Hoogedel'  id='choice_9_35_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_35_0' id='label_9_35_0' class='gform-field-label gform-field-label--type-inline'>Hoogedel<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_35_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Edel (lichtgeel - geelgoud)'  id='choice_9_35_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_35_1' id='label_9_35_1' class='gform-field-label gform-field-label--type-inline'>Edel (lichtgeel &#8211; geelgoud)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_35_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Edel (witgoud)'  id='choice_9_35_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_35_2' id='label_9_35_2' class='gform-field-label gform-field-label--type-inline'>Edel (witgoud)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_35_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Spaarlegering'  id='choice_9_35_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_35_3' id='label_9_35_3' class='gform-field-label gform-field-label--type-inline'>Spaarlegering<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_35_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Titanium'  id='choice_9_35_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_35_4' id='label_9_35_4' class='gform-field-label gform-field-label--type-inline'>Titanium<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_35_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Onedel'  id='choice_9_35_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_35_5' id='label_9_35_5' class='gform-field-label gform-field-label--type-inline'>Onedel<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_36\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Metaalvrij<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_36'>\n\t\t\t<div class='gchoice gchoice_9_36_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Forma\u00ae'  id='choice_9_36_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_36_0' id='label_9_36_0' class='gform-field-label gform-field-label--type-inline'>Forma\u00ae<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_36_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Lava\u2122 ZrO2'  id='choice_9_36_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_36_1' id='label_9_36_1' class='gform-field-label gform-field-label--type-inline'>Lava\u2122 ZrO2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_36_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='IPS e.max ZirPress op Forma\u00ae-kapje'  id='choice_9_36_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_36_2' id='label_9_36_2' class='gform-field-label gform-field-label--type-inline'>IPS e.max ZirPress op Forma\u00ae-kapje<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_36_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='IPS e.max ZirPress op Lava\u2122-kapje'  id='choice_9_36_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_36_3' id='label_9_36_3' class='gform-field-label gform-field-label--type-inline'>IPS e.max ZirPress op Lava\u2122-kapje<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_36_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='IPS e.max Press (lithiumdislicaat)'  id='choice_9_36_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_36_4' id='label_9_36_4' class='gform-field-label gform-field-label--type-inline'>IPS e.max Press (lithiumdislicaat)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_36_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='MonoZir\u00ae'  id='choice_9_36_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_36_5' id='label_9_36_5' class='gform-field-label gform-field-label--type-inline'>MonoZir\u00ae<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_36_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='MonoZir\u00ae Ultra'  id='choice_9_36_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_36_6' id='label_9_36_6' class='gform-field-label gform-field-label--type-inline'>MonoZir\u00ae Ultra<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_36_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Lava\u2122 Plus'  id='choice_9_36_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_36_7' id='label_9_36_7' class='gform-field-label gform-field-label--type-inline'>Lava\u2122 Plus<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_36_8'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Vita Enamic\u00ae'  id='choice_9_36_8' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_36_8' id='label_9_36_8' class='gform-field-label gform-field-label--type-inline'>Vita Enamic\u00ae<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_36_9'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Ceramage\u00ae'  id='choice_9_36_9' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_36_9' id='label_9_36_9' class='gform-field-label gform-field-label--type-inline'>Ceramage\u00ae<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_28\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Precisieverankering<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_28'><div class='gchoice gchoice_9_28_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.1' type='checkbox'  value='Precisieverankering'  id='choice_9_28_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_28_1' id='label_9_28_1' class='gform-field-label gform-field-label--type-inline'>Precisieverankering<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_37\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_37'>Welk soort precisieverankering?<\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_9_37' type='text' value='' class='large'    placeholder='Welk soort precisieverankering?'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_29\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Individuele lepel<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_29'><div class='gchoice gchoice_9_29_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.1' type='checkbox'  value='Individuele lepel'  id='choice_9_29_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_29_1' id='label_9_29_1' class='gform-field-label gform-field-label--type-inline'>Individuele lepel<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_31\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_31'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_31' id='input_9_31' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_41' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_9_41' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_5' class='gform_page' data-js='page-field-id-41' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_9_218\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Brug<\/h3><\/div><div id=\"field_9_52\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Brug<\/div><div id=\"field_9_42\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_42'>Aantal elementen<\/label><div class='ginput_container ginput_container_text'><input name='input_42' id='input_9_42' type='text' value='' class='large'    placeholder='Aantal elementen'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_43\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Type<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_43'>\n\t\t\t<div class='gchoice gchoice_9_43_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='Volledig metaal'  id='choice_9_43_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_43_0' id='label_9_43_0' class='gform-field-label gform-field-label--type-inline'>Volledig metaal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_43_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='Metaal porselein (VMK)'  id='choice_9_43_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_43_1' id='label_9_43_1' class='gform-field-label gform-field-label--type-inline'>Metaal porselein (VMK)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_43_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='Metaalvrij'  id='choice_9_43_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_43_2' id='label_9_43_2' class='gform-field-label gform-field-label--type-inline'>Metaalvrij<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_44\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Volledig metaal<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_44'>\n\t\t\t<div class='gchoice gchoice_9_44_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Hoogedel (opbaklegering)'  id='choice_9_44_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_44_0' id='label_9_44_0' class='gform-field-label gform-field-label--type-inline'>Hoogedel (opbaklegering)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_44_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Edel (lichtgeel - geelgoud)'  id='choice_9_44_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_44_1' id='label_9_44_1' class='gform-field-label gform-field-label--type-inline'>Edel (lichtgeel &#8211; geelgoud)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_44_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Edel (witgoud)'  id='choice_9_44_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_44_2' id='label_9_44_2' class='gform-field-label gform-field-label--type-inline'>Edel (witgoud)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_44_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Spaarlegering'  id='choice_9_44_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_44_3' id='label_9_44_3' class='gform-field-label gform-field-label--type-inline'>Spaarlegering<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_44_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Hoogedel (standaard)'  id='choice_9_44_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_44_4' id='label_9_44_4' class='gform-field-label gform-field-label--type-inline'>Hoogedel (standaard)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_44_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Titanium'  id='choice_9_44_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_44_5' id='label_9_44_5' class='gform-field-label gform-field-label--type-inline'>Titanium<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_44_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Onedel'  id='choice_9_44_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_44_6' id='label_9_44_6' class='gform-field-label gform-field-label--type-inline'>Onedel<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_45\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Metaal porselein (VMK)<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_45'>\n\t\t\t<div class='gchoice gchoice_9_45_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='Hoogedel'  id='choice_9_45_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_45_0' id='label_9_45_0' class='gform-field-label gform-field-label--type-inline'>Hoogedel<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_45_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='Edel (lichtgeel - geelgoud)'  id='choice_9_45_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_45_1' id='label_9_45_1' class='gform-field-label gform-field-label--type-inline'>Edel (lichtgeel &#8211; geelgoud)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_45_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='Edel (witgoud)'  id='choice_9_45_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_45_2' id='label_9_45_2' class='gform-field-label gform-field-label--type-inline'>Edel (witgoud)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_45_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='Spaarlegering'  id='choice_9_45_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_45_3' id='label_9_45_3' class='gform-field-label gform-field-label--type-inline'>Spaarlegering<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_45_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='Titanium'  id='choice_9_45_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_45_4' id='label_9_45_4' class='gform-field-label gform-field-label--type-inline'>Titanium<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_45_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='Onedel'  id='choice_9_45_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_45_5' id='label_9_45_5' class='gform-field-label gform-field-label--type-inline'>Onedel<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_46\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Metaalvrij<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_46'>\n\t\t\t<div class='gchoice gchoice_9_46_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Forma\u00ae'  id='choice_9_46_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_46_0' id='label_9_46_0' class='gform-field-label gform-field-label--type-inline'>Forma\u00ae<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_46_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Lava\u2122 ZrO2'  id='choice_9_46_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_46_1' id='label_9_46_1' class='gform-field-label gform-field-label--type-inline'>Lava\u2122 ZrO2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_46_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='IPS e.max ZirPress op Forma\u00ae-kapje'  id='choice_9_46_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_46_2' id='label_9_46_2' class='gform-field-label gform-field-label--type-inline'>IPS e.max ZirPress op Forma\u00ae-kapje<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_46_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='IPS e.max ZirPress op Lava\u2122-kapje'  id='choice_9_46_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_46_3' id='label_9_46_3' class='gform-field-label gform-field-label--type-inline'>IPS e.max ZirPress op Lava\u2122-kapje<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_46_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='IPS e.max Press (lithiumdislicaat)'  id='choice_9_46_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_46_4' id='label_9_46_4' class='gform-field-label gform-field-label--type-inline'>IPS e.max Press (lithiumdislicaat)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_46_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='MonoZir\u00ae'  id='choice_9_46_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_46_5' id='label_9_46_5' class='gform-field-label gform-field-label--type-inline'>MonoZir\u00ae<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_46_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='MonoZir\u00ae Ultra'  id='choice_9_46_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_46_6' id='label_9_46_6' class='gform-field-label gform-field-label--type-inline'>MonoZir\u00ae Ultra<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_46_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Lava\u2122 Plus'  id='choice_9_46_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_46_7' id='label_9_46_7' class='gform-field-label gform-field-label--type-inline'>Lava\u2122 Plus<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_46_8'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Vita Enamic\u00ae'  id='choice_9_46_8' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_46_8' id='label_9_46_8' class='gform-field-label gform-field-label--type-inline'>Vita Enamic\u00ae<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_46_9'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Ceramage\u00ae'  id='choice_9_46_9' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_46_9' id='label_9_46_9' class='gform-field-label gform-field-label--type-inline'>Ceramage\u00ae<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_49\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Precisieverankering<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_49'><div class='gchoice gchoice_9_49_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.1' type='checkbox'  value='Precisieverankering'  id='choice_9_49_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_49_1' id='label_9_49_1' class='gform-field-label gform-field-label--type-inline'>Precisieverankering<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_48\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_48'>Walk soort precisieverankering?<\/label><div class='ginput_container ginput_container_text'><input name='input_48' id='input_9_48' type='text' value='' class='large'    placeholder='Walk soort precisieverankering?'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_50\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Individuele lepel<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_50'><div class='gchoice gchoice_9_50_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.1' type='checkbox'  value='Individuele lepel'  id='choice_9_50_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_50_1' id='label_9_50_1' class='gform-field-label gform-field-label--type-inline'>Individuele lepel<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_51\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_51'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_51' id='input_9_51' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_54' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Volgende'  \/> <input type='button' id='gform_next_button_9_54' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_6' class='gform_page' data-js='page-field-id-54' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_6' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_9_219\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Etsbrug<\/h3><\/div><div id=\"field_9_55\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Etsbrug<\/div><div id=\"field_9_56\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_56'>Aantal vleugels<\/label><div class='ginput_container ginput_container_text'><input name='input_56' id='input_9_56' type='text' value='' class='large'    placeholder='Aantal vleugels'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_57\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_57'>Aantal dummies<\/label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_9_57' type='text' value='' class='large'    placeholder='Aantal dummies'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_58\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Type<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_58'>\n\t\t\t<div class='gchoice gchoice_9_58_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_58' type='radio' value='Metaal porselein (VMK)'  id='choice_9_58_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_58_0' id='label_9_58_0' class='gform-field-label gform-field-label--type-inline'>Metaal porselein (VMK)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_58_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_58' type='radio' value='Metaalvrij'  id='choice_9_58_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_58_1' id='label_9_58_1' class='gform-field-label gform-field-label--type-inline'>Metaalvrij<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_59\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Metaal porselein (VMK)<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_59'>\n\t\t\t<div class='gchoice gchoice_9_59_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_59' type='radio' value='Hoogedel'  id='choice_9_59_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_59_0' id='label_9_59_0' class='gform-field-label gform-field-label--type-inline'>Hoogedel<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_59_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_59' type='radio' value='Edel (witgoud)'  id='choice_9_59_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_59_1' id='label_9_59_1' class='gform-field-label gform-field-label--type-inline'>Edel (witgoud)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_59_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_59' type='radio' value='Spaarlegering'  id='choice_9_59_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_59_2' id='label_9_59_2' class='gform-field-label gform-field-label--type-inline'>Spaarlegering<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_59_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_59' type='radio' value='Titanium'  id='choice_9_59_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_59_3' id='label_9_59_3' class='gform-field-label gform-field-label--type-inline'>Titanium<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_59_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_59' type='radio' value='Onedel'  id='choice_9_59_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_59_4' id='label_9_59_4' class='gform-field-label gform-field-label--type-inline'>Onedel<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_60\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Metaalvrij<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_60'>\n\t\t\t<div class='gchoice gchoice_9_60_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_60' type='radio' value='Forma\u00ae'  id='choice_9_60_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_60_0' id='label_9_60_0' class='gform-field-label gform-field-label--type-inline'>Forma\u00ae<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_60_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_60' type='radio' value='Lava\u2122 ZrO2'  id='choice_9_60_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_60_1' id='label_9_60_1' class='gform-field-label gform-field-label--type-inline'>Lava\u2122 ZrO2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_60_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_60' type='radio' value='Lava\u2122 Plus'  id='choice_9_60_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_60_2' id='label_9_60_2' class='gform-field-label gform-field-label--type-inline'>Lava\u2122 Plus<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_60_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_60' type='radio' value='Composiet (Glasvezelversterkt)'  id='choice_9_60_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_60_3' id='label_9_60_3' class='gform-field-label gform-field-label--type-inline'>Composiet (Glasvezelversterkt)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_61\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Precisieverankering<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_61'><div class='gchoice gchoice_9_61_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.1' type='checkbox'  value='Precisieverankering'  id='choice_9_61_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_61_1' id='label_9_61_1' class='gform-field-label gform-field-label--type-inline'>Precisieverankering<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_62\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_62'>Welk soort precisieverankering?<\/label><div class='ginput_container ginput_container_text'><input name='input_62' id='input_9_62' type='text' value='' class='large'    placeholder='Welk soort precisieverankering?'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_63\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Individuele lepel<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_63'><div class='gchoice gchoice_9_63_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.1' type='checkbox'  value='Individuele lepel'  id='choice_9_63_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_63_1' id='label_9_63_1' class='gform-field-label gform-field-label--type-inline'>Individuele lepel<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_64\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_64'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_64' id='input_9_64' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_65' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_9_65' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_7' class='gform_page' data-js='page-field-id-65' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_7' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_9_220\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Telescoopkronen (binnen + buitenkroon)<\/h3><\/div><div id=\"field_9_66\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Telescoopkronen (binnen + buitenkroon) <\/div><div id=\"field_9_67\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_67'>Aantal elementen<\/label><div class='ginput_container ginput_container_text'><input name='input_67' id='input_9_67' type='text' value='' class='large'    placeholder='Aantal elementen'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_68\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Metaal soort (binnen &amp; buiten)<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_68'>\n\t\t\t<div class='gchoice gchoice_9_68_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_68' type='radio' value='Hoogedel'  id='choice_9_68_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_68_0' id='label_9_68_0' class='gform-field-label gform-field-label--type-inline'>Hoogedel<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_68_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_68' type='radio' value='Edel (licht-geelgoud)'  id='choice_9_68_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_68_1' id='label_9_68_1' class='gform-field-label gform-field-label--type-inline'>Edel (licht-geelgoud)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_68_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_68' type='radio' value='Spaarlegering'  id='choice_9_68_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_68_2' id='label_9_68_2' class='gform-field-label gform-field-label--type-inline'>Spaarlegering<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_68_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_68' type='radio' value='Titanium'  id='choice_9_68_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_68_3' id='label_9_68_3' class='gform-field-label gform-field-label--type-inline'>Titanium<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_68_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_68' type='radio' value='Onedel'  id='choice_9_68_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_68_4' id='label_9_68_4' class='gform-field-label gform-field-label--type-inline'>Onedel<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_69\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Individuele lepel<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_69'><div class='gchoice gchoice_9_69_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_69.1' type='checkbox'  value='Individuele lepel'  id='choice_9_69_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_69_1' id='label_9_69_1' class='gform-field-label gform-field-label--type-inline'>Individuele lepel<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_70\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_70'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_70' id='input_9_70' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_71' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_9_71' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_8' class='gform_page' data-js='page-field-id-71' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_8' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_9_221\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Stiftopbouw<\/h3><\/div><div id=\"field_9_88\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Stiftopbouw<\/div><fieldset id=\"field_9_72\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Type<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_72'>\n\t\t\t<div class='gchoice gchoice_9_72_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Metaal'  id='choice_9_72_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_0' id='label_9_72_0' class='gform-field-label gform-field-label--type-inline'>Metaal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Metaalvrij'  id='choice_9_72_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_1' id='label_9_72_1' class='gform-field-label gform-field-label--type-inline'>Metaalvrij<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_73\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Metaal<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_73'>\n\t\t\t<div class='gchoice gchoice_9_73_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_73' type='radio' value='Hoogedel'  id='choice_9_73_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_73_0' id='label_9_73_0' class='gform-field-label gform-field-label--type-inline'>Hoogedel<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_73_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_73' type='radio' value='Edel (lichtgeel -geelgoud)'  id='choice_9_73_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_73_1' id='label_9_73_1' class='gform-field-label gform-field-label--type-inline'>Edel (lichtgeel -geelgoud)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_73_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_73' type='radio' value='Spaarlegering'  id='choice_9_73_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_73_2' id='label_9_73_2' class='gform-field-label gform-field-label--type-inline'>Spaarlegering<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_73_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_73' type='radio' value='Titanium'  id='choice_9_73_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_73_3' id='label_9_73_3' class='gform-field-label gform-field-label--type-inline'>Titanium<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_73_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_73' type='radio' value='Onedel'  id='choice_9_73_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_73_4' id='label_9_73_4' class='gform-field-label gform-field-label--type-inline'>Onedel<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_74\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Metaalvrij<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_74'>\n\t\t\t<div class='gchoice gchoice_9_74_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_74' type='radio' value='Composite'  id='choice_9_74_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_74_0' id='label_9_74_0' class='gform-field-label gform-field-label--type-inline'>Composite<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_75\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_75'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_75' id='input_9_75' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_76' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_9_76' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_9' class='gform_page' data-js='page-field-id-76' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_9' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_9_222\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Facings<\/h3><\/div><div id=\"field_9_77\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Facings<\/div><div id=\"field_9_78\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_78'>Aantal elementen<\/label><div class='ginput_container ginput_container_text'><input name='input_78' id='input_9_78' type='text' value='' class='large'    placeholder='Aantal elementen'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_79\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_79'>Locatie element<\/label><div class='ginput_container ginput_container_text'><input name='input_79' id='input_9_79' type='text' value='' class='large'    placeholder='Locatie element'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_80\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_80'>Metaalsoort<\/label><div class='ginput_container ginput_container_text'><input name='input_80' id='input_9_80' type='text' value='' class='large'    placeholder='Metaalsoort'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_81\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Individuele lepel<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_81'><div class='gchoice gchoice_9_81_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_81.1' type='checkbox'  value='Individuele lepel'  id='choice_9_81_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_81_1' id='label_9_81_1' class='gform-field-label gform-field-label--type-inline'>Individuele lepel<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_82\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_82'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_82' id='input_9_82' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_83' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_9_83' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_10' class='gform_page' data-js='page-field-id-83' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_10' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_9_223\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Noodkroon- \/ brug maken<\/h3><\/div><div id=\"field_9_84\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Noodkroon- \/ brug maken<\/div><div id=\"field_9_85\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_85'>Aantal elementen<\/label><div class='ginput_container ginput_container_text'><input name='input_85' id='input_9_85' type='text' value='' class='large'    placeholder='Aantal elementen'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_86\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Individuele lepel<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_86'><div class='gchoice gchoice_9_86_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_86.1' type='checkbox'  value='Individuele lepel'  id='choice_9_86_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_86_1' id='label_9_86_1' class='gform-field-label gform-field-label--type-inline'>Individuele lepel<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_87\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_87'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_87' id='input_9_87' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_89' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_9_89' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_11' class='gform_page' data-js='page-field-id-89' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_11' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_9_198\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Prothese werk<\/h3><\/div><div id=\"field_9_91\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Prothesewerk<\/div><fieldset id=\"field_9_90\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Ik wil een offerte voor<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_90'><div class='gchoice gchoice_9_90_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.1' type='checkbox'  value='Volledige bovenprothese'  id='choice_9_90_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_90_1' id='label_9_90_1' class='gform-field-label gform-field-label--type-inline'>Volledige bovenprothese<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_90_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.2' type='checkbox'  value='Immediaat volledige bovenprothese'  id='choice_9_90_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_90_2' id='label_9_90_2' class='gform-field-label gform-field-label--type-inline'>Immediaat volledige bovenprothese<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_90_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.3' type='checkbox'  value='Volledige onderprothese'  id='choice_9_90_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_90_3' id='label_9_90_3' class='gform-field-label gform-field-label--type-inline'>Volledige onderprothese<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_90_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.4' type='checkbox'  value='Immediaat volledige onderprothese'  id='choice_9_90_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_90_4' id='label_9_90_4' class='gform-field-label gform-field-label--type-inline'>Immediaat volledige onderprothese<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_90_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.5' type='checkbox'  value='Parti\u00eble bovenprothese'  id='choice_9_90_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_90_5' id='label_9_90_5' class='gform-field-label gform-field-label--type-inline'>Parti\u00eble bovenprothese<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_90_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.6' type='checkbox'  value='Parti\u00eble onderprothese'  id='choice_9_90_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_90_6' id='label_9_90_6' class='gform-field-label gform-field-label--type-inline'>Parti\u00eble onderprothese<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_90_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.7' type='checkbox'  value='Reparatie scheur\/breuk'  id='choice_9_90_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_90_7' id='label_9_90_7' class='gform-field-label gform-field-label--type-inline'>Reparatie scheur\/breuk<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_90_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.8' type='checkbox'  value='Bijplaatsing'  id='choice_9_90_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_90_8' id='label_9_90_8' class='gform-field-label gform-field-label--type-inline'>Bijplaatsing<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_90_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.9' type='checkbox'  value='Rebasing'  id='choice_9_90_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_90_9' id='label_9_90_9' class='gform-field-label gform-field-label--type-inline'>Rebasing<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_201\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Volledige bovenprothese<\/h3><\/div><div id=\"field_9_92\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Volledige bovenprothese<\/div><fieldset id=\"field_9_93\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Gewenst productieverloop<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_93'>\n\t\t\t<div class='gchoice gchoice_9_93_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_93' type='radio' value='Alle stappen Internationale productie'  id='choice_9_93_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_93_0' id='label_9_93_0' class='gform-field-label gform-field-label--type-inline'>Alle stappen Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_93_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_93' type='radio' value='Lepel + beetplaat Lab NL, opstellen + afmaken Internationale productie'  id='choice_9_93_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_93_1' id='label_9_93_1' class='gform-field-label gform-field-label--type-inline'>Lepel + beetplaat Lab NL, opstellen + afmaken Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_93_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_93' type='radio' value='Alle stappen Lab NL'  id='choice_9_93_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_93_2' id='label_9_93_2' class='gform-field-label gform-field-label--type-inline'>Alle stappen Lab NL<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_94\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_94'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_94' id='input_9_94' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_202\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Immediaat volledige bovenprothese<\/h3><\/div><div id=\"field_9_95\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Immediaat volledige bovenprothese<\/div><div id=\"field_9_96\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_96'>Aantal immediaat elementen<\/label><div class='ginput_container ginput_container_text'><input name='input_96' id='input_9_96' type='text' value='' class='large'    placeholder='Aantal immediaat elementen'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_101\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Gewenst productieverloop<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_101'>\n\t\t\t<div class='gchoice gchoice_9_101_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_101' type='radio' value='Alle stappen Internationale productie'  id='choice_9_101_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_101_0' id='label_9_101_0' class='gform-field-label gform-field-label--type-inline'>Alle stappen Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_101_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_101' type='radio' value='Lepel + beetplaat Lab NL, opstellen + afmaken Internationale productie'  id='choice_9_101_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_101_1' id='label_9_101_1' class='gform-field-label gform-field-label--type-inline'>Lepel + beetplaat Lab NL, opstellen + afmaken Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_101_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_101' type='radio' value='Alle stappen Lab NL'  id='choice_9_101_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_101_2' id='label_9_101_2' class='gform-field-label gform-field-label--type-inline'>Alle stappen Lab NL<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_101_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_101' type='radio' value='In 1x klaar Internationale productie'  id='choice_9_101_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_101_3' id='label_9_101_3' class='gform-field-label gform-field-label--type-inline'>In 1x klaar Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_101_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_101' type='radio' value='In 1x klaar Lab NL'  id='choice_9_101_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_101_4' id='label_9_101_4' class='gform-field-label gform-field-label--type-inline'>In 1x klaar Lab NL<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_100\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_100'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_100' id='input_9_100' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_203\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Volledige onderprothese<\/h3><\/div><div id=\"field_9_102\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Volledige onderprothese<\/div><fieldset id=\"field_9_103\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Gewest productieverloop<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_103'>\n\t\t\t<div class='gchoice gchoice_9_103_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='Alle stappen Internationale productie'  id='choice_9_103_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_103_0' id='label_9_103_0' class='gform-field-label gform-field-label--type-inline'>Alle stappen Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_103_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='Lepel + beetplaat Lab NL, opstellen + afmaken Internationale productie'  id='choice_9_103_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_103_1' id='label_9_103_1' class='gform-field-label gform-field-label--type-inline'>Lepel + beetplaat Lab NL, opstellen + afmaken Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_103_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_103' type='radio' value='Alle stappen Lab NL'  id='choice_9_103_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_103_2' id='label_9_103_2' class='gform-field-label gform-field-label--type-inline'>Alle stappen Lab NL<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_104\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_104'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_104' id='input_9_104' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_204\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Immediaat volledige onderprothese<\/h3><\/div><div id=\"field_9_105\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Immediaat volledige onderprothese<\/div><div id=\"field_9_106\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_106'>Aantal immediaat elementen<\/label><div class='ginput_container ginput_container_text'><input name='input_106' id='input_9_106' type='text' value='' class='large'    placeholder='Aantal immediaat elementen'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_107\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Gewenst productieverloop<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_107'>\n\t\t\t<div class='gchoice gchoice_9_107_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_107' type='radio' value='Alle stappen Internationale productie'  id='choice_9_107_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_107_0' id='label_9_107_0' class='gform-field-label gform-field-label--type-inline'>Alle stappen Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_107_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_107' type='radio' value='Lepel + beetplaat Lab NL, opstellen + afmaken Internationale productie'  id='choice_9_107_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_107_1' id='label_9_107_1' class='gform-field-label gform-field-label--type-inline'>Lepel + beetplaat Lab NL, opstellen + afmaken Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_107_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_107' type='radio' value='Alle stappen Lab NL'  id='choice_9_107_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_107_2' id='label_9_107_2' class='gform-field-label gform-field-label--type-inline'>Alle stappen Lab NL<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_107_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_107' type='radio' value='In 1x klaar Internationale productie'  id='choice_9_107_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_107_3' id='label_9_107_3' class='gform-field-label gform-field-label--type-inline'>In 1x klaar Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_107_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_107' type='radio' value='In 1x klaar Lab NL'  id='choice_9_107_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_107_4' id='label_9_107_4' class='gform-field-label gform-field-label--type-inline'>In 1x klaar Lab NL<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_108\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_108'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_108' id='input_9_108' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_205\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Parti\u00eble bovenprothese<\/h3><\/div><div id=\"field_9_109\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Parti\u00eble bovenprothese<\/div><div id=\"field_9_115\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_115'>Aantal immediaat elementen (indien van toepassing)<\/label><div class='ginput_container ginput_container_text'><input name='input_115' id='input_9_115' type='text' value='' class='large'    placeholder='Aantal immediaat elementen (indien van toepassing)'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_111\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_111'>Totaal aantal elementen (inclusief de immediaat elementen)<\/label><div class='ginput_container ginput_container_text'><input name='input_111' id='input_9_111' type='text' value='' class='large'    placeholder='Totaal aantal elementen (inclusief de immediaat elementen)'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_112\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Gewenst productieverloop<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_112'>\n\t\t\t<div class='gchoice gchoice_9_112_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_112' type='radio' value='Alle stappen Internationale productie'  id='choice_9_112_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_112_0' id='label_9_112_0' class='gform-field-label gform-field-label--type-inline'>Alle stappen Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_112_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_112' type='radio' value='Lepel + beetplaat Lab NL, opstellen + afmaken Internationale productie'  id='choice_9_112_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_112_1' id='label_9_112_1' class='gform-field-label gform-field-label--type-inline'>Lepel + beetplaat Lab NL, opstellen + afmaken Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_112_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_112' type='radio' value='Alle stappen Lab NL'  id='choice_9_112_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_112_2' id='label_9_112_2' class='gform-field-label gform-field-label--type-inline'>Alle stappen Lab NL<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_112_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_112' type='radio' value='In 1x klaar Internationale productie'  id='choice_9_112_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_112_3' id='label_9_112_3' class='gform-field-label gform-field-label--type-inline'>In 1x klaar Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_112_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_112' type='radio' value='In 1x klaar Lab NL'  id='choice_9_112_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_112_4' id='label_9_112_4' class='gform-field-label gform-field-label--type-inline'>In 1x klaar Lab NL<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_113\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_113'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_113' id='input_9_113' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_206\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Parti\u00eble onderprothese<\/h3><\/div><div id=\"field_9_114\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Parti\u00eble onderprothese<\/div><div id=\"field_9_117\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_117'>Aantal immediaat elementen (indien van toepassing)<\/label><div class='ginput_container ginput_container_text'><input name='input_117' id='input_9_117' type='text' value='' class='large'    placeholder='Aantal immediaat elementen (indien van toepassing)'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_118\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_118'>Totaal aantal elementen (inclusief de immediaat elementen)<\/label><div class='ginput_container ginput_container_text'><input name='input_118' id='input_9_118' type='text' value='' class='large'    placeholder='Totaal aantal elementen (inclusief de immediaat elementen)'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_119\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Gewenst productieverloop<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_119'>\n\t\t\t<div class='gchoice gchoice_9_119_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_119' type='radio' value='Alle stappen Internationale productie'  id='choice_9_119_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_119_0' id='label_9_119_0' class='gform-field-label gform-field-label--type-inline'>Alle stappen Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_119_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_119' type='radio' value='Lepel + beetplaat Lab NL, opstellen + afmaken Internationale productie'  id='choice_9_119_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_119_1' id='label_9_119_1' class='gform-field-label gform-field-label--type-inline'>Lepel + beetplaat Lab NL, opstellen + afmaken Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_119_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_119' type='radio' value='Alle stappen Lab NL'  id='choice_9_119_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_119_2' id='label_9_119_2' class='gform-field-label gform-field-label--type-inline'>Alle stappen Lab NL<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_119_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_119' type='radio' value='In 1x klaar Internationale productie'  id='choice_9_119_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_119_3' id='label_9_119_3' class='gform-field-label gform-field-label--type-inline'>In 1x klaar Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_119_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_119' type='radio' value='In 1x klaar Lab NL'  id='choice_9_119_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_119_4' id='label_9_119_4' class='gform-field-label gform-field-label--type-inline'>In 1x klaar Lab NL<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_120\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_120'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_120' id='input_9_120' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_207\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Reparatie scheur\/breuk<\/h3><\/div><div id=\"field_9_121\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Reparatie scheur\/breuk<\/div><fieldset id=\"field_9_122\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Gewenst productieverloop<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_122'>\n\t\t\t<div class='gchoice gchoice_9_122_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_122' type='radio' value='Internationale productie'  id='choice_9_122_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_122_0' id='label_9_122_0' class='gform-field-label gform-field-label--type-inline'>Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_122_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_122' type='radio' value='Lab NL'  id='choice_9_122_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_122_1' id='label_9_122_1' class='gform-field-label gform-field-label--type-inline'>Lab NL<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_123\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_123'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_123' id='input_9_123' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_208\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Bijplaatsing<\/h3><\/div><div id=\"field_9_124\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Bijplaatsing\n<\/div><div id=\"field_9_125\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_125'>Aantal immediaat elementen<\/label><div class='ginput_container ginput_container_text'><input name='input_125' id='input_9_125' type='text' value='' class='large'    placeholder='Aantal immediaat elementen'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_126\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Gewenst productieverloop<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_126'>\n\t\t\t<div class='gchoice gchoice_9_126_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='Internationale productie'  id='choice_9_126_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_126_0' id='label_9_126_0' class='gform-field-label gform-field-label--type-inline'>Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_126_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_126' type='radio' value='Lab NL'  id='choice_9_126_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_126_1' id='label_9_126_1' class='gform-field-label gform-field-label--type-inline'>Lab NL<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_127\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_127'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_127' id='input_9_127' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_209\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Rebasing<\/h3><\/div><div id=\"field_9_128\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Rebasing<\/div><fieldset id=\"field_9_129\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Gewenst productieverloop<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_129'>\n\t\t\t<div class='gchoice gchoice_9_129_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_129' type='radio' value='Lab NL'  id='choice_9_129_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_129_0' id='label_9_129_0' class='gform-field-label gform-field-label--type-inline'>Lab NL<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_130\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_130'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_130' id='input_9_130' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_131' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_9_131' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_12' class='gform_page' data-js='page-field-id-131' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_12' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_9_210\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Framewerk<\/h3><\/div><div id=\"field_9_132\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Framewerk<\/div><fieldset id=\"field_9_133\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Ik wil een offerte voor<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_133'><div class='gchoice gchoice_9_133_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_133.1' type='checkbox'  value='Frame prothese boven'  id='choice_9_133_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_133_1' id='label_9_133_1' class='gform-field-label gform-field-label--type-inline'>Frame prothese boven<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_133_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_133.2' type='checkbox'  value='Frame prothese onder'  id='choice_9_133_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_133_2' id='label_9_133_2' class='gform-field-label gform-field-label--type-inline'>Frame prothese onder<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_211\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Frame prothese boven<\/h3><\/div><div id=\"field_9_134\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Frame prothese boven<\/div><div id=\"field_9_143\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_143'>Aantal immediaat elementen (indien van toepassing)<\/label><div class='ginput_container ginput_container_text'><input name='input_143' id='input_9_143' type='text' value='' class='large'    placeholder='Aantal immediaat elementen (indien van toepassing)'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_144\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_144'>Totaal aantal elementen (inclusief evt. immediaat elementen)<\/label><div class='ginput_container ginput_container_text'><input name='input_144' id='input_9_144' type='text' value='' class='large'    placeholder='Totaal aantal elementen (inclusief evt. immediaat elementen)'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_137\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Type<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_137'>\n\t\t\t<div class='gchoice gchoice_9_137_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_137' type='radio' value='Standaard CrCo'  id='choice_9_137_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_137_0' id='label_9_137_0' class='gform-field-label gform-field-label--type-inline'>Standaard CrCo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_137_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_137' type='radio' value='Titanium'  id='choice_9_137_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_137_1' id='label_9_137_1' class='gform-field-label gform-field-label--type-inline'>Titanium<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_137_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_137' type='radio' value='Resure'  id='choice_9_137_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_137_2' id='label_9_137_2' class='gform-field-label gform-field-label--type-inline'>Resure<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_138\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Titanium<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_138'>\n\t\t\t<div class='gchoice gchoice_9_138_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_138' type='radio' value='Wit anker'  id='choice_9_138_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_138_0' id='label_9_138_0' class='gform-field-label gform-field-label--type-inline'>Wit anker<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_138_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_138' type='radio' value='Vergulden'  id='choice_9_138_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_138_1' id='label_9_138_1' class='gform-field-label gform-field-label--type-inline'>Vergulden<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_138_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_138' type='radio' value='Ticoniseren'  id='choice_9_138_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_138_2' id='label_9_138_2' class='gform-field-label gform-field-label--type-inline'>Ticoniseren<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_139\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Resure<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_139'>\n\t\t\t<div class='gchoice gchoice_9_139_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_139' type='radio' value='Transparant klammer'  id='choice_9_139_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_139_0' id='label_9_139_0' class='gform-field-label gform-field-label--type-inline'>Transparant klammer<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_139_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_139' type='radio' value='Tandkleurige klammer'  id='choice_9_139_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_139_1' id='label_9_139_1' class='gform-field-label gform-field-label--type-inline'>Tandkleurige klammer<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_140\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Gewenst productieverloop<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_140'>\n\t\t\t<div class='gchoice gchoice_9_140_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Lepel, frame met waswal opstellen + afmaken'  id='choice_9_140_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_140_0' id='label_9_140_0' class='gform-field-label gform-field-label--type-inline'>Lepel, frame met waswal opstellen + afmaken<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_140_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Frame met waswal opstellen + afmaken'  id='choice_9_140_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_140_1' id='label_9_140_1' class='gform-field-label gform-field-label--type-inline'>Frame met waswal opstellen + afmaken<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_140_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Frame opstellen + afmaken'  id='choice_9_140_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_140_2' id='label_9_140_2' class='gform-field-label gform-field-label--type-inline'>Frame opstellen + afmaken<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_140_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Frame in 1x klaar'  id='choice_9_140_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_140_3' id='label_9_140_3' class='gform-field-label gform-field-label--type-inline'>Frame in 1x klaar<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_140_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_140' type='radio' value='Kaal frame'  id='choice_9_140_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_140_4' id='label_9_140_4' class='gform-field-label gform-field-label--type-inline'>Kaal frame<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_141\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_141'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_141' id='input_9_141' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_212\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Frame prothese onder<\/h3><\/div><div id=\"field_9_142\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Frame prothese onder<\/div><div id=\"field_9_135\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_135'>Aantal immediaat elementen (indien van toepassing)<\/label><div class='ginput_container ginput_container_text'><input name='input_135' id='input_9_135' type='text' value='' class='large'    placeholder='Aantal immediaat elementen (indien van toepassing)'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_136\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_136'>Totaal aantal elementen (inclusief evt. immediaat elementen)<\/label><div class='ginput_container ginput_container_text'><input name='input_136' id='input_9_136' type='text' value='' class='large'    placeholder='Totaal aantal elementen (inclusief evt. immediaat elementen)'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_147\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Type<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_147'>\n\t\t\t<div class='gchoice gchoice_9_147_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_147' type='radio' value='Standaard CrCo'  id='choice_9_147_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_147_0' id='label_9_147_0' class='gform-field-label gform-field-label--type-inline'>Standaard CrCo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_147_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_147' type='radio' value='Titanium'  id='choice_9_147_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_147_1' id='label_9_147_1' class='gform-field-label gform-field-label--type-inline'>Titanium<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_147_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_147' type='radio' value='Resure'  id='choice_9_147_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_147_2' id='label_9_147_2' class='gform-field-label gform-field-label--type-inline'>Resure<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_148\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Titanium<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_148'>\n\t\t\t<div class='gchoice gchoice_9_148_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_148' type='radio' value='Wit anker'  id='choice_9_148_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_148_0' id='label_9_148_0' class='gform-field-label gform-field-label--type-inline'>Wit anker<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_148_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_148' type='radio' value='Vergulden'  id='choice_9_148_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_148_1' id='label_9_148_1' class='gform-field-label gform-field-label--type-inline'>Vergulden<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_148_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_148' type='radio' value='Ticoniseren'  id='choice_9_148_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_148_2' id='label_9_148_2' class='gform-field-label gform-field-label--type-inline'>Ticoniseren<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_149\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Resure<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_149'>\n\t\t\t<div class='gchoice gchoice_9_149_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_149' type='radio' value='Transparant klammer'  id='choice_9_149_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_149_0' id='label_9_149_0' class='gform-field-label gform-field-label--type-inline'>Transparant klammer<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_149_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_149' type='radio' value='Tandkleurige klammer'  id='choice_9_149_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_149_1' id='label_9_149_1' class='gform-field-label gform-field-label--type-inline'>Tandkleurige klammer<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_150\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Gewenst productieverloop<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_150'>\n\t\t\t<div class='gchoice gchoice_9_150_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_150' type='radio' value='Lepel, frame met waswal opstellen + afmaken'  id='choice_9_150_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_150_0' id='label_9_150_0' class='gform-field-label gform-field-label--type-inline'>Lepel, frame met waswal opstellen + afmaken<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_150_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_150' type='radio' value='Frame met waswal opstellen + afmaken'  id='choice_9_150_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_150_1' id='label_9_150_1' class='gform-field-label gform-field-label--type-inline'>Frame met waswal opstellen + afmaken<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_150_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_150' type='radio' value='Frame opstellen + afmaken'  id='choice_9_150_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_150_2' id='label_9_150_2' class='gform-field-label gform-field-label--type-inline'>Frame opstellen + afmaken<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_150_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_150' type='radio' value='Frame in 1x klaar'  id='choice_9_150_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_150_3' id='label_9_150_3' class='gform-field-label gform-field-label--type-inline'>Frame in 1x klaar<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_150_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_150' type='radio' value='Kaal frame'  id='choice_9_150_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_150_4' id='label_9_150_4' class='gform-field-label gform-field-label--type-inline'>Kaal frame<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_151\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_151'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_151' id='input_9_151' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_152' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_9_152' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_13' class='gform_page' data-js='page-field-id-152' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_13' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_9_213\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Implantologie<\/h3><\/div><div id=\"field_9_153\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Implantologie<\/div><div id=\"field_9_155\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_155'>Locatie van het implantaat<\/label><div class='ginput_container ginput_container_text'><input name='input_155' id='input_9_155' type='text' value='' class='large'    placeholder='Locatie van het implantaat'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_157\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_157'>Merk van het implantaat<\/label><div class='ginput_container ginput_container_text'><input name='input_157' id='input_9_157' type='text' value='' class='large'    placeholder='Merk van het implantaat'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_158\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_158'>Aantal implantaten<\/label><div class='ginput_container ginput_container_text'><input name='input_158' id='input_9_158' type='text' value='' class='large'    placeholder='Aantal implantaten'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_159\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Wenst u afdrukstiften?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_159'>\n\t\t\t<div class='gchoice gchoice_9_159_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_159' type='radio' value='Ja'  id='choice_9_159_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_159_0' id='label_9_159_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_159_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_159' type='radio' value='Nee'  id='choice_9_159_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_159_1' id='label_9_159_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_160\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Individuele lepel?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_160'>\n\t\t\t<div class='gchoice gchoice_9_160_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_160' type='radio' value='Ja, open lepel'  id='choice_9_160_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_160_0' id='label_9_160_0' class='gform-field-label gform-field-label--type-inline'>Ja, open lepel<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_160_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_160' type='radio' value='Ja, gesloten lepel'  id='choice_9_160_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_160_1' id='label_9_160_1' class='gform-field-label gform-field-label--type-inline'>Ja, gesloten lepel<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_160_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_160' type='radio' value='Nee'  id='choice_9_160_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_160_2' id='label_9_160_2' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_161\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Soort abutment<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_161'>\n\t\t\t<div class='gchoice gchoice_9_161_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_161' type='radio' value='Keramisch abutment'  id='choice_9_161_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_161_0' id='label_9_161_0' class='gform-field-label gform-field-label--type-inline'>Keramisch abutment<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_161_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_161' type='radio' value='Titanium abutment'  id='choice_9_161_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_161_1' id='label_9_161_1' class='gform-field-label gform-field-label--type-inline'>Titanium abutment<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_162\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Wilt u naast een begroting met orginele onderdelen ook een begroting als het mogelijk is met een goedkoper alternatief?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_162'>\n\t\t\t<div class='gchoice gchoice_9_162_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_162' type='radio' value='Ja'  id='choice_9_162_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_162_0' id='label_9_162_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_162_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_162' type='radio' value='Nee'  id='choice_9_162_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_162_1' id='label_9_162_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_163\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Ik wil een offerte voor<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_163'><div class='gchoice gchoice_9_163_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_163.1' type='checkbox'  value='Implantaat kroon'  id='choice_9_163_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_163_1' id='label_9_163_1' class='gform-field-label gform-field-label--type-inline'>Implantaat kroon<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_163_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_163.2' type='checkbox'  value='Implantaat brug'  id='choice_9_163_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_163_2' id='label_9_163_2' class='gform-field-label gform-field-label--type-inline'>Implantaat brug<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_163_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_163.3' type='checkbox'  value='Volledige implantaat prothese'  id='choice_9_163_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_163_3' id='label_9_163_3' class='gform-field-label gform-field-label--type-inline'>Volledige implantaat prothese<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_214\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Implantaat kroon<\/h3><\/div><div id=\"field_9_164\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Implantaat kroon<\/div><fieldset id=\"field_9_165\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Type<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_165'>\n\t\t\t<div class='gchoice gchoice_9_165_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_165' type='radio' value='Volledig metaal'  id='choice_9_165_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_165_0' id='label_9_165_0' class='gform-field-label gform-field-label--type-inline'>Volledig metaal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_165_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_165' type='radio' value='Metaal porselein'  id='choice_9_165_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_165_1' id='label_9_165_1' class='gform-field-label gform-field-label--type-inline'>Metaal porselein<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_165_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_165' type='radio' value='Metaalvrij'  id='choice_9_165_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_165_2' id='label_9_165_2' class='gform-field-label gform-field-label--type-inline'>Metaalvrij<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_166\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Volledig metaal<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_166'>\n\t\t\t<div class='gchoice gchoice_9_166_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_166' type='radio' value='Goud\/geel'  id='choice_9_166_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_166_0' id='label_9_166_0' class='gform-field-label gform-field-label--type-inline'>Goud\/geel<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_166_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_166' type='radio' value='Spaarlegering'  id='choice_9_166_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_166_1' id='label_9_166_1' class='gform-field-label gform-field-label--type-inline'>Spaarlegering<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_166_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_166' type='radio' value='Titanium'  id='choice_9_166_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_166_2' id='label_9_166_2' class='gform-field-label gform-field-label--type-inline'>Titanium<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_166_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_166' type='radio' value='Onedel'  id='choice_9_166_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_166_3' id='label_9_166_3' class='gform-field-label gform-field-label--type-inline'>Onedel<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_167\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Metaal porselein<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_167'>\n\t\t\t<div class='gchoice gchoice_9_167_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_167' type='radio' value='Goud\/geel'  id='choice_9_167_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_167_0' id='label_9_167_0' class='gform-field-label gform-field-label--type-inline'>Goud\/geel<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_167_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_167' type='radio' value='Spaarlegering'  id='choice_9_167_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_167_1' id='label_9_167_1' class='gform-field-label gform-field-label--type-inline'>Spaarlegering<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_167_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_167' type='radio' value='Titanium'  id='choice_9_167_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_167_2' id='label_9_167_2' class='gform-field-label gform-field-label--type-inline'>Titanium<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_167_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_167' type='radio' value='Onedel'  id='choice_9_167_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_167_3' id='label_9_167_3' class='gform-field-label gform-field-label--type-inline'>Onedel<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_168\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Metaalvrij<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_168'>\n\t\t\t<div class='gchoice gchoice_9_168_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_168' type='radio' value='Forma\u00ae'  id='choice_9_168_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_168_0' id='label_9_168_0' class='gform-field-label gform-field-label--type-inline'>Forma\u00ae<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_168_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_168' type='radio' value='MonoZir\u00ae'  id='choice_9_168_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_168_1' id='label_9_168_1' class='gform-field-label gform-field-label--type-inline'>MonoZir\u00ae<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_168_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_168' type='radio' value='Ander materiaal'  id='choice_9_168_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_168_2' id='label_9_168_2' class='gform-field-label gform-field-label--type-inline'>Ander materiaal<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_169\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_169'>Ander materiaal<\/label><div class='ginput_container ginput_container_text'><input name='input_169' id='input_9_169' type='text' value='' class='large'    placeholder='Ander materiaal'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_170\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Verschroefd of gecementeerd<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_170'>\n\t\t\t<div class='gchoice gchoice_9_170_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_170' type='radio' value='Verschroefd'  id='choice_9_170_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_170_0' id='label_9_170_0' class='gform-field-label gform-field-label--type-inline'>Verschroefd<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_170_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_170' type='radio' value='Gecementeerd'  id='choice_9_170_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_170_1' id='label_9_170_1' class='gform-field-label gform-field-label--type-inline'>Gecementeerd<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_172\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_172'>Levert u zelf implantaatonderdelen en zoja, welke?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_172' id='input_9_172' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_173\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_173'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_173' id='input_9_173' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_215\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Implantaat brug<\/h3><\/div><div id=\"field_9_174\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Implantaat brug<\/div><div id=\"field_9_175\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_175'>Aantal elementen (implantaten + dummies)<\/label><div class='ginput_container ginput_container_text'><input name='input_175' id='input_9_175' type='text' value='' class='large'    placeholder='Aantal elementen (implantaten + dummies)'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_176\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Type<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_176'>\n\t\t\t<div class='gchoice gchoice_9_176_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_176' type='radio' value='Volledig metaal'  id='choice_9_176_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_176_0' id='label_9_176_0' class='gform-field-label gform-field-label--type-inline'>Volledig metaal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_176_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_176' type='radio' value='Metaal porselein'  id='choice_9_176_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_176_1' id='label_9_176_1' class='gform-field-label gform-field-label--type-inline'>Metaal porselein<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_176_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_176' type='radio' value='Metaalvrij'  id='choice_9_176_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_176_2' id='label_9_176_2' class='gform-field-label gform-field-label--type-inline'>Metaalvrij<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_177\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Volledig metaal<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_177'>\n\t\t\t<div class='gchoice gchoice_9_177_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_177' type='radio' value='Goud\/geel'  id='choice_9_177_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_177_0' id='label_9_177_0' class='gform-field-label gform-field-label--type-inline'>Goud\/geel<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_177_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_177' type='radio' value='Spaarlegering'  id='choice_9_177_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_177_1' id='label_9_177_1' class='gform-field-label gform-field-label--type-inline'>Spaarlegering<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_177_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_177' type='radio' value='Titanium'  id='choice_9_177_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_177_2' id='label_9_177_2' class='gform-field-label gform-field-label--type-inline'>Titanium<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_177_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_177' type='radio' value='Onedel'  id='choice_9_177_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_177_3' id='label_9_177_3' class='gform-field-label gform-field-label--type-inline'>Onedel<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_179\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Metaal porselein<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_179'>\n\t\t\t<div class='gchoice gchoice_9_179_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_179' type='radio' value='Goud\/geel'  id='choice_9_179_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_179_0' id='label_9_179_0' class='gform-field-label gform-field-label--type-inline'>Goud\/geel<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_179_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_179' type='radio' value='Spaarlegering'  id='choice_9_179_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_179_1' id='label_9_179_1' class='gform-field-label gform-field-label--type-inline'>Spaarlegering<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_179_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_179' type='radio' value='Titanium'  id='choice_9_179_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_179_2' id='label_9_179_2' class='gform-field-label gform-field-label--type-inline'>Titanium<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_179_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_179' type='radio' value='Onedel'  id='choice_9_179_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_179_3' id='label_9_179_3' class='gform-field-label gform-field-label--type-inline'>Onedel<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_180\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Metaalvrij<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_180'>\n\t\t\t<div class='gchoice gchoice_9_180_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_180' type='radio' value='Forma\u00ae'  id='choice_9_180_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_180_0' id='label_9_180_0' class='gform-field-label gform-field-label--type-inline'>Forma\u00ae<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_180_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_180' type='radio' value='MonoZir\u00ae'  id='choice_9_180_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_180_1' id='label_9_180_1' class='gform-field-label gform-field-label--type-inline'>MonoZir\u00ae<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_180_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_180' type='radio' value='Ander materiaal'  id='choice_9_180_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_180_2' id='label_9_180_2' class='gform-field-label gform-field-label--type-inline'>Ander materiaal<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_181\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_181'>Ander materiaal<\/label><div class='ginput_container ginput_container_text'><input name='input_181' id='input_9_181' type='text' value='' class='large'    placeholder='Ander materiaal'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_178\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Verschroefd of gecementeerd<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_178'>\n\t\t\t<div class='gchoice gchoice_9_178_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_178' type='radio' value='Verschroefd'  id='choice_9_178_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_178_0' id='label_9_178_0' class='gform-field-label gform-field-label--type-inline'>Verschroefd<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_178_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_178' type='radio' value='Gecementeerd'  id='choice_9_178_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_178_1' id='label_9_178_1' class='gform-field-label gform-field-label--type-inline'>Gecementeerd<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_182\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_182'>Levert u zelf implantaatonderdelen en zoja, welke?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_182' id='input_9_182' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_183\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_183'>Opmerking \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_183' id='input_9_183' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_216\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Volledige implantaat prothese<\/h3><\/div><div id=\"field_9_184\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Volledige implantaat prothese<\/div><fieldset id=\"field_9_185\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Boven of onder?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_185'>\n\t\t\t<div class='gchoice gchoice_9_185_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_185' type='radio' value='Boven'  id='choice_9_185_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_185_0' id='label_9_185_0' class='gform-field-label gform-field-label--type-inline'>Boven<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_185_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_185' type='radio' value='Onder'  id='choice_9_185_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_185_1' id='label_9_185_1' class='gform-field-label gform-field-label--type-inline'>Onder<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_186\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Type<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_186'>\n\t\t\t<div class='gchoice gchoice_9_186_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_186' type='radio' value='Drukknop'  id='choice_9_186_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_186_0' id='label_9_186_0' class='gform-field-label gform-field-label--type-inline'>Drukknop<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_186_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_186' type='radio' value='Locator'  id='choice_9_186_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_186_1' id='label_9_186_1' class='gform-field-label gform-field-label--type-inline'>Locator<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_186_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_186' type='radio' value='Hybride'  id='choice_9_186_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_186_2' id='label_9_186_2' class='gform-field-label gform-field-label--type-inline'>Hybride<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_186_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_186' type='radio' value='Forma\u00ae steg'  id='choice_9_186_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_186_3' id='label_9_186_3' class='gform-field-label gform-field-label--type-inline'>Forma\u00ae steg<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_186_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_186' type='radio' value='Anders'  id='choice_9_186_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_186_4' id='label_9_186_4' class='gform-field-label gform-field-label--type-inline'>Anders<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_187\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Distale extenties?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_187'>\n\t\t\t<div class='gchoice gchoice_9_187_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_187' type='radio' value='Ja'  id='choice_9_187_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_187_0' id='label_9_187_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_187_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_187' type='radio' value='Nee'  id='choice_9_187_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_187_1' id='label_9_187_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_189\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_189'>Anders<\/label><div class='ginput_container ginput_container_text'><input name='input_189' id='input_9_189' type='text' value='' class='large'    placeholder='Anders'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_190\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Gewenst productieverloop<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_190'>\n\t\t\t<div class='gchoice gchoice_9_190_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_190' type='radio' value='Alle stappen Internationale productie'  id='choice_9_190_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_190_0' id='label_9_190_0' class='gform-field-label gform-field-label--type-inline'>Alle stappen Internationale productie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_190_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_190' type='radio' value='Lepel + beetplaat Lab NL, opstellen + afmaken Internationale productie'  id='choice_9_190_1' 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gform-field-label' for='input_9_192'>Levert u zelf implantaatonderdelen en zoja, welke?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_192' id='input_9_192' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_191\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_191'>Opmerkingen \/ wensen<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_191' id='input_9_191' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_193' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_9_193' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_14' class='gform_page' data-js='page-field-id-193' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_14' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_9_217\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Dit veld is verborgen bij het bekijken van het formulier\"><\/i><span>Dit veld is verborgen bij het bekijken van het formulier<\/span><\/div><h3 class=\"gsection_title\">Diverse<\/h3><\/div><div id=\"field_9_194\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_194'>Hier kunt u invullen wat u begroot wilt hebben. Graag zo volledig mogelijk.<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_194' id='input_9_194' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_224' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_9_224' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Review &amp; Submit'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_15' class='gform_page gform_review_page ' data-js='page-field-id-224' 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