{"id":59631,"date":"2026-05-20T12:40:56","date_gmt":"2026-05-20T10:40:56","guid":{"rendered":"https:\/\/dentaleyepad.de\/ruecksende-formular\/"},"modified":"2026-11-06T12:28:00","modified_gmt":"2026-11-06T11:28:00","slug":"ruecksende-formular","status":"publish","type":"page","link":"https:\/\/dentaleyepad.de\/nl\/ruecksende-formular\/","title":{"rendered":"Retourformulier"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"59631\" class=\"elementor elementor-59631 elementor-59268\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5869bd70 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5869bd70\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-14bf04b8\" data-id=\"14bf04b8\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1b5a788c elementor-widget elementor-widget-heading\" data-id=\"1b5a788c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Retour- en reparatieformulier<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-234ff2e3 elementor-widget elementor-widget-text-editor\" data-id=\"234ff2e3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Vul het formulier volledig in,<br\/>zodat we je retourzending zo snel mogelijk kunnen verwerken.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-10edb4ab elementor-section-content-middle contact-mobile-adjust elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"10edb4ab\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2e1f20d5\" data-id=\"2e1f20d5\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-284bd4a1 elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"284bd4a1\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-64aec6bf\" data-id=\"64aec6bf\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-cddfdfe ruecksende-form form-max-width el-form-adjust form-newsletter elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"cddfdfe\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Verder&quot;,&quot;step_previous_label&quot;:&quot;Terug&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"R\u00fccksende- &amp; Reparaturformular\" aria-label=\"R\u00fccksende- &amp; Reparaturformular\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"59631\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"cddfdfe\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"dentaleyepad\" \/>\n\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-field_ff93451 elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"\" data-previousButton=\"\" data-nextButton=\"\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_acf9f1b elementor-col-100\">\n\t\t\t\t\t<h3 class=\"de-form-section\">Wat zou je willen teruggeven?<\/h3>\n<p style=\"margin-top:10px;\"><strong>Wil je een <span style=\"font-family: 'roboto condensed';\">dental<strong><span style=\"color: #0094d0; font-family: 'roboto condensed';\"><em style=\"font-weight: 600;\">eye<\/em><\/span>pad<\/strong><\/span> of een ander product retourneren?<\/strong>\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-dep_or_andere elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-dep_or_andere\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tdep-selectie-overig\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup de-section-header \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"dentaleyepad\" id=\"form-field-dep_or_andere-0\" name=\"form_fields[dep_or_andere]\" required=\"required\"> <label for=\"form-field-dep_or_andere-0\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2026\/05\/dep-radio-2.png\" alt=\"Tandheelkundig ooglid\"><\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"andere\" id=\"form-field-dep_or_andere-1\" name=\"form_fields[dep_or_andere]\" required=\"required\"> <label for=\"form-field-dep_or_andere-1\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2026\/05\/andere-radio-2-nl.png\" alt=\"Tandheelkundig ooglid\"\/><\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-field_36d119c elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"\" data-previousButton=\"\" data-nextButton=\"\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_721f548 elementor-col-100\">\n\t\t\t\t\t<h3 class=\"de-form-section\">Voer hier je serienummer en de postcode van aankoop in.<\/h3>\n<p style=\"margin-top:10px;\"><strong>Voor <span style=\"font-family: 'roboto condensed';\">dental<strong><span style=\"color: #0094d0; font-family: 'roboto condensed';\"><em style=\"font-weight: 600;\">eye<\/em><\/span>pad<\/strong><\/span> retouren:<\/strong>\nVoer hier het serienummer en de postcode in om uw klantgegevens automatisch te laden.\n\n<br><br>\n<strong>Hier vindt u het serienummer:<\/strong>\n<br><br>\n<img decoding=\"async\" style=\"max-width:200px\" src=\"\/wp-content\/uploads\/2022\/12\/dentaleyepad-seriennummer-einrichten.png\" alt=\"Dentaleyepad\" >\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-dep_seriennummer elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-dep_seriennummer\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tSerienummer\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[dep_seriennummer]\" id=\"form-field-dep_seriennummer\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Serienummer\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-dep_plz elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-dep_plz\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tPostcode\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[dep_plz]\" id=\"form-field-dep_plz\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Postcode\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-step elementor-field-group elementor-column elementor-field-group-field_f570ccc elementor-col-100\">\n\t\t\t\t\t\t\t<div class=\"e-field-step elementor-hidden\" data-label=\"\" data-previousButton=\"\" data-nextButton=\"\" data-iconUrl=\"\" data-iconLibrary=\"fas fa-star\" data-icon=\"\" ><\/div>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-ruecksende_nr elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-ruecksende_nr\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tR\u00dc-nummer\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[ruecksende_nr]\" id=\"form-field-ruecksende_nr\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Retournummer\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-datum elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-datum\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tDatum\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[datum]\" id=\"form-field-datum\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Datum\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_d656047 elementor-col-100\">\n\t\t\t\t\t<h3 class=\"de-form-section\">Afleveradres<\/h3>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-liefer_praxisname elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-liefer_praxisname\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tNaam praktijk\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[liefer_praxisname]\" id=\"form-field-liefer_praxisname\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Naam praktijk\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-liefer_vorname elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-liefer_vorname\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tVoornaam\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[liefer_vorname]\" id=\"form-field-liefer_vorname\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Voornaam\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-liefer_name elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-liefer_name\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tNaam\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[liefer_name]\" id=\"form-field-liefer_name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Naam\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-liefer_strasse elementor-col-75 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-liefer_strasse\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tStraat\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[liefer_strasse]\" id=\"form-field-liefer_strasse\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Straat\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-liefer_hausnummer elementor-col-25 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-liefer_hausnummer\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tHuisnr.\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[liefer_hausnummer]\" id=\"form-field-liefer_hausnummer\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Huisnr.\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-liefer_adresszusatz elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-liefer_adresszusatz\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tAdrestoevoeging\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[liefer_adresszusatz]\" id=\"form-field-liefer_adresszusatz\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Adrestoevoeging (bijv. verdieping, bus, gebouw, t.a.v.)\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-liefer_plz elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-liefer_plz\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tPostcode\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[liefer_plz]\" id=\"form-field-liefer_plz\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Postcode\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-liefer_ort elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-liefer_ort\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tPlaats\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[liefer_ort]\" id=\"form-field-liefer_ort\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Plaats\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-liefer_land_iso elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-liefer_land_iso\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tLand\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-caret-down\"><\/i>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[liefer_land_iso]\" id=\"form-field-liefer_land_iso\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"\">Selecteer<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"DE\">Duitsland<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"AT\">Oostenrijk<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"CH\">Zwitserland<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"BE\">Belgi\u00eb<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"BG\">Bulgarije<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"DK\">Denemarken<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"EE\">Estland<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"FI\">Finland<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"FR\">Frankrijk<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"GR\">Griekenland<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"IE\">Ierland<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"IT\">Itali\u00eb<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"HR\">Kroati\u00eb<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"LV\">Letland<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"LT\">Litouwen<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"LU\">Luxemburg<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"MT\">Malta<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"NL\">Nederland<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"NO\">Noorwegen<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"PL\">Polen<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"PT\">Portugal<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"RO\">Roemeni\u00eb<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"SE\">Zweden<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"SK\">Slowakije<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"SI\">Sloveni\u00eb<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"ES\">Spanje<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"CZ\">Tsjechi\u00eb<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"HU\">Hongarije<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"CY\">Cyprus<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"GB\">Verenigd Koninkrijk<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-liefer_telefon elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-liefer_telefon\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tTelefoon\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[liefer_telefon]\" id=\"form-field-liefer_telefon\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Telefoon\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-liefer_email elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-liefer_email\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\te-mail\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[liefer_email]\" id=\"form-field-liefer_email\" class=\"elementor-field elementor-size-sm de-email-field elementor-field-textual\" placeholder=\"e-mail\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_d244f94 elementor-col-100\">\n\t\t\t\t\t<h3 class=\"de-form-section\">Factuuradres<\/h3>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-rechnung_praxisname elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-rechnung_praxisname\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tNaam praktijk\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[rechnung_praxisname]\" id=\"form-field-rechnung_praxisname\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Naam praktijk\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-rechnung_vorname elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-rechnung_vorname\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tVoornaam\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[rechnung_vorname]\" id=\"form-field-rechnung_vorname\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Voornaam\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-rechnung_name elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-rechnung_name\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tNaam\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[rechnung_name]\" id=\"form-field-rechnung_name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Naam\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-rechnung_strasse elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-rechnung_strasse\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tStraat\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[rechnung_strasse]\" id=\"form-field-rechnung_strasse\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Straat\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-rechnung_plz elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-rechnung_plz\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tPostcode\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[rechnung_plz]\" id=\"form-field-rechnung_plz\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Postcode\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-rechnung_ort elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-rechnung_ort\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tLocatie\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[rechnung_ort]\" id=\"form-field-rechnung_ort\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Plaats\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-rechnung_telefon elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-rechnung_telefon\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tTelefoon\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[rechnung_telefon]\" id=\"form-field-rechnung_telefon\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Telefoon\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-rechnung_email elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-rechnung_email\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\te-mail\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[rechnung_email]\" id=\"form-field-rechnung_email\" class=\"elementor-field elementor-size-sm de-email-field elementor-field-textual\" placeholder=\"e-mail\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_03d1b06 elementor-col-100\">\n\t\t\t\t\t<h3 class=\"de-form-section\">Contactpersoon<\/h3>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-liefer_ansprechpartner elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-liefer_ansprechpartner\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tContactpersoon\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[liefer_ansprechpartner]\" id=\"form-field-liefer_ansprechpartner\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Contactpersoon\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-ansprechpartner_email elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-ansprechpartner_email\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tContactpersoon e-mail\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[ansprechpartner_email]\" id=\"form-field-ansprechpartner_email\" class=\"elementor-field elementor-size-sm de-email-field elementor-field-textual\" placeholder=\"e-mail\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_2ce299a elementor-col-100\">\n\t\t\t\t\t<h3 class=\"de-form-section\">Artikel beschrijving<\/h3>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-artikelbeschreibung elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-artikelbeschreibung\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tItem beschrijving \/ retourneren\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[artikelbeschreibung]\" id=\"form-field-artikelbeschreibung\" rows=\"3\" placeholder=\"Item beschrijving \/ retourneren\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_seriennummer elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_seriennummer\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tSerienummer\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_seriennummer]\" id=\"form-field-field_seriennummer\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Serienummer\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-kaufdatum elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-kaufdatum\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tAankoopdatum\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[kaufdatum]\" id=\"form-field-kaufdatum\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Aankoopdatum\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-kunden_nr elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-kunden_nr\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tKlantnr.\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[kunden_nr]\" id=\"form-field-kunden_nr\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Klantnr.\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-sec_fehler elementor-col-100\">\n\t\t\t\t\t<h3 class=\"de-form-section\">Foutbeschrijving \/ Reden van retourzending<\/h3>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-fehlerbeschreibung elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-fehlerbeschreibung\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tFoutbeschrijving\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[fehlerbeschreibung]\" id=\"form-field-fehlerbeschreibung\" rows=\"5\" placeholder=\"Beschrijf de fout \/ reden van retourzending zo nauwkeurig mogelijk\u2026\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-sec_abwicklung elementor-col-100\">\n\t\t\t\t\t<h3 class=\"de-form-section\">Gewenste verwerking<\/h3>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-abwicklung elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-abwicklung\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tGewenste verwerking\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup de-checkbox-list \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Reparatur\" id=\"form-field-abwicklung-0\" name=\"form_fields[abwicklung][]\"> <label for=\"form-field-abwicklung-0\">Reparatie<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Kostenvoranschlag\" id=\"form-field-abwicklung-1\" name=\"form_fields[abwicklung][]\"> <label for=\"form-field-abwicklung-1\">Kostenraming<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"UPGRADE-Angebot (Alt gegen Neu)\" id=\"form-field-abwicklung-2\" name=\"form_fields[abwicklung][]\"> <label for=\"form-field-abwicklung-2\">UPGRADE-aanbieding (oud voor nieuw)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Gutschrift\" id=\"form-field-abwicklung-3\" name=\"form_fields[abwicklung][]\"> <label for=\"form-field-abwicklung-3\">Kredietnota<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Umtausch\" id=\"form-field-abwicklung-4\" name=\"form_fields[abwicklung][]\"> <label for=\"form-field-abwicklung-4\">Ruilen<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Sonstige\" id=\"form-field-abwicklung-5\" name=\"form_fields[abwicklung][]\"> <label for=\"form-field-abwicklung-5\">Andere<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-sonstige_text elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-sonstige_text\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tAnders (beschrijf)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[sonstige_text]\" id=\"form-field-sonstige_text\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Anders (beschrijf)\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-sec_mitteilung elementor-col-100\">\n\t\t\t\t\t<h3 class=\"de-form-section\">Bericht aan het doctorseyes team<\/h3>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-mitteilung elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-mitteilung\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tCommunicatie\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[mitteilung]\" id=\"form-field-mitteilung\" rows=\"5\" placeholder=\"Uw bericht aan ons team...\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-datenschutz elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-datenschutz\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tGegevensbescherming\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[datenschutz]\" id=\"form-field-datenschutz\" class=\"elementor-field elementor-size-sm  elementor-acceptance-field\" required=\"required\">\n\t\t\t\t<label for=\"form-field-datenschutz\"><div class=\"\">Ik heb het <a href=\"\/nl\/impressum\/#datenschutz\" target=\"_blank\">privacybeleid<\/a> gelezen en ga akkoord met de verwerking van mijn gegevens voor het verwerken van de retourzending.<\/div><\/label>\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-hidden elementor-field-group elementor-column elementor-field-group-rechnung_abweichend elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"hidden\" name=\"form_fields[rechnung_abweichend]\" id=\"form-field-rechnung_abweichend\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" value=\"nein\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-hidden elementor-field-group elementor-column elementor-field-group-lang elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"hidden\" name=\"form_fields[lang]\" id=\"form-field-lang\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" value=\"nl\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_52132e2 elementor-col-100\">\n\t\t\t\t\t<p class=\"boxing-paragraph\" style=\"font-family: Roboto Condensed, Sans-serif;font-size: 24px;font-weight: 400;color: #333333;\">Stuur de dentaleyepad <strong>indien mogelijk in de originele transportdoos<\/strong> retour. Mocht u deze niet meer hebben, zorg dan voor een <strong>voldoende veilige en schokbestendige verpakking<\/strong>. <br>Wij zijn niet aansprakelijk voor schade die tijdens de retourzending ontstaat door onvoldoende of onjuiste verpakking.<br><br>\nAls VIP-klant, of indien uw apparaat zich nog binnen de garantieperiode bevindt, sturen wij u automatisch een gratis retourlabel.\n<br><br><strong>Gelieve op te sturen naar:<\/strong>\n<br>doctorseyes GmbH <br>\nTechnischer Service <br>\nAbteistr. 28<br>\n88416 Ochsenhausen<br> <\/p>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-md\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Formulier afdrukken<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<input type='hidden' name='lang' value='nl' \/><\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Retour- en reparatieformulier Vul het formulier volledig in,zodat we je retourzending zo snel mogelijk kunnen verwerken.<\/p>\n","protected":false},"author":119,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-59631","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.8 - 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