{"id":272,"date":"2025-08-04T09:52:12","date_gmt":"2025-08-04T09:52:12","guid":{"rendered":"https:\/\/byflowell.com\/?page_id=272"},"modified":"2025-08-04T10:10:19","modified_gmt":"2025-08-04T10:10:19","slug":"elementor-272","status":"publish","type":"page","link":"https:\/\/byflowell.com\/en\/elementor-272\/","title":{"rendered":"Elementor #272"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"272\" class=\"elementor elementor-272\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7db60ff e-flex e-con-boxed e-con e-parent\" data-id=\"7db60ff\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-cd57e0b e-flex e-con-boxed e-con e-parent\" data-id=\"cd57e0b\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-fcb47a6 elementor-widget elementor-widget-shortcode\" data-id=\"fcb47a6\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-shortcode\">\n<style>\n  :root { --primary-color:#0073aa; --primary-color-dark:#005a87; --text-color:#333; --bg-color:#fff; --border-radius:6px; }\n  #anamnesis-form { max-width:700px; margin:40px auto; padding:30px; background:var(--bg-color); box-shadow:0 4px 12px rgba(0,0,0,0.1); border-radius:var(--border-radius); font-family:Arial,sans-serif; color:var(--text-color); }\n  .progress-container { position:relative; margin-bottom:30px; display:flex; justify-content:space-between; }\n  .progress-container::before { content:''; position:absolute; top:50%; left:5%; right:5%; height:4px; background:#e0e0e0; transform:translateY(-50%); z-index:0; }\n  .progress-step { position:relative; z-index:1; width:30px; height:30px; background:var(--bg-color); border:2px solid #e0e0e0; border-radius:50%; display:flex; align-items:center; justify-content:center; font-size:.9em; color:#999; transition:all .3s; }\n  .progress-step.active { border-color:#494B3F; background:#494B3F; color:#fff; }\n  .form-step { display:none; animation:fadeEffect .5s ease; }\n  .form-step.active { display:block; }\n  @keyframes fadeEffect { from{opacity:0;} to{opacity:1;} }\n  .form-step h2 { margin-bottom:.5em; font-size:1.2em; color:var(--primary-color); }\n  .form-step label { display:block; margin:1em 0 .3em; font-weight:bold; }\n  .form-step input[type=\"text\"], .form-step input[type=\"email\"], .form-step input[type=\"date\"], .form-step textarea { width:100%; border:1px solid #ccc; border-radius:var(--border-radius); padding:8px 10px; font-size:1em; }\n  .form-step textarea { min-height:60px; }\n  .button-group { margin-top:20px; display:flex; justify-content:space-between; gap:10px; }\n  .btn { padding:10px 20px; font-size:1em; border:none; border-radius:var(--border-radius); cursor:pointer; background:#494B3F; color:#fff; transition:background .2s ease; }\n  .btn:hover { background:var(--primary-color-dark); }\n  .btn-prev { background:#ccc; color:#333; }\n  .btn-prev:hover { background:#bbb; }\n<\/style>\n\n<form id=\"anamnesis-form\" action=\"https:\/\/byflowell.com\/wp-admin\/admin-post.php\" method=\"post\" novalidate>\n  <input type=\"hidden\" name=\"action\" value=\"anamnesis_form_submit\" \/>\n  <input type=\"hidden\" id=\"anamnesis_nonce_field\" name=\"anamnesis_nonce_field\" value=\"228a037318\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/en\/wp-json\/wp\/v2\/pages\/272\" \/>\n\n  <div class=\"progress-container\">\n    <div class=\"progress-step active\" data-step=\"1\">1<\/div>\n    <div class=\"progress-step\" data-step=\"2\">2<\/div>\n    <div class=\"progress-step\" data-step=\"3\">3<\/div>\n    <div class=\"progress-step\" data-step=\"4\">4<\/div>\n    <div class=\"progress-step\" data-step=\"5\">5<\/div>\n    <div class=\"progress-step\" data-step=\"6\">6<\/div>\n    <div class=\"progress-step\" data-step=\"7\">7<\/div>\n  <\/div>\n\n  <!-- STEP 1 -->\n  <div class=\"form-step active\">\n    <h2>1. Identificatie cli\u00ebnt<\/h2>\n    <label for=\"client_name\">Naam cli\u00ebnt<\/label>\n    <input id=\"client_name\" name=\"client_name\" required type=\"text\" \/>\n    <label for=\"client_email\">E-mail cli\u00ebnt<\/label>\n    <input id=\"client_email\" name=\"client_email\" required type=\"email\" \/>\n    <label for=\"client_address\">Adres cli\u00ebnt<\/label>\n    <input id=\"client_address\" name=\"client_address\" required type=\"text\" \/>\n\n    <h2>Clientgegevens<\/h2>\n    <label for=\"name\">Naam<\/label>\n    <input id=\"name\" name=\"name\" required type=\"text\" \/>\n    <label for=\"age\">Leeftijd<\/label>\n    <input id=\"age\" name=\"age\" type=\"text\" \/>\n    <label for=\"address\">Adres<\/label>\n    <input id=\"address\" name=\"address\" type=\"text\" \/>\n    <label for=\"postal_city\">Postcode + Woonplaats<\/label>\n    <input id=\"postal_city\" name=\"postal_city\" type=\"text\" \/>\n    <label for=\"birth_date\">Geboortedatum<\/label>\n    <input id=\"birth_date\" name=\"birth_date\" type=\"date\" \/>\n    <label for=\"birth_place\">Geboorteplaats<\/label>\n    <input id=\"birth_place\" name=\"birth_place\" type=\"text\" \/>\n    <label for=\"origin\">Afkomst<\/label>\n    <input id=\"origin\" name=\"origin\" type=\"text\" \/>\n    <label for=\"phone\">Telefoon Werk\/Thuis\/Mobiel<\/label>\n    <input id=\"phone\" name=\"phone\" type=\"text\" \/>\n    <label for=\"email\">E-mail<\/label>\n    <input id=\"email\" name=\"email\" type=\"email\" \/>\n    <label for=\"referred_by\">Doorverwezen door<\/label>\n    <input id=\"referred_by\" name=\"referred_by\" type=\"text\" \/>\n    <label for=\"marital_status\">Burgerlijke staat<\/label>\n    <input id=\"marital_status\" name=\"marital_status\" type=\"text\" \/>\n    <label for=\"children_ages\">Leeftijden van kinderen<\/label>\n    <input id=\"children_ages\" name=\"children_ages\" type=\"text\" \/>\n\n    <div class=\"button-group\">\n      <button class=\"btn btn-next\" type=\"button\">Volgende<\/button>\n    <\/div>\n  <\/div>\n\n  <!-- STEP 2 -->\n  <div class=\"form-step\">\n    <h2>2. Intakevragen<\/h2>\n    <label for=\"q1\">1. Wat heeft je doen besluiten om een consult aan te vragen?<\/label>\n    <textarea id=\"q1\" name=\"q1\"><\/textarea>\n    <label for=\"q2\">2. Hoe voel je je momenteel?<\/label>\n    <textarea id=\"q2\" name=\"q2\"><\/textarea>\n    <label for=\"q3\">3. Hoe zou je jouw huidige gezondheidstoestand omschrijven?<\/label>\n    <textarea id=\"q3\" name=\"q3\"><\/textarea>\n    <label for=\"q4\">4. Wat zijn je doelen op het gebied van gezondheid en welzijn?<\/label>\n    <textarea id=\"q4\" name=\"q4\"><\/textarea>\n\n    <h2>Medische achtergrond<\/h2>\n    <label for=\"q5\">5. Heb je op dit moment gezondheidsklachten? Zo ja, welke?<\/label>\n    <textarea id=\"q5\" name=\"q5\"><\/textarea>\n    <label for=\"q6\">6. Gebruik je op dit moment medicatie? Zo ja, waarvoor?<\/label>\n    <textarea id=\"q6\" name=\"q6\"><\/textarea>\n    <label for=\"q7\">7. Gebruik je supplementen?<\/label>\n    <textarea id=\"q7\" name=\"q7\"><\/textarea>\n    <label for=\"q8\">8. Gebruik je andere middelen?<\/label>\n    <textarea id=\"q8\" name=\"q8\"><\/textarea>\n\n    <div class=\"button-group\">\n      <button class=\"btn btn-prev\" type=\"button\">Vorige<\/button>\n      <button class=\"btn btn-next\" type=\"button\">Volgende<\/button>\n    <\/div>\n  <\/div>\n\n  <!-- STEP 3 -->\n  <div class=\"form-step\">\n    <h2>3. Algemene Energietoestand<\/h2>\n    <label for=\"q11\">11. Heb je over het algemeen voldoende energie?<\/label>\n    <textarea id=\"q11\" name=\"q11\"><\/textarea>\n    <label for=\"q12\">12. Wanneer voel je je het meest en minst energiek?<\/label>\n    <textarea id=\"q12\" name=\"q12\"><\/textarea>\n    <label for=\"q13\">13. Word je uitgerust wakker?<\/label>\n    <textarea id=\"q13\" name=\"q13\"><\/textarea>\n    <label for=\"q14\">14. Voel je je moe na inspanning, eten of mentale activiteit?<\/label>\n    <textarea id=\"q14\" name=\"q14\"><\/textarea>\n    <label for=\"q15\">15. Is je vermoeidheid lichamelijk of mentaal?<\/label>\n    <textarea id=\"q15\" name=\"q15\"><\/textarea>\n\n    <h2>Spijsvertering &amp; Eetlust<\/h2>\n    <label for=\"q16\">16. Hoe is je eetlust?<\/label>\n    <textarea id=\"q16\" name=\"q16\"><\/textarea>\n    <label for=\"q17\">17. Voorkeur voor warm of koud eten?<\/label>\n    <textarea id=\"q17\" name=\"q17\"><\/textarea>\n    <label for=\"q18\">18. Last van een opgeblazen gevoel?<\/label>\n    <textarea id=\"q18\" name=\"q18\"><\/textarea>\n    <label for=\"q19\">19. Ontlasting: frequentie\/consistentie?<\/label>\n    <textarea id=\"q19\" name=\"q19\"><\/textarea>\n    <label for=\"q20\">20. Energie na maaltijd?<\/label>\n    <textarea id=\"q20\" name=\"q20\"><\/textarea>\n\n    <h2>Urineren &amp; Vochtbalans<\/h2>\n    <label for=\"q21\">21. Frequentie urine;<\/label>\n    <textarea id=\"q21\" name=\"q21\"><\/textarea>\n    <label for=\"q22\">22. Kleur en geur urine?<\/label>\n    <textarea id=\"q22\" name=\"q22\"><\/textarea>\n    <label for=\"q23\">23. Nachtelijk plassen?<\/label>\n    <textarea id=\"q23\" name=\"q23\"><\/textarea>\n    <label for=\"q24\">24. Vochtophopingen?<\/label>\n    <textarea id=\"q24\" name=\"q24\"><\/textarea>\n    <label for=\"q25\">25. Dorst: wanneer\/hoeveel?<\/label>\n    <textarea id=\"q25\" name=\"q25\"><\/textarea>\n\n    <div class=\"button-group\">\n      <button class=\"btn btn-prev\" type=\"button\">Vorige<\/button>\n      <button class=\"btn btn-next\" type=\"button\">Volgende<\/button>\n    <\/div>\n  <\/div>\n\n  <!-- STEP 4 -->\n  <div class=\"form-step\">\n    <h2>4. Slaapkwaliteit<\/h2>\n    <label for=\"q26\">26. Val je makkelijk in slaap?<\/label>\n    <textarea id=\"q26\" name=\"q26\"><\/textarea>\n    <label for=\"q27\">27. Word je \u2019s nachts wakker?<\/label>\n    <textarea id=\"q27\" name=\"q27\"><\/textarea>\n    <label for=\"q28\">28. Dromen?<\/label>\n    <textarea id=\"q28\" name=\"q28\"><\/textarea>\n    <label for=\"q29\">29. Voel je je uitgerust?<\/label>\n    <textarea id=\"q29\" name=\"q29\"><\/textarea>\n    <label for=\"q30\">30. Moeite om te ontspannen?<\/label>\n    <textarea id=\"q30\" name=\"q30\"><\/textarea>\n\n    <h2>Pijnklachten<\/h2>\n    <label for=\"q31\">31. Pijn of ongemak?<\/label>\n    <textarea id=\"q31\" name=\"q31\"><\/textarea>\n    <label for=\"q32\">32. Omschrijving pijn?<\/label>\n    <textarea id=\"q32\" name=\"q32\"><\/textarea>\n    <label for=\"q33\">33. Wanneer verergert?<\/label>\n    <textarea id=\"q33\" name=\"q33\"><\/textarea>\n    <label for=\"q34\">34. Be\u00efnvloed door weer\/emoties?<\/label>\n    <textarea id=\"q34\" name=\"q34\"><\/textarea>\n    <label for=\"q35\">35. Eerder klachten?<\/label>\n    <textarea id=\"q35\" name=\"q35\"><\/textarea>\n\n    <h2>Emotioneel &amp; Mentaal Welzijn<\/h2>\n    <label for=\"q36\">36. Emotioneel vlak?<\/label>\n    <textarea id=\"q36\" name=\"q36\"><\/textarea>\n    <label for=\"q37\">37. Stress of prikkelbaarheid?<\/label>\n    <textarea id=\"q37\" name=\"q37\"><\/textarea>\n    <label for=\"q38\">38. Stemmingswisselingen?<\/label>\n    <textarea id=\"q38\" name=\"q38\"><\/textarea>\n    <label for=\"q39\">39. Emoties be\u00efnvloeden lichaam?<\/label>\n    <textarea id=\"q39\" name=\"q39\"><\/textarea>\n    <label for=\"q40\">40. Innerlijke rust of spanning?<\/label>\n    <textarea id=\"q40\" name=\"q40\"><\/textarea>\n\n    <div class=\"button-group\">\n      <button class=\"btn btn-prev\" type=\"button\">Vorige<\/button>\n      <button class=\"btn btn-next\" type=\"button\">Volgende<\/button>\n    <\/div>\n  <\/div>\n\n  <!-- STEP 5 -->\n  <div class=\"form-step\">\n    <h2>5. Cyclus \/ Zwangerschap<\/h2>\n    <label for=\"q41\">41. Regelmatige menstruatie?<\/label>\n    <textarea id=\"q41\" name=\"q41\"><\/textarea>\n    <label for=\"q42\">42. Klachten rond menstruatie?<\/label>\n    <textarea id=\"q42\" name=\"q42\"><\/textarea>\n    <label for=\"q43\">43. Zwanger of recent bevallen?<\/label>\n    <textarea id=\"q43\" name=\"q43\"><\/textarea>\n    <label for=\"q44\">44. Hoe voel je je tijdens zwangerschap?<\/label>\n    <textarea id=\"q44\" name=\"q44\"><\/textarea>\n    <label for=\"q45\">45. Anticonceptie\/hormonale schommelingen?<\/label>\n    <textarea id=\"q45\" name=\"q45\"><\/textarea>\n\n    <h2>Leefstijl &amp; Gewoontes<\/h2>\n    <label for=\"q46\">46. Dagelijkse routine?<\/label>\n    <textarea id=\"q46\" name=\"q46\"><\/textarea>\n    <label for=\"q47\">47. Beweeg je regelmatig?<\/label>\n    <textarea id=\"q47\" name=\"q47\"><\/textarea>\n    <label for=\"q50\">50. Zelfzorg- of herstelmomenten?<\/label>\n    <textarea id=\"q50\" name=\"q50\"><\/textarea>\n\n    <div class=\"button-group\">\n      <button class=\"btn btn-prev\" type=\"button\">Vorige<\/button>\n      <button class=\"btn btn-next\" type=\"button\">Volgende<\/button>\n    <\/div>\n  <\/div>\n\n  <!-- STEP 6 -->\n  <div class=\"form-step\">\n    <h2>6. Voedingsanamnese<\/h2>\n    <label for=\"n1\">1. Speciaal dieet?<\/label>\n    <textarea id=\"n1\" name=\"n1\"><\/textarea>\n    <label for=\"n2\">2. Tevreden over eetpatroon?<\/label>\n    <textarea id=\"n2\" name=\"n2\"><\/textarea>\n    <label for=\"n3\">3. Kookmethode?<\/label>\n    <textarea id=\"n3\" name=\"n3\"><\/textarea>\n    <label for=\"n4a\">4a. Ontbijt<\/label>\n    <textarea id=\"n4a\" name=\"n4a\"><\/textarea>\n    <label for=\"n4b\">4b. Lunch<\/label>\n    <textarea id=\"n4b\" name=\"n4b\"><\/textarea>\n    <label for=\"n4c\">4c. Diner<\/label>\n    <textarea id=\"n4c\" name=\"n4c\"><\/textarea>\n    <label for=\"n4d\">4d. Snack<\/label>\n    <textarea id=\"n4d\" name=\"n4d\"><\/textarea>\n    <label for=\"n5\">5. Cravings?<\/label>\n    <textarea id=\"n5\" name=\"n5\"><\/textarea>\n    <label for=\"n6\">6. Favoriete voedingsmiddelen?<\/label>\n    <textarea id=\"n6\" name=\"n6\"><\/textarea>\n    <label for=\"n7\">7. Gevoel na eten?<\/label>\n    <textarea id=\"n7\" name=\"n7\"><\/textarea>\n    <label for=\"n8\">8. Slechte voeding\/veroorzaakt klachten?<\/label>\n    <textarea id=\"n8\" name=\"n8\"><\/textarea>\n    <label for=\"n9\">9. Allergie\u00ebn\/intoleranties?<\/label>\n    <textarea id=\"n9\" name=\"n9\"><\/textarea>\n\n    <div class=\"button-group\">\n      <button class=\"btn btn-prev\" type=\"button\">Vorige<\/button>\n      <button class=\"btn btn-next\" type=\"button\">Volgende<\/button>\n    <\/div>\n  <\/div>\n\n  <!-- STEP 7 -->\n  <div class=\"form-step\">\n    <h2>7. Ondertekening<\/h2>\n    <label for=\"sign_name_client\">Naam cli\u00ebnt<\/label>\n    <input id=\"sign_name_client\" name=\"sign_name_client\" required type=\"text\" \/>\n    <label for=\"sign_date_client\">Datum<\/label>\n    <input id=\"sign_date_client\" name=\"sign_date_client\" required type=\"date\" \/>\n    <label for=\"sign_name_coach\">Handtekening coach<\/label>\n    <input id=\"sign_name_coach\" name=\"sign_name_coach\" required type=\"text\" \/>\n    <label for=\"sign_date_coach\">Datum<\/label>\n    <input id=\"sign_date_coach\" name=\"sign_date_coach\" required type=\"date\" \/>\n\n    <div class=\"button-group\">\n      <button class=\"btn btn-prev\" type=\"button\">Vorige<\/button>\n      <button class=\"btn\" type=\"submit\">Verzenden<\/button>\n    <\/div>\n  <\/div>\n<\/form>\n\n<script>\n  document.addEventListener('DOMContentLoaded', () => {\n    const form = document.querySelector('#anamnesis-form');\n    if (!form) return;\n    const steps = Array.from(form.querySelectorAll('.form-step'));\n    const nextBtns = form.querySelectorAll('.btn-next');\n    const prevBtns = form.querySelectorAll('.btn-prev');\n    const progress = form.querySelectorAll('.progress-step');\n    let current = 0;\n    function update() {\n      steps.forEach((s,i) => s.classList.toggle('active', i===current));\n      progress.forEach((p,i) => p.classList.toggle('active', i<=current));\n      const firstField = steps[current].querySelector('input, textarea');\n      if (firstField) firstField.focus({preventScroll:true});\n    }\n    nextBtns.forEach(btn => btn.addEventListener('click', () => {\n      if (current < steps.length - 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