{"id":1032,"date":"2025-07-09T19:46:04","date_gmt":"2025-07-09T17:46:04","guid":{"rendered":"https:\/\/obronca.secretcats.pl\/nl\/?page_id=1032"},"modified":"2025-07-23T12:38:41","modified_gmt":"2025-07-23T10:38:41","slug":"formularz-szkody-osobowej","status":"publish","type":"page","link":"https:\/\/obronca.eu\/nl\/formularz-szkody-osobowej\/","title":{"rendered":"Formularz szkody osobowej"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1032\" class=\"elementor elementor-1032\" data-elementor-settings=\"{&quot;ha_cmc_init_switcher&quot;:&quot;no&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e3f79a4 e-flex e-con-boxed wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no e-con e-parent\" data-id=\"e3f79a4\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;slideshow&quot;,&quot;background_slideshow_gallery&quot;:[{&quot;id&quot;:1749,&quot;url&quot;:&quot;https:\\\/\\\/obronca.eu\\\/nl\\\/wp-content\\\/uploads\\\/2025\\\/07\\\/slider-2-1.jpg&quot;}],&quot;background_slideshow_transition_duration&quot;:800,&quot;background_slideshow_ken_burns&quot;:&quot;yes&quot;,&quot;background_slideshow_loop&quot;:&quot;yes&quot;,&quot;background_slideshow_slide_duration&quot;:5000,&quot;background_slideshow_slide_transition&quot;:&quot;fade&quot;,&quot;background_slideshow_ken_burns_zoom_direction&quot;:&quot;in&quot;,&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-88056f9 e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no e-con e-child\" data-id=\"88056f9\" data-element_type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c13eb06 elementor-widget elementor-widget-heading\" data-id=\"c13eb06\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\"><b><strong>Juridische en administratieve hulp <\/strong><\/b> in Nederland<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0a35f3f elementor-widget elementor-widget-heading\" data-id=\"0a35f3f\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">\u00b7 Letselschadevergoeding \u00b7 Arbeidsrecht, civiel recht, familierecht \u00b7 Vertalingen \u00b7 Begeleiding bij afspraken<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-0609e0f e-flex e-con-boxed wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no e-con e-parent\" data-id=\"0609e0f\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-d645a88 e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no e-con e-child\" data-id=\"d645a88\" data-element_type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-43c3a45 elementor-widget elementor-widget-spacer\" data-id=\"43c3a45\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b56baa7 e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no e-con e-child\" data-id=\"b56baa7\" data-element_type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t<div class=\"elementor-element elementor-element-207baa8 e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no e-con e-child\" data-id=\"207baa8\" data-element_type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2fbb75a elementor-widget elementor-widget-heading\" data-id=\"2fbb75a\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Formulier voor persoonlijk letsel<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-316c267 ha-has-bg-overlay elementor-widget elementor-widget-shortcode\" data-id=\"316c267\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f111-o1\" lang=\"pl-PL\" dir=\"ltr\" data-wpcf7-id=\"111\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/nl\/wp-json\/wp\/v2\/pages\/1032#wpcf7-f111-o1\" method=\"post\" class=\"wpcf7-form init wpcf7-acceptance-as-validation\" aria-label=\"Formularz kontaktowy\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"111\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"pl_PL\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f111-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_uacf7_hidden_conditional_fields\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div class=\"uacf7-form-111  \"><h3 class=\"contact-headline\">Klantgegevens<\/h3>\n\n<div style=\"margin: 10px 0px !important;\">\n<label>1. Achternaam en voornaam:<span class=\"wpcf7-form-control-wrap\" data-name=\"imie-nazwisko\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"imie-nazwisko\" \/><\/span><\/label>\n<label>2. Geboortedatum: <span class=\"wpcf7-form-control-wrap\" data-name=\"data-urodzenia\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"data-urodzenia\" \/><\/span><\/label>\n<label>3. Adres:<span class=\"wpcf7-form-control-wrap\" data-name=\"adres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"adres\" \/><\/span><\/label>\n<label>4. Postcode en woonplaats: <span class=\"wpcf7-form-control-wrap\" data-name=\"kod-pocztowy-miejscowosc\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"kod-pocztowy-miejscowosc\" \/><\/span><\/label>\n<label>5. Ben je ingeschreven in Nederland: <span class=\"wpcf7-form-control-wrap\" data-name=\"zameldowany-w-holandii\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"zameldowany-w-holandii\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Ja\">Ja<\/option><option value=\"Nee\">Nee<\/option><\/select><\/span><\/label>\n<label>6. Telefoonnummer: <span class=\"wpcf7-form-control-wrap\" data-name=\"numer-telefonu\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"numer-telefonu\" \/><\/span><\/label>\n<label>7. E-mailadres: <span class=\"wpcf7-form-control-wrap\" data-name=\"email-44\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" autocomplete=\"email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email-44\" \/><\/span><\/label>\n<label>8. BSN-nummer (Burgerservicenummer in Nederland):   <span class=\"wpcf7-form-control-wrap\" data-name=\"numerbsn\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"numerbsn\" \/><\/span><\/label>\n<label>9. Burgerlijke staat: <span class=\"wpcf7-form-control-wrap\" data-name=\"stan-cywilny\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"stan-cywilny\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Ongehuwd\">Ongehuwd<\/option><option value=\"Ongehuwd\">Ongehuwd<\/option><option value=\"Getrouwd\">Getrouwd<\/option><option value=\"Getrouwd\">Getrouwd<\/option><option value=\"Samenwonen\">Samenwonen<\/option><\/select><\/span><\/label>\n<label>10. Kinderen (jonger dan 18 jaar):  <span class=\"wpcf7-form-control-wrap\" data-name=\"dzieci\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"dzieci\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Ja\">Ja<\/option><option value=\"Nee\">Nee<\/option><\/select><\/span><\/label>\n<\/div>\n\n<h3 class=\"contact-headline\">Schadegegevens<\/h3>\n<div style=\"margin: 10px 0px !important;\">\n\n<label>11. Type ongeluk: <span class=\"wpcf7-form-control-wrap\" data-name=\"rodzaj-wypadku\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"rodzaj-wypadku\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Werkongeval\">Werkongeval<\/option><option value=\"Verkeersongeval\">Verkeersongeval<\/option><\/select><\/span> <\/label>\n<div class=\"uacf7_conditional rodzaj-wypadku-wypadek-na-drodze\">\n<label>11a. Als: <span class=\"wpcf7-form-control-wrap\" data-name=\"wypadek-na-drodze\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"wypadek-na-drodze\"><option value=\"Bestuurder\">Bestuurder<\/option><option value=\"Passagier\">Passagier<\/option><option value=\"Voetganger\">Voetganger<\/option><option value=\"Fietser\">Fietser<\/option><option value=\"Motorrijder\">Motorrijder<\/option><\/select><\/span> <\/label>\n<\/div>\n\n\n<label>12. Datum van het ongeluk: <span class=\"wpcf7-form-control-wrap\" data-name=\"data-wypadku\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"data-wypadku\" \/><\/span> <\/label>\n<label>13. Plaats: <span class=\"wpcf7-form-control-wrap\" data-name=\"miejsce\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"miejsce\" \/><\/span> <\/label>\n<label>14. Omschrijving van de omstandigheden: <span class=\"wpcf7-form-control-wrap\" data-name=\"okolicznosci-wypadku\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"okolicznosci-wypadku\" \/><\/span> <\/label>\n<label>15. Soort letsel: <span class=\"wpcf7-form-control-wrap\" data-name=\"rodzaj-obrazen\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"rodzaj-obrazen\" \/><\/span> <\/label>\n<label>16. Getuigen: <span class=\"wpcf7-form-control-wrap\" data-name=\"swiadkowie\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"swiadkowie\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Ja\">Ja<\/option><option value=\"Nee\">Nee<\/option><\/select><\/span> <\/label>\n<label>17. Is het ongeluk gemeld?: <span class=\"wpcf7-form-control-wrap\" data-name=\"wypadek-zgloszony\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"wypadek-zgloszony\" \/><\/span> <\/label>\n<label>18. Vervoer met ambulance: <span class=\"wpcf7-form-control-wrap\" data-name=\"transport-karetka-tak-nie\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"transport-karetka-tak-nie\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Ja\">Ja<\/option><option value=\"Nee\">Nee<\/option><\/select><\/span><\/label>\n<div class=\"uacf7_conditional transportkaretka\">\n<label>18a. Van...tot: <span class=\"wpcf7-form-control-wrap\" data-name=\"transport-karetka-od-do\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"transport-karetka-od-do\" \/><\/span> <\/label>\n<\/div>\n<label>19. Ziekenhuisopname: <span class=\"wpcf7-form-control-wrap\" data-name=\"hospitalizacja-tak-nie\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"hospitalizacja-tak-nie\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Ja\">Ja<\/option><option value=\"Nee\">Nee<\/option><\/select><\/span><\/label>\n<div class=\"uacf7_conditional hospitalizacja\">\n<label>19a. Waar: <span class=\"wpcf7-form-control-wrap\" data-name=\"gdzie-hospitalizacja\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"gdzie-hospitalizacja\" \/><\/span> <\/label>\n<\/div>\n<\/div>\n\n<h3 class=\"contact-headline\">Behandeling en toegepaste therapie\u00ebn<\/h3>\n<div style=\"margin: 10px 0px !important;\">\n<label>20. Huisarts: <span class=\"wpcf7-form-control-wrap\" data-name=\"lekarz-rodzinny\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"lekarz-rodzinny\" \/><\/span> <\/label>\n<label>21. Fysiotherapeut: <span class=\"wpcf7-form-control-wrap\" data-name=\"fizjoterapeuta\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"fizjoterapeuta\" \/><\/span> <\/label>\n<label>22. Specialisten: <span class=\"wpcf7-form-control-wrap\" data-name=\"specjalisci\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"specjalisci\" \/><\/span> <\/label>\n<label>23. Beschrijving van de behandeling: <span class=\"wpcf7-form-control-wrap\" data-name=\"opis-leczenia\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"opis-leczenia\" \/><\/span> <\/label>\n<\/div>\n<h3 class=\"contact-headline\">Huidige klachten en beperkingen<\/h3>\n<div style=\"margin: 10px 0px!important;\">\n<label>24. Beschrijving van de huidige klachten: <span class=\"wpcf7-form-control-wrap\" data-name=\"opis-aktualnych-dolegliwosci\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"opis-aktualnych-dolegliwosci\" \/><\/span> <\/label>\n<\/div>\n\n<h3 class=\"contact-headline\">Werk<\/h3>\n<div style=\"margin: 10px 0px !important;\">\n<label>25. Werkgever:  <span class=\"wpcf7-form-control-wrap\" data-name=\"pracodawca\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"pracodawca\" \/><\/span>  <\/label>\n<label>26. Zelfstandig ondernemerschap:    <span class=\"wpcf7-form-control-wrap\" data-name=\"dzialalnoscnawlasnyrachunek\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"dzialalnoscnawlasnyrachunek\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Ja\">Ja<\/option><option value=\"Nee\">Nee<\/option><\/select><\/span><\/label>\n<label>27. Werk via uitzendbureau:  <span class=\"wpcf7-form-control-wrap\" data-name=\"zatrudnienie-przez-agencje\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"zatrudnienie-przez-agencje\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Ja\">Ja<\/option><option value=\"Nee\">Nee<\/option><\/select><\/span> <\/label>\n<\/div>\n\n<h3 class=\"contact-headline\">Verlies als gevolg van schade<\/h3>\n<div style=\"margin: 10px 0px !important;\">\n<label>28. Verlies van arbeidsgeschiktheid:   <span class=\"wpcf7-form-control-wrap\" data-name=\"utratazdol\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"utratazdol\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Ja\">Ja<\/option><option value=\"Nee\">Nee<\/option><\/select><\/span><\/label>\n<\/div>\n\n<h3 class=\"contact-headline\">Aanvullende informatie<\/h3>\n<div style=\"margin: 10px !important;\">\n<label>29. Ziektekostenverzekering:   <span class=\"wpcf7-form-control-wrap\" data-name=\"ubezpieczeniezdrowotne\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"ubezpieczeniezdrowotne\" \/><\/span><\/label>\n<label>30. Passagiersverzekering (indien van toepassing):   <span class=\"wpcf7-form-control-wrap\" data-name=\"ubezpieczeniepasazerow\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"ubezpieczeniepasazerow\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Ja\">Ja<\/option><option value=\"Nee\">Nee<\/option><\/select><\/span><\/label>\n<label>31. Rechtsbijstandsverzekering:   <span class=\"wpcf7-form-control-wrap\" data-name=\"ubezpieczenieochronyprawnej\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"ubezpieczenieochronyprawnej\"><option value=\"\">&#8212;Prosz\u0119 wybra\u0107 opcj\u0119&#8212;<\/option><option value=\"Ja\">Ja<\/option><option value=\"Nee\">Nee<\/option><\/select><\/span><\/label>\n<\/div>\n\n<h3 class=\"contact-headline\">Informatie over de tegenpartij<\/h3>\n<div style=\"margin: 10px 0px!important;\">\n<label>32. Naam van het bedrijf of de dader: <span class=\"wpcf7-form-control-wrap\" data-name=\"nazwafirmynazwiskosprawcy\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nazwafirmynazwiskosprawcy\" \/><\/span><\/label>\n<label>33. Adres van de dader: <span class=\"wpcf7-form-control-wrap\" data-name=\"adressprawcy\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"adressprawcy\" \/><\/span><\/label>\n<label>34. Woonplaats: <span class=\"wpcf7-form-control-wrap\" data-name=\"miejscowosc\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"miejscowosc\" \/><\/span><\/label>\n<\/div>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"acceptance-689\"><span class=\"wpcf7-form-control wpcf7-acceptance optional\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-689\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Ik geef toestemming voor de verwerking van mijn persoonsgegevens door de beheerder van de website: Obronca.eu B.V, Zuidwenk 80 M, 3751 CG Bunschoten Spakenburg Nederland, met het doel contact op te nemen met het bedrijf. Gedetailleerde informatie over de verwerking van persoonsgegevens is te vinden in de <a href=\"https:\/\/obronca.eu\/nl\/Privacybeleid\">Privacyverklaring.<\/a><\/span><\/label><\/span><\/span><\/span>\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Verzenden\" \/><\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Juridische en administratieve hulp in Nederland \u00b7 Letselschadevergoeding \u00b7 Arbeidsrecht, civiel recht, familierecht \u00b7 Vertalingen \u00b7 Begeleiding bij afspraken Formulier voor persoonlijk letsel<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-1032","page","type-page","status-publish","hentry"],"aioseo_notices":[],"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"admin","author_link":"https:\/\/obronca.eu\/nl\/blog\/author\/admin\/"},"rttpg_comment":0,"rttpg_category":null,"rttpg_excerpt":"Juridische en administratieve hulp in Nederland \u00b7 Letselschadevergoeding \u00b7 Arbeidsrecht, civiel recht, familierecht \u00b7 Vertalingen \u00b7 Begeleiding bij afspraken Formulier voor persoonlijk letsel","_links":{"self":[{"href":"https:\/\/obronca.eu\/nl\/wp-json\/wp\/v2\/pages\/1032","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/obronca.eu\/nl\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/obronca.eu\/nl\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/obronca.eu\/nl\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/obronca.eu\/nl\/wp-json\/wp\/v2\/comments?post=1032"}],"version-history":[{"count":43,"href":"https:\/\/obronca.eu\/nl\/wp-json\/wp\/v2\/pages\/1032\/revisions"}],"predecessor-version":[{"id":2701,"href":"https:\/\/obronca.eu\/nl\/wp-json\/wp\/v2\/pages\/1032\/revisions\/2701"}],"wp:attachment":[{"href":"https:\/\/obronca.eu\/nl\/wp-json\/wp\/v2\/media?parent=1032"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}