{"id":345,"date":"2026-03-31T08:28:30","date_gmt":"2026-03-31T08:28:30","guid":{"rendered":"https:\/\/denniszorgt.nl\/?page_id=345"},"modified":"2026-04-01T11:22:07","modified_gmt":"2026-04-01T11:22:07","slug":"aanmeldformulier","status":"publish","type":"page","link":"https:\/\/denniszorgt.nl\/index.php\/aanmeldformulier\/","title":{"rendered":"Aanmeldformulier"},"content":{"rendered":"\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f349-o1\" lang=\"nl-NL\" dir=\"ltr\" data-wpcf7-id=\"349\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/345#wpcf7-f349-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contactformulier\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"349\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"nl_NL_formal\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f349-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<p>Onderstaande is makkelijk in te vullen.\n<\/p>\n<p>Dit formulier is bedoeld om je aan te melden voor vakantielogeren, weekendlogeren of persoonlijke begeleiding. Door het invullen van dit formulier kunnen wij je aanvraag zorgvuldig in behandeling nemen en kijken naar de mogelijkheden die het beste aansluiten bij jouw wensen en behoeften.\n<\/p>\n<p>Omdat Dennis Zorgt iedereen persoonlijk aandacht wil geven, is er een beperkt aantal plekken beschikbaar.\n<\/p>\n<p><label> Naam ouders\/verzorgers<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-320\"><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=\"text-320\" \/><\/span><\/label>\n<\/p>\n<p><label> e-mail<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email-285\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email-285\" \/><\/span> <\/label>\n<\/p>\n<p><label> Telefoonnummer<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel-988\"><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\" placeholder=\"06-12345678\" value=\"\" type=\"tel\" name=\"tel-988\" \/><\/span> <\/label>\n<\/p>\n<p><label> Ik meld hem\/haar aan voor:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-586\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-586[]\" value=\"Weekend logeren\" \/><span class=\"wpcf7-list-item-label\">Weekend logeren<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-586[]\" value=\"vakantie logeren\" \/><span class=\"wpcf7-list-item-label\">vakantie logeren<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-586[]\" value=\"1 op 1 begeleiding ( optie tot logeren )\" \/><span class=\"wpcf7-list-item-label\">1 op 1 begeleiding ( optie tot logeren )<\/span><\/label><\/span><\/span><\/span> <\/label>\n<\/p>\n<p class=\"hoofdtitel\">Basisgegevens van<br \/>\nzoon\/dochter\n<\/p>\n<p><label> Naam<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-588\"><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=\"text-588\" \/><\/span> <\/label>\n<\/p>\n<p><label> Geboortedatum:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date-372\"><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=\"date-372\" \/><\/span> <\/label>\n<\/p>\n<p><label> Burgerservice nummer:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"number-583\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-required wpcf7-validates-as-number\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"number-583\" \/><\/span> <\/label>\n<\/p>\n<p><label> School\/dagbesteding:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-88\"><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=\"text-88\" \/><\/span> <\/label>\n<\/p>\n<p><label> Noodnummer 1<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel-936\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" placeholder=\"06-12345678\" value=\"\" type=\"tel\" name=\"tel-936\" \/><\/span> <\/label>\n<\/p>\n<p>Noodnummer 2 (optioneel)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel-60\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" placeholder=\"06-12345678\" value=\"\" type=\"tel\" name=\"tel-60\" \/><\/span>\n<\/p>\n<p class=\"hoofdtitel\">Medische en zorg gerelateerde informatie\n<\/p>\n<p><label> Diagnose(s) of beperking(en)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-596\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"textarea-596\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Medicatie (naam, tijdstip, wijze van toedienen)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-261\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"textarea-261\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Allergie\u00ebn (voeding, medicatie, omgevingsfactoren)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-327\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"textarea-327\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Slaappatroon en slaapbehoefte<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-632\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"textarea-632\"><\/textarea><\/span><br \/>\n<\/label>\n<\/p>\n<p class=\"hoofdtitel\">Gedrag, communicatie en ondersteuning\n<\/p>\n<p><label> Hoe communiceert het kind (spraak, gebaren, pictogrammen, spraakcomputer)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-87\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"textarea-87\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Wat geeft stress of overprikkeling<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-128\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"textarea-128\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Wat helpt juist om te kalmeren<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-447\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"textarea-447\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Hoe gaat zoon\/dochter om met nieuwe situaties<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-604\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"textarea-604\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Zijn er gedragsuitdagingen waar rekening mee gehouden moet worden<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-950\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"textarea-950\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Wat vindt het kind leuk om te doen<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-926\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"textarea-926\"><\/textarea><\/span> <\/label>\n<\/p>\n<p class=\"hoofdtitel\">Persoonlijke verzorging\n<\/p>\n<p><label> Toiletgebruik (zelfstandig, hulp nodig, incontinentiemateriaal)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-768\"><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=\"text-768\" \/><\/span> <\/label>\n<\/p>\n<p><label> Douchen \/ wassen (mate van zelfstandigheid)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-68\"><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=\"text-68\" \/><\/span> <\/label>\n<\/p>\n<p><label> Eet- en drinkvaardigheden<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-57\"><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=\"text-57\" \/><\/span> <\/label>\n<\/p>\n<p><label> Nachtzorg<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-575\"><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=\"text-575\" \/><\/span> <\/label>\n<\/p>\n<p class=\"hoofdtitel\">Toestemmingen\n<\/p>\n<p><label> Voor foto's<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-645\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-645[]\" value=\"Ja\" \/><span class=\"wpcf7-list-item-label\">Ja<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-645[]\" value=\"Nee\" \/><span class=\"wpcf7-list-item-label\">Nee<\/span><\/label><\/span><\/span><\/span> <\/label>\n<\/p>\n<p><label> Uw kind mag aan alle activiteiten meedoen, denk aan: Buiten spelen, bowlen ect..<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-689\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-689[]\" value=\"Ja\" \/><span class=\"wpcf7-list-item-label\">Ja<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-689[]\" value=\"Nee\" \/><span class=\"wpcf7-list-item-label\">Nee<\/span><\/label><\/span><\/span><\/span><br \/>\n<\/label><label> Toestemming voor vervoer in de auto<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-349\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-349[]\" value=\"Ja\" \/><span class=\"wpcf7-list-item-label\">Ja<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-349[]\" value=\"Nee\" \/><span class=\"wpcf7-list-item-label\">Nee<\/span><\/label><\/span><\/span><\/span> <\/label>\n<\/p>\n<p><label> Toestemming voor medische handelingen binnen de wettelijke kaders<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-703\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-703[]\" value=\"Ja\" \/><span class=\"wpcf7-list-item-label\">Ja<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-703[]\" value=\"Nee\" \/><span class=\"wpcf7-list-item-label\">Nee<\/span><\/label><\/span><\/span><\/span><\/label>\n<\/p>\n<p><label> Toestemming voor het delen van informatie met betrokken zorgverleners (indien nodig)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-970\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-970[]\" value=\"Ja\" \/><span class=\"wpcf7-list-item-label\">Ja<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-970[]\" value=\"Nee\" \/><span class=\"wpcf7-list-item-label\">Nee<\/span><\/label><\/span><\/span><\/span> <\/label>\n<\/p>\n<p class=\"akkoord-tekst\">Ik heb de gegevens correct ingevuld en ga akkoord dat de gegevens opgeslagen worden.\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-202\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"checkbox-202[]\" value=\"Ik ga akkoord\" \/><span class=\"wpcf7-list-item-label\">Ik ga akkoord<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Ik probeer binnen 48 uur te reageren.\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Verzenden\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n\n\n\n<p><\/p>\n\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-345","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/denniszorgt.nl\/index.php\/wp-json\/wp\/v2\/pages\/345","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/denniszorgt.nl\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/denniszorgt.nl\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/denniszorgt.nl\/index.php\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/denniszorgt.nl\/index.php\/wp-json\/wp\/v2\/comments?post=345"}],"version-history":[{"count":5,"href":"https:\/\/denniszorgt.nl\/index.php\/wp-json\/wp\/v2\/pages\/345\/revisions"}],"predecessor-version":[{"id":367,"href":"https:\/\/denniszorgt.nl\/index.php\/wp-json\/wp\/v2\/pages\/345\/revisions\/367"}],"wp:attachment":[{"href":"https:\/\/denniszorgt.nl\/index.php\/wp-json\/wp\/v2\/media?parent=345"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}