{"id":4751,"date":"2022-01-02T17:37:34","date_gmt":"2022-01-02T16:37:34","guid":{"rendered":"https:\/\/microbiome-center.nl\/fuer-klienten\/selbsttest\/"},"modified":"2022-01-02T17:37:35","modified_gmt":"2022-01-02T16:37:35","slug":"selbsttest","status":"publish","type":"page","link":"https:\/\/microbiome-center.nl\/de\/fuer-klienten\/selbsttest\/","title":{"rendered":"Selbsttest"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8220;1&#8243; admin_label=&#8220;pagina kop&#8220; _builder_version=&#8220;4.9.1&#8243; _module_preset=&#8220;default&#8220; use_background_color_gradient=&#8220;on&#8220; background_color_gradient_start=&#8220;rgba(43,135,218,0)&#8220; background_color_gradient_end=&#8220;#05918f&#8220; background_color_gradient_direction=&#8220;90deg&#8220; background_color_gradient_end_position=&#8220;50%&#8220; background_image=&#8220;https:\/\/microbiome-center.nl\/wp-content\/uploads\/2020\/11\/Start-behandeling-als-patient.jpg&#8220; background_blend=&#8220;multiply&#8220; positioning=&#8220;none&#8220; custom_margin=&#8220;0px||||false|false&#8220; custom_padding=&#8220;0px||0px||false|false&#8220; hover_transition_duration=&#8220;0ms&#8220;][et_pb_row custom_padding_last_edited=&#8220;on|desktop&#8220; _builder_version=&#8220;4.9.1&#8243; _module_preset=&#8220;default&#8220; custom_margin=&#8220;100px|auto|0px|auto|false|false&#8220; custom_margin_tablet=&#8220;50px||||false|false&#8220; custom_margin_phone=&#8220;50px||||false|false&#8220; custom_margin_last_edited=&#8220;on|desktop&#8220; custom_padding=&#8220;100px||100px||false|false&#8220; custom_padding_tablet=&#8220;||50px||false|false&#8220; custom_padding_phone=&#8220;100px||50px||false|false&#8220; hover_transition_duration=&#8220;0ms&#8220;][et_pb_column type=&#8220;4_4&#8243; _builder_version=&#8220;4.6.6&#8243; _module_preset=&#8220;default&#8220;][et_pb_text _builder_version=&#8220;4.9.1&#8243; text_font=&#8220;Titillium Web|600|||||||&#8220; text_text_color=&#8220;#ffffff&#8220; text_font_size=&#8220;16px&#8220; text_line_height=&#8220;1.5em&#8220; header_font=&#8220;Titillium Web|700|||||||&#8220; header_text_align=&#8220;left&#8220; header_text_color=&#8220;#ffffff&#8220; header_font_size=&#8220;50px&#8220; header_line_height=&#8220;1.2em&#8220; background_layout=&#8220;dark&#8220; max_width_tablet=&#8220;&#8220; max_width_phone=&#8220;&#8220; max_width_last_edited=&#8220;on|desktop&#8220; custom_margin=&#8220;41px|||||&#8220; custom_margin_tablet=&#8220;0px||||false|false&#8220; custom_margin_phone=&#8220;0px||||false|false&#8220; custom_margin_last_edited=&#8220;on|desktop&#8220; custom_padding=&#8220;|29px||||&#8220; hover_transition_duration=&#8220;0ms&#8220; text_font_size_tablet=&#8220;16px&#8220; text_font_size_phone=&#8220;14px&#8220; text_font_size_last_edited=&#8220;on|phone&#8220; header_font_size_tablet=&#8220;40px&#8220; header_font_size_phone=&#8220;28px&#8220; header_font_size_last_edited=&#8220;on|phone&#8220; locked=&#8220;off&#8220; text_font_size__hover=&#8220;14px&#8220; text_font_size__hover_enabled=&#8220;14px&#8220;]<\/p>\n<h1>Testen Sie sich selbst<\/h1>\n<p>Mit dem folgenden Kurztest k\u00f6nnen Sie eine erste Einsch\u00e4tzung der M\u00f6glichkeiten zur Verbesserung Ihres Mikrobioms vornehmen. 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value='\u00dcbelkeit'  id='choice_7_2_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_2_14' id='label_7_2_14' class='gform-field-label gform-field-label--type-inline'>\u00dcbelkeit<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_7_9' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorherige'  \/> <input type='button' id='gform_next_button_7_9' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='N\u00e4chste'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_7_3' class='gform_page' data-js='page-field-id-9' style='display:none;'>\n   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background_color=&#8220;#ffffff&#8220; custom_margin=&#8220;0px|auto||auto||&#8220; custom_padding=&#8220;0px||0px|||&#8220; animation_style=&#8220;flip&#8220; border_radii=&#8220;off|||60px|&#8220; box_shadow_style=&#8220;preset3&#8243; box_shadow_vertical=&#8220;32px&#8220; box_shadow_blur=&#8220;55px&#8220; box_shadow_spread=&#8220;-32px&#8220; box_shadow_color=&#8220;rgba(46,38,69,0.54)&#8220;][et_pb_column type=&#8220;1_2&#8243; _builder_version=&#8220;4.6.6&#8243; _module_preset=&#8220;default&#8220;][\/et_pb_column][et_pb_column type=&#8220;1_2&#8243; _builder_version=&#8220;4.6.6&#8243; _module_preset=&#8220;default&#8220;][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Testen Sie sich selbst Mit dem folgenden Kurztest k\u00f6nnen Sie eine erste Einsch\u00e4tzung der M\u00f6glichkeiten zur Verbesserung Ihres Mikrobioms vornehmen. Auf dieser Grundlage k\u00f6nnen Sie entscheiden, ob Sie tats\u00e4chlich eine Mikrobiomanalyse durchf\u00fchren m\u00f6chten.\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework zelftriage_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_7' ><div id='gf_7' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_7' class='zelftriage' action='\/de\/wp-json\/wp\/v2\/pages\/4751#gf_7' data-formid='7' novalidate>\n        <div id='gf_progressbar_wrapper_7' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Schritt <span class='gf_step_current_page'>1<\/span> von <span class='gf_step_page_count'>4<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_25' style='width:25%;'><span>25%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_7_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_7' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_7_11\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_7_11'>Company<\/label><div class='ginput_container'><input name='input_11' id='input_7_11' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_7_11'>Dieses Feld dient zur Validierung und sollte nicht ver\u00e4ndert werden.<\/div><\/div><fieldset id=\"field_7_1\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Wie sieht Ihr Stuhlgang aus: Gibt es irgendwelche Probleme wie zum Beispiel...<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_7_1'><div class='gchoice gchoice_7_1_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_1.1' type='checkbox'  value='Sehr harter Stuhlgang\/Verstopfung'  id='choice_7_1_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_1_1' id='label_7_1_1' class='gform-field-label gform-field-label--type-inline'>Sehr harter Stuhlgang\/Verstopfung<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_1_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_1.2' type='checkbox'  value='Sehr weicher Stuhlgang\/Durchfall'  id='choice_7_1_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_1_2' id='label_7_1_2' class='gform-field-label gform-field-label--type-inline'>Sehr weicher Stuhlgang\/Durchfall<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_1_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_1.3' type='checkbox'  value='Schwankungen - hart\/weich oder in der H\u00e4ufigkeit'  id='choice_7_1_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_1_3' id='label_7_1_3' class='gform-field-label gform-field-label--type-inline'>Schwankungen - hart\/weich oder in der H\u00e4ufigkeit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_1_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_1.4' type='checkbox'  value='Fettiger, klebriger Stuhlgang'  id='choice_7_1_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_1_4' id='label_7_1_4' class='gform-field-label gform-field-label--type-inline'>Fettiger, klebriger Stuhlgang<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_1_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_1.5' type='checkbox'  value='Sichtbare unverdaute Reste'  id='choice_7_1_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_1_5' id='label_7_1_5' class='gform-field-label gform-field-label--type-inline'>Sichtbare unverdaute Reste<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_1_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_1.6' type='checkbox'  value='Unangenehmer Geruch'  id='choice_7_1_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_1_6' id='label_7_1_6' class='gform-field-label gform-field-label--type-inline'>Unangenehmer Geruch<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_1_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_1.7' type='checkbox'  value='Explosiver Stuhlgang'  id='choice_7_1_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_1_7' id='label_7_1_7' class='gform-field-label gform-field-label--type-inline'>Explosiver Stuhlgang<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_1_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_1.8' type='checkbox'  value='Schleim im Stuhlgang'  id='choice_7_1_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_1_8' id='label_7_1_8' class='gform-field-label gform-field-label--type-inline'>Schleim im Stuhlgang<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_1_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_1.9' type='checkbox'  value='Sehr unterschiedliche Farben'  id='choice_7_1_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_1_9' id='label_7_1_9' class='gform-field-label gform-field-label--type-inline'>Sehr unterschiedliche Farben<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_7_8' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='N\u00e4chste'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_7_2' class='gform_page' data-js='page-field-id-8' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_7_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_7_2\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Wie geht es Ihrem Magen: haben Sie regelm\u00e4\u00dfige...<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_7_2'><div class='gchoice gchoice_7_2_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_2.1' type='checkbox'  value='Bauchschmerzen'  id='choice_7_2_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_2_1' id='label_7_2_1' class='gform-field-label gform-field-label--type-inline'>Bauchschmerzen<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_2_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_2.2' type='checkbox'  value='Bauchkr\u00e4mpfe'  id='choice_7_2_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_2_2' id='label_7_2_2' class='gform-field-label gform-field-label--type-inline'>Bauchkr\u00e4mpfe<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_2_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_2.3' type='checkbox'  value='Bl\u00e4hungen'  id='choice_7_2_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_2_3' id='label_7_2_3' class='gform-field-label gform-field-label--type-inline'>Bl\u00e4hungen<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_2_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_2.4' type='checkbox'  value='V\u00f6llegef\u00fchl'  id='choice_7_2_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_2_4' id='label_7_2_4' class='gform-field-label gform-field-label--type-inline'>V\u00f6llegef\u00fchl<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_2_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_2.5' type='checkbox'  value='V\u00f6llegef\u00fchl - wenn Sie nicht viel gegessen haben'  id='choice_7_2_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_2_5' id='label_7_2_5' class='gform-field-label gform-field-label--type-inline'>V\u00f6llegef\u00fchl - wenn Sie nicht viel gegessen haben<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_2_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_2.6' type='checkbox'  value='Aufgebl\u00e4hter Bauch'  id='choice_7_2_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_2_6' id='label_7_2_6' class='gform-field-label gform-field-label--type-inline'>Aufgebl\u00e4hter Bauch<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_2_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_2.7' type='checkbox'  value='Drang, aber nicht auf Klo k\u00f6nnen'  id='choice_7_2_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_2_7' id='label_7_2_7' class='gform-field-label gform-field-label--type-inline'>Drang, aber nicht auf Klo k\u00f6nnen<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_2_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_2.8' type='checkbox'  value='Es grummelt im Bauch'  id='choice_7_2_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_2_8' id='label_7_2_8' class='gform-field-label gform-field-label--type-inline'>Es grummelt im Bauch<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_2_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_2.9' type='checkbox'  value='Bauchschmerzen nach dem Essen'  id='choice_7_2_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_2_9' id='label_7_2_9' class='gform-field-label gform-field-label--type-inline'>Bauchschmerzen nach dem Essen<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_2_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_2.11' type='checkbox'  value='Schnelles Hungergef\u00fchl nach dem Essen'  id='choice_7_2_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_2_11' id='label_7_2_11' class='gform-field-label gform-field-label--type-inline'>Schnelles Hungergef\u00fchl nach dem Essen<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_2_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_2.12' type='checkbox'  value='Aufsto\u00dfen \/ B\u00e4uerchen machen'  id='choice_7_2_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_2_12' id='label_7_2_12' class='gform-field-label gform-field-label--type-inline'>Aufsto\u00dfen \/ B\u00e4uerchen machen<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_2_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_2.13' type='checkbox'  value='Sodbrennen'  id='choice_7_2_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_2_13' id='label_7_2_13' class='gform-field-label gform-field-label--type-inline'>Sodbrennen<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_2_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_2.14' type='checkbox'  value='\u00dcbelkeit'  id='choice_7_2_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_2_14' id='label_7_2_14' class='gform-field-label gform-field-label--type-inline'>\u00dcbelkeit<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_7_9' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorherige'  \/> <input type='button' id='gform_next_button_7_9' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='N\u00e4chste'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_7_3' class='gform_page' data-js='page-field-id-9' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_7_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_7_3\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Wie ist Ihre Energie und Stimmung? Erleben Sie manchmal unverst\u00e4ndliche...<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_7_3'><div class='gchoice gchoice_7_3_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.1' type='checkbox'  value='Erm\u00fcdung'  id='choice_7_3_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_3_1' id='label_7_3_1' class='gform-field-label gform-field-label--type-inline'>Erm\u00fcdung<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_3_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.2' type='checkbox'  value='Kurzatmigkeit'  id='choice_7_3_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_3_2' id='label_7_3_2' class='gform-field-label gform-field-label--type-inline'>Kurzatmigkeit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_3_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.3' type='checkbox'  value='Schwermut'  id='choice_7_3_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_3_3' id='label_7_3_3' class='gform-field-label gform-field-label--type-inline'>Schwermut<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_3_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.4' type='checkbox'  value='Stimmungen'  id='choice_7_3_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_3_4' id='label_7_3_4' class='gform-field-label gform-field-label--type-inline'>Stimmungen<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_3_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.5' type='checkbox'  value='Gef\u00fchle von Angst oder Stress'  id='choice_7_3_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_3_5' id='label_7_3_5' class='gform-field-label gform-field-label--type-inline'>Gef\u00fchle von Angst oder Stress<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_3_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_3.6' type='checkbox'  value='Konzentrations- und Ged\u00e4chtnisschwierigkeiten'  id='choice_7_3_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_3_6' id='label_7_3_6' class='gform-field-label gform-field-label--type-inline'>Konzentrations- und Ged\u00e4chtnisschwierigkeiten<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_7_10' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorherige'  \/> <input type='button' id='gform_next_button_7_10' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='N\u00e4chste'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_7_4' class='gform_page' data-js='page-field-id-10' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_7_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_7_4\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Haben Sie langfristige Beschwerden oder eine chronische Erkrankung?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_7_4'><div class='gchoice gchoice_7_4_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_4.1' type='checkbox'  value='Laktoseintoleranz oder Glutenunvertr\u00e4glichkeit'  id='choice_7_4_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_4_1' id='label_7_4_1' class='gform-field-label gform-field-label--type-inline'>Laktoseintoleranz oder Glutenunvertr\u00e4glichkeit<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_4_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_4.2' type='checkbox'  value='Allergie, Heuschnupfen'  id='choice_7_4_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_4_2' id='label_7_4_2' class='gform-field-label gform-field-label--type-inline'>Allergie, Heuschnupfen<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_4_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_4.3' type='checkbox'  value='Autoimmunerkrankung'  id='choice_7_4_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_4_3' id='label_7_4_3' class='gform-field-label gform-field-label--type-inline'>Autoimmunerkrankung<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_4_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_4.4' type='checkbox'  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