{"id":294,"date":"2025-03-10T09:22:08","date_gmt":"2025-03-10T09:22:08","guid":{"rendered":"https:\/\/animaplus.be\/doorverwijzen\/"},"modified":"2025-04-16T09:24:51","modified_gmt":"2025-04-16T09:24:51","slug":"referrals","status":"publish","type":"page","link":"https:\/\/animaplus.be\/en\/referrals\/","title":{"rendered":"Referrals"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_section full_width=&#8221;stretch_row_content&#8221; el_class=&#8221;hero&#8221; css=&#8221;.vc_custom_1739452557647{background-image: url(https:\/\/animaplus.be\/wp-content\/uploads\/2025\/02\/contact.jpg?id=115) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}&#8221;][vc_row el_class=&#8221;container&#8221;][vc_column width=&#8221;5\/12&#8243;][vc_column_text css=&#8221;&#8221; el_class=&#8221;green&#8221;]<\/p>\n<h1>Vet referrals<\/h1>\n<p>[\/vc_column_text][\/vc_column][vc_column width=&#8221;7\/12&#8243;][\/vc_column][\/vc_row][\/vc_section][vc_section][vc_row el_class=&#8221;container&#8221;][vc_column][vc_column_text css=&#8221;&#8221;]<nav aria-label=\"breadcrumbs\" class=\"rank-math-breadcrumb\"><p><span class=\"last\">Home<\/span><\/p><\/nav>[\/vc_column_text][\/vc_column][\/vc_row][\/vc_section][vc_section css=&#8221;.vc_custom_1739452250864{background-color: #F1F1F1 !important;}&#8221;][vc_row el_class=&#8221;container doorverwijzenForm&#8221;][vc_column css=&#8221;.vc_custom_1739452240263{background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}&#8221;]\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f351-o1\" lang=\"nl-NL\" dir=\"ltr\" data-wpcf7-id=\"351\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/pages\/294#wpcf7-f351-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contactformulier\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"351\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.2.2\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"nl_NL\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f351-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<div class=\"row\">\n\t<div class=\"col-12\">\n\t\t<h2>Details of referring practice\n\t\t<\/h2>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-6\">\n\t\t<p><label> Name of referring vet<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"naam-arts\"><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=\"naam-arts\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-6\">\n\t\t<p><label> Name of referring practice<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"naam-praktijk\"><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=\"naam-praktijk\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-6\">\n\t\t<p><label> E-mail address of referring practice<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email_praktijk\"><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_praktijk\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-12\">\n\t\t<h2>Client details\n\t\t<\/h2>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-6\">\n\t\t<p><label> First name<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"voornaam_client\"><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=\"voornaam_client\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-6\">\n\t\t<p><label> Surname<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"naam_client\"><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=\"naam_client\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-6\">\n\t\t<p><label> E-mail<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email_client\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-text wpcf7-validates-as-email\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email_client\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-6\">\n\t\t<p><label> Telephone number<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel_client\"><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=\"tel_client\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-6\">\n\t\t<p><label> Address<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"adres_client\"><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_client\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-12\">\n\t\t<h2>Patient details\n\t\t<\/h2>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-6\">\n\t\t<p><label> Name<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"naam_dier\"><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=\"naam_dier\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-6\">\n\t\t<p><label> Species<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"diersoort\"><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=\"diersoort\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-6\">\n\t\t<p><span>To which service does your referral or question relate?<\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"reden_verwijzing\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"reden_verwijzing[]\" value=\"Cardiology\" \/><span class=\"wpcf7-list-item-label\">Cardiology<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"reden_verwijzing[]\" value=\"Surgery\" \/><span class=\"wpcf7-list-item-label\">Surgery<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"reden_verwijzing[]\" value=\"Dermatology\" \/><span class=\"wpcf7-list-item-label\">Dermatology<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"reden_verwijzing[]\" value=\"Scopy\" \/><span class=\"wpcf7-list-item-label\">Scopy<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"reden_verwijzing[]\" value=\"Hospitalisation\" \/><span class=\"wpcf7-list-item-label\">Hospitalisation<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"reden_verwijzing[]\" value=\"In-house laboratory\" \/><span class=\"wpcf7-list-item-label\">In-house laboratory<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"reden_verwijzing[]\" value=\"Internal medicine and oncology\" \/><span class=\"wpcf7-list-item-label\">Internal medicine and oncology<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"reden_verwijzing[]\" value=\"Medical imaging\" \/><span class=\"wpcf7-list-item-label\">Medical imaging<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"reden_verwijzing[]\" value=\"Neurology\" \/><span class=\"wpcf7-list-item-label\">Neurology<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"reden_verwijzing[]\" value=\"Ophthalmology\" \/><span class=\"wpcf7-list-item-label\">Ophthalmology<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"reden_verwijzing[]\" value=\"Emergency care\" \/><span class=\"wpcf7-list-item-label\">Emergency care<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"reden_verwijzing[]\" value=\"Dentistry and stomatology\" \/><span class=\"wpcf7-list-item-label\">Dentistry and stomatology<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-6\">\n\t\t<p><label>Patient card (.jpeg, .png, .webp or .pdf)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"kaart\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\".jpeg,.jpg,.png,.webp,.pdf\" aria-invalid=\"false\" type=\"file\" name=\"kaart\" \/><\/span><\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-12\">\n\t\t<h2>Follow-up\n\t\t<\/h2>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-6\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"vervolg\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"vervolg\" value=\"Aftercare \/ further treatment by referrer\" \/><span class=\"wpcf7-list-item-label\">Aftercare \/ further treatment by referrer<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"vervolg\" value=\"Aftercare \/ further treatment by AnimaPlus\" \/><span class=\"wpcf7-list-item-label\">Aftercare \/ further treatment by AnimaPlus<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-12\">\n\t\t<h2>Comment\n\t\t<\/h2>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"opmerking\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"opmerking\"><\/textarea><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-12\">\n\t\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner afspraak\" type=\"submit\" value=\"Submit\" \/>\n\t\t<\/p>\n\t<\/div>\n<\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n[\/vc_column][\/vc_row][\/vc_section]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_section full_width=&#8221;stretch_row_content&#8221; el_class=&#8221;hero&#8221; css=&#8221;.vc_custom_1739452557647{background-image: url(https:\/\/animaplus.be\/wp-content\/uploads\/2025\/02\/contact.jpg?id=115) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}&#8221;][vc_row el_class=&#8221;container&#8221;][vc_column width=&#8221;5\/12&#8243;][vc_column_text css=&#8221;&#8221; el_class=&#8221;green&#8221;] Vet referrals [\/vc_column_text][\/vc_column][vc_column width=&#8221;7\/12&#8243;][\/vc_column][\/vc_row][\/vc_section][vc_section][vc_row el_class=&#8221;container&#8221;][vc_column][vc_column_text css=&#8221;&#8221;][\/vc_column_text][\/vc_column][\/vc_row][\/vc_section][vc_section css=&#8221;.vc_custom_1739452250864{background-color: #F1F1F1 !important;}&#8221;][vc_row el_class=&#8221;container doorverwijzenForm&#8221;][vc_column css=&#8221;.vc_custom_1739452240263{background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}&#8221;][\/vc_column][\/vc_row][\/vc_section]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-294","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/animaplus.be\/en\/wp-json\/wp\/v2\/pages\/294","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/animaplus.be\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/animaplus.be\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/animaplus.be\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/animaplus.be\/en\/wp-json\/wp\/v2\/comments?post=294"}],"version-history":[{"count":3,"href":"https:\/\/animaplus.be\/en\/wp-json\/wp\/v2\/pages\/294\/revisions"}],"predecessor-version":[{"id":352,"href":"https:\/\/animaplus.be\/en\/wp-json\/wp\/v2\/pages\/294\/revisions\/352"}],"wp:attachment":[{"href":"https:\/\/animaplus.be\/en\/wp-json\/wp\/v2\/media?parent=294"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}