{"id":8519,"date":"2025-09-07T19:05:35","date_gmt":"2025-09-07T19:05:35","guid":{"rendered":"https:\/\/ahaamobilplus.ch\/?page_id=8519"},"modified":"2026-04-29T15:00:56","modified_gmt":"2026-04-29T15:00:56","slug":"bestellformular","status":"publish","type":"page","link":"https:\/\/ahaamobilplus.ch\/index.php\/bestellformular\/","title":{"rendered":"Bestellformular"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"8519\" class=\"elementor elementor-8519\" data-elementor-post-type=\"page\">\n\t\t\t\t<header class=\"elementor-element elementor-element-4185dc6a e-flex e-con-boxed e-con e-parent\" data-id=\"4185dc6a\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-db480b7 elementor-widget elementor-widget-html\" data-id=\"db480b7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t\t\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f4717-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"4717\">\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\/8519#wpcf7-f4717-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"4717\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f4717-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<div class=\"mp-premium-form\">\n\n  <h2>Transport Bestellung<\/h2>\n  <p class=\"mp-intro\">Schnell und einfach Transportanfrage senden.<\/p>\n\n  <div class=\"mp-box\">\n    <h3>Schritt 1: Dienstleistung<\/h3>\n\n    <label>Transportart *\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"transportart\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"transportart\"><option value=\"\">Bitte ausw\u00e4hlen<\/option><option value=\"Liegendtransport\">Liegendtransport<\/option><option value=\"Rollstuhltransport\">Rollstuhltransport<\/option><option value=\"Sitzendtransport\">Sitzendtransport<\/option><option value=\"Betreuter Transport\">Betreuter Transport<\/option><option value=\"Schultransport\">Schultransport<\/option><\/select><\/span>\n    <\/label>\n\n    <div class=\"mp-confirm\">\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"begleitung\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"begleitung[]\" value=\"Mit Begleitung buchen\" \/><span class=\"wpcf7-list-item-label\">Mit Begleitung buchen<\/span><\/label><\/span><\/span><\/span>\n    <\/div>\n  <\/div>\n\n\n  <div class=\"mp-box\">\n    <h3>Schritt 2: Patienten + Transport<\/h3>\n\n    <div class=\"mp-two-col\">\n\n      <div>\n        <h4>Patienteninformationen<\/h4>\n\n        <label>Patientenname *\n          <span class=\"wpcf7-form-control-wrap\" data-name=\"patientenname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Vor- und Nachname\" value=\"\" type=\"text\" name=\"patientenname\" \/><\/span>\n        <\/label>\n\n        <label>Geburtsdatum *\n          <span class=\"wpcf7-form-control-wrap\" data-name=\"geburtsdatum\"><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=\"geburtsdatum\" \/><\/span>\n        <\/label>\n\n        <label>Antragsteller *\n          <span class=\"wpcf7-form-control-wrap\" data-name=\"antragsteller\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Name des Antragstellers\" value=\"\" type=\"text\" name=\"antragsteller\" \/><\/span>\n        <\/label>\n\n        <label>E-Mail *\n          <span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><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\" placeholder=\"email@beispiel.ch\" value=\"\" type=\"email\" name=\"email\" \/><\/span>\n        <\/label>\n\n        <label>Telefon *\n          <span class=\"wpcf7-form-control-wrap\" data-name=\"telefon\"><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=\"Telefonnummer\" value=\"\" type=\"tel\" name=\"telefon\" \/><\/span>\n        <\/label>\n      <\/div>\n\n\n      <div>\n        <h4>Transportangaben<\/h4>\n\n        <label>Abholort *\n          <span class=\"wpcf7-form-control-wrap\" data-name=\"abholort\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Institution, Strasse, PLZ, Ort\" value=\"\" type=\"text\" name=\"abholort\" \/><\/span>\n        <\/label>\n\n        <label>Zielort *\n          <span class=\"wpcf7-form-control-wrap\" data-name=\"zielort\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Institution, Strasse, PLZ, Ort\" value=\"\" type=\"text\" name=\"zielort\" \/><\/span>\n        <\/label>\n\n        <label>Transportdatum *\n          <span class=\"wpcf7-form-control-wrap\" data-name=\"datum\"><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=\"datum\" \/><\/span>\n        <\/label>\n\n        <label>Transportzeit *\n          <span class=\"wpcf7-form-control-wrap\" data-name=\"zeit\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"z.B. 14:30 Uhr\" value=\"\" type=\"text\" name=\"zeit\" \/><\/span>\n        <\/label>\n\n        <label>R\u00fcckfahrt\n          <span class=\"wpcf7-form-control-wrap\" data-name=\"rueckfahrt\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"rueckfahrt\"><option value=\"\">Bitte ausw\u00e4hlen<\/option><option value=\"Nein\">Nein<\/option><option value=\"Ja\">Ja<\/option><\/select><\/span>\n        <\/label>\n\n        <label>R\u00fcckfahrzeit\n          <span class=\"wpcf7-form-control-wrap\" data-name=\"rueckfahrzeit\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"z.B. 16:30 Uhr\" value=\"\" type=\"text\" name=\"rueckfahrzeit\" \/><\/span>\n        <\/label>\n\n        <label>Zusatzinfos\n          <span class=\"wpcf7-form-control-wrap\" data-name=\"zusatzinfos\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Stockwerk, Zimmer, besondere Hinweise...\" name=\"zusatzinfos\"><\/textarea><\/span>\n        <\/label>\n      <\/div>\n\n    <\/div>\n  <\/div>\n\n\n  <div class=\"mp-box\">\n    <h3>Schritt 3: Rechnungsadresse<\/h3>\n\n    <label>Name \/ Firma *\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"rechnungsname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Name oder Firma\" value=\"\" type=\"text\" name=\"rechnungsname\" \/><\/span>\n    <\/label>\n\n    <label>Adresse *\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"rechnungsadresse\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Strasse, Hausnummer, PLZ, Ort\" value=\"\" type=\"text\" name=\"rechnungsadresse\" \/><\/span>\n    <\/label>\n\n    <label>Rechnungs-E-Mail *\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"rechnungemail\"><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\" placeholder=\"email@beispiel.ch\" value=\"\" type=\"email\" name=\"rechnungemail\" \/><\/span>\n    <\/label>\n  <\/div>\n\n\n  <div class=\"mp-box\">\n    <h3>Schritt 4: Bemerkungen + Best\u00e4tigung<\/h3>\n\n    <label>Bemerkungen\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"bemerkungen\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Weitere Informationen zum Transport...\" name=\"bemerkungen\"><\/textarea><\/span>\n    <\/label>\n\n    <div class=\"mp-confirm\">\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"bestaetigung\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"bestaetigung\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Ich best\u00e4tige, dass die Angaben korrekt sind.<\/span><\/label><\/span><\/span><\/span>\n    <\/div>\n  <\/div>\n\n\n  <div class=\"mp-submit\">\n    <input class=\"wpcf7-form-control 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