{"id":415,"date":"2026-09-03T19:11:54","date_gmt":"2026-09-03T19:11:54","guid":{"rendered":"https:\/\/calebadventministry.nl\/?page_id=415"},"modified":"2026-11-10T11:06:44","modified_gmt":"2026-11-10T10:06:44","slug":"intakeformulier-2","status":"publish","type":"page","link":"https:\/\/calebadventministry.nl\/?page_id=415","title":{"rendered":"Intakeformulier"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"415\" class=\"elementor elementor-415\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4652653b e-flex e-con-boxed e-con e-parent\" data-id=\"4652653b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b652291 e-flex e-con-boxed e-con e-parent\" data-id=\"b652291\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-490730b e-con-full e-flex e-con e-parent\" data-id=\"490730b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-82b3b8a elementor-widget elementor-widget-html\" data-id=\"82b3b8a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t\t<style>\r\n:root{\r\n  --p:#214e47;\r\n  --p2:#2f6f65;\r\n  --bg:#f5f8f7;\r\n  --line:#ccd9d6;\r\n  --soft:#edf6f4;\r\n  --danger:#8b1e1e;\r\n  --txt:#172622;\r\n}\r\n*{box-sizing:border-box}\r\n.cam-intake{\r\n  width:100%;\r\n  max-width:980px;\r\n  margin:20px auto;\r\n  padding:0 14px;\r\n  color:var(--txt);\r\n  font:16px\/1.5 system-ui,-apple-system,\"Segoe UI\",Arial,sans-serif\r\n}\r\n.cam-card{\r\n  background:#fff;\r\n  border:1px solid var(--line);\r\n  border-radius:16px;\r\n  padding:26px;\r\n  box-shadow:0 8px 28px #173b3512\r\n}\r\n.cam-card h1,.cam-card h2{\r\n  color:var(--p);\r\n  line-height:1.2\r\n}\r\n.cam-card h1{margin:0 0 15px;font-size:2.15rem}\r\n.cam-card h2{font-size:1.5rem}\r\n.note,.alert{padding:14px 16px;border-radius:8px;margin:14px 0}\r\n.note{background:var(--soft);border-left:5px solid var(--p2)}\r\n.alert{background:#fff2f2;border-left:5px solid var(--danger)}\r\n.progress{\r\n  height:10px;\r\n  background:#e5ecea;\r\n  border-radius:20px;\r\n  overflow:hidden;\r\n  margin:16px 0\r\n}\r\n.progress span{\r\n  display:block;\r\n  height:100%;\r\n  width:10%;\r\n  background:var(--p2);\r\n  transition:width .2s\r\n}\r\n.step{display:none}\r\n.step.active{display:block}\r\n.grid{display:grid;grid-template-columns:1fr 1fr;gap:16px}\r\n.q{margin:18px 0;min-width:0}\r\n.q>label{display:block;font-weight:700;margin-bottom:7px}\r\n.chips{display:flex;flex-wrap:wrap;gap:8px}\r\n.chips label{\r\n  border:1px solid var(--line);\r\n  border-radius:10px;\r\n  padding:9px 11px;\r\n  background:#fff;\r\n  cursor:pointer\r\n}\r\n.chips input{margin-right:6px}\r\n.cam-card input[type=text],\r\n.cam-card input[type=email],\r\n.cam-card input[type=tel],\r\n.cam-card input[type=date],\r\n.cam-card input[type=number],\r\n.cam-card select,\r\n.cam-card textarea{\r\n  width:100%;\r\n  max-width:100%;\r\n  padding:11px;\r\n  border:1px solid #aebfbb;\r\n  border-radius:8px;\r\n  background:#fff;\r\n  color:var(--txt);\r\n  font:inherit\r\n}\r\n.cam-card textarea{min-height:95px;resize:vertical}\r\n.small{font-size:.9rem;color:#52635f}\r\n.req{color:#a31e1e}\r\n.buttons{\r\n  display:flex;\r\n  justify-content:space-between;\r\n  gap:12px;\r\n  margin-top:26px\r\n}\r\n.buttons button,.print-btn{\r\n  border:0;\r\n  border-radius:9px;\r\n  padding:12px 18px;\r\n  font:inherit;\r\n  font-weight:700;\r\n  cursor:pointer\r\n}\r\n.prev{background:#e5ecea;color:#173b35}\r\n.next,.send{background:var(--p);color:#fff}\r\n.hidden{display:none!important}\r\n.summary{\r\n  white-space:pre-wrap;\r\n  background:#f8faf9;\r\n  border:1px solid var(--line);\r\n  border-radius:9px;\r\n  padding:15px;\r\n  max-height:440px;\r\n  overflow:auto\r\n}\r\n.top-actions{\r\n  display:flex;\r\n  justify-content:flex-end;\r\n  margin-bottom:18px\r\n}\r\n.print-btn{\r\n  background:#fff;\r\n  color:var(--p);\r\n  border:2px solid var(--p)\r\n}\r\n.route-grid{\r\n  display:grid;\r\n  grid-template-columns:repeat(3,minmax(0,1fr));\r\n  gap:12px\r\n}\r\n.route-option{display:block;position:relative}\r\n.route-option input{\r\n  position:absolute;\r\n  opacity:0;\r\n  width:1px;\r\n  height:1px\r\n}\r\n.route-card{\r\n  display:flex;\r\n  align-items:center;\r\n  justify-content:center;\r\n  min-height:100px;\r\n  height:100%;\r\n  padding:15px;\r\n  border:2px solid var(--line);\r\n  border-radius:12px;\r\n  color:var(--p);\r\n  font-weight:700;\r\n  text-align:center;\r\n  cursor:pointer\r\n}\r\n.route-option input:checked+.route-card{\r\n  background:var(--soft);\r\n  border-color:var(--p2);\r\n  box-shadow:0 0 0 3px rgba(47,111,101,.12)\r\n}\r\n.form-message{\r\n  display:none;\r\n  margin-top:20px;\r\n  padding:16px;\r\n  border-radius:10px;\r\n  font-weight:700\r\n}\r\n.form-message.error{\r\n  display:block;\r\n  background:#fff2f2;\r\n  border-left:5px solid var(--danger);\r\n  color:#681515\r\n}\r\n.form-message.success{\r\n  display:block;\r\n  background:var(--soft);\r\n  border-left:5px solid var(--p2);\r\n  color:var(--p)\r\n}\r\n\r\n@media(max-width:720px){\r\n  .cam-intake{margin:6px auto;padding:0 8px}\r\n  .cam-card{padding:16px 13px;border-radius:10px}\r\n  .cam-card h1{font-size:1.7rem}\r\n  .cam-card h2{font-size:1.3rem}\r\n  .grid,.route-grid{grid-template-columns:1fr}\r\n  .route-card{min-height:68px;justify-content:flex-start;text-align:left}\r\n  .buttons{flex-direction:column}\r\n  .buttons button,.print-btn{width:100%}\r\n  .top-actions{display:block}\r\n  .chips{flex-direction:column}\r\n  .chips label{width:100%}\r\n  .cam-card input,.cam-card select,.cam-card textarea{font-size:16px}\r\n}\r\n<\/style>\r\n\r\n<div class=\"cam-intake\">\r\n<div class=\"cam-card\">\r\n\r\n<div class=\"top-actions\">\r\n<button type=\"button\" class=\"print-btn\" id=\"printBtn\">Printversie<\/button>\r\n<\/div>\r\n\r\n<h1>Intakeformulier - holistische begeleiding<\/h1>\r\n\r\n<p>\r\nVoor volwassenen van 18 jaar en ouder. Deze intake ondersteunt brede professionele beeldvorming.\r\nAfhankelijk van de hulpvraag kunnen psychologische, gedragsgerichte, relationele\/systemische,\r\ncontextuele, leefstijl- en zingevingsgerichte perspectieven worden betrokken.\r\n<\/p>\r\n\r\n<div class=\"note\">\r\n<strong>Professionele afbakening.<\/strong>\r\nBinnen deze praktijk worden geen GGZ-behandelingen of medische behandelingen uitgevoerd,\r\ngeen medische diagnoses gesteld, geen medisch advies gegeven en geen medicatie voorgeschreven of beoordeeld.\r\nProfessionele interpretatie en keuzes blijven bij de begeleider.\r\n<\/div>\r\n\r\n<div class=\"note\">\r\n<strong>Vertrouwelijkheid.<\/strong>\r\nDe informatie wordt vertrouwelijk behandeld binnen de toepasselijke beroepsethische en wettelijke kaders.\r\nInhoudelijke dossierinzage is binnen de praktijk beperkt tot Rodney Blomhof.\r\n<\/div>\r\n\r\n<div class=\"alert\">\r\n<strong>Geen crisisdienst.<\/strong>\r\nDit formulier wordt niet voortdurend bewaakt.\r\nBel bij direct gevaar 112.\r\nBij gedachten aan zelfdoding: neem direct contact op met 113 Zelfmoordpreventie via 113 of 0800-0113.\r\n<\/div>\r\n\r\n<div>Stap <span id=\"n\">1<\/span> van 10<\/div>\r\n<div class=\"progress\"><span id=\"bar\"><\/span><\/div>\r\n\r\n<form id=\"f\" method=\"post\" action=\"\/wp-admin\/admin-post.php\" novalidate>\r\n\r\n<input type=\"hidden\" name=\"action\" value=\"cam_public_intake_prod\">\r\n\r\n<section class=\"step active\" data-print-title=\"1. Persoonlijke en contactgegevens\">\r\n<h2>1. Persoonlijke en contactgegevens<\/h2>\r\n\r\n<div class=\"q\">\r\n<div class=\"chips\">\r\n<label>\r\n<input type=\"checkbox\" name=\"leeftijd_18_plus\" value=\"Ja\" required>\r\nIk ben 18 jaar of ouder <span class=\"req\">*<\/span>\r\n<\/label>\r\n<\/div>\r\n<\/div>\r\n\r\n<div class=\"grid\">\r\n<div class=\"q\"><label>Volledige naam <span class=\"req\">*<\/span><\/label><input name=\"naam\" type=\"text\" required><\/div>\r\n<div class=\"q\"><label>Geboortedatum <span class=\"req\">*<\/span><\/label><input name=\"geboortedatum\" id=\"geboortedatum\" type=\"date\" required><\/div>\r\n<div class=\"q\"><label>E-mailadres <span class=\"req\">*<\/span><\/label><input name=\"email\" type=\"email\" required><\/div>\r\n<div class=\"q\"><label>Telefoonnummer <span class=\"req\">*<\/span><\/label><input name=\"telefoon\" type=\"tel\" required><\/div>\r\n<\/div>\r\n\r\n<div class=\"q\">\r\n<label>Voorkeur voor contact<\/label>\r\n<select name=\"contactwijze\">\r\n<option value=\"\">Kies<\/option>\r\n<option>E-mail<\/option>\r\n<option>Telefoon<\/option>\r\n<option>Videogesprek<\/option>\r\n<option>Op locatie<\/option>\r\n<option>Geen voorkeur<\/option>\r\n<\/select>\r\n<\/div>\r\n\r\n<div class=\"q\">\r\n<label>Hoe ben je bij Caleb Advent Ministry terechtgekomen?<\/label>\r\n<select name=\"verwijzer\">\r\n<option value=\"\">Kies<\/option>\r\n<option>Zelf gezocht<\/option>\r\n<option>Via huisarts<\/option>\r\n<option>Via andere begeleider\/hulpverlener<\/option>\r\n<option>Via kerk\/geloofsgemeenschap<\/option>\r\n<option>Via familie\/bekende<\/option>\r\n<option>Via internet\/sociale media<\/option>\r\n<option>Anders<\/option>\r\n<\/select>\r\n<\/div>\r\n<\/section>\r\n\r\n<section class=\"step\" data-print-title=\"2. Hulpvraag en gewenste begeleiding\">\r\n<h2>2. Hulpvraag en gewenste begeleiding<\/h2>\r\n\r\n<div class=\"q\">\r\n<label>Welke vorm van begeleiding zoek je? <span class=\"req\">*<\/span><\/label>\r\n\r\n<div class=\"route-grid\">\r\n<label class=\"route-option\">\r\n<input type=\"radio\" name=\"begeleidingsroute\" value=\"Psychologische begeleiding\" required>\r\n<span class=\"route-card\">Psychologische begeleiding<\/span>\r\n<\/label>\r\n\r\n<label class=\"route-option\">\r\n<input type=\"radio\" name=\"begeleidingsroute\" value=\"Coaching \/ counseling\" required>\r\n<span class=\"route-card\">Coaching \/ counseling<\/span>\r\n<\/label>\r\n\r\n<label class=\"route-option\">\r\n<input type=\"radio\" name=\"begeleidingsroute\" value=\"Pastorale begeleiding \/ geestelijke verzorging\" required>\r\n<span class=\"route-card\">Pastorale begeleiding \/ geestelijke verzorging<\/span>\r\n<\/label>\r\n<\/div>\r\n<\/div>\r\n\r\n<div class=\"q\">\r\n<label>Waar gaat je hulpvraag vooral over? <span class=\"req\">*<\/span><\/label>\r\n<div class=\"chips multi required-group\" data-name=\"hulpvraag_gebieden\">Persoonlijke ontwikkeling|Spanning\/stress|Somberheid\/verlies van perspectief|Angst\/onzekerheid\/piekeren|Rouw\/verlies\/verandering|Relatie\/gezin|Werk\/studie\/daginvulling|Grenzen stellen|Zelfbeeld\/zelfvertrouwen|Gedrag\/gewoonten|Geloof\/zingeving\/levensvragen|Ingrijpende ervaringen|Middelen\/leefstijl|Anders<\/div>\r\n<\/div>\r\n\r\n<div class=\"q\">\r\n<label>Waarom zoek je juist nu begeleiding? <span class=\"req\">*<\/span><\/label>\r\n<div class=\"chips multi\" data-name=\"aanleiding_keuze\">Recent iets gebeurd|Speelt al langer|Neemt toe|Dagelijks functioneren be\u00efnvloed|Advies van iemand anders|Voorkomen dat het erger wordt|Groeien\/patroon doorbreken|Anders<\/div>\r\n<textarea name=\"aanleiding\" required><\/textarea>\r\n<\/div>\r\n\r\n<div class=\"q\">\r\n<label>Hoe belastend is de situatie?<\/label>\r\n<select name=\"belasting\">\r\n<option value=\"\">Kies<\/option>\r\n<option>Licht<\/option>\r\n<option>Matig<\/option>\r\n<option>Ernstig<\/option>\r\n<option>Wisselend<\/option>\r\n<\/select>\r\n<\/div>\r\n\r\n<div class=\"q\">\r\n<label>Korte toelichting op je hulpvraag <span class=\"req\">*<\/span><\/label>\r\n<textarea name=\"klachten_beschrijving\" required><\/textarea>\r\n<\/div>\r\n\r\n<div class=\"q\">\r\n<label>Wat heb je al geprobeerd?<\/label>\r\n<div class=\"chips multi\" data-name=\"zelf_geprobeerd_keuze\">Familie\/vrienden|Predikant\/geestelijk verzorger|Coaching\/counseling|Professionele begeleiding|Zelfhulp\/boeken\/online|Gebed\/geloofsgemeenschap|Leefstijl aangepast|Afleiding\/vermijden|Nog niets|Anders<\/div>\r\n<\/div>\r\n\r\n<input type=\"hidden\" name=\"zelf_geprobeerd\" id=\"zelf_geprobeerd\">\r\n<\/section>\r\n\r\n<section class=\"step\" data-print-title=\"3. Patronen en samenhang\">\r\n<h2>3. Patronen en samenhang<\/h2>\r\n\r\n<div class=\"q\"><label>Wanneer speelt het vooral?<\/label><div class=\"chips multi\" data-name=\"patroon_situaties\">Thuis|Werk\/studie|Sociale situaties|Relatie\/gezin|Alleen zijn|Conflict|Kritiek\/afwijzing|Onzekerheid\/onverwachte gebeurtenissen|Herinneringen|Geloof\/zingeving|Sterk wisselend|Anders<\/div><\/div>\r\n\r\n<div class=\"q\"><label>Wat gaat er vaak aan vooraf?<\/label><div class=\"chips multi\" data-name=\"patroon_vooraf\">Kritiek\/meningsverschil|Afwijzing\/afstand|Prestatiedruk|Verantwoordelijkheid\/beslissing|Onzekerheid|Verlies\/herinnering|Vermoeidheid\/spanning|Geen duidelijke aanleiding|Anders<\/div><\/div>\r\n\r\n<div class=\"q\"><label>Wat gaat er vaak door je heen?<\/label><div class=\"chips multi\" data-name=\"patroon_gedachten\">Ik kan dit niet aan|Ik doe het niet goed|Ik word afgewezen|Er gaat iets mis|Ik moet controle houden|Ik moet sterk blijven|Ik mag geen fouten maken|Ik ben niet goed genoeg|Anderen zijn niet te vertrouwen|Ik ben verantwoordelijk|Anders<\/div><\/div>\r\n\r\n<div class=\"q\"><label>Welke betekenis krijgt de situatie voor jou?<\/label><div class=\"chips multi\" data-name=\"patroon_betekenis\">Niet veilig|Machteloos|Tekortschieten|Schuld|Alleen|Controle verliezen|Afwijzing|Falen|Mezelf beschermen|Anders<\/div><\/div>\r\n\r\n<div class=\"q\"><label>Wat voel je meestal?<\/label><div class=\"chips multi\" data-name=\"patroon_gevoel\">Angst|Spanning|Somberheid|Boosheid|Schuld|Schaamte|Verdriet|Eenzaamheid|Machteloosheid|Onrust|Leeg\/verdoofd|Anders<\/div><\/div>\r\n\r\n<div class=\"q\"><label>Wat merk je lichamelijk?<\/label><div class=\"chips multi\" data-name=\"patroon_lichaam\">Snelle hartslag|Druk op borst|Trillen|Zweten|Benauwdheid|Buikklachten|Hoofdpijn|Spierspanning|Vermoeidheid|Slaapproblemen|Nauwelijks iets|Anders<\/div><\/div>\r\n\r\n<div class=\"q\"><label>Wat doe je vervolgens?<\/label><div class=\"chips multi\" data-name=\"patroon_gedrag\">Vermijden|Terugtrekken|Uitstellen|Controleren|Geruststelling vragen|Piekeren|Overvoorbereiden|Aanpassen\/toegeven|Boos reageren|Afleiding|Gebed\/geestelijke steun|Middelen gebruiken|Anders<\/div><\/div>\r\n\r\n<div class=\"q\"><label>Wat levert dit op korte termijn op?<\/label><div class=\"chips multi\" data-name=\"patroon_kort\">Minder spanning|Meer controle|Conflict vermijden|Geruststelling|Afleiding|Bescherming tegen afwijzing|Geen merkbaar voordeel|Anders<\/div><\/div>\r\n\r\n<div class=\"q\"><label>Wat zijn gevolgen op langere termijn?<\/label><div class=\"chips multi\" data-name=\"patroon_lang\">Probleem blijft bestaan|Meer spanning\/angst|Minder zelfvertrouwen|Meer conflicten|Meer vermijding|Minder sociale contacten|Problemen werk\/studie|Zingevingsproblemen|Anders<\/div><\/div>\r\n\r\n<div class=\"q\"><label>Concreet voorbeeld<\/label><textarea name=\"patroon_voorbeeld\"><\/textarea><\/div>\r\n<\/section>\r\n\r\n<section class=\"step\" data-print-title=\"4. Duur en functioneren\">\r\n<h2>4. Duur en functioneren<\/h2>\r\n\r\n<div class=\"grid\">\r\n<div class=\"q\"><label>Hoe lang speelt dit? <span class=\"req\">*<\/span><\/label>\r\n<select name=\"duur\" required>\r\n<option value=\"\">Kies<\/option>\r\n<option>&lt; 1 maand<\/option>\r\n<option>1-3 maanden<\/option>\r\n<option>3-6 maanden<\/option>\r\n<option>6-12 maanden<\/option>\r\n<option>1-5 jaar<\/option>\r\n<option>&gt; 5 jaar<\/option>\r\n<option>Wisselend door de jaren<\/option>\r\n<\/select>\r\n<\/div>\r\n\r\n<div class=\"q\"><label>Hoe vaak? <span class=\"req\">*<\/span><\/label>\r\n<select name=\"frequentie\" required>\r\n<option value=\"\">Kies<\/option>\r\n<option>Minder dan maandelijks<\/option>\r\n<option>Enkele keren per maand<\/option>\r\n<option>Wekelijks<\/option>\r\n<option>Meerdere keren per week<\/option>\r\n<option>Dagelijks<\/option>\r\n<option>Vrijwel voortdurend<\/option>\r\n<\/select>\r\n<\/div>\r\n\r\n<div class=\"q\"><label>Hoe zwaar ervaar je dit? 0-10 <span class=\"req\">*<\/span><\/label><input name=\"ernst\" type=\"number\" min=\"0\" max=\"10\" required><\/div>\r\n<div class=\"q\"><label>Energieniveau 0-10<\/label><input name=\"energie\" type=\"number\" min=\"0\" max=\"10\"><\/div>\r\n<\/div>\r\n\r\n<div class=\"q\"><label>Welke gebieden worden be\u00efnvloed?<\/label><div class=\"chips multi\" data-name=\"functioneren_gebieden\">Werk|Studie|Relatie|Gezin|Vriendschappen|Zelfzorg|Slaap|Geloofsleven|Sociale activiteiten|Anders<\/div><\/div>\r\n\r\n<div class=\"grid\">\r\n<div class=\"q\"><label>Slaapduur<\/label><select name=\"slaapuren\"><option value=\"\">Kies<\/option><option>&lt; 4 uur<\/option><option>4-6 uur<\/option><option>6-8 uur<\/option><option>8-10 uur<\/option><option>&gt; 10 uur<\/option><\/select><\/div>\r\n<div class=\"q\"><label>Slaapkwaliteit<\/label><select name=\"slaapkwaliteit\"><option value=\"\">Kies<\/option><option>Goed<\/option><option>Redelijk<\/option><option>Matig<\/option><option>Slecht<\/option><option>Zeer slecht<\/option><\/select><\/div>\r\n<div class=\"q\"><label>Eetlust<\/label><select name=\"eetlust\"><option value=\"\">Kies<\/option><option>Onveranderd<\/option><option>Minder<\/option><option>Meer<\/option><option>Wisselend<\/option><\/select><\/div>\r\n<div class=\"q\"><label>Concentratie<\/label><select name=\"concentratie\"><option value=\"\">Kies<\/option><option>Goed<\/option><option>Redelijk<\/option><option>Matig<\/option><option>Slecht<\/option><\/select><\/div>\r\n<\/div>\r\n<\/section>\r\n\r\n<section class=\"step\" data-print-title=\"5. Begeleiding en gezondheidscontext\">\r\n<h2>5. Eerdere begeleiding en relevante gezondheidscontext<\/h2>\r\n\r\n<div class=\"q\"><label>Ontvang je momenteel begeleiding?<\/label><select name=\"huidige_begeleiding\"><option value=\"\">Kies<\/option><option>Nee<\/option><option>Ja<\/option><option>Op wachtlijst<\/option><option>Liever mondeling<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Soort professional<\/label><div class=\"chips multi\" data-name=\"begeleider_soort\">Huisarts|Psycholoog\/therapeut|Coach\/counselor|Geestelijk verzorger\/predikant|Maatschappelijk werker|Andere professional<\/div><\/div>\r\n\r\n<div class=\"q\"><label>Eerdere begeleiding of therapie?<\/label><select name=\"eerdere_begeleiding\"><option value=\"\">Kies<\/option><option>Nee<\/option><option>Ja<\/option><option>Liever mondeling<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Was eerdere begeleiding helpend?<\/label><select name=\"begeleiding_omschrijving\"><option value=\"\">Kies<\/option><option>Niet van toepassing<\/option><option>Ja<\/option><option>Gedeeltelijk<\/option><option>Nee<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Eerder iets professioneel vastgesteld?<\/label><select name=\"diagnoses\"><option value=\"\">Kies<\/option><option>Nee<\/option><option>Ja<\/option><option>Weet ik niet<\/option><option>Liever mondeling<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Relevante medicatiecontext?<\/label><select name=\"medicatie\"><option value=\"\">Kies<\/option><option>Nee<\/option><option>Ja<\/option><option>Weet ik niet<\/option><option>Liever mondeling<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Relevante gezondheidsomstandigheden?<\/label><select name=\"medisch\"><option value=\"\">Kies<\/option><option>Nee<\/option><option>Ja<\/option><option>Liever mondeling<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Ingrijpende gebeurtenissen relevant?<\/label><select name=\"trauma\"><option value=\"\">Kies<\/option><option>Nee<\/option><option>Ja<\/option><option>Misschien<\/option><option>Liever mondeling<\/option><\/select><\/div>\r\n<\/section>\r\n\r\n<section class=\"step\" data-print-title=\"6. Leefstijl en middelen\">\r\n<h2>6. Leefstijl en middelen<\/h2>\r\n\r\n<div class=\"grid\">\r\n<div class=\"q\"><label>Alcohol<\/label><select name=\"alcohol\"><option value=\"\">Kies<\/option><option>Niet<\/option><option>Minder dan wekelijks<\/option><option>Wekelijks<\/option><option>Meerdere dagen per week<\/option><option>Dagelijks<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Nicotine<\/label><select name=\"nicotine\"><option value=\"\">Kies<\/option><option>Niet<\/option><option>Soms<\/option><option>Dagelijks<\/option><option>Gestopt<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Cannabis<\/label><select name=\"cannabis\"><option value=\"\">Kies<\/option><option>Niet<\/option><option>Soms<\/option><option>Regelmatig<\/option><option>Gestopt<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Andere middelen<\/label><select name=\"drugs\"><option value=\"\">Kies<\/option><option>Niet<\/option><option>Soms<\/option><option>Regelmatig<\/option><option>Gestopt<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Cafe\u00efne<\/label><select name=\"cafeine\"><option value=\"\">Kies<\/option><option>Niet<\/option><option>1-2 per dag<\/option><option>3-5 per dag<\/option><option>&gt; 5 per dag<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Beweging<\/label><select name=\"beweging\"><option value=\"\">Kies<\/option><option>Nauwelijks<\/option><option>1x per week<\/option><option>2-3x per week<\/option><option>4+ per week<\/option><\/select><\/div>\r\n<\/div>\r\n\r\n<div class=\"q\"><label>Zorgen over middelengebruik?<\/label><select name=\"middelen_toelichting\"><option value=\"\">Kies<\/option><option>Nee<\/option><option>Enigszins<\/option><option>Ja<\/option><option>Liever mondeling<\/option><\/select><\/div>\r\n<\/section>\r\n\r\n<section class=\"step\" data-print-title=\"7. Levensgebieden en steun\">\r\n<h2>7. Levensgebieden en steun<\/h2>\r\n\r\n<div class=\"grid\">\r\n<div class=\"q\"><label>Woonsituatie<\/label><select name=\"woonsituatie\"><option value=\"\">Kies<\/option><option>Alleen<\/option><option>Met partner<\/option><option>Met gezin<\/option><option>Bij familie<\/option><option>Anders<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Kinderen\/zorgtaken<\/label><select name=\"kinderen\"><option value=\"\">Kies<\/option><option>Nee<\/option><option>Ja<\/option><option>Liever mondeling<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Werk\/studie\/daginvulling<\/label><select name=\"werk\"><option value=\"\">Kies<\/option><option>Betaald werk<\/option><option>Zelfstandig ondernemer<\/option><option>Studie<\/option><option>Vrijwilligerswerk<\/option><option>Werkzoekend<\/option><option>Ziekteverlof\/arbeidsongeschikt<\/option><option>Pensioen<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Financi\u00eble zorgen<\/label><select name=\"financien\"><option value=\"\">Kies<\/option><option>Nee<\/option><option>Enigszins<\/option><option>Ja<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Relatie\/gezin<\/label><select name=\"relatiestatus\"><option value=\"\">Kies<\/option><option>Geen actuele zorgen<\/option><option>Enige spanning<\/option><option>Ernstige spanning\/conflict<\/option><option>Verlies\/scheiding<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Sociale steun<\/label><select name=\"sociale_steun\"><option value=\"\">Kies<\/option><option>Goed<\/option><option>Redelijk<\/option><option>Beperkt<\/option><option>Geen<\/option><option>Wisselend<\/option><\/select><\/div>\r\n<\/div>\r\n\r\n<div class=\"q\"><label>Steunbronnen<\/label><div class=\"chips multi\" data-name=\"beschermende_factoren\">Partner|Familie|Vrienden|Kerk\/geloofsgemeenschap|Professionele begeleiding|Collega's|Buurt\/vereniging|Geen|Anders<\/div><\/div>\r\n\r\n<div class=\"q\"><label>Actuele stressfactoren<\/label><div class=\"chips multi\" data-name=\"stressoren\">Werk\/studie|Relatie\/gezin|Financi\u00ebn|Zorgtaken|Verlies\/rouw|Gezondheid|Wonen|Eenzaamheid|Geloof\/zingeving|Geen bijzondere stressfactor|Anders<\/div><\/div>\r\n<\/section>\r\n\r\n<section class=\"step\" data-print-title=\"8. Veiligheid\">\r\n<h2>8. Veiligheid en passende route<\/h2>\r\n\r\n<div class=\"q\">\r\n<label>In de afgelopen maand gedacht dat je beter dood zou kunnen zijn of jezelf iets zou kunnen aandoen? <span class=\"req\">*<\/span><\/label>\r\n<select name=\"suicide_gedachten\" id=\"suicide\" required>\r\n<option value=\"\">Kies<\/option>\r\n<option>Nee<\/option>\r\n<option>Ja, zonder concreet plan<\/option>\r\n<option>Ja, met plan of voorbereiding<\/option>\r\n<option>Liever mondeling<\/option>\r\n<\/select>\r\n<\/div>\r\n\r\n<div id=\"crisis\" class=\"alert hidden\">\r\n<strong>Zoek nu directe hulp.<\/strong>\r\nWacht niet op een reactie via dit formulier.\r\nBel bij direct gevaar 112 of neem contact op met 113 Zelfmoordpreventie.\r\n<\/div>\r\n\r\n<div class=\"q\"><label>Eerdere poging relevant voor huidige veiligheid?<\/label><select name=\"poging\"><option value=\"\">Kies<\/option><option>Nee<\/option><option>Ja<\/option><option>Liever mondeling<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Gedachten om iemand anders schade toe te brengen?<\/label><select name=\"risico_anderen\"><option value=\"\">Kies<\/option><option>Nee<\/option><option>Ja<\/option><option>Liever mondeling<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Voel je je thuis en in naaste relaties veilig?<\/label><select name=\"veilig_thuis\"><option value=\"\">Kies<\/option><option>Ja<\/option><option>Niet altijd<\/option><option>Nee<\/option><option>Liever mondeling<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Wat helpt je veilig te blijven?<\/label><div class=\"chips multi\" data-name=\"beschermend_veiligheid\">Partner\/familie\/vriend|Professional|Geloof\/gebed|Afleiding\/vaste activiteiten|Veiligheidsafspraken|Ik weet het niet|Anders<\/div><\/div>\r\n<\/section>\r\n\r\n<section class=\"step\" data-print-title=\"9. Zingeving en doelen\">\r\n<h2>9. Zingeving en doelen<\/h2>\r\n\r\n<div class=\"q\"><label>Wil je geloof of zingeving betrekken?<\/label><select name=\"integratie_geloof\"><option value=\"\">Kies<\/option><option>Nee<\/option><option>Ja<\/option><option>Misschien<\/option><option>Weet ik nog niet<\/option><\/select><\/div>\r\n\r\n<div class=\"q\"><label>Welke aspecten zijn relevant?<\/label><div class=\"chips multi\" data-name=\"geloof_toelichting\">Geloof\/Godsbeeld|Waarden\/levenskeuzes|Gebed|Kerk\/geloofsgemeenschap|Schuld\/vergeving|Hoop\/toekomst|Identiteit\/roeping|Verlies\/geloofstwijfel|Niet van toepassing|Anders<\/div><\/div>\r\n\r\n<div class=\"q\"><label>Korte termijn doelen <span class=\"req\">*<\/span><\/label><div class=\"chips multi required-group\" data-name=\"doelen_kort\">Meer inzicht|Minder vermijding|Beter omgaan met spanning|Grenzen stellen|Patronen doorbreken|Meer structuur|Betere relaties|Gebeurtenissen verwerken|Groei in geloof\/zingeving|Anders<\/div><\/div>\r\n\r\n<div class=\"q\"><label>Lange termijn doelen<\/label><div class=\"chips multi\" data-name=\"doelen_lang\">Zelfstandiger functioneren|Terugval voorkomen|Meer zelfvertrouwen|Duurzame gedragsverandering|Betere balans|Meer verbondenheid|Meer richting\/zingeving|Anders<\/div><\/div>\r\n\r\n<div class=\"q\"><label>Waaraan merk je dat begeleiding helpt?<\/label><div class=\"chips multi\" data-name=\"succes\">Meer doen wat belangrijk is|Minder vermijden|Beter functioneren|Relaties verbeteren|Meer rust\/richting|Anders<\/div><\/div>\r\n\r\n<div class=\"grid\">\r\n<div class=\"q\"><label>Motivatie 0-10<\/label><input name=\"motivatie\" type=\"number\" min=\"0\" max=\"10\"><\/div>\r\n<div class=\"q\"><label>Voorkeur begeleiding<\/label><select name=\"voorkeur\"><option value=\"\">Kies<\/option><option>Online<\/option><option>Op locatie<\/option><option>Geen voorkeur<\/option><\/select><\/div>\r\n<\/div>\r\n<\/section>\r\n\r\n<section class=\"step\" data-print-title=\"10. Controle en toestemming\">\r\n<h2>10. Controle en toestemming<\/h2>\r\n\r\n<div class=\"note\">\r\nDe onderstaande samenvatting is uitsluitend een feitelijke weergave van de antwoorden.\r\n<\/div>\r\n\r\n<div id=\"summary\" class=\"summary\"><\/div>\r\n\r\n<div class=\"q\"><div class=\"chips\"><label><input type=\"checkbox\" name=\"waarheid\" value=\"1\" required> Ik verklaar dat ik de vragen naar beste weten heb ingevuld. <span class=\"req\">*<\/span><\/label><\/div><\/div>\r\n\r\n<div class=\"q\"><div class=\"chips\"><label><input type=\"checkbox\" name=\"privacy_gelezen\" value=\"1\" required> Ik heb de privacyverklaring gelezen. <span class=\"req\">*<\/span><\/label><\/div><\/div>\r\n\r\n<div class=\"q\"><div class=\"chips\"><label><input type=\"checkbox\" name=\"noodzakelijke_verwerking_bevestigd\" value=\"1\" required> Ik geef uitdrukkelijk toestemming voor verwerking van de verstrekte gegevens voor intake, professionele begeleiding, contact en interne dossiervoering. <span class=\"req\">*<\/span><\/label><\/div><\/div>\r\n\r\n<div class=\"q\"><div class=\"chips\"><label><input type=\"checkbox\" name=\"geen_crisisroute\" value=\"1\" required> Ik begrijp dat dit formulier geen crisis- of spoedroute is. <span class=\"req\">*<\/span><\/label><\/div><\/div>\r\n\r\n<div class=\"q\"><div class=\"chips\"><label><input type=\"checkbox\" name=\"email_toestemming\" value=\"1\"> Ik geef afzonderlijk toestemming voor praktische communicatie per e-mail.<\/label><\/div><\/div>\r\n\r\n<input type=\"hidden\" name=\"intakeverslag\" id=\"intakeverslag\">\r\n<input type=\"hidden\" name=\"screening_scores\" value=\"Geen automatische screening in deze versie.\">\r\n<\/section>\r\n\r\n<div class=\"buttons\">\r\n<button type=\"button\" class=\"prev\" id=\"prev\">Vorige<\/button>\r\n<button type=\"button\" class=\"next\" id=\"next\">Volgende<\/button>\r\n<button type=\"submit\" class=\"send hidden\" id=\"send\">Intake veilig verzenden<\/button>\r\n<\/div>\r\n\r\n<\/form>\r\n\r\n<div id=\"formMessage\" class=\"form-message\" role=\"alert\" aria-live=\"polite\"><\/div>\r\n\r\n<\/div>\r\n<\/div>\r\n\r\n<script>\r\n(()=>{\r\n'use strict';\r\n\r\nconst f=document.getElementById('f');\r\nconst steps=[...document.querySelectorAll('.step')];\r\nconst bar=document.getElementById('bar');\r\nconst n=document.getElementById('n');\r\nconst prev=document.getElementById('prev');\r\nconst next=document.getElementById('next');\r\nconst send=document.getElementById('send');\r\nconst summary=document.getElementById('summary');\r\nconst report=document.getElementById('intakeverslag');\r\nconst suicide=document.getElementById('suicide');\r\nconst crisis=document.getElementById('crisis');\r\nconst printBtn=document.getElementById('printBtn');\r\nconst message=document.getElementById('formMessage');\r\nconst zelf=document.getElementById('zelf_geprobeerd');\r\nconst dob=document.getElementById('geboortedatum');\r\n\r\nlet i=0;\r\n\r\n\/* Keuzevelden opbouwen *\/\r\ndocument.querySelectorAll('.multi').forEach(box=>{\r\n  const name=box.dataset.name;\r\n  const vals=box.textContent.split('|').map(x=>x.trim()).filter(Boolean);\r\n\r\n  box.textContent='';\r\n\r\n  vals.forEach(v=>{\r\n    const label=document.createElement('label');\r\n    const input=document.createElement('input');\r\n\r\n    input.type='checkbox';\r\n    input.name=name+'[]';\r\n    input.value=v;\r\n\r\n    label.append(input,document.createTextNode(v));\r\n    box.append(label);\r\n  });\r\n});\r\n\r\n\/* Leeftijd *\/\r\nfunction getAge(value){\r\n  if(!value)return null;\r\n\r\n  const parts=value.split('-').map(Number);\r\n\r\n  if(parts.length!==3)return null;\r\n\r\n  const today=new Date();\r\n  let age=today.getFullYear()-parts[0];\r\n\r\n  if(\r\n    today.getMonth()+1<parts[1] ||\r\n    (\r\n      today.getMonth()+1===parts[1] &&\r\n      today.getDate()<parts[2]\r\n    )\r\n  ){\r\n    age--;\r\n  }\r\n\r\n  return age;\r\n}\r\n\r\nfunction validateAdult(){\r\n  const age=getAge(dob.value);\r\n\r\n  if(age===null){\r\n    dob.setCustomValidity('Vul een geldige geboortedatum in.');\r\n    return false;\r\n  }\r\n\r\n  if(age<18){\r\n    dob.setCustomValidity('Deze intake is uitsluitend bestemd voor volwassenen van 18 jaar en ouder.');\r\n    return false;\r\n  }\r\n\r\n  dob.setCustomValidity('');\r\n  return true;\r\n}\r\n\r\ndob.addEventListener('change',validateAdult);\r\n\r\n\/* Afgeleid veld *\/\r\nfunction updateDerived(){\r\n  zelf.value=[\r\n    ...f.querySelectorAll('[name=\"zelf_geprobeerd_keuze[]\"]:checked')\r\n  ].map(x=>x.value).join(', ');\r\n}\r\n\r\n\/* Navigatie *\/\r\nfunction show(){\r\n  steps.forEach((step,index)=>{\r\n    step.classList.toggle('active',index===i);\r\n  });\r\n\r\n  n.textContent=i+1;\r\n  bar.style.width=((i+1)\/steps.length*100)+'%';\r\n\r\n  prev.style.visibility=i?'visible':'hidden';\r\n  next.classList.toggle('hidden',i===steps.length-1);\r\n  send.classList.toggle('hidden',i!==steps.length-1);\r\n\r\n  if(i===steps.length-1){\r\n    buildSummary();\r\n  }\r\n\r\n  document.querySelector('.cam-intake').scrollIntoView({\r\n    behavior:'smooth',\r\n    block:'start'\r\n  });\r\n}\r\n\r\nfunction validateStep(){\r\n  if(i===0&&!validateAdult()){\r\n    dob.reportValidity();\r\n    return false;\r\n  }\r\n\r\n  for(const element of steps[i].querySelectorAll('[required]')){\r\n    if(!element.checkValidity()){\r\n      element.reportValidity();\r\n      return false;\r\n    }\r\n  }\r\n\r\n  for(const group of steps[i].querySelectorAll('.required-group')){\r\n    if(!group.querySelector('input:checked')){\r\n      alert('Kies minimaal \u00e9\u00e9n antwoord bij deze verplichte vraag.');\r\n      return false;\r\n    }\r\n  }\r\n\r\n  return true;\r\n}\r\n\r\n\/* Labels *\/\r\nfunction getLabel(element){\r\n  const q=element.closest('.q');\r\n\r\n  if(q){\r\n    const label=q.querySelector(':scope > label');\r\n\r\n    if(label){\r\n      return label.innerText.replace(\/\\*\/g,'').trim();\r\n    }\r\n\r\n    const nested=q.querySelector('label');\r\n\r\n    if(nested){\r\n      return nested.innerText.replace(\/\\*\/g,'').trim();\r\n    }\r\n  }\r\n\r\n  return element.name.replace(\/\\[\\]$\/,'');\r\n}\r\n\r\nfunction prettyValue(name,value){\r\n  if(\r\n    [\r\n      'waarheid',\r\n      'privacy_gelezen',\r\n      'noodzakelijke_verwerking_bevestigd',\r\n      'geen_crisisroute',\r\n      'email_toestemming'\r\n    ].includes(name)\r\n  ){\r\n    return value==='1'?'Ja':'Nee';\r\n  }\r\n\r\n  if(name==='screening_scores'){\r\n    return 'Niet toegepast';\r\n  }\r\n\r\n  return value;\r\n}\r\n\r\n\/* Samenvatting *\/\r\nfunction collectData(){\r\n  updateDerived();\r\n\r\n  const grouped=new Map();\r\n\r\n  for(const element of f.elements){\r\n    if(!element.name)continue;\r\n\r\n    if(\r\n      ['action','intakeverslag'].includes(element.name) ||\r\n      ['button','submit'].includes(element.type)\r\n    ){\r\n      continue;\r\n    }\r\n\r\n    if(\r\n      (element.type==='checkbox'||element.type==='radio') &&\r\n      !element.checked\r\n    ){\r\n      continue;\r\n    }\r\n\r\n    let value=String(element.value||'').trim();\r\n\r\n    if(!value)continue;\r\n\r\n    const name=element.name.replace(\/\\[\\]$\/,'');\r\n\r\n    value=prettyValue(name,value);\r\n\r\n    if(!grouped.has(name)){\r\n      grouped.set(name,{\r\n        label:getLabel(element),\r\n        values:[]\r\n      });\r\n    }\r\n\r\n    if(!grouped.get(name).values.includes(value)){\r\n      grouped.get(name).values.push(value);\r\n    }\r\n  }\r\n\r\n  return grouped;\r\n}\r\n\r\nfunction buildSummary(){\r\n  const grouped=collectData();\r\n  const lines=[];\r\n\r\n  grouped.forEach(item=>{\r\n    lines.push(item.label+': '+item.values.join(', '));\r\n  });\r\n\r\n  const text=lines.join('\\n');\r\n\r\n  summary.textContent=text||'Nog geen antwoorden.';\r\n  report.value=text;\r\n\r\n  return text;\r\n}\r\n\r\n\/* Veilige HTML voor print *\/\r\nfunction escapeHtml(value){\r\n  return String(value)\r\n    .replace(\/&\/g,'&amp;')\r\n    .replace(\/<\/g,'&lt;')\r\n    .replace(\/>\/g,'&gt;')\r\n    .replace(\/\"\/g,'&quot;')\r\n    .replace(\/'\/g,'&#039;');\r\n}\r\n\r\n\/* NIEUWE LOSSE PRINTVERSIE *\/\r\nfunction createPrintVersion(){\r\n  buildSummary();\r\n\r\n  const grouped=collectData();\r\n  let rows='';\r\n\r\n  grouped.forEach(item=>{\r\n    rows+=\r\n      '<div class=\"answer\">'+\r\n        '<div class=\"label\">'+escapeHtml(item.label)+'<\/div>'+\r\n        '<div class=\"value\">'+escapeHtml(item.values.join(', '))+'<\/div>'+\r\n      '<\/div>';\r\n  });\r\n\r\n  const printWindow=window.open('','_blank','width=900,height=700');\r\n\r\n  if(!printWindow){\r\n    showMessage(\r\n      'error',\r\n      'De printversie kon niet worden geopend. Sta pop-ups voor deze website toe en probeer opnieuw.'\r\n    );\r\n    return;\r\n  }\r\n\r\n  printWindow.document.open();\r\n\r\n  printWindow.document.write(\r\n`<!doctype html>\r\n<html lang=\"nl\">\r\n<head>\r\n<meta charset=\"utf-8\">\r\n<title>Intakeformulier - printversie<\/title>\r\n\r\n<style>\r\n@page{\r\n  size:A4;\r\n  margin:18mm;\r\n}\r\n\r\n*{\r\n  box-sizing:border-box;\r\n}\r\n\r\nbody{\r\n  margin:0;\r\n  color:#172622;\r\n  background:#fff;\r\n  font:11pt\/1.45 Arial,Helvetica,sans-serif;\r\n}\r\n\r\n.document{\r\n  max-width:180mm;\r\n  margin:0 auto;\r\n}\r\n\r\n.header{\r\n  border-bottom:3px solid #214e47;\r\n  padding-bottom:12px;\r\n  margin-bottom:20px;\r\n}\r\n\r\nh1{\r\n  margin:0 0 6px;\r\n  color:#214e47;\r\n  font-size:22pt;\r\n}\r\n\r\n.subtitle{\r\n  color:#52635f;\r\n  font-size:10.5pt;\r\n}\r\n\r\n.notice{\r\n  margin:16px 0 20px;\r\n  background:#edf6f4;\r\n  border-left:4px solid #2f6f65;\r\n  padding:10px 12px;\r\n}\r\n\r\nh2{\r\n  color:#214e47;\r\n  font-size:14pt;\r\n  margin:24px 0 10px;\r\n  padding-bottom:5px;\r\n  border-bottom:1px solid #ccd9d6;\r\n}\r\n\r\n.answer{\r\n  display:grid;\r\n  grid-template-columns:38% 62%;\r\n  border-bottom:1px solid #e1e7e5;\r\n  break-inside:avoid;\r\n  page-break-inside:avoid;\r\n}\r\n\r\n.label{\r\n  font-weight:bold;\r\n  color:#214e47;\r\n  padding:7px 10px 7px 0;\r\n}\r\n\r\n.value{\r\n  padding:7px 0 7px 10px;\r\n  white-space:pre-wrap;\r\n  overflow-wrap:anywhere;\r\n}\r\n\r\n.footer{\r\n  margin-top:24px;\r\n  border-top:1px solid #ccd9d6;\r\n  padding-top:10px;\r\n  color:#667570;\r\n  font-size:9pt;\r\n}\r\n\r\n.no-print{\r\n  text-align:right;\r\n  margin-bottom:16px;\r\n}\r\n\r\nbutton{\r\n  background:#214e47;\r\n  color:#fff;\r\n  border:0;\r\n  border-radius:6px;\r\n  padding:10px 16px;\r\n  font-weight:bold;\r\n  cursor:pointer;\r\n}\r\n\r\n@media print{\r\n  .no-print{\r\n    display:none!important;\r\n  }\r\n\r\n  body{\r\n    -webkit-print-color-adjust:exact;\r\n    print-color-adjust:exact;\r\n  }\r\n}\r\n<\/style>\r\n<\/head>\r\n\r\n<body>\r\n\r\n<div class=\"document\">\r\n\r\n<div class=\"no-print\">\r\n<button onclick=\"window.print()\">Afdrukken \/ Opslaan als PDF<\/button>\r\n<\/div>\r\n\r\n<div class=\"header\">\r\n<h1>Intakeformulier<\/h1>\r\n<div class=\"subtitle\">\r\nHolistische begeleiding | Caleb Advent Ministry | 18+\r\n<\/div>\r\n<\/div>\r\n\r\n<div class=\"notice\">\r\n<strong>Printversie van de ingevulde intake.<\/strong><br>\r\nDeze weergave bevat uitsluitend de antwoorden uit het intakeformulier.\r\nEr wordt geen automatische diagnose of behandelbeslissing gegenereerd.\r\n<\/div>\r\n\r\n<h2>Ingevulde gegevens<\/h2>\r\n\r\n${rows || '<p>Er zijn nog geen ingevulde antwoorden beschikbaar.<\/p>'}\r\n\r\n<div class=\"footer\">\r\nVertrouwelijke intakegegevens. Behandel deze print of PDF zorgvuldig.\r\n<\/div>\r\n\r\n<\/div>\r\n\r\n<\/body>\r\n<\/html>`\r\n  );\r\n\r\n  printWindow.document.close();\r\n  printWindow.focus();\r\n}\r\n\r\n\/* Printknop gebruikt voortaan uitsluitend losse intakeweergave *\/\r\nprintBtn.addEventListener('click',createPrintVersion);\r\n\r\n\/* Meldingen *\/\r\nfunction showMessage(type,text){\r\n  message.className='form-message '+type;\r\n  message.textContent=text;\r\n\r\n  message.scrollIntoView({\r\n    behavior:'smooth',\r\n    block:'center'\r\n  });\r\n}\r\n\r\nfunction resetSend(){\r\n  send.disabled=false;\r\n  send.textContent='Intake veilig verzenden';\r\n}\r\n\r\nfunction humanError(code,field,messageText){\r\n  if(messageText)return messageText;\r\n\r\n  if(code==='adult_only'){\r\n    return 'Deze intake is uitsluitend bestemd voor volwassenen van 18 jaar en ouder.';\r\n  }\r\n\r\n  if(code==='invalid_birthdate'){\r\n    return 'Vul een geldige geboortedatum in.';\r\n  }\r\n\r\n  if(code==='invalid_email'){\r\n    return 'Vul een geldig e-mailadres in.';\r\n  }\r\n\r\n  if(code==='missing_required_field'){\r\n    const names={\r\n      naam:'de volledige naam',\r\n      geboortedatum:'de geboortedatum',\r\n      email:'het e-mailadres',\r\n      telefoon:'het telefoonnummer',\r\n      begeleidingsroute:'de gewenste vorm van begeleiding',\r\n      hulpvraag_gebieden:'minimaal \u00e9\u00e9n hulpvraaggebied',\r\n      aanleiding:'de aanleiding',\r\n      klachten_beschrijving:'de toelichting op de hulpvraag',\r\n      duur:'de duur',\r\n      frequentie:'de frequentie',\r\n      ernst:'de ervaren ernst',\r\n      suicide_gedachten:'de veiligheidsvraag',\r\n      doelen_kort:'minimaal \u00e9\u00e9n kortetermijndoel'\r\n    };\r\n\r\n    return 'Vul '+(names[field]||field||'het verplichte veld')+' in.';\r\n  }\r\n\r\n  if(code==='missing_confirmation'){\r\n    return 'Controleer alle verplichte verklaringen en toestemmingen.';\r\n  }\r\n\r\n  if(code==='production_storage_unavailable'){\r\n    return 'De beveiligde dossieropslag is momenteel niet beschikbaar.';\r\n  }\r\n\r\n  return 'De intake kon niet worden verzonden. Controleer de ingevulde gegevens.';\r\n}\r\n\r\n\/* Navigatie *\/\r\nnext.addEventListener('click',()=>{\r\n  if(validateStep()){\r\n    updateDerived();\r\n\r\n    if(i<steps.length-1){\r\n      i++;\r\n    }\r\n\r\n    show();\r\n  }\r\n});\r\n\r\nprev.addEventListener('click',()=>{\r\n  if(i>0){\r\n    i--;\r\n    show();\r\n  }\r\n});\r\n\r\n\/* Crisiswaarschuwing *\/\r\nsuicide.addEventListener('change',()=>{\r\n  crisis.classList.toggle(\r\n    'hidden',\r\n    suicide.value!=='Ja, met plan of voorbereiding'\r\n  );\r\n});\r\n\r\n\/* WERKENDE PRODUCTIEVERZENDING BEHOUDEN *\/\r\nf.addEventListener('submit',async event=>{\r\n  event.preventDefault();\r\n\r\n  buildSummary();\r\n\r\n  if(!validateAdult()){\r\n    i=0;\r\n    show();\r\n    dob.reportValidity();\r\n    return;\r\n  }\r\n\r\n  if(!f.checkValidity()){\r\n    f.reportValidity();\r\n    return;\r\n  }\r\n\r\n  for(const group of f.querySelectorAll('.required-group')){\r\n    if(!group.querySelector('input:checked')){\r\n      showMessage(\r\n        'error',\r\n        'Controleer de verplichte keuzevragen voordat je de intake verzendt.'\r\n      );\r\n      return;\r\n    }\r\n  }\r\n\r\n  send.disabled=true;\r\n  send.textContent='Bezig met verzenden...';\r\n\r\n  message.className='form-message';\r\n  message.textContent='';\r\n\r\n  try{\r\n    \/*\r\n     * BELANGRIJK:\r\n     * getAttribute('action') blijft behouden.\r\n     * Dit is de al bewezen reparatie voor de eerdere\r\n     * \/[object HTMLInputElement]-fout.\r\n     *\/\r\n    const endpoint=f.getAttribute('action');\r\n\r\n    if(!endpoint){\r\n      throw new Error(\r\n        'De verzendbestemming ontbreekt.'\r\n      );\r\n    }\r\n\r\n    const response=await fetch(\r\n      endpoint,\r\n      {\r\n        method:'POST',\r\n        body:new FormData(f),\r\n        credentials:'same-origin',\r\n        headers:{\r\n          'X-Requested-With':'XMLHttpRequest',\r\n          'Accept':'application\/json'\r\n        }\r\n      }\r\n    );\r\n\r\n    const raw=await response.text();\r\n    let result;\r\n\r\n    try{\r\n      result=JSON.parse(raw);\r\n    }catch(error){\r\n      throw new Error(\r\n        'De server gaf geen geldige bevestiging terug. HTTP-status: '+\r\n        response.status+\r\n        '.'\r\n      );\r\n    }\r\n\r\n    if(\r\n      !response.ok ||\r\n      result.ok!==true\r\n    ){\r\n      showMessage(\r\n        'error',\r\n        humanError(\r\n          result.code,\r\n          result.field,\r\n          result.message\r\n        )\r\n      );\r\n\r\n      resetSend();\r\n      return;\r\n    }\r\n\r\n    const reference=result.case_code\r\n      ?' Referentienummer: '+result.case_code+'.'\r\n      :'';\r\n\r\n    showMessage(\r\n      'success',\r\n      'De intake is veilig ontvangen.'+\r\n      reference+\r\n      ' Je kunt deze pagina nu sluiten.'\r\n    );\r\n\r\n    f.classList.add('hidden');\r\n\r\n  }catch(error){\r\n    showMessage(\r\n      'error',\r\n      error&&error.message\r\n        ?error.message\r\n        :'De intake kon niet worden verzonden.'\r\n    );\r\n\r\n    resetSend();\r\n  }\r\n});\r\n\r\nshow();\r\n})();\r\n<\/script>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-060e224 e-flex e-con-boxed e-con e-parent\" data-id=\"060e224\" 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-35f221d elementor-widget elementor-widget-html\" data-id=\"35f221d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t\t<form action=\"\/verwerk-intake.php\" method=\"post\">\r\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-27a991f e-flex e-con-boxed e-con e-parent\" data-id=\"27a991f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\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>Printversie Intakeformulier &#8211; holistische begeleiding Voor volwassenen van 18 jaar en ouder. Deze intake ondersteunt brede professionele beeldvorming. Afhankelijk van de hulpvraag kunnen psychologische, gedragsgerichte, relationele\/systemische, contextuele, leefstijl- en zingevingsgerichte perspectieven worden betrokken. Professionele afbakening. Binnen deze praktijk worden geen GGZ-behandelingen of medische behandelingen uitgevoerd, geen medische diagnoses gesteld, geen medisch advies gegeven en geen [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-415","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/calebadventministry.nl\/index.php?rest_route=\/wp\/v2\/pages\/415","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/calebadventministry.nl\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/calebadventministry.nl\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/calebadventministry.nl\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/calebadventministry.nl\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=415"}],"version-history":[{"count":51,"href":"https:\/\/calebadventministry.nl\/index.php?rest_route=\/wp\/v2\/pages\/415\/revisions"}],"predecessor-version":[{"id":1588,"href":"https:\/\/calebadventministry.nl\/index.php?rest_route=\/wp\/v2\/pages\/415\/revisions\/1588"}],"wp:attachment":[{"href":"https:\/\/calebadventministry.nl\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=415"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}