{"id":256,"date":"2026-07-30T14:27:29","date_gmt":"2026-07-30T14:27:29","guid":{"rendered":"https:\/\/thecounselingstudio.nl\/?page_id=256"},"modified":"2026-08-24T12:04:31","modified_gmt":"2026-08-24T12:04:31","slug":"intake-inplannen","status":"publish","type":"page","link":"https:\/\/thecounselingstudio.nl\/en\/intake-inplannen\/","title":{"rendered":"Schedule intake"},"content":{"rendered":"\n\t\t<div id=\"fws_6ad379d0a30b9\"  data-column-margin=\"default\" data-midnight=\"dark\"  class=\"wpb_row vc_row-fluid vc_row full-width-section  height_desktop_320px\"  style=\"padding-top: 0px; padding-bottom: 0px; \"><div class=\"row-bg-wrap\" data-bg-animation=\"none\" data-bg-animation-delay=\"\" data-bg-overlay=\"true\"><div class=\"inner-wrap row-bg-layer using-image\" ><div class=\"row-bg viewport-desktop using-image\"  style=\"background-image: url(https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/08\/intake-plannen-header.png); background-position: center center; background-repeat: no-repeat; \"><\/div><\/div><div class=\"row-bg-overlay row-bg-layer\" style=\"background: #6B564D; background: linear-gradient(90deg,#6B564D 0%,#AEB6A1 100%);  opacity: 0.5; \"><\/div><\/div><div class=\"row_col_wrap_12 col span_12 dark left\">\n\t<div  class=\"vc_col-sm-12 wpb_column column_container vc_column_container col no-extra-padding inherit_tablet inherit_phone flex_gap_desktop_10px \"  data-padding-pos=\"all\" data-has-bg-color=\"false\" data-bg-color=\"\" data-bg-opacity=\"1\" data-animation=\"\" data-delay=\"0\" >\n\t\t<div class=\"vc_column-inner\" >\n\t\t\t<div class=\"wpb_wrapper\">\n\t\t\t\t\n\t\t\t<\/div> \n\t\t<\/div>\n\t<\/div> \n<\/div><\/div>\n\t\t<div id=\"fws_6ad379d0a3494\"  data-column-margin=\"default\" data-midnight=\"dark\" data-top-percent=\"5%\" data-bottom-percent=\"5%\"  class=\"wpb_row vc_row-fluid vc_row full-width-section\"  style=\"padding-top: calc(100vw * 0.05); padding-bottom: calc(100vw * 0.05); \"><div class=\"row-bg-wrap\" data-bg-animation=\"none\" data-bg-animation-delay=\"\" data-bg-overlay=\"false\"><div class=\"inner-wrap row-bg-layer\" ><div class=\"row-bg viewport-desktop\"  style=\"\"><\/div><\/div><\/div><div class=\"row_col_wrap_12 col span_12 dark left\">\n\t<div  class=\"vc_col-sm-12 wpb_column column_container vc_column_container col no-extra-padding inherit_tablet inherit_phone flex_gap_desktop_10px \"  data-padding-pos=\"all\" data-has-bg-color=\"false\" data-bg-color=\"\" data-bg-opacity=\"1\" data-animation=\"\" data-delay=\"0\" >\n\t\t<div class=\"vc_column-inner\" >\n\t\t\t<div class=\"wpb_wrapper\">\n\t\t\t\t\n<div class=\"wpb_text_column wpb_content_element \" >\n\t<div class='fluentform ff-default fluentform_wrapper_3 ffs_default_wrap'><form data-form_id=\"3\" id=\"fluentform_3\" class=\"frm-fluent-form fluent_form_3 ff-el-form-top ff_form_instance_3_1 ff-form-loading ffs_default\" data-form_instance=\"ff_form_instance_3_1\" method=\"POST\" ><fieldset  style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;box-shadow: none!important;outline: none!important; min-inline-size: 100%;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"display: block; margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;overflow:hidden;\">Intakeformulier \u2013 The Counseling Studio<\/legend><input type='hidden' name='__fluent_form_embded_post_id' value='256' \/><input type=\"hidden\" id=\"_fluentform_3_fluentformnonce\" name=\"_fluentform_3_fluentformnonce\" value=\"9d7f3e1da9\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/en\/wp-json\/wp\/v2\/pages\/256\" \/><div class='ff-el-group ff_list_2col'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  >In welke taal wil je de intake invullen?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check- ff_item_selected'><label class='ff-el-form-check-label' for='input_radio_fe8dcc3f9a76e5b9d88c82a2f15c64c5'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" checked=\"1\" value=\"Nederlands\"  id='input_radio_fe8dcc3f9a76e5b9d88c82a2f15c64c5' aria-label='Nederlands' aria-invalid='false' aria-required=true> <span>Nederlands<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_f43d4b0873ac52f68698c2b7d6d40c62'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"English\"  id='input_radio_f43d4b0873ac52f68698c2b7d6d40c62' aria-label='English' aria-invalid='false' aria-required=true> <span>English<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-3_1\" ><div class=\"intake-section-title\">\n<h3>Persoonlijke gegevens<\/h3>\n<\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-3_2\" ><div class=\"intake-section-title\">\n<h3>Personal Details<\/h3>\n<\/div><\/div><div data-type=\"name-element\" data-name=\"names\" class=\"has-conditions  ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_names_first_name_' id='label_ff_3_names_first_name_'>Voornaam<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names[first_name]\" id=\"ff_3_names_first_name_\" class=\"ff-el-form-control\" placeholder=\"Voer je voornaam in\" aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_names_last_name_' id='label_ff_3_names_last_name_'>Achternaam<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names[last_name]\" id=\"ff_3_names_last_name_\" class=\"ff-el-form-control\" placeholder=\"Voer je achternaam in\" aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><\/div><div data-type=\"name-element\" data-name=\"names_1\" class=\"has-conditions  ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_names_1_first_name_' id='label_ff_3_names_1_first_name_'>First name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_1[first_name]\" id=\"ff_3_names_1_first_name_\" class=\"ff-el-form-control\" placeholder=\"Enter your first name\" aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_names_1_last_name_' id='label_ff_3_names_1_last_name_'>Last name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_1[last_name]\" id=\"ff_3_names_1_last_name_\" class=\"ff-el-form-control\" placeholder=\"Enter your last name\" aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_datetime' id='label_ff_3_datetime'>Date of birth<\/label><\/div><div class='ff-el-input--content'><input  aria-label='Date of birth Use arrow keys to navigate dates. Press enter to select a date.'  aria-haspopup='dialog' data-type-datepicker data-format='d\/m\/Y' type=\"text\" name=\"datetime\" id=\"ff_3_datetime\" class=\"ff-el-form-control ff-el-datepicker\" placeholder=\"dd-mm-jjjj\" data-name=\"datetime\"  aria-invalid='false' aria-required=true><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_datetime_2' id='label_ff_3_datetime_2'>Geboortedatum<\/label><\/div><div class='ff-el-input--content'><input  aria-label='Geboortedatum Use arrow keys to navigate dates. Press enter to select a date.'  aria-haspopup='dialog' data-type-datepicker data-format='d\/m\/Y' type=\"text\" name=\"datetime_2\" id=\"ff_3_datetime_2\" class=\"ff-el-form-control ff-el-datepicker\" placeholder=\"dd-mm-jjjj\" data-name=\"datetime_2\"  aria-invalid='false' aria-required=true><\/div><\/div><div class=\"ff-name-address-wrapper fluent-address has-conditions\" data-type=\"address-element\" data-name=\"address_1\" ><div class='ff-el-input--content'><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_address_1_address_line_1_' id='label_ff_3_address_1_address_line_1_'>Street<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[address_line_1]\" id=\"ff_3_address_1_address_line_1_\" class=\"ff-el-form-control\" data-key_name=\"address_line_1\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_address_1_address_line_2_' id='label_ff_3_address_1_address_line_2_'>House number<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[address_line_2]\" id=\"ff_3_address_1_address_line_2_\" class=\"ff-el-form-control\" data-key_name=\"address_line_2\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_address_1_city_' id='label_ff_3_address_1_city_'>ZIP<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[city]\" id=\"ff_3_address_1_city_\" class=\"ff-el-form-control\" data-key_name=\"city\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell'><div class='ff-el-group'><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[zip]\" id=\"ff_3_address_1_zip_\" class=\"ff-el-form-control\" placeholder=\"Postal code\" data-key_name=\"zip\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"ff-name-address-wrapper fluent-address has-conditions\" data-type=\"address-element\" data-name=\"address_2\" ><div class='ff-el-input--content'><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_address_2_address_line_1_' id='label_ff_3_address_2_address_line_1_'>Straat<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_2[address_line_1]\" id=\"ff_3_address_2_address_line_1_\" class=\"ff-el-form-control\" data-key_name=\"address_line_1\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_address_2_address_line_2_' id='label_ff_3_address_2_address_line_2_'>Huisnummer<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_2[address_line_2]\" id=\"ff_3_address_2_address_line_2_\" class=\"ff-el-form-control\" data-key_name=\"address_line_2\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_address_2_city_' id='label_ff_3_address_2_city_'>Postcode<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_2[city]\" id=\"ff_3_address_2_city_\" class=\"ff-el-form-control\" data-key_name=\"city\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell'><div class='ff-el-group'><div class='ff-el-input--content'><input type=\"text\" name=\"address_2[state]\" id=\"ff_3_address_2_state_\" class=\"ff-el-form-control\" placeholder=\"Provincie\" data-key_name=\"state\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text' id='label_ff_3_input_text'>Phone number<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text\" class=\"ff-el-form-control\" placeholder=\"06 12345678\" data-name=\"input_text\" id=\"ff_3_input_text\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_19' id='label_ff_3_input_text_19'>Telefoonnummer<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_19\" class=\"ff-el-form-control\" placeholder=\"06 12345678\" data-name=\"input_text_19\" id=\"ff_3_input_text_19\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_email' id='label_ff_3_email'>E-mail<\/label><\/div><div class='ff-el-input--content'><input type=\"email\" name=\"email\" id=\"ff_3_email\" class=\"ff-el-form-control\" placeholder=\"jouw@email.nl\" data-name=\"email\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_email_1' id='label_ff_3_email_1'>Email address<\/label><\/div><div class='ff-el-input--content'><input type=\"email\" name=\"email_1\" id=\"ff_3_email_1\" class=\"ff-el-form-control\" placeholder=\"yourname@email.nl\" data-name=\"email_1\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_1' id='label_ff_3_input_text_1'>Zorgverzekering<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_1\" class=\"ff-el-form-control\" placeholder=\"Naam zorgverzekeraar\" data-name=\"input_text_1\" id=\"ff_3_input_text_1\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_20' id='label_ff_3_input_text_20'>Health insurance<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_20\" class=\"ff-el-form-control\" placeholder=\"Name of insurance\" data-name=\"input_text_20\" id=\"ff_3_input_text_20\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_2' id='label_ff_3_input_text_2'>BSN (Dutch Citizen Service Number)<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_2\" class=\"ff-el-form-control\" placeholder=\"Fill in your Dutch Citizen Service Number\" data-name=\"input_text_2\" id=\"ff_3_input_text_2\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_21' id='label_ff_3_input_text_21'>BSN<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_21\" class=\"ff-el-form-control\" placeholder=\"Vul je BSN in\" data-name=\"input_text_21\" id=\"ff_3_input_text_21\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_3' id='label_ff_3_input_text_3'>Huisarts<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_3\" class=\"ff-el-form-control\" placeholder=\"Naam huisarts\" data-name=\"input_text_3\" id=\"ff_3_input_text_3\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_22' id='label_ff_3_input_text_22'>General practitioner<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_22\" class=\"ff-el-form-control\" placeholder=\"Name of general practitioner \" data-name=\"input_text_22\" id=\"ff_3_input_text_22\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_4' id='label_ff_3_input_text_4'>Marital status<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_4\" class=\"ff-el-form-control\" placeholder=\"Marital status\" data-name=\"input_text_4\" id=\"ff_3_input_text_4\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_23' id='label_ff_3_input_text_23'>Burgerlijke staat<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_23\" class=\"ff-el-form-control\" placeholder=\"Burgerlijke staat\" data-name=\"input_text_23\" id=\"ff_3_input_text_23\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_5' id='label_ff_3_input_text_5'>Occupation\/work situation<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_5\" class=\"ff-el-form-control\" placeholder=\"Occupation\/work situation\" data-name=\"input_text_5\" id=\"ff_3_input_text_5\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_24' id='label_ff_3_input_text_24'>Beroep\/werksituatie<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_24\" class=\"ff-el-form-control\" placeholder=\"Beroep\/werksituatie\" data-name=\"input_text_24\" id=\"ff_3_input_text_24\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-3_3\" ><div class=\"intake-section-title\">\n<h3>Pregnancy\/Birth<\/h3>\n<\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-3_4\" ><div class=\"intake-section-title\">\n<h3>Zwangerschap\/geboorte<\/h3>\n<\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  >Are you currently pregnant?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_1_7e3b8c1a09c0b9800a590e86f797c6d7'><input  type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Yes\"  id='input_radio_1_7e3b8c1a09c0b9800a590e86f797c6d7' aria-label='Yes' aria-invalid='false' aria-required=true> <span>Yes<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_1_253424ab35d05c2c20e0823d6cac5d3e'><input  type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"No\"  id='input_radio_1_253424ab35d05c2c20e0823d6cac5d3e' aria-label='No' aria-invalid='false' aria-required=true> <span>No<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  >Ben je momenteel zwanger?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_7_dfbd70735d24a83563196ea6ace3ddb5'><input  type=\"radio\" name=\"input_radio_7\" data-name=\"input_radio_7\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Ja\"  id='input_radio_7_dfbd70735d24a83563196ea6ace3ddb5' aria-label='Ja' aria-invalid='false' aria-required=true> <span>Ja<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_7_3ca2dc02805159bc2237cc98d588a6f4'><input  type=\"radio\" name=\"input_radio_7\" data-name=\"input_radio_7\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Nee\"  id='input_radio_7_3ca2dc02805159bc2237cc98d588a6f4' aria-label='Nee' aria-invalid='false' aria-required=true> <span>Nee<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_6' id='label_ff_3_input_text_6'>If yes, how many weeks pregnant are you?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_6\" class=\"ff-el-form-control\" data-name=\"input_text_6\" id=\"ff_3_input_text_6\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_25' id='label_ff_3_input_text_25'>Zo ja, hoeveel weken ben je zwanger?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_25\" class=\"ff-el-form-control\" data-name=\"input_text_25\" id=\"ff_3_input_text_25\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_datetime_1' id='label_ff_3_datetime_1'>What is your due date?<\/label><\/div><div class='ff-el-input--content'><input  aria-label='What is your due date? Use arrow keys to navigate dates. Press enter to select a date.'  aria-haspopup='dialog' data-type-datepicker data-format='d\/m\/Y' type=\"text\" name=\"datetime_1\" id=\"ff_3_datetime_1\" class=\"ff-el-form-control ff-el-datepicker\" data-name=\"datetime_1\"  aria-invalid='false' aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_datetime_3' id='label_ff_3_datetime_3'>Wat is je uitgerekende datum?<\/label><\/div><div class='ff-el-input--content'><input  aria-label='Wat is je uitgerekende datum? Use arrow keys to navigate dates. Press enter to select a date.'  aria-haspopup='dialog' data-type-datepicker data-format='d\/m\/Y' type=\"text\" name=\"datetime_3\" id=\"ff_3_datetime_3\" class=\"ff-el-form-control ff-el-datepicker\" data-name=\"datetime_3\"  aria-invalid='false' aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_7' id='label_ff_3_input_text_7'>Which pregnancy and\/or birth is this for you?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_7\" class=\"ff-el-form-control\" data-name=\"input_text_7\" id=\"ff_3_input_text_7\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_26' id='label_ff_3_input_text_26'>Hoeveelste zwangerschap en\/of bevalling is dit?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_26\" class=\"ff-el-form-control\" data-name=\"input_text_26\" id=\"ff_3_input_text_26\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_8' id='label_ff_3_input_text_8'>Can you briefly describe how this experience has been?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_8\" class=\"ff-el-form-control\" data-name=\"input_text_8\" id=\"ff_3_input_text_8\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_27' id='label_ff_3_input_text_27'>Kun je kort beschrijven hoe deze ervaring is geweest?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_27\" class=\"ff-el-form-control\" data-name=\"input_text_27\" id=\"ff_3_input_text_27\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-3_5\" ><div class=\"intake-section-title\">\n<h3>Reason for Seeking Support<\/h3>\n<\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-3_6\" ><div class=\"intake-section-title\">\n<h3>Aanleiding aanmelding<\/h3>\n<\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_9' id='label_ff_3_input_text_9'>What is the main reason you are seeking coaching\/therapy?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_9\" class=\"ff-el-form-control\" data-name=\"input_text_9\" id=\"ff_3_input_text_9\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_30' id='label_ff_3_input_text_30'>Wat is de belangrijkste reden dat je je aanmeldt voor coaching\/therapie?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_30\" class=\"ff-el-form-control\" data-name=\"input_text_30\" id=\"ff_3_input_text_30\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_10' id='label_ff_3_input_text_10'>Are there any specific themes you would like to work on?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_10\" class=\"ff-el-form-control\" placeholder=\"For example: anxiety, a previous traumatic birth, processing experiences, insecurity, preparing for birth, parenthood\" data-name=\"input_text_10\" id=\"ff_3_input_text_10\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_31' id='label_ff_3_input_text_31'>Zijn er specifieke thema\u2019s waar je aan wilt werken?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_31\" class=\"ff-el-form-control\" placeholder=\"Bijvoorbeeld angst, eerdere traumatische bevalling, verwerking, onzekerheid, voorbereiding op geboorte, ouderschap\" data-name=\"input_text_31\" id=\"ff_3_input_text_31\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_11' id='label_ff_3_input_text_11'>What do you hope to achieve through the guidance?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_11\" class=\"ff-el-form-control\" data-name=\"input_text_11\" id=\"ff_3_input_text_11\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_32' id='label_ff_3_input_text_32'>Wat hoop je te bereiken met de begeleiding?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_32\" class=\"ff-el-form-control\" data-name=\"input_text_32\" id=\"ff_3_input_text_32\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description' id='label_ff_3_description'>What are the most impactful events you have experienced in your life?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description\" name=\"description\" id=\"ff_3_description\" class=\"ff-el-form-control\" rows=\"3\" cols=\"2\" data-name=\"description\" ><\/textarea><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_9' id='label_ff_3_description_9'>Wat zijn de meest ingrijpende gebeurtenissen die je hebt meegemaakt in je leven?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_9\" name=\"description_9\" id=\"ff_3_description_9\" class=\"ff-el-form-control\" rows=\"3\" cols=\"2\" data-name=\"description_9\" ><\/textarea><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_1' id='label_ff_3_description_1'>What would you like support with?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_1\" name=\"description_1\" id=\"ff_3_description_1\" class=\"ff-el-form-control\" rows=\"3\" cols=\"2\" data-name=\"description_1\" ><\/textarea><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_10' id='label_ff_3_description_10'>Wat is je hulpvraag?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_10\" name=\"description_10\" id=\"ff_3_description_10\" class=\"ff-el-form-control\" rows=\"3\" cols=\"2\" data-name=\"description_10\" ><\/textarea><\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-3_7\" ><div class=\"intake-section-title\">\n<h3>Physical and Mental Well-being<\/h3>\n<\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-3_8\" ><div class=\"intake-section-title\">\n<h3>Lichamelijk en mentaal welzijn<\/h3>\n<\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_2' id='label_ff_3_description_2'>Are you currently experiencing any physical symptoms? If so, which ones?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_2\" name=\"description_2\" id=\"ff_3_description_2\" class=\"ff-el-form-control\" rows=\"3\" cols=\"2\" data-name=\"description_2\" ><\/textarea><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_11' id='label_ff_3_description_11'>Ervaar je momenteel lichamelijke klachten? Zo ja, welke?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_11\" name=\"description_11\" id=\"ff_3_description_11\" class=\"ff-el-form-control\" rows=\"3\" cols=\"2\" data-name=\"description_11\" ><\/textarea><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_13' id='label_ff_3_input_text_13'>When did these symptoms begin?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_13\" class=\"ff-el-form-control\" data-name=\"input_text_13\" id=\"ff_3_input_text_13\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_33' id='label_ff_3_input_text_33'>Wanneer zijn deze klachten begonnen?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_33\" class=\"ff-el-form-control\" data-name=\"input_text_33\" id=\"ff_3_input_text_33\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_3' id='label_ff_3_description_3'>Can you identify one or more possible triggers?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_3\" name=\"description_3\" id=\"ff_3_description_3\" class=\"ff-el-form-control\" rows=\"3\" cols=\"2\" data-name=\"description_3\" ><\/textarea><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_12' id='label_ff_3_description_12'>Kun je \u00e9\u00e9n of meer aanleidingen aanwijzen?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_12\" name=\"description_12\" id=\"ff_3_description_12\" class=\"ff-el-form-control\" rows=\"3\" cols=\"2\" data-name=\"description_12\" ><\/textarea><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label  >Have you previously received coaching, therapy or psychological support?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_026713d783117625fe11cd94eb7ad75c'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Yes\"  id='input_radio_2_026713d783117625fe11cd94eb7ad75c' aria-label='Yes' aria-invalid='false' aria-required=false> <span>Yes<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_4e5aab940cd807b9b66dcf2cb7b27667'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"No\"  id='input_radio_2_4e5aab940cd807b9b66dcf2cb7b27667' aria-label='No' aria-invalid='false' aria-required=false> <span>No<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label  >Heb je eerder coaching, therapie of psychologische hulp gehad?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_8_0bdbc4abcc884f3f95fac3b302b4b1ac'><input  type=\"radio\" name=\"input_radio_8\" data-name=\"input_radio_8\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Ja\"  id='input_radio_8_0bdbc4abcc884f3f95fac3b302b4b1ac' aria-label='Ja' aria-invalid='false' aria-required=false> <span>Ja<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_8_e07922b6e8688070eec64ddd2fb4dfe4'><input  type=\"radio\" name=\"input_radio_8\" data-name=\"input_radio_8\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Nee\"  id='input_radio_8_e07922b6e8688070eec64ddd2fb4dfe4' aria-label='Nee' aria-invalid='false' aria-required=false> <span>Nee<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_4' id='label_ff_3_description_4'>If so, can you briefly explain?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_4\" name=\"description_4\" id=\"ff_3_description_4\" class=\"ff-el-form-control\" rows=\"3\" cols=\"2\" data-name=\"description_4\" ><\/textarea><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_13' id='label_ff_3_description_13'>Zo ja, kun je dit kort toelichten?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_13\" name=\"description_13\" id=\"ff_3_description_13\" class=\"ff-el-form-control\" rows=\"3\" cols=\"2\" data-name=\"description_13\" ><\/textarea><\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-3_9\" ><div class=\"intake-section-title\">\n<h3>Medical background<\/h3>\n<\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-3_10\" ><div class=\"intake-section-title\">\n<h3>Medische achtergrond<\/h3>\n<\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label  >Are you currently under the care of a midwife, gynaecologist or another healthcare professional?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_3_4bbad2e8ac9e11e26b66d3edb8fb3dfb'><input  type=\"radio\" name=\"input_radio_3\" data-name=\"input_radio_3\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Yes\"  id='input_radio_3_4bbad2e8ac9e11e26b66d3edb8fb3dfb' aria-label='Yes' aria-invalid='false' aria-required=false> <span>Yes<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_3_282a44f8fd923cf913486f5ee09926f6'><input  type=\"radio\" name=\"input_radio_3\" data-name=\"input_radio_3\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"No\"  id='input_radio_3_282a44f8fd923cf913486f5ee09926f6' aria-label='No' aria-invalid='false' aria-required=false> <span>No<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label  >Sta je onder behandeling van een verloskundige, gynaecoloog of andere zorgverlener?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_9_b4341dc781b49f9f3ac62d552056338d'><input  type=\"radio\" name=\"input_radio_9\" data-name=\"input_radio_9\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Ja\"  id='input_radio_9_b4341dc781b49f9f3ac62d552056338d' aria-label='Ja' aria-invalid='false' aria-required=false> <span>Ja<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_9_5babed58649da8c5d1ce7a84cadb13ba'><input  type=\"radio\" name=\"input_radio_9\" data-name=\"input_radio_9\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Nee\"  id='input_radio_9_5babed58649da8c5d1ce7a84cadb13ba' aria-label='Nee' aria-invalid='false' aria-required=false> <span>Nee<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_14' id='label_ff_3_input_text_14'>If so, with whom and where?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_14\" class=\"ff-el-form-control\" data-name=\"input_text_14\" id=\"ff_3_input_text_14\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_34' id='label_ff_3_input_text_34'>Zo ja, bij wie en waar?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_34\" class=\"ff-el-form-control\" data-name=\"input_text_34\" id=\"ff_3_input_text_34\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label  >Are you taking any medication?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_4_345a52674f958513a5a9fd2a56d150a9'><input  type=\"radio\" name=\"input_radio_4\" data-name=\"input_radio_4\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Yes \"  id='input_radio_4_345a52674f958513a5a9fd2a56d150a9' aria-label='Yes' aria-invalid='false' aria-required=false> <span>Yes <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_4_5f125aaa9a4415bed5ab4731bf50f1c0'><input  type=\"radio\" name=\"input_radio_4\" data-name=\"input_radio_4\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"No\"  id='input_radio_4_5f125aaa9a4415bed5ab4731bf50f1c0' aria-label='No' aria-invalid='false' aria-required=false> <span>No<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label  >Gebruik je medicatie?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_10_c089985995a5d2f0aeec7aa72aa5018d'><input  type=\"radio\" name=\"input_radio_10\" data-name=\"input_radio_10\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Ja\"  id='input_radio_10_c089985995a5d2f0aeec7aa72aa5018d' aria-label='Ja' aria-invalid='false' aria-required=false> <span>Ja<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_10_a7ae29e9dc1e58b3fff1c7d655780bc1'><input  type=\"radio\" name=\"input_radio_10\" data-name=\"input_radio_10\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Nee\"  id='input_radio_10_a7ae29e9dc1e58b3fff1c7d655780bc1' aria-label='Nee' aria-invalid='false' aria-required=false> <span>Nee<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_15' id='label_ff_3_input_text_15'>If so, which medication?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_15\" class=\"ff-el-form-control\" data-name=\"input_text_15\" id=\"ff_3_input_text_15\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_35' id='label_ff_3_input_text_35'>Zo ja, welke?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_35\" class=\"ff-el-form-control\" data-name=\"input_text_35\" id=\"ff_3_input_text_35\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_16' id='label_ff_3_input_text_16'>Are there any medical circumstances that may be relevant to the guidance?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_16\" class=\"ff-el-form-control\" data-name=\"input_text_16\" id=\"ff_3_input_text_16\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_36' id='label_ff_3_input_text_36'>Zijn er medische bijzonderheden die relevant kunnen zijn voor de begeleiding?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_36\" class=\"ff-el-form-control\" data-name=\"input_text_36\" id=\"ff_3_input_text_36\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-3_11\" ><div class=\"intake-section-title\">\n<h3>Social Environment and Support<\/h3>\n<\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-3_12\" ><div class=\"intake-section-title\">\n<h3>Sociale omgeving en ondersteuning<\/h3>\n<\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_5' id='label_ff_3_description_5'>What does your support network look like?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_5\" name=\"description_5\" id=\"ff_3_description_5\" class=\"ff-el-form-control\" placeholder=\"Partner, family, friends\" rows=\"3\" cols=\"2\" data-name=\"description_5\" ><\/textarea><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_14' id='label_ff_3_description_14'>Hoe ziet jouw vangnet eruit?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_14\" name=\"description_14\" id=\"ff_3_description_14\" class=\"ff-el-form-control\" placeholder=\"Partner, familie, vrienden\" rows=\"3\" cols=\"2\" data-name=\"description_14\" ><\/textarea><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label  >Is your partner involved in the process?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_5_46bdb284323cf119727bf2c61761c5ef'><input  type=\"radio\" name=\"input_radio_5\" data-name=\"input_radio_5\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Yes\"  id='input_radio_5_46bdb284323cf119727bf2c61761c5ef' aria-label='Yes' aria-invalid='false' aria-required=false> <span>Yes<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_5_ca15701c35e1ec96e50826f72d7b0078'><input  type=\"radio\" name=\"input_radio_5\" data-name=\"input_radio_5\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"No\"  id='input_radio_5_ca15701c35e1ec96e50826f72d7b0078' aria-label='No' aria-invalid='false' aria-required=false> <span>No<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label  >Is je partner betrokken bij het traject?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_11_b4d25e22148c35ebb39a615bd86e2416'><input  type=\"radio\" name=\"input_radio_11\" data-name=\"input_radio_11\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Ja\"  id='input_radio_11_b4d25e22148c35ebb39a615bd86e2416' aria-label='Ja' aria-invalid='false' aria-required=false> <span>Ja<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_11_ccd9bd9b57a4b879a72529de274aaa0d'><input  type=\"radio\" name=\"input_radio_11\" data-name=\"input_radio_11\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Nee\"  id='input_radio_11_ccd9bd9b57a4b879a72529de274aaa0d' aria-label='Nee' aria-invalid='false' aria-required=false> <span>Nee<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_6' id='label_ff_3_description_6'>What does your (family) situation look like?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_6\" name=\"description_6\" id=\"ff_3_description_6\" class=\"ff-el-form-control\" placeholder=\"Partner, kids\" rows=\"3\" cols=\"2\" data-name=\"description_6\" ><\/textarea><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_15' id='label_ff_3_description_15'>Hoe ziet jouw (gezins)situatie eruit?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_15\" name=\"description_15\" id=\"ff_3_description_15\" class=\"ff-el-form-control\" placeholder=\"Partner, kinderen\" rows=\"3\" cols=\"2\" data-name=\"description_15\" ><\/textarea><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_17' id='label_ff_3_input_text_17'>What was your position within the family you grew up in (oldest\/youngest)?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_17\" class=\"ff-el-form-control\" data-name=\"input_text_17\" id=\"ff_3_input_text_17\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_37' id='label_ff_3_input_text_37'>Wat was jouw plaats binnen het gezin waar je uit komt (oudste\/jongste?)<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_37\" class=\"ff-el-form-control\" data-name=\"input_text_37\" id=\"ff_3_input_text_37\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_7' id='label_ff_3_description_7'>How was\/is your relationship with your parents?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_7\" name=\"description_7\" id=\"ff_3_description_7\" class=\"ff-el-form-control\" rows=\"3\" cols=\"2\" data-name=\"description_7\" ><\/textarea><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_16' id='label_ff_3_description_16'>Hoe was\/is het contact met je ouders?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_16\" name=\"description_16\" id=\"ff_3_description_16\" class=\"ff-el-form-control\" rows=\"3\" cols=\"2\" data-name=\"description_16\" ><\/textarea><\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-3_13\" ><div class=\"intake-section-title\">\n<h3>Practical Information<\/h3>\n<\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-3_14\" ><div class=\"intake-section-title\">\n<h3>Praktische informatie<\/h3>\n<\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_18' id='label_ff_3_input_text_18'>How did you find me?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_18\" class=\"ff-el-form-control\" data-name=\"input_text_18\" id=\"ff_3_input_text_18\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_input_text_38' id='label_ff_3_input_text_38'>Hoe ben je bij mij terecht gekomen?<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_38\" class=\"ff-el-form-control\" data-name=\"input_text_38\" id=\"ff_3_input_text_38\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-3_15\" ><div class=\"intake-section-title\">\n<h3>Additional Information<\/h3>\n<\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-3_16\" ><div class=\"intake-section-title\">\n<h3>Aanvullende informatie<\/h3>\n<\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_8' id='label_ff_3_description_8'>Is there anything else you would like to share that is important for me to know?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_8\" name=\"description_8\" id=\"ff_3_description_8\" class=\"ff-el-form-control\" rows=\"3\" cols=\"2\" data-name=\"description_8\" ><\/textarea><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_17' id='label_ff_3_description_17'>Is er nog iets dat je graag wilt delen en dat belangrijk is voor mij om te weten?<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_17\" name=\"description_17\" id=\"ff_3_description_17\" class=\"ff-el-form-control\" rows=\"3\" cols=\"2\" data-name=\"description_17\" ><\/textarea><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label  >Do you give permission for me, if necessary, to consult with your midwife\/gynaecologist\/general practitioner?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_6_c07788b00e0a39b4f596d1d8ec31f6de'><input  type=\"radio\" name=\"input_radio_6\" data-name=\"input_radio_6\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Yes\"  id='input_radio_6_c07788b00e0a39b4f596d1d8ec31f6de' aria-label='Yes' aria-invalid='false' aria-required=false> <span>Yes<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_6_a7b43322908b14a4d9315062c9b5d43a'><input  type=\"radio\" name=\"input_radio_6\" data-name=\"input_radio_6\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"No\"  id='input_radio_6_a7b43322908b14a4d9315062c9b5d43a' aria-label='No' aria-invalid='false' aria-required=false> <span>No<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label  >Geef je toestemming dat ik, zo nodig, overleg met je verloskundige\/gynaecoloog\/huisarts<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_12_4941e01648ee3be801a317ffe2a6b2e2'><input  type=\"radio\" name=\"input_radio_12\" data-name=\"input_radio_12\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Ja \"  id='input_radio_12_4941e01648ee3be801a317ffe2a6b2e2' aria-label='Ja' aria-invalid='false' aria-required=false> <span>Ja <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_12_72efed4cc617965b266ee3cedac2c00a'><input  type=\"radio\" name=\"input_radio_12\" data-name=\"input_radio_12\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Nee\"  id='input_radio_12_72efed4cc617965b266ee3cedac2c00a' aria-label='Nee' aria-invalid='false' aria-required=false> <span>Nee<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group ff-el-form-hide_label has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  > ingevuld en geef toestemming om deze gegevens te gebruiken ten behoeve van coaching en therapie.<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_08f91ad7285c077985fa0295695e134a'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Ik verklaar dat ik dit formulier naar waarheid heb ingevuld en geef toestemming om deze gegevens te gebruiken ten behoeve van coaching en therapie.\"  id='checkbox_08f91ad7285c077985fa0295695e134a' aria-label='Ik verklaar dat ik dit formulier naar waarheid heb ingevuld en geef toestemming om deze gegevens te gebruiken ten behoeve van coaching en therapie.' aria-invalid='false' aria-required=true> <span>Ik verklaar dat ik dit formulier naar waarheid heb ingevuld en geef toestemming om deze gegevens te gebruiken ten behoeve van coaching en therapie.<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group ff-el-form-hide_label has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  > ingevuld en geef toestemming om deze gegevens te gebruiken ten behoeve van coaching en therapie.<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_32b90363829362050d9da0bfd333f681'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"I declare that I have completed this form truthfully and give permission for this information to be used for the purposes of coaching and therapy.\"  id='checkbox_1_32b90363829362050d9da0bfd333f681' aria-label='I declare that I have completed this form truthfully and give permission for this information to be used for the purposes of coaching and therapy.' aria-invalid='false' aria-required=true> <span>I declare that I have completed this form truthfully and give permission for this information to be used for the purposes of coaching and therapy.<\/span><\/label><\/div><\/div><\/div><div class='ff-form-inline-style' hidden><style>form.fluent_form_3 .ff-btn-submit:not(.ff_btn_no_style) { background-color: var(--fluentform-primary); color: #ffffff; }<\/style><\/div><div class='ff-el-group ff-text-left ff_submit_btn_wrapper'><button type=\"submit\" class=\"ff-btn ff-btn-submit ff-btn-md ff_btn_style\"  aria-label=\"Verzenden\">Verzenden<\/button><\/div><\/fieldset><\/form><div id='fluentform_3_errors' class='ff-errors-in-stack ff_form_instance_3_1 ff-form-loading_errors ff_form_instance_3_1_errors'><\/div><\/div>            <script 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                           <\/script>\n            \n<\/div>\n\n\n\n\n\t\t\t<\/div> \n\t\t<\/div>\n\t<\/div> \n<\/div><\/div>\n\t\t<div id=\"fws_6ad379d0c0c1a\"  data-column-margin=\"default\" data-midnight=\"light\" data-top-percent=\"3%\" data-bottom-percent=\"3%\"  class=\"wpb_row vc_row-fluid vc_row full-width-section has-row-bg-color vc_row-o-equal-height vc_row-flex\"  style=\"padding-top: calc(100vw * 0.03); padding-bottom: calc(100vw * 0.03); --row-bg-color: #6B564D;\"><div class=\"row-bg-wrap\" data-bg-animation=\"none\" data-bg-animation-delay=\"\" data-bg-overlay=\"false\"><div class=\"inner-wrap row-bg-layer\" ><div class=\"row-bg viewport-desktop using-bg-color\"  style=\"background-color: #6B564D; \"><\/div><\/div><\/div><div class=\"row_col_wrap_12 col span_12 light left\">\n\t<div  class=\"vc_col-sm-12 wpb_column column_container vc_column_container col no-extra-padding inherit_tablet inherit_phone flex_gap_desktop_10px \"  data-padding-pos=\"all\" data-has-bg-color=\"false\" data-bg-color=\"\" data-bg-opacity=\"1\" data-animation=\"\" data-delay=\"0\" >\n\t\t<div class=\"vc_column-inner\" >\n\t\t\t<div class=\"wpb_wrapper\">\n\t\t\t\t<div id=\"fws_6ad379d0c0fb4\" data-midnight=\"\" data-column-margin=\"default\" class=\"wpb_row vc_row-fluid vc_row inner_row vc_row-o-equal-height vc_row-flex nectar-flex-sizing\"  style=\"\"><div class=\"row-bg-wrap\"> <div class=\"row-bg\" ><\/div> <\/div><div class=\"row_col_wrap_12_inner col span_12  left\">\n\t<div  class=\"vc_col-sm-4 wpb_column column_container vc_column_container col child_column no-extra-padding inherit_tablet inherit_phone flex_gap_desktop_10px \"   data-padding-pos=\"all\" data-has-bg-color=\"false\" data-bg-color=\"\" data-bg-opacity=\"1\" data-animation=\"\" data-delay=\"0\" >\n\t\t<div class=\"vc_column-inner\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<div class=\"img-with-aniamtion-wrap  mask_shape_circle mask_size_contain \" data-max-width=\"50%\" data-max-width-mobile=\"default\" data-shadow=\"none\" data-animation=\"none\" >\n      <div class=\"inner\">\n        <div class=\"hover-wrap\"> \n          <div class=\"hover-wrap-inner\">\n            <img loading=\"lazy\" decoding=\"async\" class=\"img-with-animation skip-lazy\" data-delay=\"0\" height=\"480\" width=\"480\" data-animation=\"none\" src=\"https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/07\/favicon-white.png\" alt=\"\" srcset=\"https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/07\/favicon-white.png 480w, https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/07\/favicon-white-300x300.png 300w, https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/07\/favicon-white-150x150.png 150w, https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/07\/favicon-white-140x140.png 140w, https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/07\/favicon-white-100x100.png 100w, https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/07\/favicon-white-350x350.png 350w\" sizes=\"auto, (max-width: 480px) 100vw, 480px\" \/>\n          <\/div>\n        <\/div>\n        \n      <\/div>\n    <\/div>\n<div class=\"wpb_text_column wpb_content_element  wpb_animate_when_almost_visible wpb_fadeIn fadeIn\" style=\" max-width: 300px; display: inline-block;\">\n\t<p style=\"text-align: left;\">Coaching en therapie rondom zwangerschap, geboorte, moederschap en persoonlijke ontwikkeling.<\/p>\n<\/div>\n\n\n\n<div class=\"divider-wrap\" data-alignment=\"default\"><div style=\"margin-top: 7.5px; width: 60px; height: 2px; margin-bottom: 7.5px;\" data-width=\"60px\" data-animate=\"\" data-animation-delay=\"\" data-color=\"extra-color-2\" class=\"divider-small-border\"><\/div><\/div><div class=\"img-with-aniamtion-wrap \" data-max-width=\"75%\" data-max-width-mobile=\"default\" data-shadow=\"none\" data-animation=\"none\"  style=\"margin-top: 8%; \">\n      <div class=\"inner\">\n        <div class=\"hover-wrap\"> \n          <div class=\"hover-wrap-inner\">\n            <img loading=\"lazy\" decoding=\"async\" class=\"img-with-animation skip-lazy\" data-delay=\"0\" height=\"768\" width=\"2048\" data-animation=\"none\" src=\"https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/08\/footer-tekst-2.png\" alt=\"\" srcset=\"https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/08\/footer-tekst-2.png 2048w, https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/08\/footer-tekst-2-300x113.png 300w, https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/08\/footer-tekst-2-1024x384.png 1024w, https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/08\/footer-tekst-2-768x288.png 768w, https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/08\/footer-tekst-2-1536x576.png 1536w, https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/08\/footer-tekst-2-18x7.png 18w\" sizes=\"auto, (max-width: 2048px) 100vw, 2048px\" \/>\n          <\/div>\n        <\/div>\n        \n      <\/div>\n    <\/div>\n\t\t<\/div> \n\t<\/div>\n\t<\/div> \n\n\t<div  class=\"vc_col-sm-4 wpb_column column_container vc_column_container col child_column no-extra-padding inherit_tablet inherit_phone flex_gap_desktop_10px \"   data-padding-pos=\"all\" data-has-bg-color=\"false\" data-bg-color=\"\" data-bg-opacity=\"1\" data-animation=\"\" data-delay=\"0\" >\n\t\t<div class=\"vc_column-inner\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<h4 style=\"font-size: 22px;color: #FFFFFF;line-height: 1.2;text-align: left;font-family:Playfair Display;font-weight:700;font-style:normal\" class=\"vc_custom_heading vc_do_custom_heading wpb_animate_when_almost_visible wpb_fadeIn fadeIn\" >Ontdek<\/h4><div class=\"divider-wrap\" data-alignment=\"default\"><div style=\"margin-top: 17.5px; width: 60px; height: 2px; margin-bottom: 17.5px;\" data-width=\"60px\" data-animate=\"\" data-animation-delay=\"\" data-color=\"extra-color-2\" class=\"divider-small-border\"><\/div><\/div>\n<div class=\"wpb_text_column wpb_content_element \" >\n\t<p><span style=\"color: #ffffff;\"><a style=\"color: #ffffff;\" href=\"https:\/\/thecounselingstudio.nl\/over-mij\/\">Over mij<\/a><\/span><\/p>\n<p><span style=\"color: #ffffff;\"><a style=\"color: #ffffff;\" href=\"https:\/\/thecounselingstudio.nl\/coaching\/\">Coaching<\/a><\/span><\/p>\n<p><span style=\"color: #ffffff;\"><a style=\"color: #ffffff;\" href=\"https:\/\/thecounselingstudio.nl\/werkwijze\/\">Werkwijze<\/a><\/span><\/p>\n<p><span style=\"color: #ffffff;\"><a style=\"color: #ffffff;\" href=\"https:\/\/thecounselingstudio.nl\/methodieken\/\">Methodieken<\/a><\/span><\/p>\n<p><span style=\"color: #ffffff;\"><a style=\"color: #ffffff;\" href=\"https:\/\/thecounselingstudio.nl\/tarieven-trajecten\/\">Tarieven &amp; trajecten<\/a><\/span><\/p>\n<p><span style=\"color: #ffffff;\"><a style=\"color: #ffffff;\" href=\"https:\/\/thecounselingstudio.nl\/contact\/\">Contact<\/a><\/span><\/p>\n<\/div>\n\n\n\n\n\t\t<\/div> \n\t<\/div>\n\t<\/div> \n\n\t<div  class=\"vc_col-sm-4 wpb_column column_container vc_column_container col child_column no-extra-padding inherit_tablet inherit_phone flex_gap_desktop_10px \"   data-padding-pos=\"all\" data-has-bg-color=\"false\" data-bg-color=\"\" data-bg-opacity=\"1\" data-animation=\"\" data-delay=\"0\" >\n\t\t<div class=\"vc_column-inner\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<h4 style=\"font-size: 22px;color: #FFFFFF;line-height: 1.2;text-align: left;font-family:Playfair Display;font-weight:700;font-style:normal\" class=\"vc_custom_heading vc_do_custom_heading wpb_animate_when_almost_visible wpb_fadeIn fadeIn\" >Contact<\/h4><div class=\"divider-wrap\" data-alignment=\"default\"><div style=\"margin-top: 17.5px; width: 60px; height: 2px; margin-bottom: 17.5px;\" data-width=\"60px\" data-animate=\"\" data-animation-delay=\"\" data-color=\"extra-color-2\" class=\"divider-small-border\"><\/div><\/div><div class=\"iwithtext\"><div class=\"iwt-icon\"> <i class=\"icon-default-style fa fa-envelope-o extra-color-2\"><\/i> <\/div><div class=\"iwt-text\"> \n<p class=\"p1\"><span style=\"color: #ffffff;\"><a style=\"color: #ffffff;\" href=\"mailto:info@thecounselingstudio.nl\">info@thecounselingstudio.nl<\/a><\/span><\/p>\n <\/div><div class=\"clear\"><\/div><\/div><div class=\"iwithtext\"><div class=\"iwt-icon\"> <i class=\"icon-default-style fa fa-instagram extra-color-2\"><\/i> <\/div><div class=\"iwt-text\"> \n<p class=\"p1\"><span style=\"color: #ffffff;\"><a style=\"color: #ffffff;\" href=\"https:\/\/www.instagram.com\/thecounselingstudionl\">@thecounselingstudionl<\/a><\/span><\/p>\n <\/div><div class=\"clear\"><\/div><\/div><div class=\"divider-wrap\" data-alignment=\"default\"><div style=\"height: 35px;\" class=\"divider\"><\/div><\/div><div class=\"img-with-aniamtion-wrap \" data-max-width=\"50%\" data-max-width-mobile=\"default\" data-shadow=\"none\" data-animation=\"none\"  style=\"margin-top: 5%; \">\n      <div class=\"inner\">\n        <div class=\"hover-wrap\"> \n          <div class=\"hover-wrap-inner\">\n            <img loading=\"lazy\" decoding=\"async\" class=\"img-with-animation skip-lazy\" data-delay=\"0\" height=\"748\" width=\"2103\" data-animation=\"none\" src=\"https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/08\/tot-snel-footer.png\" alt=\"\" srcset=\"https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/08\/tot-snel-footer.png 2103w, https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/08\/tot-snel-footer-300x107.png 300w, https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/08\/tot-snel-footer-1024x364.png 1024w, https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/08\/tot-snel-footer-768x273.png 768w, https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/08\/tot-snel-footer-1536x546.png 1536w, https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/08\/tot-snel-footer-2048x728.png 2048w, https:\/\/thecounselingstudio.nl\/wp-content\/uploads\/2026\/08\/tot-snel-footer-18x6.png 18w\" sizes=\"auto, (max-width: 2103px) 100vw, 2103px\" \/>\n          <\/div>\n        <\/div>\n        \n      <\/div>\n    <\/div>\n\t\t<\/div> \n\t<\/div>\n\t<\/div> \n<\/div><\/div>\n\t\t\t<\/div> \n\t\t<\/div>\n\t<\/div> \n<\/div><\/div>\n\t\t<div id=\"fws_6ad379d0c2c1e\"  data-column-margin=\"default\" data-midnight=\"light\" data-top-percent=\"4%\" data-bottom-percent=\"2%\"  class=\"wpb_row vc_row-fluid vc_row full-width-section has-row-bg-color\"  style=\"padding-top: calc(100vw * 0.04); padding-bottom: calc(100vw * 0.02); --row-bg-color: #6B564D;\"><div class=\"row-bg-wrap\" data-bg-animation=\"none\" data-bg-animation-delay=\"\" data-bg-overlay=\"false\"><div class=\"inner-wrap row-bg-layer\" ><div class=\"row-bg viewport-desktop using-bg-color\"  style=\"background-color: #6B564D; \"><\/div><\/div><\/div><div class=\"nectar-shape-divider-wrap \" style=\" height:1px;\"  data-height=\"1\" data-front=\"\" data-style=\"straight_section\" data-position=\"top\" ><svg class=\"nectar-shape-divider\" aria-hidden=\"true\" fill=\"#B3B3B3\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 100 10\" preserveAspectRatio=\"none\"> <polygon points=\"104 10, 104 0, 0 0, 0 10\"><\/polygon> <\/svg><\/div><div class=\"row_col_wrap_12 col span_12 light left\">\n\t<div  class=\"vc_col-sm-3 wpb_column column_container vc_column_container col no-extra-padding inherit_tablet inherit_phone flex_gap_desktop_10px \"  data-padding-pos=\"all\" data-has-bg-color=\"false\" data-bg-color=\"\" data-bg-opacity=\"1\" data-animation=\"\" data-delay=\"0\" >\n\t\t<div class=\"vc_column-inner\" >\n\t\t\t<div class=\"wpb_wrapper\">\n\t\t\t\t<div id=\"fws_6ad379d0c2e8a\" data-midnight=\"\" data-column-margin=\"default\" class=\"wpb_row vc_row-fluid vc_row inner_row\"  style=\"\"><div class=\"row-bg-wrap\"> <div class=\"row-bg\" ><\/div> <\/div><div class=\"row_col_wrap_12_inner col span_12  left\">\n\t<div  class=\"vc_col-sm-12 wpb_column column_container vc_column_container col child_column no-extra-padding inherit_tablet inherit_phone flex_gap_desktop_10px \"   data-padding-pos=\"all\" data-has-bg-color=\"false\" data-bg-color=\"\" data-bg-opacity=\"1\" data-animation=\"\" data-delay=\"0\" >\n\t\t<div class=\"vc_column-inner\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t\n<div class=\"wpb_text_column wpb_content_element \" >\n\t<p>\u00a9 2026 The Counseling Studio<\/p>\n<\/div>\n\n\n\n\n\t\t<\/div> \n\t<\/div>\n\t<\/div> \n<\/div><\/div>\n\t\t\t<\/div> \n\t\t<\/div>\n\t<\/div> \n\n\t<div  class=\"vc_col-sm-3 wpb_column column_container vc_column_container col no-extra-padding inherit_tablet inherit_phone flex_gap_desktop_10px \"  data-padding-pos=\"all\" data-has-bg-color=\"false\" data-bg-color=\"\" data-bg-opacity=\"1\" data-animation=\"\" data-delay=\"0\" >\n\t\t<div class=\"vc_column-inner\" >\n\t\t\t<div class=\"wpb_wrapper\">\n\t\t\t\t\n<div class=\"wpb_text_column wpb_content_element \" >\n\t<p><span style=\"color: #ffffff;\"><a style=\"color: #ffffff;\" href=\"https:\/\/thecounselingstudio.nl\/privacyverklaring\/\">Privacyverklaring<\/a><\/span><\/p>\n<\/div>\n\n\n\n\n\t\t\t<\/div> \n\t\t<\/div>\n\t<\/div> \n\n\t<div  class=\"vc_col-sm-3 wpb_column column_container vc_column_container col no-extra-padding inherit_tablet inherit_phone flex_gap_desktop_10px \"  data-padding-pos=\"all\" data-has-bg-color=\"false\" data-bg-color=\"\" data-bg-opacity=\"1\" data-animation=\"\" data-delay=\"0\" >\n\t\t<div class=\"vc_column-inner\" >\n\t\t\t<div class=\"wpb_wrapper\">\n\t\t\t\t\n<div class=\"wpb_text_column wpb_content_element \" >\n\t<p><span style=\"color: #ffffff;\"><a style=\"color: #ffffff;\" href=\"https:\/\/thecounselingstudio.nl\/algemene-voorwaarden\/\">Algemene voorwaarden<\/a><\/span><\/p>\n<\/div>\n\n\n\n\n\t\t\t<\/div> \n\t\t<\/div>\n\t<\/div> \n\n\t<div  class=\"vc_col-sm-3 wpb_column column_container vc_column_container col no-extra-padding inherit_tablet inherit_phone flex_gap_desktop_10px \"  data-padding-pos=\"all\" data-has-bg-color=\"false\" data-bg-color=\"\" data-bg-opacity=\"1\" data-animation=\"\" data-delay=\"0\" >\n\t\t<div class=\"vc_column-inner\" >\n\t\t\t<div class=\"wpb_wrapper\">\n\t\t\t\t\n<div class=\"wpb_text_column wpb_content_element \" >\n\t<p><span style=\"color: #ffffff;\"><a style=\"color: #ffffff;\" href=\"https:\/\/lioncreations.nl\/\">Website gebouwd door Lion Creations<\/a><\/span><\/p>\n<\/div>\n\n\n\n\n\t\t\t<\/div> \n\t\t<\/div>\n\t<\/div> \n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"Intakeformulier \u2013 The Counseling StudioIn welke taal wil je de intake invullen? Nederlands English Persoonlijke gegevens Personal Details VoornaamAchternaamFirst nameLast nameDate of birthGeboortedatumStreetHouse numberZIPStraatHuisnummerPostcodePhone numberTelefoonnummerE-mailEmail addressZorgverzekeringHealth insuranceBSN (Dutch Citizen Service...","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-256","page","type-page","status-publish"],"_links":{"self":[{"href":"https:\/\/thecounselingstudio.nl\/en\/wp-json\/wp\/v2\/pages\/256","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/thecounselingstudio.nl\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/thecounselingstudio.nl\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/thecounselingstudio.nl\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/thecounselingstudio.nl\/en\/wp-json\/wp\/v2\/comments?post=256"}],"version-history":[{"count":5,"href":"https:\/\/thecounselingstudio.nl\/en\/wp-json\/wp\/v2\/pages\/256\/revisions"}],"predecessor-version":[{"id":529,"href":"https:\/\/thecounselingstudio.nl\/en\/wp-json\/wp\/v2\/pages\/256\/revisions\/529"}],"wp:attachment":[{"href":"https:\/\/thecounselingstudio.nl\/en\/wp-json\/wp\/v2\/media?parent=256"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}