Bestelformulier

Leden van Revalidatie Nederland kunnen kosteloos publicaties bestellen bij Revalidatie Nederland. Vult u hiertoe het onderstaande formulier in. U kunt hierbij aangeven hoeveel exemplaren u van een bepaalde publicatie wilt ontvangen.

[{"level":"2"}]
{"label":"Bestelformulier Publicaties"}
[]

Bestelformulier Publicaties

[{"mandatory":"","unique":"","validation":"numeric","default_value":"","has_placeholder":""}]
{"label":"Scenariopublicatie 'Revalidatie in 2030'","error_mandatory":"Dit veld is verplicht.","error_unique":"Deze waarde is al bezet.","error_validation":"Dit moet een getal zijn."}
[]
[{"mandatory":"","unique":"","validation":"numeric","default_value":"","has_placeholder":""}]
{"label":"Factsheet revalidatie na beroerte","error_mandatory":"Dit veld is verplicht.","error_unique":"Deze waarde is al bezet.","error_validation":"Dit moet een getal zijn."}
[]
[{"mandatory":"","unique":"","validation":"numeric","default_value":"","has_placeholder":""}]
{"label":"Factsheet Dwarslaesierevalidatie","error_mandatory":"Dit veld is verplicht.","error_unique":"Deze waarde is al bezet.","error_validation":"Dit moet een getal zijn."}
[]
[{"unique":"","mandatory":"","has_placeholder":"","default_value":"","validation":"numeric"}]
{"error_validation":"Dit moet een getal zijn.","error_unique":"Deze waarde is al bezet.","error_mandatory":"Dit veld is verplicht.","label":"Factsheet Kinderrevalidatie"}
[]
[{"mandatory":"","unique":"","validation":"numeric","default_value":"","has_placeholder":""}]
{"label":"Factsheet Pijnrevalidatie","error_mandatory":"Dit veld is verplicht.","error_unique":"Deze waarde is al bezet.","error_validation":"Dit moet een getal zijn."}
[]
[{"has_placeholder":"","default_value":"","validation":"numeric","unique":"","mandatory":""}]
{"error_validation":"Dit moet een getal zijn.","error_unique":"Deze waarde is al bezet.","label":"Flyer Medisch specialistische revalidatie","error_mandatory":"Dit veld is verplicht."}
[]
[{"default_value":"","unique":"","mandatory":"","has_placeholder":"","validation":"numeric"}]
{"error_validation":"Dit moet een getal zijn.","error_unique":"Deze waarde is al bezet.","label":"Factsheet Revalidatiegeneeskunde","error_mandatory":"Dit veld is verplicht."}
[]
[{"mandatory":"","unique":"","validation":"","default_value":"","has_placeholder":"","source_type":""}]
{"label":"Factsheet Revalidatie, sport en bewegen","error_mandatory":"Dit veld is verplicht.","error_unique":"Deze waarde is al bezet.","error_validation":""}
[]
[{"mandatory":"","unique":"","validation":"numeric","default_value":"","has_placeholder":""}]
{"label":"Flyers digitaal Revalidatie Magazine","error_mandatory":"Dit veld is verplicht.","error_unique":"Deze waarde is al bezet.","error_validation":"Dit moet een getal zijn."}
[]
[{"mandatory":"","unique":"","validation":"numeric","default_value":"","has_placeholder":""}]
{"label":"Boek Perspectief","error_mandatory":"Dit veld is verplicht.","error_unique":"Deze waarde is al bezet.","error_validation":"Dit moet een getal zijn."}
[]
[{"mandatory":"","unique":"","validation":"","default_value":"","has_placeholder":""}]
{"label":"Folder Revalidatie Nederland in vogelvlucht","error_mandatory":"Dit veld is verplicht.","error_unique":"Deze waarde is al bezet.","error_validation":""}
[]
[[]]
[]
[]

[{"mandatory":"true","unique":"","validation":"","default_value":"","has_placeholder":""}]
{"label":"Naam organisatie","error_mandatory":"Dit veld is verplicht.","error_unique":"Deze waarde is al bezet.","error_validation":""}
[]
[{"mandatory":"","unique":"","validation":"","default_value":"","has_placeholder":""}]
{"label":"Afdeling","error_mandatory":"Dit veld is verplicht.","error_unique":"Deze waarde is al bezet.","error_validation":""}
[]
[{"prefix":"","infix":"1","mandatory":"1"}]
{"firstname":"Voornaam","label":"Naam","infix":"Tussenv.","lastname":"Achternaam","sir":"Dhr.","madam":"Mevr.","family":"Fam.","error_mandatory":"Uw volledige naam is verplicht."}
[]
[{"has_placeholder":"","mandatory":"true"}]
{"label":"Adres","street":"Straatnaam","housenumber":"Huisnummer","zipcode":"Postcode","city":"Woonplaats","error_mandatory":"Adres is verplicht."}
[]
[{"mandatory":"true","unique":"","validation":"email","default_value":"","has_placeholder":""}]
{"label":"E-mailadres","error_mandatory":"Dit veld is verplicht.","error_unique":"Deze waarde is al bezet.","error_validation":"Dit is geen geldig e-mailadres."}
[]
[[]]
[]
[]

[[]]
{"label":"Formulier verzenden"}
[]
[{"default_value":"","validation":"","unique":"","mandatory":"","has_placeholder":"","source_type":""}]
{"label":"Tekstvak","error_mandatory":"Dit veld is verplicht.","error_unique":"Deze waarde is al bezet.","error_validation":""}
[]
[{"mandatory":"","unique":"","validation":"","default_value":"","has_placeholder":"","source_type":""}]
{"label":"Tekstvak","error_mandatory":"Dit veld is verplicht.","error_unique":"Deze waarde is al bezet.","error_validation":""}
[]