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feat(content): Add new French content for 'Commande', 'Infirmier Independant', 'Module Supplementaire Infirmiers Independants', 'Version de Demonstration', 'Contact', 'Declaration de Confidentialité', 'Liste de Prix', 'Mentions Legales' pages.

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Andreas Hnida 2024-04-01 09:27:20 +02:00
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content/french/commande/module-supplementaire-infirmiers-independants.md Normal file
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date = '2024-02-21T13:22:03Z'
draft = false
title = 'Zusatzmodule Freiberufliche'
translationKey = 'zusatzmodule-freiberufliche'
bestellformular = true
+++
<!-- {{% veruaslider height="450px" %}}
{{% slide image="../bestellungen-header.jpg" first="true " %}}
{{% /veruaslider %}} -->
{{% section %}}
{{% aligncenter %}}
#### Formulaire de commande
## VeruA ** Facturation et Administration
### infirmiers indépendants module supplementaire
<br>
---
<br>
{{% /aligncenter %}}
<form action="https://verua.dev-1.andreashnida.de/php/ajaxmail.php" method="POST" id="bestellformular">
<input type="hidden" name="formularart" value="Zusatzmodule Freiberufliche">
<div>
<label class="hidden" for="gender">Sexe</label>
<select id="gender" name="gender" required >
<option value="weiblich">Femme</option>
<option value="männlich">Homme</option>
<option value="divers">Divers</option>
</select>
</div>
<div>
<label for="sprache">Langue</label>
<select id="sprache" name="sprache" required >
<option value="deutsch">Allemand</option>
<option value="franzoesisch">Français</option>
</select>
</div>
<div>
<label for="name">Nom</label>
<input type="text" id="name" name="name" required >
</div>
<div>
<label for="vorname">Prénom</label>
<input type="text" id="vorname" name="vorname" required >
</div>
<div>
<input type="text" id="hobbies" name="hobbies" autocomplete="off">
</div>
<div>
<label for="strasse">Rue</label>
<input type="text" id="strasse" name="strasse" required >
</div>
<div>
<input type="text" id="age" name="age" autocomplete="off">
</div>
<div>
<label for="plz_ort">NPAI Localité</label>
<input type="text" id="plz_ort" name="plz_ort" required >
</div>
<div>
<label for="telefon">Téléphone</label>
<input type="text" id="telefon" name="telefon" required >
</div>
<div>
<label for="email">E-mail</label>
<input type="email" id="email" name="email" required >
</div>
<div>
<input type="verify_email" id="verify_email" name="verify_email" autocomplete="off">
</div>
<div id="zsr-tooltip" data-tooltip="Veuillez entrer un numéro RCC valide ou 'demandé'.">
<label for="zsr_nummer">Nr. RCC</label>
<input type="text" id="zsr_nummer" name="zsr_nummer" required >
</div>
<div><br><br>
<h5>Quelles extensions souhaitez-vous ajouter ?</h5><br>
<div id="checkbox-group">
<input type="checkbox" id="zusatzmodul-materialverwaltung" name="zusatzmodul-materialverwaltung" value="Ja">
<label for="zusatzmodul-materialverwaltung">Module complémentaire gestion du matériel pour 260 CHF</label>
<br>
<input type="checkbox" id="zusatzmodul-qr-code" name="zusatzmodul-qr-code" value="Ja">
<label for="zusatzmodul-qr-code">Module complémentaire code QR pour 36.00 CHF par an, frais de désactivation uniques par instance 50.00 CHF</label>
<br>
<input type="checkbox" id="zusatzmodul-perigon" name="zusatzmodul-perigon" value="Ja">
<label for="zusatzmodul-perigon">Module complémentaire Perigon, frais de désactivation uniques 50.00 CHF</label>
</div>
<!-- <div class ="captcha-container"></div> nous renonçons pour le moment au Captcha -->
<div class="w-full flex justify-center">
<button id="bestellformular-btn" type="submit" class="submitbutton text-white mx-auto submit-after-valid-captcha-bak">Commander avec obligation de paiement</button>
<div id="notification" class="bg-blue-500 text-white rounded invisible opacity-0 hidden">Notification</div>
</div>
</form>
{{% /section %}}