{"id":272,"date":"2013-06-17T13:25:20","date_gmt":"2013-06-17T11:25:20","guid":{"rendered":"http:\/\/www.atlaspraxis.de\/?page_id=272"},"modified":"2026-07-08T19:35:19","modified_gmt":"2026-07-08T17:35:19","slug":"anmeldung","status":"publish","type":"page","link":"https:\/\/www.atlaspraxis.de\/en\/kontakt\/anmeldung\/","title":{"rendered":"Application"},"content":{"rendered":"\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1600\" height=\"200\" src=\"https:\/\/www.atlaspraxis.de\/wp-content\/uploads\/Registration.png\" alt=\"Application\" class=\"wp-image-10711\" style=\"width:600px\" srcset=\"https:\/\/www.atlaspraxis.de\/wp-content\/uploads\/Registration.png 1600w, https:\/\/www.atlaspraxis.de\/wp-content\/uploads\/Registration-600x75.png 600w, https:\/\/www.atlaspraxis.de\/wp-content\/uploads\/Registration-1024x128.png 1024w, https:\/\/www.atlaspraxis.de\/wp-content\/uploads\/Registration-768x96.png 768w, https:\/\/www.atlaspraxis.de\/wp-content\/uploads\/Registration-1536x192.png 1536w\" sizes=\"auto, (max-width: 1600px) 100vw, 1600px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">If you already have an <strong>appointment<\/strong>, you may send us some information in advance.<\/p>\n\n\n\n<div style=\"height:40px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><div class=\"wpforms-container wpforms-render-modern\" id=\"wpforms-8676\"><form id=\"wpforms-form-8676\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"8676\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/en\/wp-json\/wp\/v2\/pages\/272\" data-token=\"a3e62909dd38fd9ba0714c1681ce47df\" data-token-time=\"1784158525\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-8676-field_9-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-8676-field_9\">First name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-8676-field_9\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][9]\" aria-errormessage=\"wpforms-8676-field_9-error\" required><\/div><div id=\"wpforms-8676-field_5-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-8676-field_5\">Last name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-8676-field_5\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][5]\" aria-errormessage=\"wpforms-8676-field_5-error\" required><\/div><div id=\"wpforms-8676-field_2-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-8676-field_2\">E-mail address <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-8676-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" spellcheck=\"false\" aria-errormessage=\"wpforms-8676-field_2-error\" required><\/div><div id=\"wpforms-8676-field_14-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-8676-field_14\">Phone number <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-8676-field_14\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][14]\" aria-errormessage=\"wpforms-8676-field_14-error\" required><\/div><div id=\"wpforms-8676-field_13-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-8676-field_13\">Appointment <\/label><input type=\"text\" id=\"wpforms-8676-field_13\" class=\"wpforms-field-medium\" name=\"wpforms[fields][13]\" aria-errormessage=\"wpforms-8676-field_13-error\" ><\/div><div id=\"wpforms-8676-field_15-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-8676-field_15\">Date of Birth <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-8676-field_15\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][15]\" aria-errormessage=\"wpforms-8676-field_15-error\" required><\/div><div id=\"wpforms-8676-field_6-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-8676-field_6\">Street <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-8676-field_6\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][6]\" aria-errormessage=\"wpforms-8676-field_6-error\" required><\/div><div id=\"wpforms-8676-field_12-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-8676-field_12\">ZIP <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-8676-field_12\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][12]\" aria-errormessage=\"wpforms-8676-field_12-error\" required><\/div><div id=\"wpforms-8676-field_7-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-8676-field_7\">City <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-8676-field_7\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][7]\" aria-errormessage=\"wpforms-8676-field_7-error\" required><\/div><div id=\"wpforms-8676-field_8-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-8676-field_8\">Country<\/label><input type=\"text\" id=\"wpforms-8676-field_8\" class=\"wpforms-field-medium\" name=\"wpforms[fields][8]\" aria-errormessage=\"wpforms-8676-field_8-error\" ><\/div><div id=\"wpforms-8676-field_16-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-8676-field_16\">Occupation<\/label><input type=\"text\" id=\"wpforms-8676-field_16\" class=\"wpforms-field-medium\" name=\"wpforms[fields][16]\" aria-errormessage=\"wpforms-8676-field_16-error\" ><\/div><div id=\"wpforms-8676-field_3-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-8676-field_3\">Medical complaints<\/label><textarea id=\"wpforms-8676-field_3\" class=\"wpforms-field-medium\" name=\"wpforms[fields][3]\" aria-errormessage=\"wpforms-8676-field_3-error\" ><\/textarea><\/div><div id=\"wpforms-8676-field_17-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-8676-field_17\">Accidents<\/label><textarea id=\"wpforms-8676-field_17\" class=\"wpforms-field-medium\" name=\"wpforms[fields][17]\" aria-errormessage=\"wpforms-8676-field_17-error\" ><\/textarea><\/div><div id=\"wpforms-8676-field_18-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-8676-field_18\">Spine problems<\/label><textarea id=\"wpforms-8676-field_18\" class=\"wpforms-field-medium\" name=\"wpforms[fields][18]\" aria-errormessage=\"wpforms-8676-field_18-error\" ><\/textarea><\/div><div id=\"wpforms-8676-field_19-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"19\"><fieldset><legend class=\"wpforms-field-label\">Are you pregnant at the time? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-8676-field_19\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-8676-field_19_1\" name=\"wpforms[fields][19][]\" value=\"Yes\" aria-errormessage=\"wpforms-8676-field_19_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-8676-field_19_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-8676-field_19_2\" name=\"wpforms[fields][19][]\" value=\"No\" aria-errormessage=\"wpforms-8676-field_19_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-8676-field_19_2\">No<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-8676-field_19_3\" name=\"wpforms[fields][19][]\" value=\"Uncertain\" aria-errormessage=\"wpforms-8676-field_19_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-8676-field_19_3\">Uncertain<\/label><\/li><\/ul><\/fieldset><\/div>\t\t<div id=\"wpforms-8676-field_1-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"1\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-8676-field_1\" >Spine done <\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-8676-field_1\" class=\"wpforms-field-medium\" name=\"wpforms[fields][1]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-8676-field_20-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"20\"><fieldset><legend class=\"wpforms-field-label\">Did you have an Atlasprofilax method done before? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-8676-field_20\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-8676-field_20_1\" name=\"wpforms[fields][20][]\" value=\"Yes\" aria-errormessage=\"wpforms-8676-field_20_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-8676-field_20_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-8676-field_20_2\" name=\"wpforms[fields][20][]\" value=\"No\" aria-errormessage=\"wpforms-8676-field_20_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-8676-field_20_2\">No<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-8676-field_20_3\" name=\"wpforms[fields][20][]\" value=\"Uncertain\" aria-errormessage=\"wpforms-8676-field_20_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-8676-field_20_3\">Uncertain<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-8676-field_23-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"23\"><fieldset><legend class=\"wpforms-field-label\">Application<\/legend><ul id=\"wpforms-8676-field_23\"><li class=\"choice-1 depth-1 wpforms-selected\"><input type=\"checkbox\" id=\"wpforms-8676-field_23_1\" name=\"wpforms[fields][23][]\" value=\"Atlas Therapy\" aria-errormessage=\"wpforms-8676-field_23_1-error\"   checked='checked'><label class=\"wpforms-field-label-inline\" for=\"wpforms-8676-field_23_1\">Atlas Therapy<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-8676-field_23_2\" name=\"wpforms[fields][23][]\" value=\"Atlas Therapy PLUS\" aria-errormessage=\"wpforms-8676-field_23_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-8676-field_23_2\">Atlas Therapy PLUS<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-8676-field_23_3\" name=\"wpforms[fields][23][]\" value=\"Naturopathy\" aria-errormessage=\"wpforms-8676-field_23_3-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-8676-field_23_3\">Naturopathy<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-8676-field_21-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-8676-field_21\">Notes<\/label><textarea id=\"wpforms-8676-field_21\" class=\"wpforms-field-medium\" name=\"wpforms[fields][21]\" aria-errormessage=\"wpforms-8676-field_21-error\" ><\/textarea><\/div><div id=\"wpforms-8676-field_22-container\" class=\"wpforms-field wpforms-field-gdpr-checkbox\" data-field-id=\"22\"><label class=\"wpforms-field-label\">GDPR consent <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><ul id=\"wpforms-8676-field_22\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"checkbox\" id=\"wpforms-8676-field_22_1\" name=\"wpforms[fields][22][]\" value=\"I consent to this website storing the information I submit so that my inquiry can be answered.\" aria-errormessage=\"wpforms-8676-field_22_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-8676-field_22_1\">I consent to this website storing the information I submit so that my inquiry can be answered.<\/label><\/li><\/ul><\/div><script>\n\t\t\t\t( function() {\n\t\t\t\t\tconst style = document.createElement( 'style' );\n\t\t\t\t\tstyle.appendChild( document.createTextNode( '#wpforms-8676-field_1-container { position: absolute !important; overflow: hidden !important; display: inline !important; height: 1px !important; width: 1px !important; z-index: -1000 !important; padding: 0 !important; } #wpforms-8676-field_1-container input { visibility: hidden; } #wpforms-conversational-form-page #wpforms-8676-field_1-container label { counter-increment: none; }' ) );\n\t\t\t\t\tdocument.head.appendChild( style );\n\t\t\t\t\tdocument.currentScript?.remove();\n\t\t\t\t} )();\n\t\t\t<\/script><\/div><!-- .wpforms-field-container --><div class=\"wpforms-recaptcha-container wpforms-is-recaptcha wpforms-is-recaptcha-type-v3\" ><input type=\"hidden\" name=\"wpforms[recaptcha]\" value=\"\"><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"8676\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/www.atlaspraxis.de\/en\/wp-json\/wp\/v2\/pages\/272\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-8676\" class=\"wpforms-submit\" data-alt-text=\"Wird gesendet\u00a0\u2026\" data-submit-text=\"Absenden\" aria-live=\"assertive\" value=\"wpforms-submit\">Absenden<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.atlaspraxis.de\/wp-content\/plugins\/wpforms-lite\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container --><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Fields marked with * are required.<\/p>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">You can also print out the application form and bring it with you when you are here for the appointment:<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-button-style-1\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/www.atlaspraxis.de\/wp-content\/uploads\/Anmeldung.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">PDF download: Registration atlas therapy <\/a><\/div>\n\n\n\n<div class=\"wp-block-button is-style-button-style-1\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/www.atlaspraxis.de\/wp-content\/uploads\/Anmeldung-Atlastherapie-Plus.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">PDF download: Registration atlas therapy PLUS<\/a><\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Further information<\/strong><\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-button-style-1\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/www.atlaspraxis.de\/en\/atlasprofilax\/\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>Atlas Therapy<\/strong><\/a><\/div>\n\n\n\n<div class=\"wp-block-button is-style-button-style-1\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/www.atlaspraxis.de\/en\/atlasprofilax\/atlastherapieplus\/\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>Atlas Therapy<\/strong> PLUS<\/a><\/div>\n\n\n\n<div class=\"wp-block-button is-style-button-style-1\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/www.atlaspraxis.de\/en\/atlasprofilax\/kosten\/\" target=\"_blank\" rel=\"noreferrer noopener\">Pricing<\/a><\/div>\n<\/div>\n\n\n\n<p class=\"has-small-font-size wp-block-paragraph\">By using this contact form you agree to our <a href=\"https:\/\/www.atlaspraxis.de\/en\/datenschutzerklaerung\/?lang=en\" target=\"_blank\" rel=\"noopener noreferrer\">privacy policy<\/a>. You also agree to the use of Google reCAPTCHA.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>If you already have an appointment, you may send us some information in advance. Fields marked with * are required. You can also print out the application form and bring it with you when you are here for the appointment: Further information By using this contact form you agree to our privacy policy. You also<a class=\"more-link\" href=\"https:\/\/www.atlaspraxis.de\/en\/kontakt\/anmeldung\/\">Read more  &#10230;<\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"parent":153,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-272","page","type-page","status-publish","hentry"],"translation":{"provider":"WPGlobus","version":"3.0.2","language":"en","enabled_languages":["de","en"],"languages":{"de":{"title":true,"content":true,"excerpt":false},"en":{"title":true,"content":true,"excerpt":false}}},"_links":{"self":[{"href":"https:\/\/www.atlaspraxis.de\/en\/wp-json\/wp\/v2\/pages\/272","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.atlaspraxis.de\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.atlaspraxis.de\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.atlaspraxis.de\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.atlaspraxis.de\/en\/wp-json\/wp\/v2\/comments?post=272"}],"version-history":[{"count":70,"href":"https:\/\/www.atlaspraxis.de\/en\/wp-json\/wp\/v2\/pages\/272\/revisions"}],"predecessor-version":[{"id":10834,"href":"https:\/\/www.atlaspraxis.de\/en\/wp-json\/wp\/v2\/pages\/272\/revisions\/10834"}],"up":[{"embeddable":true,"href":"https:\/\/www.atlaspraxis.de\/en\/wp-json\/wp\/v2\/pages\/153"}],"wp:attachment":[{"href":"https:\/\/www.atlaspraxis.de\/en\/wp-json\/wp\/v2\/media?parent=272"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}