{"id":130,"date":"2023-02-22T10:24:08","date_gmt":"2023-02-22T10:24:08","guid":{"rendered":"https:\/\/manneziit.webcomplete.io\/questionannaire\/"},"modified":"2023-02-24T19:01:02","modified_gmt":"2023-02-24T19:01:02","slug":"questionannaire","status":"publish","type":"page","link":"https:\/\/manneziit.webcomplete.io\/de\/questionannaire\/","title":{"rendered":"Questionannaire"},"content":{"rendered":"<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_6' ><style>#gform_wrapper_6[data-form-index=\"0\"].gform-theme,[data-parent-form=\"6_0\"]{--gform-theme-color-primary: #204ce5;--gform-theme-color-primary-rgb: 32, 76, 229;--gform-theme-color-primary-contrast: #fff;--gform-theme-color-primary-contrast-rgb: 255, 255, 255;--gform-theme-color-primary-darker: #001AB3;--gform-theme-color-primary-lighter: #527EFF;--gform-theme-color-secondary: #fff;--gform-theme-color-secondary-rgb: 255, 255, 255;--gform-theme-color-secondary-contrast: #112337;--gform-theme-color-secondary-contrast-rgb: 17, 35, 55;--gform-theme-color-secondary-darker: #F5F5F5;--gform-theme-color-secondary-lighter: #FFFFFF;--gform-theme-color-outside-control-light: rgba(17, 35, 55, 0.1);--gform-theme-color-outside-control-light-rgb: 17, 35, 55;--gform-theme-color-outside-control-light-darker: rgba(104, 110, 119, 0.35);--gform-theme-color-outside-control-light-lighter: #F5F5F5;--gform-theme-color-outside-control-dark: #585e6a;--gform-theme-color-outside-control-dark-rgb: 88, 94, 106;--gform-theme-color-outside-control-dark-darker: #112337;--gform-theme-color-outside-control-dark-lighter: rgba(17, 35, 55, 0.65);--gform-theme-color-inside-control: #fff;--gform-theme-color-inside-control-rgb: 255, 255, 255;--gform-theme-color-inside-control-contrast: #112337;--gform-theme-color-inside-control-contrast-rgb: 17, 35, 55;--gform-theme-color-inside-control-darker: #F5F5F5;--gform-theme-color-inside-control-lighter: #FFFFFF;--gform-theme-color-inside-control-primary: #204ce5;--gform-theme-color-inside-control-primary-rgb: 32, 76, 229;--gform-theme-color-inside-control-primary-contrast: #fff;--gform-theme-color-inside-control-primary-contrast-rgb: 255, 255, 255;--gform-theme-color-inside-control-primary-darker: #001AB3;--gform-theme-color-inside-control-primary-lighter: #527EFF;--gform-theme-color-inside-control-light: rgba(17, 35, 55, 0.1);--gform-theme-color-inside-control-light-rgb: 17, 35, 55;--gform-theme-color-inside-control-light-darker: rgba(104, 110, 119, 0.35);--gform-theme-color-inside-control-light-lighter: #F5F5F5;--gform-theme-color-inside-control-dark: #585e6a;--gform-theme-color-inside-control-dark-rgb: 88, 94, 106;--gform-theme-color-inside-control-dark-darker: #112337;--gform-theme-color-inside-control-dark-lighter: rgba(17, 35, 55, 0.65);--gform-theme-border-radius: 3px;--gform-theme-font-size-secondary: 14px;--gform-theme-font-size-tertiary: 13px;--gform-theme-icon-control-number: url(\"data:image\/svg+xml,%3Csvg width='8' height='14' viewBox='0 0 8 14' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M4 0C4.26522 5.96046e-08 4.51957 0.105357 4.70711 0.292893L7.70711 3.29289C8.09763 3.68342 8.09763 4.31658 7.70711 4.70711C7.31658 5.09763 6.68342 5.09763 6.29289 4.70711L4 2.41421L1.70711 4.70711C1.31658 5.09763 0.683417 5.09763 0.292893 4.70711C-0.0976311 4.31658 -0.097631 3.68342 0.292893 3.29289L3.29289 0.292893C3.48043 0.105357 3.73478 0 4 0ZM0.292893 9.29289C0.683417 8.90237 1.31658 8.90237 1.70711 9.29289L4 11.5858L6.29289 9.29289C6.68342 8.90237 7.31658 8.90237 7.70711 9.29289C8.09763 9.68342 8.09763 10.3166 7.70711 10.7071L4.70711 13.7071C4.31658 14.0976 3.68342 14.0976 3.29289 13.7071L0.292893 10.7071C-0.0976311 10.3166 -0.0976311 9.68342 0.292893 9.29289Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gform-theme-icon-control-select: url(\"data:image\/svg+xml,%3Csvg width='10' height='6' viewBox='0 0 10 6' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M0.292893 0.292893C0.683417 -0.097631 1.31658 -0.097631 1.70711 0.292893L5 3.58579L8.29289 0.292893C8.68342 -0.0976311 9.31658 -0.0976311 9.70711 0.292893C10.0976 0.683417 10.0976 1.31658 9.70711 1.70711L5.70711 5.70711C5.31658 6.09763 4.68342 6.09763 4.29289 5.70711L0.292893 1.70711C-0.0976311 1.31658 -0.0976311 0.683418 0.292893 0.292893Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gform-theme-icon-control-search: url(\"data:image\/svg+xml,%3Csvg version='1.1' xmlns='http:\/\/www.w3.org\/2000\/svg' width='640' height='640'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gform-theme-control-border-color: #686e77;--gform-theme-control-size: var(--gform-theme-control-size-md);--gform-theme-control-label-color-primary: #112337;--gform-theme-control-label-color-secondary: #112337;--gform-theme-control-choice-size: var(--gform-theme-control-choice-size-md);--gform-theme-control-checkbox-check-size: var(--gform-theme-control-checkbox-check-size-md);--gform-theme-control-radio-check-size: var(--gform-theme-control-radio-check-size-md);--gform-theme-control-button-font-size: var(--gform-theme-control-button-font-size-md);--gform-theme-control-button-padding-inline: var(--gform-theme-control-button-padding-inline-md);--gform-theme-control-button-size: var(--gform-theme-control-button-size-md);--gform-theme-control-button-border-color-secondary: #686e77;--gform-theme-control-file-button-background-color-hover: #EBEBEB;--gform-theme-field-page-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><div id='gf_6' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Questionannaire DE<\/h2>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>\u201e<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\u201c zeigt erforderliche Felder an<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_6'  action='\/de\/wp-json\/wp\/v2\/pages\/130#gf_6' data-formid='6' novalidate>\n        <div id='gf_progressbar_wrapper_6' class='gf_progressbar_wrapper'>\n        \t<p class=\"gf_progressbar_title\">Schritt <span class='gf_step_current_page'>1<\/span> von <span class='gf_step_page_count'>23<\/span> &#8211; Questionannaire_Intro\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_gray' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_gray percentbar_4' style='width:4%;'><span>4%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_6_1' class='gform_page wcl-2-column-page' data-js='page-field-id-1' >\n                                    <div class='gform_page_fields'><div id='gform_fields_6' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_6_1\"  class=\"gfield gfield--type-html gfield--width-half gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_1\"><h1>Wir sind da, um dir mit deinen Problemen als Mann in der Schweiz zu helfen!<\/h1>\n\t\n<p>Nach Beantwortung folgender Fragen und einem kurzen R\u00fcckruf eines Arztes liefern wir dir diskret dein gew\u00fcnschtes Pr\u00e4parat zur Abhilfe bei erektiler Dysfunktion zu. Alle deine Antworten werden streng vertraulich behandelt und nur mit einem Apotheker aus deinem Kanton geteilt!<\/p>\n\n<div class=\"wcl-button-wrapper\">\n<a href=\"#\" class=\"wcl-button gf-banner-button\">\nBehandlung starten\n<i class=\"manneziit-arrow-right data-icon\"><\/i>\n<\/a>\n<\/div><\/div><div id=\"field_6_3\"  class=\"gfield gfield--type-html gfield--width-half gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_3\"><div class=\"image-wrapper\">\n<img decoding=\"async\" src=\"http:\/\/manneziit.webcomplete.io\/wp-content\/uploads\/2023\/02\/Illustration_Delivery.svg\">\n<\/div>\n<div class=\"wcl-button-wrapper\">\n<a href=\"#\" class=\"wcl-button gf-banner-button\">\nBehandlung starten\n<i class=\"manneziit-arrow-right data-icon\"><\/i>\n<\/a>\n<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_6_6' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"2\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"2\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_2_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_2' class='gform_page wcl-3-column-page' data-js='page-field-id-6' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_2' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_8\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_8\"><legend class='gfield_label gform-field-label'  >In welchem Kanton wohnst du?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_8'>\n\t\t\t<div class='gchoice gchoice_6_8_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey886104fac'  id='choice_6_8_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_0' id='label_6_8_0' class='gform-field-label gform-field-label--type-inline'>Aargau<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey879aae61f'  id='choice_6_8_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_1' id='label_6_8_1' class='gform-field-label gform-field-label--type-inline'>Appenzell Innerrhoden<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey842e9e451'  id='choice_6_8_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_2' id='label_6_8_2' class='gform-field-label gform-field-label--type-inline'>Appenzell Ausserrhoden<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey868a207e6'  id='choice_6_8_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_3' id='label_6_8_3' class='gform-field-label gform-field-label--type-inline'>Bern<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey82e141331'  id='choice_6_8_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_4' id='label_6_8_4' class='gform-field-label gform-field-label--type-inline'>Basel-Landschaft<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey8c16b7a6d'  id='choice_6_8_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_5' id='label_6_8_5' class='gform-field-label gform-field-label--type-inline'>Basel-Stadt<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey813e68792'  id='choice_6_8_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_6' id='label_6_8_6' class='gform-field-label gform-field-label--type-inline'>Freiburg<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey8cf5633b4'  id='choice_6_8_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_7' id='label_6_8_7' class='gform-field-label gform-field-label--type-inline'>Genf<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_8'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey803f0e262'  id='choice_6_8_8' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_8' id='label_6_8_8' class='gform-field-label gform-field-label--type-inline'>Glarus<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_9'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey8f1d9cf39'  id='choice_6_8_9' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_9' id='label_6_8_9' class='gform-field-label gform-field-label--type-inline'>Graub\u00fcnden<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_10'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey889cbe1da'  id='choice_6_8_10' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_10' id='label_6_8_10' class='gform-field-label gform-field-label--type-inline'>Jura<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_11'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey8eb150d8a'  id='choice_6_8_11' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_11' id='label_6_8_11' class='gform-field-label gform-field-label--type-inline'>Luzern<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_12'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey884878e80'  id='choice_6_8_12' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_12' id='label_6_8_12' class='gform-field-label gform-field-label--type-inline'>Neuenburg<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_13'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey86338c89a'  id='choice_6_8_13' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_13' id='label_6_8_13' class='gform-field-label gform-field-label--type-inline'>Nidwalden<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_14'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey87bf9d28b'  id='choice_6_8_14' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_14' id='label_6_8_14' class='gform-field-label gform-field-label--type-inline'>Obwalden<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_15'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey87c7358d8'  id='choice_6_8_15' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_15' id='label_6_8_15' class='gform-field-label gform-field-label--type-inline'>St. Gallen<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_16'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey871874c1d'  id='choice_6_8_16' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_16' id='label_6_8_16' class='gform-field-label gform-field-label--type-inline'>Schaffhausen<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_17'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey87279592e'  id='choice_6_8_17' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_17' id='label_6_8_17' class='gform-field-label gform-field-label--type-inline'>Solothurn<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_18'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey82e0fe5b5'  id='choice_6_8_18' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_18' id='label_6_8_18' class='gform-field-label gform-field-label--type-inline'>Schwyz<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_19'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey87e955211'  id='choice_6_8_19' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_19' id='label_6_8_19' class='gform-field-label gform-field-label--type-inline'>Thurgau<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_20'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey858922fa5'  id='choice_6_8_20' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_20' id='label_6_8_20' class='gform-field-label gform-field-label--type-inline'>Tessin<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_21'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey874fa1265'  id='choice_6_8_21' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_21' id='label_6_8_21' class='gform-field-label gform-field-label--type-inline'>Uri<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_22'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey8a384e597'  id='choice_6_8_22' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_22' id='label_6_8_22' class='gform-field-label gform-field-label--type-inline'>Waadt<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_23'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey846144275'  id='choice_6_8_23' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_23' id='label_6_8_23' class='gform-field-label gform-field-label--type-inline'>Wallis<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_24'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey8a68f63f0'  id='choice_6_8_24' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_24' id='label_6_8_24' class='gform-field-label gform-field-label--type-inline'>Zug<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_8_25'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='gsurvey8a8108c8b'  id='choice_6_8_25' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_8_25' id='label_6_8_25' class='gform-field-label gform-field-label--type-inline'>Z\u00fcrich<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_12' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"1\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"1\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_12' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"3\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"3\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_3_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_3' class='gform_page' data-js='page-field-id-12' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_3' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_15\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_15\"><legend class='gfield_label gform-field-label'  >Hast Du regelm\u00e4\u00dfig Schwierigkeiten eine Erektion zu bekommen oder zu halten?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_15'>\n\t\t\t<div class='gchoice gchoice_6_15_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='gsurvey886104fac'  id='choice_6_15_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_15_0' id='label_6_15_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_15_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='gsurvey879aae61f'  id='choice_6_15_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_15_1' id='label_6_15_1' class='gform-field-label gform-field-label--type-inline'>Nein<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_17' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"2\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"2\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_17' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"4\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"4\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_4_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_4' class='gform_page' data-js='page-field-id-17' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_4' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_16\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_16\"><legend class='gfield_label gform-field-label'  >Hast Du seit mehr als einem Jahr Schwierigkeiten mit der Erektion?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_16'>\n\t\t\t<div class='gchoice gchoice_6_16_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='gsurvey886104fac'  id='choice_6_16_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_16_0' id='label_6_16_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_16_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='gsurvey879aae61f'  id='choice_6_16_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_16_1' id='label_6_16_1' class='gform-field-label gform-field-label--type-inline'>Nein<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_19' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"3\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"3\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_19' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"5\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"5\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_5_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_5' class='gform_page' data-js='page-field-id-19' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_5' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_18\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_18\"><legend class='gfield_label gform-field-label'  >Wie w\u00fcrdest Du Deine Zuversicht einsch\u00e4tzen, eine Erektion zu bekommen und zu halten?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_18'>\n\t\t\t<div class='gchoice gchoice_6_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='gsurvey886104fac'  id='choice_6_18_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_18_0' id='label_6_18_0' class='gform-field-label gform-field-label--type-inline'>Kein Geschlechtsverkehr versucht<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='gsurvey879aae61f'  id='choice_6_18_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_18_1' id='label_6_18_1' class='gform-field-label gform-field-label--type-inline'>Sehr gering<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_18_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='gsurvey18c43ad6bd'  id='choice_6_18_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_18_2' id='label_6_18_2' class='gform-field-label gform-field-label--type-inline'>Gering<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_18_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='gsurvey18a303b576'  id='choice_6_18_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_18_3' id='label_6_18_3' class='gform-field-label gform-field-label--type-inline'>Mittelm\u00e4ssig<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_18_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='gsurvey18ca76315f'  id='choice_6_18_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_18_4' id='label_6_18_4' class='gform-field-label gform-field-label--type-inline'>Hoch<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_18_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='gsurvey184cce6263'  id='choice_6_18_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_18_5' id='label_6_18_5' class='gform-field-label gform-field-label--type-inline'>Sehr hoch<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_21' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"4\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"4\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_21' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"6\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"6\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_6_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_6' class='gform_page' data-js='page-field-id-21' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_6' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_20\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_20\"><legend class='gfield_label gform-field-label'  >Wenn Du bei sexueller Stimulation Erektionen hattest, wie oft waren Deine Erektionen hart genug f\u00fcr eine Penetration?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_20'>\n\t\t\t<div class='gchoice gchoice_6_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='gsurvey886104fac'  id='choice_6_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_20_0' id='label_6_20_0' class='gform-field-label gform-field-label--type-inline'>Kein Geschlechtsverkehr versucht<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='gsurvey879aae61f'  id='choice_6_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_20_1' id='label_6_20_1' class='gform-field-label gform-field-label--type-inline'>(Fast) Nie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_20_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='gsurvey18c43ad6bd'  id='choice_6_20_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_20_2' id='label_6_20_2' class='gform-field-label gform-field-label--type-inline'>Ein paar mal (weniger als die H\u00e4lfte der Zeit)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_20_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='gsurvey18a303b576'  id='choice_6_20_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_20_3' id='label_6_20_3' class='gform-field-label gform-field-label--type-inline'>Manchmal (etwa die H\u00e4lfte der Zeit)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_20_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='gsurvey18ca76315f'  id='choice_6_20_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_20_4' id='label_6_20_4' class='gform-field-label gform-field-label--type-inline'>Meistens (mehr als die H\u00e4lfte der Zeit)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_20_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='gsurvey184cce6263'  id='choice_6_20_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_20_5' id='label_6_20_5' class='gform-field-label gform-field-label--type-inline'>(Fast) Immer<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_23' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"5\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"5\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_23' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"7\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"7\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_7_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_7' class='gform_page' data-js='page-field-id-23' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_7' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_22\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_22\"><legend class='gfield_label gform-field-label'  >Wie oft konntest Du die Erektion w\u00e4hrend des Geschlechtsakts aufrechterhalten, nachdem Du in Deine(n) Partner(in) eingedrungen warst?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_22'>\n\t\t\t<div class='gchoice gchoice_6_22_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='gsurvey886104fac'  id='choice_6_22_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_22_0' id='label_6_22_0' class='gform-field-label gform-field-label--type-inline'>Kein Geschlechtsverkehr versucht<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_22_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='gsurvey879aae61f'  id='choice_6_22_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_22_1' id='label_6_22_1' class='gform-field-label gform-field-label--type-inline'>(Fast) Nie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_22_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='gsurvey18c43ad6bd'  id='choice_6_22_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_22_2' id='label_6_22_2' class='gform-field-label gform-field-label--type-inline'>Ein paar mal (weniger als die H\u00e4lfte der Zeit)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_22_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='gsurvey18a303b576'  id='choice_6_22_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_22_3' id='label_6_22_3' class='gform-field-label gform-field-label--type-inline'>Manchmal (etwa die H\u00e4lfte der Zeit)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_22_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='gsurvey18ca76315f'  id='choice_6_22_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_22_4' id='label_6_22_4' class='gform-field-label gform-field-label--type-inline'>Meistens (mehr als die H\u00e4lfte der Zeit)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_22_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='gsurvey184cce6263'  id='choice_6_22_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_22_5' id='label_6_22_5' class='gform-field-label gform-field-label--type-inline'>(Fast) Immer<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_26' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"6\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"6\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_26' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"8\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"8\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_8_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_8' class='gform_page' data-js='page-field-id-26' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_8' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_25\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_25\"><legend class='gfield_label gform-field-label'  >Wie schwierig war es beim Geschlechtsverkehr Deine Erektion bis zur Vollendung des Geschlechtsverkehrs aufrechtzuerhalten?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_25'>\n\t\t\t<div class='gchoice gchoice_6_25_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='gsurvey886104fac'  id='choice_6_25_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_25_0' id='label_6_25_0' class='gform-field-label gform-field-label--type-inline'>Kein Geschlechtsverkehr versucht<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_25_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='gsurvey879aae61f'  id='choice_6_25_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_25_1' id='label_6_25_1' class='gform-field-label gform-field-label--type-inline'>Extrem schwierig<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_25_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='gsurvey18c43ad6bd'  id='choice_6_25_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_25_2' id='label_6_25_2' class='gform-field-label gform-field-label--type-inline'>Sehr schwierig<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_25_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='gsurvey18a303b576'  id='choice_6_25_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_25_3' id='label_6_25_3' class='gform-field-label gform-field-label--type-inline'>Schwierig<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_25_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='gsurvey18ca76315f'  id='choice_6_25_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_25_4' id='label_6_25_4' class='gform-field-label gform-field-label--type-inline'>Etwas schwierig<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_25_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='gsurvey184cce6263'  id='choice_6_25_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_25_5' id='label_6_25_5' class='gform-field-label gform-field-label--type-inline'>Nicht schwierig<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_28' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"7\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"7\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_28' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"9\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"9\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_9_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_9' class='gform_page' data-js='page-field-id-28' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_9' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_27\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_27\"><legend class='gfield_label gform-field-label'  >Wenn Du versucht hast, Geschlechtsverkehr zu haben, wie oft war er befriedigend f\u00fcr Dich?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_27'>\n\t\t\t<div class='gchoice gchoice_6_27_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='gsurvey886104fac'  id='choice_6_27_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_27_0' id='label_6_27_0' class='gform-field-label gform-field-label--type-inline'>Kein Geschlechtsverkehr versucht<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_27_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='gsurvey879aae61f'  id='choice_6_27_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_27_1' id='label_6_27_1' class='gform-field-label gform-field-label--type-inline'>(Fast) Nie<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_27_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='gsurvey18c43ad6bd'  id='choice_6_27_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_27_2' id='label_6_27_2' class='gform-field-label gform-field-label--type-inline'>Ein paar mal (weniger als die H\u00e4lfte der Zeit)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_27_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='gsurvey18a303b576'  id='choice_6_27_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_27_3' id='label_6_27_3' class='gform-field-label gform-field-label--type-inline'>Manchmal (etwa die H\u00e4lfte der Zeit)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_27_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='gsurvey18ca76315f'  id='choice_6_27_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_27_4' id='label_6_27_4' class='gform-field-label gform-field-label--type-inline'>Meistens (mehr als die H\u00e4lfte der Zeit)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_27_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='gsurvey184cce6263'  id='choice_6_27_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_27_5' id='label_6_27_5' class='gform-field-label gform-field-label--type-inline'>(Fast) Immer<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_30' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"8\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"8\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_30' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"10\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"10\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_10_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_10' class='gform_page' data-js='page-field-id-30' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_10' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_29\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_29\"><legend class='gfield_label gform-field-label'  >Hast Du manchmal keine Probleme mit der Erektion? Beispielsweise beim morgendlichen Erwachen, beim Masturbieren oder beim Geschlechtsverkehr?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_29'>\n\t\t\t<div class='gchoice gchoice_6_29_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='gsurvey886104fac'  id='choice_6_29_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_29_0' id='label_6_29_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_29_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='gsurvey879aae61f'  id='choice_6_29_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_29_1' id='label_6_29_1' class='gform-field-label gform-field-label--type-inline'>Nein<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_33' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"9\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"9\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_33' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"11\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"11\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_11_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_11' class='gform_page wcl-2-column-page' data-js='page-field-id-33' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_11' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_6_31\"  class=\"gfield gfield--type-html gfield--width-half gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_31\"><h1>Danke f\u00fcr deine Ehrlichkeit!<\/h1>\n<h3>Du bist nicht alleine. \u00dcber 500&#8217;000 M\u00e4nner in der Schweiz leiden an erektiler Dysfunktion.<\/h3>\n\t\n<p>Die n\u00e4chsten Fragen betreffen deine Gesundheit.<\/p>\n\n<div class=\"wcl-button-wrapper\">\n<a href=\"#\" class=\"wcl-button gf-banner-button\">\nZustimmen und weiter\n<i class=\"manneziit-arrow-right data-icon\"><\/i>\n<\/a>\n<\/div><\/div><div id=\"field_6_32\"  class=\"gfield gfield--type-html gfield--width-half gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_32\"><div class=\"image-wrapper\">\n<img decoding=\"async\" src=\"http:\/\/manneziit.webcomplete.io\/wp-content\/uploads\/2023\/02\/Illustration_Couple.svg\">\n<\/div>\n<div class=\"wcl-button-wrapper\">\n<a href=\"#\" class=\"wcl-button gf-banner-button\">\nZustimmen und weiter\n<i class=\"manneziit-arrow-right data-icon\"><\/i>\n<\/a>\n<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_36' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"10\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"10\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_36' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"12\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"12\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_12_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_12' class='gform_page' data-js='page-field-id-36' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_12' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_35\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_35\"><legend class='gfield_label gform-field-label'  >Wie lauten Deine aktuellen Blutdruckwerte?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_35'>\n\t\t\t<div class='gchoice gchoice_6_35_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='gsurvey886104fac'  id='choice_6_35_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_35_0' id='label_6_35_0' class='gform-field-label gform-field-label--type-inline'>Niederig &#8211; Unter 90\/160<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_35_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='gsurvey879aae61f'  id='choice_6_35_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_35_1' id='label_6_35_1' class='gform-field-label gform-field-label--type-inline'>Normal &#8211; Zwischen 90\/160 &#8211; 140\/90<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_35_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='gsurvey355da1927c'  id='choice_6_35_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_35_2' id='label_6_35_2' class='gform-field-label gform-field-label--type-inline'>Hoch &#8211; \u00dcber 140\/90<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_38' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"11\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"11\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_38' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"13\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"13\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_13_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_13' class='gform_page wcl-show-next-button' data-js='page-field-id-38' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_13' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_6_71\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_71\"><h2>Wir ben\u00f6tigen Deine Gr\u00f6\u00dfe und Dein Gewicht um deinen BMI zu errechnen! <\/h2><\/div><div id=\"field_6_72\"  class=\"gfield gfield--type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_72\"><label class='gfield_label gform-field-label' for='input_6_72' >Gr\u00f6\u00dfe in Zentimeter<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_72' id='input_6_72' type='number' step='any' min='100' max='250' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_6_72\" \/><div class='gfield_description instruction ' id='gfield_instruction_6_72'>Bitte gib eine Zahl von <strong>100<\/strong> bis <strong>250<\/strong> ein.<\/div><\/div><\/div><div id=\"field_6_73\"  class=\"gfield gfield--type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_73\"><label class='gfield_label gform-field-label' for='input_6_73' >Gewicht in Kilogramm<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_73' id='input_6_73' type='number' step='any' min='40' max='350' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_6_73\" \/><div class='gfield_description instruction ' id='gfield_instruction_6_73'>Bitte gib eine Zahl von <strong>40<\/strong> bis <strong>350<\/strong> ein.<\/div><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_41' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"12\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"12\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_41' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"14\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"14\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_14_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_14' class='gform_page' data-js='page-field-id-41' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_14' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_40\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_40\"><legend class='gfield_label gform-field-label'  >Wie ist Dein Umgang mit Alkohol?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_40'>\n\t\t\t<div class='gchoice gchoice_6_40_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='gsurvey886104fac'  id='choice_6_40_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_40_0' id='label_6_40_0' class='gform-field-label gform-field-label--type-inline'>Ich trinke nie Alkohol<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_40_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='gsurvey879aae61f'  id='choice_6_40_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_40_1' id='label_6_40_1' class='gform-field-label gform-field-label--type-inline'>Ich trinke unregelm\u00e4ssig Alkohol, auf jeden Fall im Durchschnitt nicht mehr als einen halben Liter Bier oder ein Glass Wein pro Tag<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_40_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='gsurvey355da1927c'  id='choice_6_40_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_40_2' id='label_6_40_2' class='gform-field-label gform-field-label--type-inline'>Ich trinke regelm\u00e4ssig Alkohol, aber insgesamt weniger als einen Liter Bier oder einen halben Liter Wein pro Tag<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_40_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='gsurvey40f90d391b'  id='choice_6_40_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_40_3' id='label_6_40_3' class='gform-field-label gform-field-label--type-inline'>Ich trinke mehr als einen Liter Bier oder einen halben Liter Wein pro Tag<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_43' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"13\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"13\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_43' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"15\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"15\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_15_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_15' class='gform_page' data-js='page-field-id-43' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_15' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_42\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_42\"><legend class='gfield_label gform-field-label'  >Wie ist dein Rauchverhalten?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_42'>\n\t\t\t<div class='gchoice gchoice_6_42_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='gsurvey886104fac'  id='choice_6_42_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_42_0' id='label_6_42_0' class='gform-field-label gform-field-label--type-inline'>Ich rauche nicht<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_42_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='gsurvey879aae61f'  id='choice_6_42_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_42_1' id='label_6_42_1' class='gform-field-label gform-field-label--type-inline'>Ich rauche unregelm\u00e4ssig (z.B. auf Parties), aber auf keinen Fall mehr als eine halbe Packung am Tag<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_42_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='gsurvey355da1927c'  id='choice_6_42_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_42_2' id='label_6_42_2' class='gform-field-label gform-field-label--type-inline'>Ich rauche regelm\u00e4ssig, aber seit weniger als 5 Jahren und weniger als 1 Schachtel pro Tag<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_42_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='gsurvey40f90d391b'  id='choice_6_42_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_42_3' id='label_6_42_3' class='gform-field-label gform-field-label--type-inline'>Ich rauche regelm\u00e4ssig, seit mehr als 5 aber weniger als 10 Jahren und weniger als 1 Schachtel pro Tag<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_42_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='gsurvey427233fd3d'  id='choice_6_42_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_42_4' id='label_6_42_4' class='gform-field-label gform-field-label--type-inline'>Ich rauche regelm\u00e4ssig, und zwar seit mehr als 10 Jahren oder mehr als 1 Schachtel pro Tag<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_45' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"14\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"14\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_45' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"16\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"16\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_16_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_16' class='gform_page wcl-show-next-button' data-js='page-field-id-45' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_16' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_44\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_44\"><legend class='gfield_label gform-field-label gfield_label_before_complex'  >Trifft einer der folgenden Zust\u00e4nde, Krankheiten oder Behandlungen auf Dich zu?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_6_44'><div class='gchoice gchoice_6_44_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.1' type='checkbox'  value='gsurvey44a202bb9d'  id='choice_6_44_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_1' id='label_6_44_1' class='gform-field-label gform-field-label--type-inline'>Bewegungsmangel (weniger als 2.5 Stunden pro Woche)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_44_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.2' type='checkbox'  value='gsurvey44770887de'  id='choice_6_44_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_2' id='label_6_44_2' class='gform-field-label gform-field-label--type-inline'>Diabetes mellitus<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_44_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.3' type='checkbox'  value='gsurvey44ef409524'  id='choice_6_44_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_3' id='label_6_44_3' class='gform-field-label gform-field-label--type-inline'>Dyslipoprotein\u00e4mie<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_44_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.4' type='checkbox'  value='gsurvey4479ebf366'  id='choice_6_44_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_4' id='label_6_44_4' class='gform-field-label gform-field-label--type-inline'>Schwere Herz-Kreislauf-Erkrankungen wie ausgepr\u00e4gte Herzschw\u00e4che (Herzinsuffizienz NYHA III-IV), Herzrhythmusst\u00f6rungen (Arrhythmien) mit hohem Risiko, moderate bis schwere Herzklappenerkrankungen (Valvulopathien), Herzmuskelver\u00e4nderungen (Kardiomyopathien) oder Linksventrikul\u00e4re Dysfunktion<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_44_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.5' type='checkbox'  value='gsurvey443363dc11'  id='choice_6_44_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_5' id='label_6_44_5' class='gform-field-label gform-field-label--type-inline'>Prostatektomie (Prostataentfernung), Bestrahlung oder Seeds der Prostata<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_44_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.6' type='checkbox'  value='gsurvey44ad7decf2'  id='choice_6_44_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_6' id='label_6_44_6' class='gform-field-label gform-field-label--type-inline'>Operation im kleinen Becken mit wahrscheinlicher Beeintr\u00e4chtigung der neurovaskul\u00e4ren Versorgung (z.B. Rektumresektion, Harnblasenentfernung)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_44_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.7' type='checkbox'  value='gsurvey440acaa74f'  id='choice_6_44_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_7' id='label_6_44_7' class='gform-field-label gform-field-label--type-inline'>Unfall mit Beteiligung des Beckens\/des Penis\/der Wirbels\u00e4ule<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_44_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.8' type='checkbox'  value='gsurvey441733331b'  id='choice_6_44_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_8' id='label_6_44_8' class='gform-field-label gform-field-label--type-inline'>Nervale Erkrankungen und k\u00f6rperliche Traumen (z.B. Morbus Parkinson, Multiple Sklerose, R\u00fcckenmarkserkrankungen, Querschnittsl\u00e4hmungen, Sch\u00e4del-Hirn-Trauma)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_44_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.9' type='checkbox'  value='gsurvey44a1b0cd57'  id='choice_6_44_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_9' id='label_6_44_9' class='gform-field-label gform-field-label--type-inline'>(Neuro)psychiatrische Erkrankungen (z.B. Demenz)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_44_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.11' type='checkbox'  value='gsurvey4484888e4b'  id='choice_6_44_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_11' id='label_6_44_11' class='gform-field-label gform-field-label--type-inline'>Autoinjektionstherapie (SKAT, MUSE)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_44_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.12' type='checkbox'  value='gsurvey44ea038b9d'  id='choice_6_44_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_44_12' id='label_6_44_12' class='gform-field-label gform-field-label--type-inline'>Keine der oben genannten<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_48' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"15\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"15\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_48' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"17\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"17\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_17_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_17' class='gform_page wcl-show-next-button' data-js='page-field-id-48' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_17' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_47\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_47\"><legend class='gfield_label gform-field-label gfield_label_before_complex'  >Wurde bei Dir eine der folgenden Krankheiten oder medizinischen Ereignisse durch einen Arzt diagnostiziert? Bitte w\u00e4hle Zutreffende aus.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_6_47'><div class='gchoice gchoice_6_47_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.1' type='checkbox'  value='gsurvey44a202bb9d'  id='choice_6_47_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_47_1' id='label_6_47_1' class='gform-field-label gform-field-label--type-inline'>Allergien oder andere negative Reationen auf Medikamente gegen Erektionsst\u00f6rung<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_47_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.2' type='checkbox'  value='gsurvey44770887de'  id='choice_6_47_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_47_2' id='label_6_47_2' class='gform-field-label gform-field-label--type-inline'>Herzinfarkt<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_47_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.3' type='checkbox'  value='gsurvey44ef409524'  id='choice_6_47_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_47_3' id='label_6_47_3' class='gform-field-label gform-field-label--type-inline'>Herzschmerz (Angina Pectoris)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_47_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.4' type='checkbox'  value='gsurvey4479ebf366'  id='choice_6_47_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_47_4' id='label_6_47_4' class='gform-field-label gform-field-label--type-inline'>Schlaganfall oder Mini-Schlaganfall (Transitorisch isch\u00e4mische Attacke)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_47_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.5' type='checkbox'  value='gsurvey443363dc11'  id='choice_6_47_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_47_5' id='label_6_47_5' class='gform-field-label gform-field-label--type-inline'>Sehst\u00f6rungen aufgrund von Kreislaufschwierigkeiten<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_47_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.6' type='checkbox'  value='gsurvey44ad7decf2'  id='choice_6_47_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_47_6' id='label_6_47_6' class='gform-field-label gform-field-label--type-inline'>Erbliche Augenerkrankung wie eine Retinitis pigmentosa (RP)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_47_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.7' type='checkbox'  value='gsurvey440acaa74f'  id='choice_6_47_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_47_7' id='label_6_47_7' class='gform-field-label gform-field-label--type-inline'>Nieren- oder Lebersch\u00e4den<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_47_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.8' type='checkbox'  value='gsurvey4798e95c35'  id='choice_6_47_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_47_8' id='label_6_47_8' class='gform-field-label gform-field-label--type-inline'>Deformation oder Winkelung des Penis (Peyronie)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_47_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.9' type='checkbox'  value='gsurvey478a3b3305'  id='choice_6_47_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_47_9' id='label_6_47_9' class='gform-field-label gform-field-label--type-inline'>Sichelzellenerkrankung, Leuk\u00e4mie oder Morbus Kahler (Multiples Myelom)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_47_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.11' type='checkbox'  value='gsurvey4712dc332e'  id='choice_6_47_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_47_11' id='label_6_47_11' class='gform-field-label gform-field-label--type-inline'>Blutgerinnungsst\u00f6rung (H\u00e4mophilie)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_47_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.12' type='checkbox'  value='gsurvey473a60ef4e'  id='choice_6_47_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_47_12' id='label_6_47_12' class='gform-field-label gform-field-label--type-inline'>Aktive oder peptische Magengeschw\u00fcre (Magenulkus)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_47_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_47.13' type='checkbox'  value='gsurvey476f559632'  id='choice_6_47_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_47_13' id='label_6_47_13' class='gform-field-label gform-field-label--type-inline'>Keine der genannten Diagnosen<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_50' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"16\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"16\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_50' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"18\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"18\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_18_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_18' class='gform_page wcl-show-next-button' data-js='page-field-id-50' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_18' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_49\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_49\"><legend class='gfield_label gform-field-label gfield_label_before_complex'  >Nimmst Du aktuell eines der folgenden Medikamente ein? Bitte w\u00e4hle Zutreffende aus.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_6_49'><div class='gchoice gchoice_6_49_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.1' type='checkbox'  value='gsurvey44a202bb9d'  id='choice_6_49_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_49_1' id='label_6_49_1' class='gform-field-label gform-field-label--type-inline'>Andere Medikamente gegen Erektionsst\u00f6rungen als Viagra\/Sildenafil, Cialis\/Tadalafil, Levitra\/Vardenafil oder Spedra<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_49_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.2' type='checkbox'  value='gsurvey44770887de'  id='choice_6_49_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_49_2' id='label_6_49_2' class='gform-field-label gform-field-label--type-inline'>Nitrate gegen Herzerkrankungen wie zum Beispiel Glycerintrinitrat, Isosorbidmononitrat, Isosorbiddinitrat, GTN Spray\/Gel oder Nicorandil<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_49_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.3' type='checkbox'  value='gsurvey44ef409524'  id='choice_6_49_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_49_3' id='label_6_49_3' class='gform-field-label gform-field-label--type-inline'>Ritonavir, Indinavir oder Medizin gegen HIV<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_49_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.4' type='checkbox'  value='gsurvey4479ebf366'  id='choice_6_49_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_49_4' id='label_6_49_4' class='gform-field-label gform-field-label--type-inline'>Riociguat bei hohem Lungenblutdruck<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_49_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.5' type='checkbox'  value='gsurvey443363dc11'  id='choice_6_49_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_49_5' id='label_6_49_5' class='gform-field-label gform-field-label--type-inline'>Ketoconazol, Itraconazol oder andere Anti-Pilz Medikamente<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_49_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.6' type='checkbox'  value='gsurvey44ad7decf2'  id='choice_6_49_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_49_6' id='label_6_49_6' class='gform-field-label gform-field-label--type-inline'>Chemische \u201aPartydrogen\u2018, insbesonders Amyl Nitrate (Poppers)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_49_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.7' type='checkbox'  value='gsurvey440acaa74f'  id='choice_6_49_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_49_7' id='label_6_49_7' class='gform-field-label gform-field-label--type-inline'>Alpha-Blocker (werden zum Teil bei Bluthochdruck oder Prostatavergr\u00f6\u00dferung eingesetzt) wie zum Beispiel Alfuzosin, Doxazosin, Indoramin, Prazosin, Tamsulosin oder Terazosin<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_49_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_49.8' type='checkbox'  value='gsurvey49a4035959'  id='choice_6_49_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_49_8' id='label_6_49_8' class='gform-field-label gform-field-label--type-inline'>Keine der genannten Medikamente<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_52' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"17\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"17\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_52' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"19\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"19\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_19_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_19' class='gform_page' data-js='page-field-id-52' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_19' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_51\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_51\"><legend class='gfield_label gform-field-label'  >Wurde Dir durch einen Mediziner empfohlen, starke k\u00f6rperliche Anstrengungen zu vermeiden? Zum Beispiel wegen ernsthaften Herzerkrankungen oder Herzschmerz (Angina pectoris oder Instabile Angina)?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_51'>\n\t\t\t<div class='gchoice gchoice_6_51_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_51' type='radio' value='gsurvey886104fac'  id='choice_6_51_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_51_0' id='label_6_51_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_51_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_51' type='radio' value='gsurvey879aae61f'  id='choice_6_51_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_51_1' id='label_6_51_1' class='gform-field-label gform-field-label--type-inline'>Nein<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_55' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"18\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"18\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_55' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"20\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"20\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_20_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_20' class='gform_page wcl-2-column-page' data-js='page-field-id-55' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_20' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_6_53\"  class=\"gfield gfield--type-html gfield--width-half gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_53\"><h1>Deine Antworten helfen uns sehr!<\/h1>\n<h3>Mehrere gesundheitliche Faktoren k\u00f6nnen zur erektiler Dysfunktion f\u00fchren. <\/h3>\n\t\n<p>Mit deinen Antworten finden wir die beste Behandlung f\u00fcr dich. \n<\/p>\n<p>Kommen wir nun zu den letzten paar Fragen.<\/p>\n\n<div class=\"wcl-button-wrapper\">\n<a href=\"#\" class=\"wcl-button gf-banner-button\">\nWeiter\n<i class=\"manneziit-arrow-right data-icon\"><\/i>\n<\/a>\n<\/div><\/div><div id=\"field_6_54\"  class=\"gfield gfield--type-html gfield--width-half gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_54\"><div class=\"image-wrapper\">\n<img decoding=\"async\" src=\"http:\/\/manneziit.webcomplete.io\/wp-content\/uploads\/2023\/02\/Illustration_Doctor.svg\">\n<\/div>\n<div class=\"wcl-button-wrapper\">\n<a href=\"#\" class=\"wcl-button gf-banner-button\">\nWeiter\n<i class=\"manneziit-arrow-right data-icon\"><\/i>\n<\/a>\n<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_57' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"19\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"19\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_57' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"21\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"21\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_21_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_21' class='gform_page' data-js='page-field-id-57' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_21' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_6_56\"  class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" data-js-reload=\"field_6_56\"><legend class='gfield_label gform-field-label'  >Bitte gib Dein Geschlecht an. Es ist wichtig, dass du das Geschlecht angibst welches Du bei Deiner Geburt hattest. Diese Angabe ist notwendig um dich so gut wie m\u00f6glich zu behandeln!<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_56'>\n\t\t\t<div class='gchoice gchoice_6_56_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_56' type='radio' value='gsurvey886104fac'  id='choice_6_56_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_56_0' id='label_6_56_0' class='gform-field-label gform-field-label--type-inline'>M\u00e4nnlich<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_56_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_56' type='radio' value='gsurvey879aae61f'  id='choice_6_56_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_56_1' id='label_6_56_1' class='gform-field-label gform-field-label--type-inline'>Weiblich<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_56_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_56' type='radio' value='gsurvey564e13dd0b'  id='choice_6_56_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_56_2' id='label_6_56_2' class='gform-field-label gform-field-label--type-inline'>Intersexuell<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_59' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"20\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"20\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_59' class='gform_next_button gform-theme-button button' value='Weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"22\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"22\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_22_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_22' class='gform_page wcl-show-next-button' data-js='page-field-id-59' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_22' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_6_58\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_58\"><div class=\"gf-subpage-description\">\n<p>Wir weisen Dich darauf hin, dass Du umgehend einen Arzt aufsuchen solltest, wenn Deine Erektion 4 Stunden oder l\u00e4nger andauert. Obwohl das nur selten vorkommt, solltest Du sofort medizinischen Rat einholen, um dauerhafte Sch\u00e4den zu vermeiden.\n<\/p>\n<p>Au\u00dferdem solltest Du keine Kombination aus mehreren Medikamenten gegen Erektionsst\u00f6rung einnehmen. Zwischen 2 Einnahmen sollte eine Pause von 24 Stunden (bei Cialis\/Tadalafil von 36 Stunden) eingehalten werden um Risiken auszuschlie\u00dfen. Auch solltest Du nicht die verschriebene Dosis \u00fcberschreiten.\n<\/p>\n<p>Sei Dir bewusst, dass es empfehlenswert ist bereits Erfahrungen mit Sildenafil oder Tadalafil bzw. Viagra oder Cialis gehabt zu haben, bevor du verschiedene Wirkungsst\u00e4rken ausprobierst.<\/p><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_61' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"21\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"21\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_6_61' class='gform_next_button gform-theme-button button' value='Zustimmen und weiter'  onclick='jQuery(\"#gform_target_page_number_6\").val(\"23\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_6\").val(\"23\");  jQuery(\"#gform_6\").trigger(\"submit\",[true]); } ' \/> <button type='button'  id='gform_save_6_23_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_23' class='gform_page wcl-show-next-button' data-js='page-field-id-61' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_23' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_6_64\"  class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_64\"><h1>Adresse<\/h1><\/div><div id=\"field_6_74\"  class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_74\"><label class='gfield_label gform-field-label' for='input_6_74' >Comments<\/label><div class='ginput_container'><input name='input_74' id='input_6_74' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_6_74'>Dieses Feld dient zur Validierung und sollte nicht ver\u00e4ndert werden.<\/div><\/div><\/div><\/div>\n        <div class='gform_page_footer top_label'><input type='submit' id='gform_previous_button_6' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Vorherige'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;}  jQuery(\"#gform_6\").trigger(\"submit\",[true]); }' \/> <input type='submit' id='gform_submit_button_6' class='gform_button button' value='Weiter'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;}  jQuery(\"#gform_6\").trigger(\"submit\",[true]); }' \/> <button type='button'  id='gform_save_6_footer_link' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  onclick='if(window[\"gf_submitting_6\"]){return false;}  if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]);' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_6\"]){return false;} if( !jQuery(\"#gform_6\")[0].checkValidity || jQuery(\"#gform_6\")[0].checkValidity()){window[\"gf_submitting_6\"]=true;} jQuery(\"#gform_save_6\").val(1); jQuery(\"#gform_6\").trigger(\"submit\",[true]); }'><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save &#038; Continue<\/button>\n            <input type='hidden' class='gform_hidden' name='is_submit_6' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='6' \/>\n            <input type='hidden' class='gform_hidden' name='gform_save' id='gform_save_6' value='' \/>\n                             <input type='hidden' class='gform_hidden' name='gform_resume_token' id='gform_resume_token_6' value='' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_6' value='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' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_6' id='gform_target_page_number_6' value='2' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_6' id='gform_source_page_number_6' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/div><\/div>\n                        <\/form>\n                        <\/div><script>\ngform.initializeOnLoaded( function() {gformInitSpinner( 6, 'https:\/\/manneziit.webcomplete.io\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_6').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_6');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_6').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){jQuery('#gform_wrapper_6').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_6').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_6').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/ jQuery(document).scrollTop(jQuery('#gform_wrapper_6').offset().top - mt); }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_6').val();gformInitSpinner( 6, 'https:\/\/manneziit.webcomplete.io\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [6, current_page]);window['gf_submitting_6'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery('#gform_wrapper_6').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_6').offset().top - mt);jQuery(document).trigger('gform_confirmation_loaded', [6]);window['gf_submitting_6'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_6').text());}, 50);}else{jQuery('#gform_6').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger('gform_post_render', [6, current_page]);gform.utils.trigger({ event: 'gform\/postRender', native: false, data: { formId: 6, currentPage: current_page } });} );} );\n<\/script>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"questionnaire-template.php","meta":{"inline_featured_image":false},"acf":[],"_links":{"self":[{"href":"https:\/\/manneziit.webcomplete.io\/de\/wp-json\/wp\/v2\/pages\/130"}],"collection":[{"href":"https:\/\/manneziit.webcomplete.io\/de\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/manneziit.webcomplete.io\/de\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/manneziit.webcomplete.io\/de\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/manneziit.webcomplete.io\/de\/wp-json\/wp\/v2\/comments?post=130"}],"version-history":[{"count":3,"href":"https:\/\/manneziit.webcomplete.io\/de\/wp-json\/wp\/v2\/pages\/130\/revisions"}],"predecessor-version":[{"id":139,"href":"https:\/\/manneziit.webcomplete.io\/de\/wp-json\/wp\/v2\/pages\/130\/revisions\/139"}],"wp:attachment":[{"href":"https:\/\/manneziit.webcomplete.io\/de\/wp-json\/wp\/v2\/media?parent=130"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}