{"id":409,"date":"2021-09-27T13:28:54","date_gmt":"2021-09-27T11:28:54","guid":{"rendered":"https:\/\/cfverzekeringen.com.vallonic.com\/?page_id=409"},"modified":"2021-11-02T14:00:30","modified_gmt":"2021-11-02T13:00:30","slug":"report-damage","status":"publish","type":"page","link":"https:\/\/cfverzekeringen.com\/en\/report-damage\/","title":{"rendered":"Report damage"},"content":{"rendered":"<div class=\"section--header-intro wf-section\">\n    <div class=\"container no--padding w-container\">\n        <div class=\"header-intro__background-container extended-page--both\">\n            <img decoding=\"async\" data-src=\"https:\/\/cfverzekeringen.com\/wp-content\/themes\/vallonic-cfverzekeringen\/dist\/images\/Vallonic__CF-Verzekeringen__home__intro__background2x_288cf0c1.png\" loading=\"lazy\" alt=\"\" class=\"header-intro__background-img lazyload\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\"><noscript><img decoding=\"async\" src=\"https:\/\/cfverzekeringen.com\/wp-content\/themes\/vallonic-cfverzekeringen\/dist\/images\/Vallonic__CF-Verzekeringen__home__intro__background2x_288cf0c1.png\" loading=\"lazy\" alt=\"\" class=\"header-intro__background-img\"><\/noscript>\n        <\/div>\n                <div class=\"header-intro__title-container  \">\n                            <h1 class=\"header-intro__title \">\n                    Report damage\n                    <!-- Wij laten u onbezorgd<br>genieten<br> -->\n                <\/h1>\n                                        <h3 class=\"header-intro__sub-title\">\n                    \n                    In case of damage\r<br \/>We will help you\n                <\/h3>\n                                <\/div>\n                    <\/div>\n    <\/div>\n\n\n\n\n<div style=\"height:60px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n<div class=\"section--contact-form wf-section\">\n    <div class=\"container w-container\">\n        <div class=\"contact-form__inner\">\n            <h2 class=\"contact-form__title\">\n                \n                Report damage\n            <\/h2>\n            <p class=\"contact-form__p\">\n                \n                Fill in the form as complete as possible. We will contact you soon once we have received your damage report.\n            <\/p>\n        <\/div>\n        <div class=\"w-layout-grid contact__grid\">\n            <div id=\"w-node-d81f4440-b545-267b-621b-c54e47e52a60-74ac8bb6\" class=\"contact-grid__form\">\n                <div class=\"forminator-ui forminator-custom-form forminator-custom-form-1326 forminator-design--flat forminator-custom forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-1326\" data-uid=\"6632609377ce2\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-1326\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-1326 forminator-design--flat forminator-custom forminator_ajax\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"1326\"\n\t\t\t\t\n\t\t\t\tdata-design=\"flat\"\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\tdata-grid=\"custom\"\n\t\t\t\tenctype=\"multipart\/form-data\"\n\t\t\t\t\n\t\t\t\tstyle=\"display: none;\"\n\t\t\t\t\n\t\t\t\tdata-uid=\"6632609377ce2\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_6632609377ce2\" id=\"forminator-field-email-1_6632609377ce2-label\" class=\"forminator-label\">Email <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"Your email\" id=\"forminator-field-email-1_6632609377ce2\" class=\"forminator-input forminator-email--field\" data-required=\"true\" aria-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-2\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-2_6632609377ce2\" id=\"forminator-field-text-2_6632609377ce2-label\" class=\"forminator-label\">Insurance number <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-2\" value=\"\" placeholder=\"Insurance number\" id=\"forminator-field-text-2_6632609377ce2\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-1\" class=\"forminator-field-date forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-date-1-picker_6632609377ce2\" id=\"forminator-field-date-1-picker_6632609377ce2-label\" class=\"forminator-label\">Date of Damage <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-input-with-icon\"><label for=\"forminator-field-date-1-picker_6632609377ce2\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><\/label><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-1\" value=\"01-05-2024\" placeholder=\"Choose date\" id=\"forminator-field-date-1-picker_6632609377ce2\" class=\"forminator-input forminator-datepicker\" data-required=\"1\" data-format=\"dd-mm-yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1924\" data-end-year=\"2124\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-1\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-1_6632609377ce2\" id=\"forminator-field-text-1_6632609377ce2-label\" class=\"forminator-label\">Type of Damage <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"Type of damage\" id=\"forminator-field-text-1_6632609377ce2\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-1\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-1_6632609377ce2\" id=\"forminator-field-textarea-1_6632609377ce2-label\" class=\"forminator-label\">Description\/cause <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-1\" placeholder=\"Describe the situation\/cause\" id=\"forminator-field-textarea-1_6632609377ce2\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-1\" class=\"forminator-field-upload forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-upload-1_6632609377ce2\" id=\"forminator-field-upload-1_6632609377ce2-label\" class=\"forminator-label\">Upload files\/photos<\/label><div class=\"forminator-multi-upload \" data-element=\"upload-1_6632609377ce2\" aria-describedby=\"forminator-field-upload-1_6632609377ce2-description\"><input type=\"file\" name=\"upload-1[]\" id=\"forminator-field-upload-1_6632609377ce2\" class=\"forminator-input-file forminator-field-upload-1_6632609377ce2-1326\" multiple=\"multiple\" data-method=\"ajax\" data-size=\"8000000\" data-size-message=\"Maximum file size allowed is 8 MB. \"><div class=\"forminator-multi-upload-message\" aria-hidden=\"true\"><span class=\"forminator-icon-upload\" aria-hidden=\"true\"><\/span><p>Drag and Drop (or) <a class=\"forminator-upload-file--forminator-field-upload-1_6632609377ce2\" href=\"javascript:void(0)\">Choose Files<\/a><\/p><\/div><\/div><ul class=\"forminator-uploaded-files upload-container-upload-1_6632609377ce2\"><\/ul><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"captcha-1\" class=\"forminator-field-captcha forminator-col forminator-col-12 \"><div class=\"forminator-g-recaptcha recaptcha-invisible\" data-theme=\"light\" data-badge=\"inline\" data-sitekey=\"6Ldrv_wfAAAAANj0cywLlAxmKcJIzIJQSYX-xf23\" data-size=\"invisible\"><\/div> <\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div class=\"forminator-row forminator-row-last\"><div class=\"forminator-col\"><div class=\"forminator-field\"><button class=\"forminator-button forminator-button-submit\">Send<\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"51b2a74406\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/en\/wp-json\/wp\/v2\/pages\/409\/\" \/><input type=\"hidden\" name=\"form_id\" value=\"1326\"><input type=\"hidden\" name=\"page_id\" value=\"409\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/cfverzekeringen.com\/en\/report-damage\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"forminator-multifile-hidden\" class=\"forminator-multifile-hidden\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><label for=\"input_7\" class=\"forminator-hidden\" aria-hidden=\"true\">Please do not fill in this field. <input id=\"input_7\" type=\"text\" name=\"input_7\" value=\"\" autocomplete=\"off\"><\/label><\/form>\n            <\/div>\n\n                        \n                            <div id=\"w-node-c87cecc6-9167-7136-8388-da071c90e674-74ac8bb6\" class=\"contact-grid__maps\">\n\n                                            <img decoding=\"async\" data-src=\"https:\/\/cfverzekeringen.com\/wp-content\/uploads\/2021\/09\/inventarisgoederen.png\" class=\"google-maps lazyload\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 1080px; --smush-placeholder-aspect-ratio: 1080\/1080;\"><noscript><img decoding=\"async\" src=\"https:\/\/cfverzekeringen.com\/wp-content\/uploads\/2021\/09\/inventarisgoederen.png\" class=\"google-maps\"><\/noscript>\n                                    <\/div>\n                    <\/div>\n        <div class=\"spacer-90\">\n        <\/div>\n    <\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"categories":[],"tags":[],"acf":[],"_links":{"self":[{"href":"https:\/\/cfverzekeringen.com\/en\/wp-json\/wp\/v2\/pages\/409"}],"collection":[{"href":"https:\/\/cfverzekeringen.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cfverzekeringen.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cfverzekeringen.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/cfverzekeringen.com\/en\/wp-json\/wp\/v2\/comments?post=409"}],"version-history":[{"count":5,"href":"https:\/\/cfverzekeringen.com\/en\/wp-json\/wp\/v2\/pages\/409\/revisions"}],"predecessor-version":[{"id":1518,"href":"https:\/\/cfverzekeringen.com\/en\/wp-json\/wp\/v2\/pages\/409\/revisions\/1518"}],"wp:attachment":[{"href":"https:\/\/cfverzekeringen.com\/en\/wp-json\/wp\/v2\/media?parent=409"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cfverzekeringen.com\/en\/wp-json\/wp\/v2\/categories?post=409"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cfverzekeringen.com\/en\/wp-json\/wp\/v2\/tags?post=409"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}