<link rel="stylesheet" href="https://sibforms.com/forms/end-form/build/sib-styles.css">
<!-- END - We recommend to place the above code in head tag of your website html -->
<!-- START - We recommend to place the below code where you want the form in your website html -->
<div class="sib-form" style="text-align: center;
background-color: transparent; ">
<div id="sib-form-container" class="sib-form-container">
<div id="error-message" class="sib-form-message-panel" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#661d1d; background-color:#ffeded; border-radius:3px; border-color:#ff4949;max-width:540px;">
<div class="sib-form-message-panel__text sib-form-message-panel__text--center">
<svg viewBox="0 0 512 512" class="sib-icon sib-notification__icon">
<path d="M256 40c118.621 0 216 96.075 216 216 0 119.291-96.61 216-216 216-119.244 0-216-96.562-216-216 0-119.203 96.602-216 216-216m0-32C119.043 8 8 119.083 8 256c0 136.997 111.043 248 248 248s248-111.003 248-248C504 119.083 392.957 8 256 8zm-11.49 120h22.979c6.823 0 12.274 5.682 11.99 12.5l-7 168c-.268 6.428-5.556 11.5-11.99 11.5h-8.979c-6.433 0-11.722-5.073-11.99-11.5l-7-168c-.283-6.818 5.167-12.5 11.99-12.5zM256 340c-15.464 0-28 12.536-28 28s12.536 28 28 28 28-12.536 28-28-12.536-28-28-28z" />
</svg>
<span class="sib-form-message-panel__inner-text">
Ihre Anmeldung konnte nicht gespeichert werden. Bitte versuchen Sie es erneut.
</span>
</div>
</div>
<div></div>
<div id="success-message" class="sib-form-message-panel" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#085229; background-color:#e7faf0; border-radius:3px; border-color:#13ce66;max-width:540px;">
<div class="sib-form-message-panel__text sib-form-message-panel__text--center">
<svg viewBox="0 0 512 512" class="sib-icon sib-notification__icon">
<path d="M256 8C119.033 8 8 119.033 8 256s111.033 248 248 248 248-111.033 248-248S392.967 8 256 8zm0 464c-118.664 0-216-96.055-216-216 0-118.663 96.055-216 216-216 118.664 0 216 96.055 216 216 0 118.663-96.055 216-216 216zm141.63-274.961L217.15 376.071c-4.705 4.667-12.303 4.637-16.97-.068l-85.878-86.572c-4.667-4.705-4.637-12.303.068-16.97l8.52-8.451c4.705-4.667 12.303-4.637 16.97.068l68.976 69.533 163.441-162.13c4.705-4.667 12.303-4.637 16.97.068l8.451 8.52c4.668 4.705 4.637 12.303-.068 16.97z" />
</svg>
<span class="sib-form-message-panel__inner-text">
Ihre Anmeldung war erfolgreich.
</span>
</div>
</div>
<div></div>
<div id="sib-container" class="sib-container--large sib-container--vertical" style="text-align:center; background-color:rgba(255,255,255,1); max-width:540px; border-radius:3px; border-width:1px; border-color:#C0CCD9; border-style:solid; direction:ltr">
<form id="sib-form" method="POST" action="https://0f0c7895.sibforms.com/serve/MUIFAOwLXPv9y9zjOnzOaYFlLy_PIZ_KKspJbG4VQxEnySvGDfU9v_1sdRHPzpv98tvjbfotllfxzkwEaXRm_VQjiDrkJxAg4kEMBlgVh210tgOxxTIJFE0hev2eWa6lPfKps9fBn5p3g-CNx8nxft4vYqz3Hss7F7ZSLVcdEwpSHNeEKFsv88_5w20_w-DQoNiVV51mArDt9Z2G" data-type="subscription">
<div style="padding: 8px 0;">
<div class="sib-form-block" style="font-size:32px; text-align:left; font-weight:700; font-family:"Trebuchet MS", sans-serif; color:#3C4858; background-color:transparent; text-align:left">
<p>Newsletter</p>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-form-block" style="font-size:16px; text-align:left; font-family:"Trebuchet MS", sans-serif; color:#3C4858; background-color:transparent; text-align:left">
<div class="sib-text-form-block">
<p>Melden Sie sich zu unserem Newsletter an, um auf dem Laufenden zu bleiben.</p>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-input sib-form-block">
<div class="form__entry entry_block">
<div class="form__label-row ">
<label class="entry__label" style="font-weight: 700; text-align:left; font-size:16px; text-align:left; font-weight:700; font-family:"Trebuchet MS", sans-serif; color:#3c4858;" for="VORNAME" data-required="*">Geben Sie Ihren VORNAMEN ein</label>
<div class="entry__field">
<input class="input " maxlength="200" type="text" id="VORNAME" name="VORNAME" autocomplete="off" placeholder="gfgfgf" data-required="true" required />
</div>
</div>
<label class="entry__error entry__error--primary" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#661d1d; background-color:#ffeded; border-radius:3px; border-color:#ff4949;">
</label>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-input sib-form-block">
<div class="form__entry entry_block">
<div class="form__label-row ">
<label class="entry__label" style="font-weight: 700; text-align:left; font-size:16px; text-align:left; font-weight:700; font-family:"Trebuchet MS", sans-serif; color:#3c4858;" for="NAME" data-required="*">Geben Sie Ihren NAMEN ein</label>
<div class="entry__field">
<input class="input " maxlength="200" type="text" id="NAME" name="NAME" autocomplete="off" placeholder="NAME" data-required="true" required />
</div>
</div>
<label class="entry__error entry__error--primary" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#661d1d; background-color:#ffeded; border-radius:3px; border-color:#ff4949;">
</label>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-select sib-form-block" data-required="true">
<div class="form__entry entry_block">
<div class="form__label-row ">
<label class="entry__label" style="font-weight: 700; text-align:left; font-size:16px; text-align:left; font-weight:700; font-family:"Trebuchet MS", sans-serif; color:#3c4858;" for="TAETIGKEIT" data-required="*">Geben Sie eine TÄTIGKEIT an</label>
<div class="entry__field">
<select class="input" id="TAETIGKEIT" name="TAETIGKEIT" data-required="true">
<option value="" disabled selected hidden>Wählen Sie einen Wert aus</option>
<option class="sib-menu__item" value="1">
Ärztin/Arzt
</option>
<option class="sib-menu__item" value="2">
Apotheken
</option>
<option class="sib-menu__item" value="3">
Gesundheitsberufe
</option>
<option class="sib-menu__item" value="4">
Sonstige
</option>
</select>
</div>
</div>
<label class="entry__error entry__error--primary" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#661d1d; background-color:#ffeded; border-radius:3px; border-color:#ff4949;">
</label>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-select sib-form-block" data-required="true">
<div class="form__entry entry_block">
<div class="form__label-row ">
<label class="entry__label" style="font-weight: 700; text-align:left; font-size:16px; text-align:left; font-weight:700; font-family:"Trebuchet MS", sans-serif; color:#3c4858;" for="LAND" data-required="*">Bitte geben Sie Ihr LAND an</label>
<div class="entry__field">
<select class="input" id="LAND" name="LAND" data-required="true">
<option value="" disabled selected hidden>Wählen Sie einen Wert aus</option>
<option class="sib-menu__item" value="1">
Deutschland
</option>
<option class="sib-menu__item" value="2">
Österreich
</option>
<option class="sib-menu__item" value="3">
Schweiz
</option>
<option class="sib-menu__item" value="4">
Andere
</option>
</select>
</div>
</div>
<label class="entry__error entry__error--primary" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#661d1d; background-color:#ffeded; border-radius:3px; border-color:#ff4949;">
</label>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-input sib-form-block">
<div class="form__entry entry_block">
<div class="form__label-row ">
<label class="entry__label" style="font-weight: 700; text-align:left; font-size:16px; text-align:left; font-weight:700; font-family:"Trebuchet MS", sans-serif; color:#3c4858;" for="EMAIL" data-required="*">Geben Sie Ihre E-Mail-Adresse ein, um sich anzumelden</label>
<div class="entry__field">
<input class="input " type="text" id="EMAIL" name="EMAIL" autocomplete="off" placeholder="EMAIL" data-required="true" required />
</div>
</div>
<label class="entry__error entry__error--primary" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#661d1d; background-color:#ffeded; border-radius:3px; border-color:#ff4949;">
</label>
<label class="entry__specification" style="font-size:12px; text-align:left; font-family:"Trebuchet MS", sans-serif; color:#8390A4; text-align:left">
Geben Sie bitte Ihre E-Mail-Adresse für die Anmeldung an, z. B. abc@xyz.com.
</label>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="g-recaptcha" data-sitekey="6LeP1SYpAAAAAMr4Dh4wK5z7E7Y-3HHJvlwmqwWo" data-callback="invisibleCaptchaCallback" data-size="invisible" onclick="executeCaptcha"></div>
</div>
<div style="padding: 8px 0;">
<div class="sib-optin sib-form-block">
<div class="form__entry entry_mcq">
<div class="form__label-row ">
<div class="entry__choice" style="">
<label>
<input type="checkbox" class="input_replaced" value="1" id="REFERENT" name="REFERENT" />
<span class="checkbox checkbox_tick_positive"
style="margin-left:"
></span><span style="font-size:14px; text-align:left; font-family:"Trebuchet MS", sans-serif; color:#3C4858; background-color:transparent;"><p>Ich möchte Ihren Newsletter erhalten und akzeptiere die Datenschutzerklärung.</p></span> </label>
</div>
</div>
<label class="entry__error entry__error--primary" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#661d1d; background-color:#ffeded; border-radius:3px; border-color:#ff4949;">
</label>
<label class="entry__specification" style="font-size:12px; text-align:left; font-family:"Trebuchet MS", sans-serif; color:#8390A4; text-align:left">
Sie können den Newsletter jederzeit über den Link in unserem Newsletter abbestellen.
</label>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-form__declaration" style="direction:ltr">
<div class="declaration-block-icon">
<svg class="icon__SVG" width="0" height="0" version="1.1" xmlns="http://www.w3.org/2000/svg">
<defs>
<symbol id="svgIcon-sphere" viewBox="0 0 63 63">
<path class="path1" d="M31.54 0l1.05 3.06 3.385-.01-2.735 1.897 1.05 3.042-2.748-1.886-2.738 1.886 1.044-3.05-2.745-1.897h3.393zm13.97 3.019L46.555 6.4l3.384.01-2.743 2.101 1.048 3.387-2.752-2.1-2.752 2.1 1.054-3.382-2.745-2.105h3.385zm9.998 10.056l1.039 3.382h3.38l-2.751 2.1 1.05 3.382-2.744-2.091-2.743 2.091 1.054-3.381-2.754-2.1h3.385zM58.58 27.1l1.04 3.372h3.379l-2.752 2.096 1.05 3.387-2.744-2.091-2.75 2.092 1.054-3.387-2.747-2.097h3.376zm-3.076 14.02l1.044 3.364h3.385l-2.743 2.09 1.05 3.392-2.744-2.097-2.743 2.097 1.052-3.377-2.752-2.117 3.385-.01zm-9.985 9.91l1.045 3.364h3.393l-2.752 2.09 1.05 3.393-2.745-2.097-2.743 2.097 1.05-3.383-2.751-2.1 3.384-.01zM31.45 55.01l1.044 3.043 3.393-.008-2.752 1.9L34.19 63l-2.744-1.895-2.748 1.891 1.054-3.05-2.743-1.9h3.384zm-13.934-3.98l1.036 3.364h3.402l-2.752 2.09 1.053 3.393-2.747-2.097-2.752 2.097 1.053-3.382-2.743-2.1 3.384-.01zm-9.981-9.91l1.045 3.364h3.398l-2.748 2.09 1.05 3.392-2.753-2.1-2.752 2.096 1.053-3.382-2.743-2.102 3.384-.009zM4.466 27.1l1.038 3.372H8.88l-2.752 2.097 1.053 3.387-2.743-2.09-2.748 2.09 1.053-3.387L0 30.472h3.385zm3.069-14.025l1.045 3.382h3.395L9.23 18.56l1.05 3.381-2.752-2.09-2.752 2.09 1.053-3.381-2.744-2.1h3.384zm9.99-10.056L18.57 6.4l3.393.01-2.743 2.1 1.05 3.373-2.754-2.092-2.751 2.092 1.053-3.382-2.744-2.1h3.384zm24.938 19.394l-10-4.22a2.48 2.48 0 00-1.921 0l-10 4.22A2.529 2.529 0 0019 24.75c0 10.47 5.964 17.705 11.537 20.057a2.48 2.48 0 001.921 0C36.921 42.924 44 36.421 44 24.75a2.532 2.532 0 00-1.537-2.336zm-2.46 6.023l-9.583 9.705a.83.83 0 01-1.177 0l-5.416-5.485a.855.855 0 010-1.192l1.177-1.192a.83.83 0 011.177 0l3.65 3.697 7.819-7.916a.83.83 0 011.177 0l1.177 1.191a.843.843 0 010 1.192z" fill="#0092FF"></path>
</symbol>
</defs>
</svg>
<svg class="svgIcon-sphere" style="width:63px; height:63px;">
<use xlink:href="#svgIcon-sphere"></use>
</svg>
</div>
<div style="font-size:14px; text-align:left; font-family:"Trebuchet MS", sans-serif; color:#687484; background-color:transparent;">
<p>Wir verwenden Brevo als unsere Marketing-Plattform. Wenn Sie das Formular ausfüllen und absenden, bestätigen Sie, dass die von Ihnen angegebenen Informationen an Brevo zur Bearbeitung gemäß den <a href="https://www.brevo.com/de/legal/termsofuse/" target="_blank">Nutzungsbedingungen</a> übertragen werden</p>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-form-block" style="text-align: left">
<button class="sib-form-block__button sib-form-block__button-with-loader" style="font-size:16px; text-align:left; font-weight:700; font-family:"Trebuchet MS", sans-serif; color:#FFFFFF; background-color:#0d812c; border-radius:20px; border-width:0px;" form="sib-form" type="submit">
<svg class="icon clickable__icon progress-indicator__icon sib-hide-loader-icon" viewBox="0 0 512 512">
<path d="M460.116 373.846l-20.823-12.022c-5.541-3.199-7.54-10.159-4.663-15.874 30.137-59.886 28.343-131.652-5.386-189.946-33.641-58.394-94.896-95.833-161.827-99.676C261.028 55.961 256 50.751 256 44.352V20.309c0-6.904 5.808-12.337 12.703-11.982 83.556 4.306 160.163 50.864 202.11 123.677 42.063 72.696 44.079 162.316 6.031 236.832-3.14 6.148-10.75 8.461-16.728 5.01z" />
</svg>
ANMELDEN
</button>
</div>
</div>
<input type="text" name="email_address_check" value="" class="input--hidden">
<input type="hidden" name="locale" value="de">
</form>
</div>
</div>
</div>
<!-- END - We recommend to place the above code where you want the form in your website html -->
<!-- START - We recommend to place the below code in footer or bottom of your website html -->
<script>
window.REQUIRED_CODE_ERROR_MESSAGE = 'Wählen Sie bitte einen Ländervorwahl aus.';
window.LOCALE = 'de';
window.EMAIL_INVALID_MESSAGE = window.SMS_INVALID_MESSAGE = "Die eingegebenen Informationen sind nicht gültig. Bitte überprüfen Sie das Feldformat und versuchen Sie es erneut.";
window.REQUIRED_ERROR_MESSAGE = "Dieses Feld darf nicht leer sein. ";
window.GENERIC_INVALID_MESSAGE = "Die eingegebenen Informationen sind nicht gültig. Bitte überprüfen Sie das Feldformat und versuchen Sie es erneut.";
window.translation = {
common: {
selectedList: '{quantity} Liste ausgewählt',
selectedLists: '{quantity} Listen ausgewählt'
}
};
var AUTOHIDE = Boolean(0);
</script>
<script defer src="https://sibforms.com/forms/end-form/build/main.js"></script>
<script src="https://www.google.com/recaptcha/api.js?hl=de"></script>
<!-- END - We recommend to place the above code in footer or bottom of your website html -->
<!-- End Brevo Form -->