{"id":103379,"date":"2024-04-25T08:52:04","date_gmt":"2024-04-25T08:52:04","guid":{"rendered":"https:\/\/sfizabelagajowska.dev10.pro\/?page_id=103379"},"modified":"2024-06-06T09:15:59","modified_gmt":"2024-06-06T09:15:59","slug":"ankieta-ubezpieczeniowa","status":"publish","type":"page","link":"https:\/\/sfizabelagajowska.dev10.pro\/index.php\/pl\/ankieta-ubezpieczeniowa\/","title":{"rendered":"Ankieta Ubezpieczeniowa"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"103379\" class=\"elementor elementor-103379\">\n\t\t\t\t<div class=\"default show_shadow elementor-element elementor-element-2ff8b62 e-flex e-con-boxed e-con e-parent\" data-id=\"2ff8b62\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-53b70d8 elementor-widget elementor-widget-shortcode\" data-id=\"53b70d8\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-shortcode\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f103382-o1\" lang=\"pl-PL\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/103379#wpcf7-f103382-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formularz kontaktowy\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"103382\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.9.3\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"pl_PL\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f103382-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<h2>Ankieta Ubezpieczeniowa\n<\/h2>\n<h3>Wybierz p\u0142e\u0107:\n<\/h3>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"plec\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"plec\" value=\"M\u0119\u017cczyzna\" \/><span class=\"wpcf7-list-item-label\">M\u0119\u017cczyzna<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"plec\" value=\"Kobieta\" \/><span class=\"wpcf7-list-item-label\">Kobieta<\/span><\/span><\/span><\/span>\n<\/p>\n<h3>Czy w ci\u0105gu ostatnich 12 miesi\u0119cy pali\u0142e\u015b papierosy, b\u0105d\u017a za\u017cywasz jakiekolwiek substancje zawieraj\u0105ce nikotyn\u0119:\n<\/h3>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"nikotyna\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"nikotyna\" value=\"TAK\" \/><span class=\"wpcf7-list-item-label\">TAK<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"nikotyna\" value=\"NIE\" \/><span class=\"wpcf7-list-item-label\">NIE<\/span><\/span><\/span><\/span>\n<\/p>\n<h3>Wycena dla:\n<\/h3>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"wycena\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"wycena\" value=\"Tylko dla mnie\" \/><span class=\"wpcf7-list-item-label\">Tylko dla mnie<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"wycena\" value=\"Dla mnie i partnera\" \/><span class=\"wpcf7-list-item-label\">Dla mnie i partnera<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"wycena\" value=\"Dla mnie, partnera i dziecka\/dzieci\" \/><span class=\"wpcf7-list-item-label\">Dla mnie, partnera i dziecka\/dzieci<\/span><\/span><\/span><\/span>\n<\/p>\n<h3>Wybierz benefity polisy, kt\u00f3rymi jeste\u015b zainteresowany najbardziej w pakiecie podstawowym:\n<\/h3>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"benefity\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"benefity[]\" value=\"Z\u0142amania ko\u015bci\" \/><span class=\"wpcf7-list-item-label\">Z\u0142amania ko\u015bci<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"benefity[]\" value=\"\u015amier\u0107 wypadkowa\" \/><span class=\"wpcf7-list-item-label\">\u015amier\u0107 wypadkowa<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"benefity[]\" value=\"Ca\u0142kowite i trwa\u0142e kalectwo\" \/><span class=\"wpcf7-list-item-label\">Ca\u0142kowite i trwa\u0142e kalectwo<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"benefity[]\" value=\"Trwa\u0142e uszkodzenia spowodowane wypadkiem\" \/><span class=\"wpcf7-list-item-label\">Trwa\u0142e uszkodzenia spowodowane wypadkiem<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"benefity[]\" value=\"Rekompensata za pobyt w szpitalu\" \/><span class=\"wpcf7-list-item-label\">Rekompensata za pobyt w szpitalu<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"benefity[]\" value=\"\u015amier\u0107 nie spowodowana wypadkiem\" \/><span class=\"wpcf7-list-item-label\">\u015amier\u0107 nie spowodowana wypadkiem<\/span><\/span><\/span><\/span>\n<\/p>\n<h3>Wybierz opcjonalne dodatki do polisy:\n<\/h3>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"dodatki\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"dodatki[]\" value=\"Zabezpieczenie dzieci\" \/><span class=\"wpcf7-list-item-label\">Zabezpieczenie dzieci<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"dodatki[]\" value=\"Zabezpieczenie dla aktywnego stylu \u017cycia\" \/><span class=\"wpcf7-list-item-label\">Zabezpieczenie dla aktywnego stylu \u017cycia<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"dodatki[]\" value=\"Zabezpieczenie dla pracownik\u00f3w s\u0142u\u017cby zdrowia\" \/><span class=\"wpcf7-list-item-label\">Zabezpieczenie dla pracownik\u00f3w s\u0142u\u017cby zdrowia<\/span><\/span><\/span><\/span>\n<\/p>\n<h3>Uwa\u017caj\u0105c suwaka, wybierz kwot\u0119 zabezpieczenia na \u017cycie, kt\u00f3rej cen\u0119 b\u0119dziesz chcia\u0142 pozna\u0107 z polisy typu \u201cLife insurance\u201d Od \u00a310.000 do \u00a31,000,000\n<\/h3>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"kwota_ubezpieczenia_slider\"><input class=\"wpcf7-form-control wpcf7-range wpcf7-validates-as-number slider-input\" id=\"ubezpieczenie-slider\" min=\"10000\" max=\"1000000\" step=\"10000\" aria-invalid=\"false\" value=\"505000\" type=\"range\" name=\"kwota_ubezpieczenia_slider\" \/><\/span>\n<\/p>\n<div class=\"insurenc-price\">\n\t<p>\u00a3\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"kwota_ubezpieczenia\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text slider-value\" id=\"ubezpieczenie-output\" readonly=\"readonly\" aria-invalid=\"false\" value=\"10000\" type=\"text\" name=\"kwota_ubezpieczenia\" \/><\/span>\n\t<\/p>\n<\/div>\n<h3>Upewnij si\u0119, \u017ce poni\u017csze dane s\u0105 w\u0142a\u015bciwe, \u017ceby otrzyma\u0107 spersonalizowan\u0105 i niezobowi\u0105zuj\u0105c\u0105 wycen\u0119:\n<\/h3>\n<div class=\"form-input\">\n\t<p>Imi\u0119:\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"imie\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"imie\" \/><\/span>\n\t<\/p>\n<\/div>\n<div class=\"form-input\">\n\t<p>Nazwisko:\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"nazwisko\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nazwisko\" \/><\/span>\n\t<\/p>\n<\/div>\n<div class=\"form-input\">\n\t<p>Numer telefonu:\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"telefon\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"telefon\" \/><\/span>\n\t<\/p>\n<\/div>\n<div class=\"form-input\">\n\t<p>Rok urodzenia:\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"urodzenie\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" min=\"1900\" max=\"2024\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"urodzenie\" \/><\/span>\n\t<\/p>\n<\/div>\n<div class=\"form-input\">\n\t<p>Kraj zamieszkania:\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"kraj\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"kraj\"><option value=\"Anglia\">Anglia<\/option><option value=\"Szkocja\">Szkocja<\/option><option value=\"Walia\">Walia<\/option><option value=\"Irlandia P\u00f3\u0142nocna\">Irlandia P\u00f3\u0142nocna<\/option><\/select><\/span>\n\t<\/p>\n<\/div>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Prze\u015blij formularz\" \/>\n<\/p>\n<\/form>\n<\/div>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-103379","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/sfizabelagajowska.dev10.pro\/index.php\/wp-json\/wp\/v2\/pages\/103379","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sfizabelagajowska.dev10.pro\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/sfizabelagajowska.dev10.pro\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/sfizabelagajowska.dev10.pro\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/sfizabelagajowska.dev10.pro\/index.php\/wp-json\/wp\/v2\/comments?post=103379"}],"version-history":[{"count":4,"href":"https:\/\/sfizabelagajowska.dev10.pro\/index.php\/wp-json\/wp\/v2\/pages\/103379\/revisions"}],"predecessor-version":[{"id":103385,"href":"https:\/\/sfizabelagajowska.dev10.pro\/index.php\/wp-json\/wp\/v2\/pages\/103379\/revisions\/103385"}],"wp:attachment":[{"href":"https:\/\/sfizabelagajowska.dev10.pro\/index.php\/wp-json\/wp\/v2\/media?parent=103379"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}