{"id":7256,"date":"2026-08-27T14:40:58","date_gmt":"2026-08-27T14:40:58","guid":{"rendered":"https:\/\/demo.myboderm.com\/?page_id=7256"},"modified":"2026-09-01T08:45:02","modified_gmt":"2026-09-01T08:45:02","slug":"online-order-form","status":"publish","type":"page","link":"https:\/\/demo.myboderm.com\/de\/online-order-form\/","title":{"rendered":"Online Order Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"7256\" class=\"elementor elementor-7256 elementor-7188\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-460014f e-flex e-con-boxed e-con e-parent\" data-id=\"460014f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d3a90e4 elementor-widget elementor-widget-heading\" data-id=\"d3a90e4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Online Order Form<\/h2>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-a752ba8 e-con-full e-flex e-con e-parent\" data-id=\"a752ba8\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-eb7e3dc elementor-widget elementor-widget-image\" data-id=\"eb7e3dc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"1536\" height=\"448\" src=\"https:\/\/demo.myboderm.com\/wp-content\/uploads\/2026\/08\/PRODUCT.jpg\" class=\"attachment-full size-full wp-image-7262\" alt=\"\" srcset=\"https:\/\/demo.myboderm.com\/wp-content\/uploads\/2026\/08\/PRODUCT.jpg 1536w, https:\/\/demo.myboderm.com\/wp-content\/uploads\/2026\/08\/PRODUCT-300x88.jpg 300w, https:\/\/demo.myboderm.com\/wp-content\/uploads\/2026\/08\/PRODUCT-1024x299.jpg 1024w, https:\/\/demo.myboderm.com\/wp-content\/uploads\/2026\/08\/PRODUCT-768x224.jpg 768w, https:\/\/demo.myboderm.com\/wp-content\/uploads\/2026\/08\/PRODUCT-600x175.jpg 600w, https:\/\/demo.myboderm.com\/wp-content\/uploads\/2026\/08\/PRODUCT-64x19.jpg 64w\" sizes=\"(max-width: 1536px) 100vw, 1536px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d9412ed e-flex e-con-boxed e-con e-parent\" data-id=\"d9412ed\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d32762b elementor-widget elementor-widget-text-editor\" data-id=\"d32762b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Willkommen auf der Bestellplattform von <strong>BODERM<\/strong>. Dieses Formular wurde f\u00fcr die einfache, direkte und schnelle \u00dcbermittlung Ihrer Bestellungen erstellt.<\/p><p>Bitte f\u00fcllen Sie die Daten Ihrer Apotheke aus, w\u00e4hlen Sie die Kategorie und das gew\u00fcnschte Produkt sowie die gew\u00fcnschte St\u00fcckzahl.<\/p><p>(Hinweis: Die Rechnungsdaten \u2013 USt-Nummer &amp; Finanzamt \u2013 sind f\u00fcr die Ausstellung der entsprechenden Rechnung \/ des Lieferscheins erforderlich.)<\/p><p><strong>Bestellbearbeitung<\/strong><br \/>Sobald wir Ihre Anfrage erhalten, wird die Verkaufsabteilung Ihre Bestellung erfassen und Sie zur Best\u00e4tigung und Versandplanung kontaktieren. Bestellungen, die bis 14:00 Uhr eingehen, werden am selben Tag bearbeitet.<\/p><p><strong>Telefonischer Support<\/strong><br \/>F\u00fcr telefonische Bestellungen, Fragen oder Kl\u00e4rungen k\u00f6nnen Sie die Verkaufsabteilung unter +30 21 0800 4250 oder per E\u2011Mail unter info@boderm.com kontaktieren.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-56e9135 e-flex e-con-boxed e-con e-parent\" data-id=\"56e9135\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ba14a33 elementor-widget elementor-widget-html\" data-id=\"ba14a33\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t\t        <form id=\"custom-woo-order-form\" class=\"custom-order-form layout-one-col\" enctype=\"multipart\/form-data\">\n            \n            <input type=\"text\" name=\"ecs_hp_website\" value=\"\" style=\"display:none !important;\" tabindex=\"-1\" autocomplete=\"off\">\n\n            <div class=\"form-fields-grid\">\n            <div class=\"form-row\"><label for=\"pharmacy_name\">Name der Apotheke *<\/label><input type=\"text\" id=\"pharmacy_name\" name=\"pharmacy_name\" required><\/div><div class=\"form-row\"><label for=\"pharmacist_name\">Name des Apothekers *<\/label><input type=\"text\" id=\"pharmacist_name\" name=\"pharmacist_name\" required><\/div><div class=\"form-row\"><label for=\"afm\">USt-IdNr *<\/label><input type=\"number\" id=\"afm\" name=\"afm\" required><\/div><div class=\"form-row\"><label for=\"doy\">Finanzamt *<\/label><input type=\"text\" id=\"doy\" name=\"doy\" required><\/div><div class=\"form-row\"><label for=\"cust_phone\">Kontakttelefon *<\/label><input type=\"tel\" id=\"cust_phone\" name=\"cust_phone\" required><\/div><div class=\"form-row\"><label for=\"cust_email\">Email *<\/label><input type=\"email\" id=\"cust_email\" name=\"cust_email\" required><\/div><div class=\"form-row\"><label for=\"address\"> Lieferadresse &amp; PLZ *<\/label><input type=\"text\" id=\"address\" name=\"address\" required><\/div><div class=\"form-row\"><label for=\"del_date\">Gew\u00fcnschtes Lieferdatum<\/label><input type=\"date\" id=\"del_date\" name=\"del_date\" ><\/div><div class=\"form-row\"><label for=\"del_time\">Gew\u00fcnschte Lieferzeit<\/label><select id=\"del_time\" name=\"del_time\" ><option value=\"\">\u2014  Bitte w\u00e4hlen \u2014<\/option><option value=\"Vormittag (09:00 - 14:00)\">Vormittag (09:00 - 14:00)<\/option><option value=\"Nachmittag (17:00 - 20:00)\">Nachmittag (17:00 - 20:00)<\/option><\/select><\/div><div class=\"form-row\"><label for=\"shipping_method\">Versandart<\/label><select id=\"shipping_method\" name=\"shipping_method\" ><option value=\"\">\u2014  Bitte w\u00e4hlen \u2014<\/option><option value=\"Kurier\">Kurier<\/option><option value=\"Spedition \/ Frachtb\u00fcro\">Spedition \/ Frachtb\u00fcro<\/option><option value=\"Abholung von unserem Firmensitz\">Abholung von unserem Firmensitz<\/option><\/select><\/div><div class=\"form-row\"><label for=\"payment_method\">Zahlungsart<\/label><select id=\"payment_method\" name=\"payment_method\" ><option value=\"\">\u2014  Bitte w\u00e4hlen \u2014<\/option><option value=\"Auf Kredit \/ Nach Vereinbarung\">Auf Kredit \/ Nach Vereinbarung<\/option><option value=\"\u00dcberweisung auf Bankkonto\">\u00dcberweisung auf Bankkonto<\/option><option value=\" Nachnahme\"> Nachnahme<\/option><\/select><\/div>            <\/div>\n\n            <!-- \u03a0\u039f\u039b\u039b\u0391\u03a0\u039b\u0391 \u03a0\u03a1\u039f\u03aa\u039f\u039d\u03a4\u0391 -->\n            <div class=\"woo-products-block form-row-full\">\n                <div class=\"woo-products-block-title\"> Bestellprodukte *<\/div>\n                <div id=\"woo-products-repeater\"><\/div>\n                <button type=\"button\" id=\"woo-add-product-row\" class=\"woo-add-btn\">+ Weiteres Produkt hinzuf\u00fcgen<\/button>\n            <\/div>\n\n            <!-- FILE UPLOAD -->\n                            <div class=\"form-row form-row-full woo-upload-row\" style=\"background:#f9f9f9; padding:15px; border-radius:5px; border:1px solid #ddd;\">\n                    <label>\ud83d\udcce <\/label>\n                    <input type=\"file\" name=\"ecs_file_upload\" style=\"background:#fff; padding:8px;\">\n                <\/div>\n            \n            <div class=\"form-row form-row-full\"><div class=\"form-row form-row-full\"><label for=\"message\">Kommentare \/ Anmerkungen<\/label><textarea id=\"message\" name=\"message\" rows=\"4\" ><\/textarea><\/div><\/div>\n            <!-- GDPR -->\n                            <div class=\"form-row form-row-full woo-gdpr-row\" style=\"margin:20px 0;\">\n                    <label style=\"display:flex; align-items:center; gap:10px; font-weight:normal;\">\n                        <input type=\"checkbox\" name=\"ecs_gdpr\" value=\"1\" required>\n                        <span>\n                            Ich akzeptiere die Datenschutzrichtlinie                             *\n                        <\/span>\n                    <\/label>\n                <\/div>\n            \n            <button type=\"submit\" id=\"submit-btn\" class=\"form-row-full\">Bestellung absenden<\/button>\n            <div id=\"form-response\" class=\"form-row-full\"><\/div>\n        <\/form>\n\n        <style>\n            .custom-order-form { max-width: 650px; width: 100%; margin: 0 auto; background: #fff; padding: 25px; border-radius: 8px; border: 1px solid #eaeaea; box-shadow: 0 4px 15px rgba(0,0,0,0.05); }\n            .custom-order-form .form-row { margin-bottom: 18px; }\n            .custom-order-form label { display: block; font-weight: 600; margin-bottom: 8px; color: #333; }\n            .custom-order-form input[type=\"text\"], .custom-order-form input[type=\"email\"], .custom-order-form input[type=\"tel\"], .custom-order-form input[type=\"number\"], .custom-order-form input[type=\"date\"], .custom-order-form select, .custom-order-form textarea { width: 100%; padding: 12px 15px; border: 1px solid #ddd; border-radius: 5px; font-size: 15px; box-sizing: border-box; }\n            .custom-order-form select:disabled { background: #f7f7f7; color: #999; }\n            .custom-order-form button#submit-btn { background: #0073aa; color: #fff; padding: 14px 24px; border: none; border-radius: 5px; cursor: pointer; font-size: 16px; font-weight: bold; width: 100%; }\n            .custom-order-form button#submit-btn:hover { background: #005177; }\n            .custom-order-form button:disabled { background: #999; cursor: not-allowed; }\n            #form-response { margin-top: 15px; font-weight: bold; text-align: center; padding: 10px; border-radius: 5px; display: none; }\n            #form-response.msg-success { background: #e6f7eb; color: #28a745; display: block; border: 1px solid #28a745; }\n            #form-response.msg-error { background: #fde8e8; color: #dc3545; display: block; border: 1px solid #dc3545; }\n            \n            .woo-products-block { margin: 10px 0 22px; padding: 15px; background: #f8fafc; border: 1px dashed #c5d0dc; border-radius: 8px; }\n            .woo-products-block-title { font-weight: 700; margin-bottom: 12px; color: #1d4f7a; font-size: 16px; }\n            .woo-product-row { background: #fff; border: 1px solid #e2e8f0; border-radius: 8px; padding: 14px; margin-bottom: 12px; position: relative; }\n            .woo-row-head { display: flex; justify-content: space-between; align-items: center; margin-bottom: 8px; }\n            .woo-remove-row { background: #fff; border: 1px solid #e11d48; color: #e11d48; width: 32px; height: 32px; border-radius: 50%; font-size: 20px; line-height: 1; cursor: pointer; }\n            .woo-add-btn { background: #fff; border: 2px dashed #0073aa; color: #0073aa; width: 100%; padding: 12px; border-radius: 6px; font-weight: 700; cursor: pointer; }\n            \n            .custom-order-form.layout-two-col { max-width: 900px; }\n            .custom-order-form.layout-two-col .form-fields-grid { display: grid; grid-template-columns: 1fr 1fr; gap: 0 20px; }\n            .form-row-full { grid-column: 1 \/ -1 !important; }\n            @media (max-width: 700px) { .custom-order-form.layout-two-col .form-fields-grid { grid-template-columns: 1fr; } }\n        <\/style>\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":"<p>Online Order Form Willkommen auf der Bestellplattform von BODERM. Dieses Formular wurde f\u00fcr die einfache, direkte und schnelle \u00dcbermittlung Ihrer [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":7000,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"site-sidebar-layout":"no-sidebar","site-content-layout":"","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-7256","page","type-page","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/demo.myboderm.com\/de\/wp-json\/wp\/v2\/pages\/7256","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/demo.myboderm.com\/de\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/demo.myboderm.com\/de\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/demo.myboderm.com\/de\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/demo.myboderm.com\/de\/wp-json\/wp\/v2\/comments?post=7256"}],"version-history":[{"count":7,"href":"https:\/\/demo.myboderm.com\/de\/wp-json\/wp\/v2\/pages\/7256\/revisions"}],"predecessor-version":[{"id":7268,"href":"https:\/\/demo.myboderm.com\/de\/wp-json\/wp\/v2\/pages\/7256\/revisions\/7268"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/demo.myboderm.com\/de\/wp-json\/wp\/v2\/media\/7000"}],"wp:attachment":[{"href":"https:\/\/demo.myboderm.com\/de\/wp-json\/wp\/v2\/media?parent=7256"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}