{"id":46619,"date":"2025-10-16T10:04:15","date_gmt":"2025-10-16T08:04:15","guid":{"rendered":"https:\/\/fnnitra.sk\/e-prescription-order\/"},"modified":"2026-10-22T10:00:31","modified_gmt":"2026-10-22T08:00:31","slug":"e-prescription-order","status":"publish","type":"page","link":"https:\/\/fnnitra.sk\/en\/e-prescription-order\/","title":{"rendered":"e-Prescription Order"},"content":{"rendered":"\n\t<section class=\"section\" id=\"section_387358230\">\n\t\t<div class=\"section-bg fill\" >\n\t\t\t\t\t\t\t\t\t\n\t\t\t\n\n\t\t<\/div>\n\n\t\t\n\n\t\t<div class=\"section-content relative\">\n\t\t\t\n<div class=\"row\"  id=\"row-488053654\">\n\n\t<div id=\"col-953561470\" class=\"col small-12 large-12\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n<h1>E-Prescription Request<\/h1>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\n\n\t<div id=\"col-594394403\" class=\"col medium-4 small-12 large-4\"  >\n\t\t<div class=\"is-sticky-column\"><div class=\"is-sticky-column__inner\">\t\t<div class=\"col-inner box-shadow-2\" style=\"background-color:rgb(244, 246, 242);\" >\n\t\t\t\n\t\t\t\n<ul>\n<li>This online request applies only to medicines that <strong>have already been prescribed to you in the past by a clinic at FN Nitra and that you take regularly on a long-term basis<\/strong>.<\/li>\n<li>The prescription can also be issued by <strong>a doctor of the same specialization<\/strong> at FN Nitra, even if they were not the original prescriber.<\/li>\n<li><strong>Please fill in all fields accurately<\/strong> \u2013 incomplete or incorrect information will prevent your request from being processed.<\/li>\n<li>We will process your request <strong>within 5 business days at the latest<\/strong>.<\/li>\n<li>Information about the issued prescription can be found <strong>in your health insurance company&#8217;s mobile app or online branch<\/strong>; <strong>the pharmacy<\/strong> where you pick up your medicine can also confirm this for you.<\/li>\n<\/ul>\n\t\t<\/div>\n\t\t<\/div><\/div>\t\t\n<style>\n#col-594394403 > .is-sticky-column > .is-sticky-column__inner > .col-inner {\n  padding: 1rem 1rem 1rem 1rem;\n  border-radius: 13px;\n}\n<\/style>\n\t<\/div>\n\n\t\n\n\t<div id=\"col-1934324229\" class=\"col medium-8 small-12 large-8\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n\t\t<div class=\"hidden\">\n\t\t\t\t\n<style id=\"wpforms-css-vars-720\">\n\t\t\t\t#wpforms-720 {\n\t\t\t\t--wpforms-field-size-input-height: 43px;\n--wpforms-field-size-input-spacing: 15px;\n--wpforms-field-size-font-size: 16px;\n--wpforms-field-size-line-height: 19px;\n--wpforms-field-size-padding-h: 14px;\n--wpforms-field-size-checkbox-size: 16px;\n--wpforms-field-size-sublabel-spacing: 5px;\n--wpforms-field-size-icon-size: 1;\n--wpforms-label-size-font-size: 16px;\n--wpforms-label-size-line-height: 19px;\n--wpforms-label-size-sublabel-font-size: 14px;\n--wpforms-label-size-sublabel-line-height: 17px;\n--wpforms-button-size-font-size: 17px;\n--wpforms-button-size-height: 41px;\n--wpforms-button-size-padding-h: 15px;\n--wpforms-button-size-margin-top: 10px;\n--wpforms-container-shadow-size-box-shadow: none;\n\t\t\t}\n\t\t\t<\/style><div class=\"wpforms-container wpforms-container-full wpforms-render-modern\" id=\"wpforms-720\"><form id=\"wpforms-form-720\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"720\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/en\/wp-json\/wp\/v2\/pages\/46619\" data-token=\"90569b89b444f284f0dc23d45f0cb1cc\" data-token-time=\"1792667634\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-field-container\"><div class=\"wpforms-page wpforms-page-1 \" data-page=\"1\">\t\t<div id=\"wpforms-720-field_7-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"7\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-720-field_7\" >Information of and<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-720-field_7\" class=\"wpforms-field-medium\" name=\"wpforms[fields][7]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-720-field_19-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-type=\"pagebreak\" data-field-id=\"19\"><\/div><div id=\"wpforms-720-field_3-container\" class=\"wpforms-field wpforms-field-layout\" data-field-type=\"layout\" data-field-id=\"3\"><h3 class=\"wpforms-field-label\">\n\t\t\t\tClinic\n\t\t\t<\/h3><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-720-field_1-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-modern\" data-field-type=\"select\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-720-field_1\">Name of the clinic where the medication was prescribed <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-720-field_1\" class=\"wpforms-field-large wpforms-field-required choicesjs-select\" data-size-class=\"wpforms-field-row wpforms-field-large\" data-search-enabled=\"1\" name=\"wpforms[fields][1]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>--- Select clinic ---<\/option><option value=\"47040\"  class=\"choice-0 depth-1\"  >Algesiology Clinic - Chronic Pain Clinic<\/option><option value=\"47036\"  class=\"choice-1 depth-1\"  >Anesthesiology Clinic<\/option><option value=\"47007\"  class=\"choice-2 depth-1\"  >Angiology Clinic<\/option><option value=\"47218\"  class=\"choice-3 depth-1\"  >Angiology Clinic -<\/option><option value=\"47180\"  class=\"choice-4 depth-1\"  >Arrhythmology and Pacemaker Clinic<\/option><option value=\"47056\"  class=\"choice-5 depth-1\"  >Cardiology \/ Internal Preoperative Clinic I.<\/option><option value=\"47089\"  class=\"choice-6 depth-1\"  >Chronic Wound Clinic<\/option><option value=\"46998\"  class=\"choice-7 depth-1\"  >Clinic for Children with Perinatal Risk<\/option><option value=\"47933\"  class=\"choice-8 depth-1\"  >Clinic for Surgical Diseases of the Breast Gland<\/option><option value=\"47094\"  class=\"choice-9 depth-1\"  >Clinic for Surgical Diseases of the Colon I.<\/option><option value=\"47797\"  class=\"choice-10 depth-1\"  >Clinic for Surgical Diseases of the Colon II.<\/option><option value=\"47707\"  class=\"choice-11 depth-1\"  >Clinic for Surgical Diseases of the Thyroid Gland<\/option><option value=\"47351\"  class=\"choice-12 depth-1\"  >Clinical Immunology and Allergology Clinic<\/option><option value=\"47200\"  class=\"choice-13 depth-1\"  >Clinical Logopedics Clinic<\/option><option value=\"47026\"  class=\"choice-14 depth-1\"  >Clinical Oncology Clinic - Dispensary Clinic<\/option><option value=\"47096\"  class=\"choice-15 depth-1\"  >Clinical Oncology Clinic - Dispensary Clinic II.<\/option><option value=\"47013\"  class=\"choice-16 depth-1\"  >Clinical Oncology Clinic I.<\/option><option value=\"47010\"  class=\"choice-17 depth-1\"  >Clinical Oncology Clinic II.<\/option><option value=\"47009\"  class=\"choice-18 depth-1\"  >Clinical Oncology Clinic III.<\/option><option value=\"46990\"  class=\"choice-19 depth-1\"  >Clinical Oncology Clinic V.<\/option><option value=\"47035\"  class=\"choice-20 depth-1\"  >Clinical Oncology Clinic VI.<\/option><option value=\"48101\"  class=\"choice-21 depth-1\"  >Clinical Pharmacology Clinic<\/option><option value=\"47660\"  class=\"choice-22 depth-1\"  >Clinical Psychologist<\/option><option value=\"47215\"  class=\"choice-23 depth-1\"  >Densitometry Workplace at the Rheumatology Clinic<\/option><option value=\"47965\"  class=\"choice-24 depth-1\"  >Dermatovenereology Clinic I.<\/option><option value=\"47226\"  class=\"choice-25 depth-1\"  >Dermatovenereology Clinic II.<\/option><option value=\"47800\"  class=\"choice-26 depth-1\"  >Dermatovenereology Clinic II. - Phototherapy Section<\/option><option value=\"47876\"  class=\"choice-27 depth-1\"  >Diabetology Clinic I.<\/option><option value=\"47544\"  class=\"choice-28 depth-1\"  >Diabetology Clinic I. - Internal Section<\/option><option value=\"47563\"  class=\"choice-29 depth-1\"  >Diabetology Clinic II.<\/option><option value=\"47061\"  class=\"choice-30 depth-1\"  >Endocrinology Clinic<\/option><option value=\"47008\"  class=\"choice-31 depth-1\"  >Endovascular Treatment Workplace<\/option><option value=\"47400\"  class=\"choice-32 depth-1\"  >ENT Clinic - Audiometric-Vestibular Section<\/option><option value=\"47399\"  class=\"choice-33 depth-1\"  >ENT Clinic - General Admission<\/option><option value=\"47401\"  class=\"choice-34 depth-1\"  >ENT Clinic - Logopedics Section<\/option><option value=\"46997\"  class=\"choice-35 depth-1\"  >Functional Diagnostics Workplace<\/option><option value=\"47196\"  class=\"choice-36 depth-1\"  >Gastroenterology Clinic<\/option><option value=\"47176\"  class=\"choice-37 depth-1\"  >General Surgical Admission Clinic<\/option><option value=\"48113\"  class=\"choice-38 depth-1\"  >Geriatric Clinic<\/option><option value=\"47076\"  class=\"choice-39 depth-1\"  >Gynecological Consultation Clinic<\/option><option value=\"47243\"  class=\"choice-40 depth-1\"  >Hematology Clinic I.<\/option><option value=\"47246\"  class=\"choice-41 depth-1\"  >Hematology Clinic II.<\/option><option value=\"47225\"  class=\"choice-42 depth-1\"  >Hepatology Clinic<\/option><option value=\"47182\"  class=\"choice-43 depth-1\"  >Hepatopancreatobiliary Surgery Clinic I. - Surgical Diseases of the Liver<\/option><option value=\"47087\"  class=\"choice-44 depth-1\"  >Hepatopancreatobiliary Surgery Clinic II. - Surgical Diseases of the Upper GIT<\/option><option value=\"47093\"  class=\"choice-45 depth-1\"  >High-Risk Pregnancy Clinic<\/option><option value=\"47463\"  class=\"choice-46 depth-1\"  >Infectious Disease Clinic I<\/option><option value=\"47659\"  class=\"choice-47 depth-1\"  >Infectious Diseases Clinic II<\/option><option value=\"47623\"  class=\"choice-48 depth-1\"  >Infectious Diseases Clinic III - Tropical Diseases Clinic \/ Vaccination Center<\/option><option value=\"47191\"  class=\"choice-49 depth-1\"  >Internal Medicine Clinic II - Internal Admission Clinic<\/option><option value=\"48157\"  class=\"choice-50 depth-1\"  >Internal Medicine Clinic II - Internal Clinic I.<\/option><option value=\"47555\"  class=\"choice-51 depth-1\"  >Internal Medicine Clinic II - Internal Clinic II.<\/option><option value=\"47109\"  class=\"choice-52 depth-1\"  >Internal Medicine Clinic III - Hypertension Clinic<\/option><option value=\"47072\"  class=\"choice-53 depth-1\"  >Interventional Ultrasonography in Urology<\/option><option value=\"47114\"  class=\"choice-54 depth-1\"  >Medical Genetics Clinic<\/option><option value=\"48023\"  class=\"choice-55 depth-1\"  >Nephrology Clinic<\/option><option value=\"47397\"  class=\"choice-56 depth-1\"  >Neurology Clinic I - Admission and Consultation Clinic<\/option><option value=\"47536\"  class=\"choice-57 depth-1\"  >Neurology Clinic II - Infusion Day Hospital<\/option><option value=\"47204\"  class=\"choice-58 depth-1\"  >Neurology Clinic II - Vertebrogenic Clinic<\/option><option value=\"47192\"  class=\"choice-59 depth-1\"  >Neurology Clinic III - Neurophysiological Clinic - Multiple Sclerosis Treatment Center<\/option><option value=\"47219\"  class=\"choice-60 depth-1\"  >Neurology Clinic IV - focused on Headaches<\/option><option value=\"47722\"  class=\"choice-61 depth-1\"  >Neurology Clinic IV - Neurosonology Clinic (Brain Vessel Ultrasound)<\/option><option value=\"47900\"  class=\"choice-62 depth-1\"  >Neurology Clinic IV - Neurovascular Diseases \/Cerebrovascular\/<\/option><option value=\"47156\"  class=\"choice-63 depth-1\"  >Neurology Clinic V - Electroencephalographic Laboratory (EEG)<\/option><option value=\"47158\"  class=\"choice-64 depth-1\"  >Neurology Clinic V - Seizure Disorders of the CNS<\/option><option value=\"47174\"  class=\"choice-65 depth-1\"  >Neurology Clinic VI - focused on Parkinsonism and other Extrapyramidal Movement Disorders<\/option><option value=\"47216\"  class=\"choice-66 depth-1\"  >Neurology Clinic VI - Neuromyology Clinic - Electromyography (EMG) and Evoked Potentials (EP)<\/option><option value=\"47194\"  class=\"choice-67 depth-1\"  >Neurology Clinic VI - specializing in neuromuscular diseases<\/option><option value=\"46992\"  class=\"choice-68 depth-1\"  >Neuropsychology Clinic<\/option><option value=\"47041\"  class=\"choice-69 depth-1\"  >Neurosurgery Clinic<\/option><option value=\"47073\"  class=\"choice-70 depth-1\"  >Ophthalmology Clinic - One-Day Ophthalmic Surgery<\/option><option value=\"47075\"  class=\"choice-71 depth-1\"  >Ophthalmology Clinic I. - Metabolic-Vascular<\/option><option value=\"47074\"  class=\"choice-72 depth-1\"  >Ophthalmology Clinic III. - Glaucoma Clinic<\/option><option value=\"47081\"  class=\"choice-73 depth-1\"  >Ophthalmology Clinic IV. - Microsurgical Clinic<\/option><option value=\"47083\"  class=\"choice-74 depth-1\"  >Ophthalmology Clinic V. - Retinology Clinic<\/option><option value=\"47599\"  class=\"choice-75 depth-1\"  >Oral Surgery Clinic<\/option><option value=\"47051\"  class=\"choice-76 depth-1\"  >Orthopedic Clinic<\/option><option value=\"47000\"  class=\"choice-77 depth-1\"  >Orthopedic Clinic - Sonographic Clinic for Pediatric Hip Joints<\/option><option value=\"47162\"  class=\"choice-78 depth-1\"  >Pediatric Admission and Consultation Clinic<\/option><option value=\"47149\"  class=\"choice-79 depth-1\"  >Pediatric Cardiology Clinic<\/option><option value=\"47211\"  class=\"choice-80 depth-1\"  >Pediatric Endocrinology and Diabetology Clinic<\/option><option value=\"48091\"  class=\"choice-81 depth-1\"  >Pediatric Gastroenterology Clinic<\/option><option value=\"47394\"  class=\"choice-82 depth-1\"  >Pediatric Gynecology Clinic<\/option><option value=\"47078\"  class=\"choice-83 depth-1\"  >Pediatric Neurology Clinic<\/option><option value=\"47084\"  class=\"choice-84 depth-1\"  >Pediatric Ophthalmology Clinic<\/option><option value=\"47107\"  class=\"choice-85 depth-1\"  >Pediatric Psychiatry Clinic<\/option><option value=\"47561\"  class=\"choice-86 depth-1\"  >Pediatric Rheumatology Clinic<\/option><option value=\"47556\"  class=\"choice-87 depth-1\"  >Pediatric Surgery Clinic<\/option><option value=\"47068\"  class=\"choice-88 depth-1\"  >Pediatric Urology Clinic<\/option><option value=\"47055\"  class=\"choice-89 depth-1\"  >Plastic Surgery Clinic<\/option><option value=\"46995\"  class=\"choice-90 depth-1\"  >Pre-habilitation Clinic<\/option><option value=\"47001\"  class=\"choice-91 depth-1\"  >Preventive Cardiology Clinic<\/option><option value=\"47187\"  class=\"choice-92 depth-1\"  >Primary Contact Clinic<\/option><option value=\"47207\"  class=\"choice-93 depth-1\"  >Primary Contact Clinic - focused on Cervical Pathology and Colposcopy<\/option><option value=\"47249\"  class=\"choice-94 depth-1\"  >Psychiatric Clinic - Admission<\/option><option value=\"47082\"  class=\"choice-95 depth-1\"  >Psychology Clinic I.<\/option><option value=\"47003\"  class=\"choice-96 depth-1\"  >Psychology Clinic II. - Traffic Psychology<\/option><option value=\"47065\"  class=\"choice-97 depth-1\"  >Psychology Clinic II. ---Jan\u010diarova KDaD<\/option><option value=\"47023\"  class=\"choice-98 depth-1\"  >Psychology Clinic III.<\/option><option value=\"47110\"  class=\"choice-99 depth-1\"  >Pulmonology and Phthisiology Clinic<\/option><option value=\"47030\"  class=\"choice-100 depth-1\"  >Radiation Oncology Clinic I. - Admission Clinic<\/option><option value=\"47027\"  class=\"choice-101 depth-1\"  >Radiation Oncology Clinic II.<\/option><option value=\"47046\"  class=\"choice-102 depth-1\"  >Rehabilitation Clinic for Adults<\/option><option value=\"47097\"  class=\"choice-103 depth-1\"  >Rehabilitation Clinic for Adults - Spastic Paresis Counseling Center<\/option><option value=\"47047\"  class=\"choice-104 depth-1\"  >Rehabilitation Clinic for Children, Adolescents and Adults<\/option><option value=\"47208\"  class=\"choice-105 depth-1\"  >Rheumatology Clinic I.<\/option><option value=\"47166\"  class=\"choice-106 depth-1\"  >Rheumatology Clinic II.<\/option><option value=\"47213\"  class=\"choice-107 depth-1\"  >Sonography Clinic<\/option><option value=\"47519\"  class=\"choice-108 depth-1\"  >Stoma Counseling Center at the Surgical Clinic - Mgr. Michal Pra\u017e\u00e1k, Mgr. Nina Smutn\u00e1<\/option><option value=\"47048\"  class=\"choice-109 depth-1\"  >Trauma Surgery Clinic I<\/option><option value=\"47050\"  class=\"choice-110 depth-1\"  >Trauma Surgery Clinic II.<\/option><option value=\"47392\"  class=\"choice-111 depth-1\"  >Ultrasound Gynecology Clinic<\/option><option value=\"47202\"  class=\"choice-112 depth-1\"  >URGENT Surgical Clinic in the Treatment Pavilion<\/option><option value=\"47088\"  class=\"choice-113 depth-1\"  >URGENT Trauma Surgery Clinic<\/option><option value=\"47060\"  class=\"choice-114 depth-1\"  >Urodynamic Counseling Center at the Urology Clinic<\/option><option value=\"47063\"  class=\"choice-115 depth-1\"  >Urology Clinic<\/option><option value=\"47173\"  class=\"choice-116 depth-1\"  >Urology Clinic - Admission Section<\/option><option value=\"47057\"  class=\"choice-117 depth-1\"  >Urology Clinic - Uro-oncology Section<\/option><option value=\"47016\"  class=\"choice-118 depth-1\"  >Vascular Surgery Clinic<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-720-field_2-container\" class=\"wpforms-field wpforms-field-name\" data-field-type=\"name\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-720-field_2\">First and last name of the doctor prescribing the medication <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-720-field_2\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][2]\" aria-errormessage=\"wpforms-720-field_2-error\" required><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-720-field_4-container\" class=\"wpforms-field wpforms-field-layout\" data-field-type=\"layout\" data-field-id=\"4\"><h3 class=\"wpforms-field-label\">\n\t\t\t\tPatient Information\n\t\t\t<\/h3><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-720-field_5-container\" class=\"wpforms-field wpforms-field-name\" data-field-type=\"name\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-720-field_5\">Patient&#039;s first and last name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-720-field_5\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][5]\" aria-errormessage=\"wpforms-720-field_5-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-720-field_6-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-720-field_6\">Patient&#039;s birth number <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-720-field_6\" class=\"wpforms-field-large wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"999999\/999[9]\" name=\"wpforms[fields][6]\" aria-errormessage=\"wpforms-720-field_6-error\" required><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-720-field_8-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-720-field_8\">Mobile number <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-720-field_8\" class=\"wpforms-field-large wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"+421 999 999 999\" name=\"wpforms[fields][8]\" placeholder=\"+421 XXX XXX XXX\" aria-errormessage=\"wpforms-720-field_8-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-720-field_9-container\" class=\"wpforms-field wpforms-field-email\" data-field-type=\"email\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-720-field_9\">Email address <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-720-field_9\" class=\"wpforms-field-large wpforms-field-required\" data-disable-suggestions=\"1\" name=\"wpforms[fields][9]\" placeholder=\"@\" spellcheck=\"false\" aria-errormessage=\"wpforms-720-field_9-error\" required><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-720-field_17-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-modern\" data-field-type=\"select\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-720-field_17\">Health insurance company <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-720-field_17\" class=\"wpforms-field-large wpforms-field-required choicesjs-select\" data-size-class=\"wpforms-field-row wpforms-field-large\" data-search-enabled=\"\" name=\"wpforms[fields][17]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>--- Select your insurance company ---<\/option><option value=\"25 \u2013 V\u0160EOBECN\u00c1 health insurance company\"  class=\"choice-5 depth-1\"  >25 \u2013 V\u0160EOBECN\u00c1 health insurance company<\/option><option value=\"24 \u2013 D\u00d4VERA health insurance company\"  class=\"choice-4 depth-1\"  >24 \u2013 D\u00d4VERA health insurance company<\/option><option value=\"27 \u2013 UNION health insurance company\"  class=\"choice-6 depth-1\"  >27 \u2013 UNION health insurance company<\/option><\/select><\/div><div id=\"wpforms-720-field_10-container\" class=\"wpforms-field wpforms-field-repeater wpforms-field-repeater-display-blocks\" data-rows-min=\"1\" data-rows-max=\"5\" data-clone-num=\"2\" data-field-type=\"repeater\" data-field-id=\"10\"><h3 class=\"wpforms-field-label\">\n\t\t\t\tMedication\n\t\t\t<\/h3><div id=\"wpforms-720-field_10-description\" class=\"wpforms-field-description\">Check more medications only if you want to repeatedly prescribe an e-prescription for several different medications. The medications must be prescribed by the same doctor at the same clinic.\n<\/div><input type=\"hidden\" class=\"wpforms-field-repeater-clone-list\" name=\"wpforms[fields][10][clone_list]\" value=\"[]\"><script type=\"text\/html\" class=\"tmpl-wpforms-field-repeater-template-10-720\"><div id=\"wpforms-720-repeater-field_10-clone_{CLONE}\" class=\"wpforms-field-repeater-clone-wrap\" data-clone=\"{CLONE}\">\n\t\t\t\t<h3 class=\"wpforms-field-repeater-block-title\">\n\t\t\t\tMedication <span class=\"wpforms-wpforms-field-repeater-block-num\">#{CLONE}<\/span>\n\t\t\t<\/h3><div class=\"wpforms-field-description\">Check more medications only if you want to repeatedly prescribe an e-prescription for several different medications. The medications must be prescribed by the same doctor at the same clinic.\n<\/div><div class=\"wpforms-field-layout-rows wpforms-field-large wpforms-field-repeater-display-blocks wpforms-field-repeater-preset-50-25-25\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-720-field_12_{CLONE}-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"12_{CLONE}\"><label class=\"wpforms-field-label\" for=\"wpforms-720-field_12_{CLONE}\">Name of medication <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-720-field_12_{CLONE}\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][12_{CLONE}]\" aria-errormessage=\"wpforms-720-field_12_{CLONE}-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-720-field_13_{CLONE}-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"13_{CLONE}\"><label class=\"wpforms-field-label\" for=\"wpforms-720-field_13_{CLONE}\">Medication strength<\/label><input type=\"text\" id=\"wpforms-720-field_13_{CLONE}\" class=\"wpforms-field-large\" name=\"wpforms[fields][13_{CLONE}]\" aria-errormessage=\"wpforms-720-field_13_{CLONE}-error\" aria-describedby=\"wpforms-720-field_13_{CLONE}-description\" ><div id=\"wpforms-720-field_13_{CLONE}-description\" class=\"wpforms-field-description\">active ingredient in g, mg, etc.<\/div><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-720-field_14_{CLONE}-container\" class=\"wpforms-field wpforms-field-number\" data-field-type=\"number\" data-field-id=\"14_{CLONE}\"><label class=\"wpforms-field-label\" for=\"wpforms-720-field_14_{CLONE}\">Number of packages <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"number\" id=\"wpforms-720-field_14_{CLONE}\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][14_{CLONE}]\" min=\"1\" step=\"any\" aria-errormessage=\"wpforms-720-field_14_{CLONE}-error\" required><\/div><\/div><\/div><\/div><div class=\"wpforms-field-repeater-display-blocks-buttons\" data-button-type=\"buttons_with_icons\">\n\t\t\t\t<button type=\"button\" class=\"wpforms-field-repeater-button-add\">\n\t\t\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M12.129 7.984v1.032a.392.392 0 0 1-.387.387H8.903v2.839a.392.392 0 0 1-.387.387H7.484a.373.373 0 0 1-.387-.387V9.403H4.258a.373.373 0 0 1-.387-.387V7.984c0-.194.161-.387.387-.387h2.839V4.758c0-.193.161-.387.387-.387h1.032c.194 0 .387.194.387.387v2.839h2.839c.193 0 .387.193.387.387ZM16 8.5c0 4.42-3.58 8-8 8s-8-3.58-8-8 3.58-8 8-8 8 3.58 8 8Zm-1.548 0c0-3.548-2.904-6.452-6.452-6.452A6.45 6.45 0 0 0 1.548 8.5 6.43 6.43 0 0 0 8 14.952 6.45 6.45 0 0 0 14.452 8.5Z\" fill=\"currentColor\"\/><\/svg><span>Prida\u0165 \u010fal\u0161\u00ed liek<\/span>\n\t\t\t\t<\/button>\n\t\t\t\t<button type=\"button\" class=\"wpforms-field-repeater-button-remove wpforms-disabled\">\n\t\t\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M4.258 9.403a.373.373 0 0 1-.387-.387V7.984c0-.194.161-.387.387-.387h7.484c.193 0 .387.193.387.387v1.032a.392.392 0 0 1-.387.387H4.258ZM16 8.5c0 4.42-3.58 8-8 8s-8-3.58-8-8 3.58-8 8-8 8 3.58 8 8Zm-1.548 0c0-3.548-2.904-6.452-6.452-6.452A6.45 6.45 0 0 0 1.548 8.5 6.43 6.43 0 0 0 8 14.952 6.45 6.45 0 0 0 14.452 8.5Z\" fill=\"currentColor\"\/><\/svg><span>Odstr\u00e1ni\u0165 liek<\/span>\n\t\t\t\t<\/button>\n\t\t\t<\/div>\n\t\t\t<\/div><\/script><div class=\"wpforms-field-layout-rows wpforms-field-large wpforms-field-repeater-display-blocks wpforms-field-repeater-preset-50-25-25\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-720-field_12-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-720-field_12\">Name of medication <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-720-field_12\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][12]\" aria-errormessage=\"wpforms-720-field_12-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-720-field_13-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-720-field_13\">Medication strength<\/label><input type=\"text\" id=\"wpforms-720-field_13\" class=\"wpforms-field-large\" name=\"wpforms[fields][13]\" aria-errormessage=\"wpforms-720-field_13-error\" aria-describedby=\"wpforms-720-field_13-description\" ><div id=\"wpforms-720-field_13-description\" class=\"wpforms-field-description\">active ingredient in g, mg, etc.<\/div><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-720-field_14-container\" class=\"wpforms-field wpforms-field-number\" data-field-type=\"number\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-720-field_14\">Number of packages <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"number\" id=\"wpforms-720-field_14\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][14]\" value=\"1\" min=\"1\" step=\"any\" aria-errormessage=\"wpforms-720-field_14-error\" required><\/div><\/div><\/div><\/div><div class=\"wpforms-field-repeater-display-blocks-buttons\" data-button-type=\"buttons_with_icons\">\n\t\t\t\t<button type=\"button\" class=\"wpforms-field-repeater-button-add\">\n\t\t\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M12.129 7.984v1.032a.392.392 0 0 1-.387.387H8.903v2.839a.392.392 0 0 1-.387.387H7.484a.373.373 0 0 1-.387-.387V9.403H4.258a.373.373 0 0 1-.387-.387V7.984c0-.194.161-.387.387-.387h2.839V4.758c0-.193.161-.387.387-.387h1.032c.194 0 .387.194.387.387v2.839h2.839c.193 0 .387.193.387.387ZM16 8.5c0 4.42-3.58 8-8 8s-8-3.58-8-8 3.58-8 8-8 8 3.58 8 8Zm-1.548 0c0-3.548-2.904-6.452-6.452-6.452A6.45 6.45 0 0 0 1.548 8.5 6.43 6.43 0 0 0 8 14.952 6.45 6.45 0 0 0 14.452 8.5Z\" fill=\"currentColor\"\/><\/svg><span>Prida\u0165 \u010fal\u0161\u00ed liek<\/span>\n\t\t\t\t<\/button>\n\t\t\t\t<button type=\"button\" class=\"wpforms-field-repeater-button-remove wpforms-disabled\">\n\t\t\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M4.258 9.403a.373.373 0 0 1-.387-.387V7.984c0-.194.161-.387.387-.387h7.484c.193 0 .387.193.387.387v1.032a.392.392 0 0 1-.387.387H4.258ZM16 8.5c0 4.42-3.58 8-8 8s-8-3.58-8-8 3.58-8 8-8 8 3.58 8 8Zm-1.548 0c0-3.548-2.904-6.452-6.452-6.452A6.45 6.45 0 0 0 1.548 8.5 6.43 6.43 0 0 0 8 14.952 6.45 6.45 0 0 0 14.452 8.5Z\" fill=\"currentColor\"\/><\/svg><span>Odstr\u00e1ni\u0165 liek<\/span>\n\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><div id=\"wpforms-720-field_18-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-type=\"pagebreak\" data-field-id=\"18\"><div class=\"wpforms-clear wpforms-pagebreak-left\"><span class=\"wpforms-page-button-group\"><button class=\"wpforms-page-button wpforms-page-next wpforms-disabled\"\n\t\t\t\t\tdata-action=\"next\" data-page=\"1\" data-formid=\"720\" aria-disabled=\"true\" aria-describedby=\"wpforms-error-noscript\">Go to summary<\/button><img decoding=\"async\" src=\"https:\/\/fnnitra.sk\/wp-content\/plugins\/wpforms\/assets\/images\/submit-spin.svg\" class=\"wpforms-page-button-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/span><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-2 last \" data-page=\"2\" style=\"display:none;\"><div id=\"wpforms-720-field_21-container\" class=\"wpforms-field wpforms-field-entry-preview\" data-field-type=\"entry-preview\" data-field-id=\"21\"><div class=\"wpforms-entry-preview-updating-message\">Updating preview\u2026<\/div><div class=\"wpforms-entry-preview-notice\" style=\"display: none;\">Please take a moment to verify your information. You can also go back and make changes.<\/div><div class=\"wpforms-entry-preview-wrapper\" style=\"display: none;\"><\/div><\/div><div id=\"wpforms-720-field_15-container\" class=\"wpforms-field wpforms-field-gdpr-checkbox\" data-field-type=\"gdpr-checkbox\" data-field-id=\"15\"><label class=\"wpforms-field-label wpforms-label-hide\" aria-hidden=\"false\">GDPR <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><ul id=\"wpforms-720-field_15\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"checkbox\" id=\"wpforms-720-field_15_1\" name=\"wpforms[fields][15][]\" value=\"By submitting this form, you agree to the processing of personal data. You can find the privacy policy &lt;a target=&quot;_blank&quot; href=&quot;https:\/\/fnnitra.sk\/ochrana-osobnych-udajov\/&quot;&gt;here&lt;\/a&gt;.\" aria-errormessage=\"wpforms-720-field_15_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-720-field_15_1\">By submitting this form, you agree to the processing of personal data. You can find the privacy policy <a target=\"_blank\" href=\"https:\/\/fnnitra.sk\/ochrana-osobnych-udajov\/\">here<\/a>. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><\/li><\/ul><\/div><div id=\"wpforms-720-field_0-container\" class=\"wpforms-field wpforms-field-hidden\" data-field-type=\"hidden\" data-field-id=\"0\"><input type=\"hidden\" id=\"wpforms-720-field_0\" name=\"wpforms[fields][0]\" value=\"en\"><\/div><div id=\"wpforms-720-field_20-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-type=\"pagebreak\" data-field-id=\"20\"><div class=\"wpforms-clear wpforms-pagebreak-left\"><span class=\"wpforms-page-button-group\"><button class=\"wpforms-page-button wpforms-page-prev wpforms-disabled\"\n\t\t\t\t\tdata-action=\"prev\" data-page=\"2\" data-formid=\"720\" aria-disabled=\"true\" aria-describedby=\"wpforms-error-noscript\">Edit details<\/button><\/span><\/div><\/div><\/div><script>\n\t\t\t\t( function() {\n\t\t\t\t\tconst style = document.createElement( 'style' );\n\t\t\t\t\tstyle.appendChild( document.createTextNode( '#wpforms-720-field_7-container { position: absolute !important; overflow: hidden !important; display: inline !important; height: 1px !important; width: 1px !important; z-index: -1000 !important; padding: 0 !important; } #wpforms-720-field_7-container input { visibility: hidden; } #wpforms-conversational-form-page #wpforms-720-field_7-container label { counter-increment: none; }' ) );\n\t\t\t\t\tdocument.head.appendChild( style );\n\t\t\t\t\tdocument.currentScript?.remove();\n\t\t\t\t} )();\n\t\t\t<\/script><\/div><!-- .wpforms-field-container -->    <script>\n    document.addEventListener('DOMContentLoaded', function() {\n        document.querySelectorAll('.wpforms-field').forEach(function(field) {\n            const label = field.querySelector('label.wpforms-field-label');\n            const required = field.querySelector('.wpforms-required-label');\n            if (label && !required) {\n                if (!label.querySelector('.wpforms-optional-label')) {\n                    const span = document.createElement('span');\n                    span.className = 'wpforms-optional-label op-5';\n                    span.textContent = '(volite\u013en\u00e9)';\n                    label.appendChild(document.createTextNode(' '));\n                    label.appendChild(span);\n                }\n            }\n        });\n    });\n    <\/script>\n    <div class=\"wpforms-submit-container\" style=\"display:none;\"><input type=\"hidden\" name=\"wpforms[id]\" value=\"720\"><input type=\"hidden\" name=\"wpforms[time_token]\" value=\"1792667634.ce8de541cd638c01edd2db303e22b85249237ffe988c628c47feaafa267dfc5e\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/fnnitra.sk\/en\/wp-json\/wp\/v2\/pages\/46619\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-720\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Order\" aria-live=\"assertive\" value=\"wpforms-submit\">Order<\/button><img decoding=\"async\" src=\"https:\/\/fnnitra.sk\/wp-content\/plugins\/wpforms\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container -->\n\t\t<\/div>\n\t\n\t\t<div class=\"h1 alert-color strong text-center mb mt\">\n\t\t\t\t\n<p>This service is currently unavailable. Please contact your doctor.<br \/>\n\t\t<\/div>\n\t\n\t<div id=\"text-2811406114\" class=\"text italic bt pt-half strong\">\n\t\t\n<p>The &#8220;E-Prescription&#8221; form is an alternative to ordering medication by phone and falls under the collection of medical and healthcare information.<\/p>\n\t\t\n<style>\n#text-2811406114 {\n  font-size: 0.89rem;\n}\n<\/style>\n\t<\/div>\n\t\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\n<\/div>\n\t\t<\/div>\n\n\t\t\n<style>\n#section_387358230 {\n  padding-top: 30px;\n  padding-bottom: 30px;\n}\n<\/style>\n\t<\/section>\n\t\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-46619","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/fnnitra.sk\/en\/wp-json\/wp\/v2\/pages\/46619","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/fnnitra.sk\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/fnnitra.sk\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/fnnitra.sk\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/fnnitra.sk\/en\/wp-json\/wp\/v2\/comments?post=46619"}],"version-history":[{"count":2,"href":"https:\/\/fnnitra.sk\/en\/wp-json\/wp\/v2\/pages\/46619\/revisions"}],"predecessor-version":[{"id":46621,"href":"https:\/\/fnnitra.sk\/en\/wp-json\/wp\/v2\/pages\/46619\/revisions\/46621"}],"wp:attachment":[{"href":"https:\/\/fnnitra.sk\/en\/wp-json\/wp\/v2\/media?parent=46619"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}