Translated by

<p class=MsoNormal><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal align=center style='text-align:center;line-height:150%'><b<!-- [et_pb_line_break_holder] -->style='mso-bidi-font-weight:normal'><span lang=DE style='font-size:14.0pt;<!-- [et_pb_line_break_holder] -->mso-bidi-font-size:11.0pt;line-height:150%'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal align=center style='text-align:center;line-height:150%'><b<!-- [et_pb_line_break_holder] -->style='mso-bidi-font-weight:normal'><span lang=DE style='font-size:14.0pt;<!-- [et_pb_line_break_holder] -->mso-bidi-font-size:11.0pt;line-height:150%;text-transform:uppercase'>Deutsche<!-- [et_pb_line_break_holder] -->Version des Index zum Beitrag pflegender Angehöriger zur Selbstpflege bei<!-- [et_pb_line_break_holder] -->Patienten mit Herzinsuffizienz<span style='mso-spacerun:yes'> <!-- [et_pb_line_break_holder] --></span>(G-CC-SCHFI)<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal align=center style='text-align:center;line-height:150%'><span<!-- [et_pb_line_break_holder] -->style='font-size:14.0pt;mso-bidi-font-size:11.0pt;line-height:150%;mso-ansi-language:<!-- [et_pb_line_break_holder] -->EN-US'>(GERMAN VERSION OF THE CAREGIVER CONTRIBUTION TO SELF-CARE OF HEART<!-- [et_pb_line_break_holder] -->FAILURE INDEX)<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal align=center style='text-align:center;line-height:150%'><span<!-- [et_pb_line_break_holder] -->style='font-size:14.0pt;mso-bidi-font-size:11.0pt;line-height:150%;mso-ansi-language:<!-- [et_pb_line_break_holder] -->EN-US'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal align=center style='text-align:center;line-height:150%'><span<!-- [et_pb_line_break_holder] -->style='font-size:14.0pt;mso-bidi-font-size:11.0pt;line-height:150%;mso-ansi-language:<!-- [et_pb_line_break_holder] -->EN-US'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal align=center style='text-align:center;line-height:150%'><span<!-- [et_pb_line_break_holder] -->style='font-size:14.0pt;mso-bidi-font-size:11.0pt;line-height:150%;mso-ansi-language:<!-- [et_pb_line_break_holder] -->EN-US'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal align=center style='text-align:center;line-height:150%'><span<!-- [et_pb_line_break_holder] -->style='font-size:14.0pt;mso-bidi-font-size:11.0pt;line-height:150%;mso-ansi-language:<!-- [et_pb_line_break_holder] -->EN-US'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal align=center style='text-align:center;line-height:150%'><span<!-- [et_pb_line_break_holder] -->style='font-size:14.0pt;mso-bidi-font-size:11.0pt;line-height:150%;mso-ansi-language:<!-- [et_pb_line_break_holder] -->EN-US'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal align=center style='text-align:center;line-height:150%'><span<!-- [et_pb_line_break_holder] -->style='font-size:14.0pt;mso-bidi-font-size:11.0pt;line-height:150%;mso-ansi-language:<!-- [et_pb_line_break_holder] -->EN-US'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal align=center style='text-align:center;line-height:150%'><span<!-- [et_pb_line_break_holder] -->style='font-size:14.0pt;mso-bidi-font-size:11.0pt;line-height:150%;mso-ansi-language:<!-- [et_pb_line_break_holder] -->EN-US'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal align=center style='text-align:center;line-height:150%'><span<!-- [et_pb_line_break_holder] -->style='font-size:14.0pt;mso-bidi-font-size:11.0pt;line-height:150%;mso-ansi-language:<!-- [et_pb_line_break_holder] -->EN-US'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal align=center style='text-align:center;line-height:150%'><span<!-- [et_pb_line_break_holder] -->style='font-size:14.0pt;mso-bidi-font-size:11.0pt;line-height:150%;mso-ansi-language:<!-- [et_pb_line_break_holder] -->EN-US'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal align=center style='text-align:center;line-height:150%'><span<!-- [et_pb_line_break_holder] -->style='font-size:14.0pt;mso-bidi-font-size:11.0pt;line-height:150%;mso-ansi-language:<!-- [et_pb_line_break_holder] -->EN-US'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal align=center style='text-align:center;line-height:150%'><span<!-- [et_pb_line_break_holder] -->style='font-size:14.0pt;mso-bidi-font-size:11.0pt;line-height:150%;mso-ansi-language:<!-- [et_pb_line_break_holder] -->EN-US'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] -->text-align:center;line-height:normal'><span style='font-size:10.0pt;mso-bidi-font-family:<!-- [et_pb_line_break_holder] -->Calibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:EN-US'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><b><span lang=DE style='font-size:12.0pt;line-height:115%;font-family:"Calibri",sans-serif;<!-- [et_pb_line_break_holder] -->mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:<!-- [et_pb_line_break_holder] -->minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-theme-font:minor-latin;<!-- [et_pb_line_break_holder] -->mso-ansi-language:DE;mso-fareast-language:EN-US;mso-bidi-language:AR-SA'><br<!-- [et_pb_line_break_holder] -->clear=all style='page-break-before:always;mso-break-type:section-break'><!-- [et_pb_line_break_holder] --></span></b><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><div class=WordSection2><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;<!-- [et_pb_line_break_holder] -->margin-left:0in'><b><span lang=DE style='font-size:12.0pt;line-height:115%;<!-- [et_pb_line_break_holder] -->mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'>Wir möchten Sie<!-- [et_pb_line_break_holder] -->bitten, über die Unterstützung, die Sie der Person mit Herzschwäche in den<!-- [et_pb_line_break_holder] -->letzten Monaten gegeben haben, nachzudenken. Es gibt keine richtigen oder<!-- [et_pb_line_break_holder] -->falschen Antworten.<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><table class=MsoTableGrid border=1 cellspacing=0 cellpadding=0<!-- [et_pb_line_break_holder] --> style='border-collapse:collapse;border:none;mso-border-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> mso-yfti-tbllook:1184;mso-padding-alt:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'><!-- [et_pb_line_break_holder] --> <td width=36 valign=top style='width:21.75pt;border:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-right:none;mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:<!-- [et_pb_line_break_holder] --> solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .5pt;background:<!-- [et_pb_line_break_holder] --> #BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:191;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><b><span lang=DE style='font-size:<!-- [et_pb_line_break_holder] --> 12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'>A<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=645 colspan=5 valign=top style='width:483.7pt;border-top:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-left:none;border-bottom:solid windowtext 1.0pt;border-right:none;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> background:#BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:<!-- [et_pb_line_break_holder] --> 191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><b><span lang=DE style='font-size:<!-- [et_pb_line_break_holder] --> 12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'>Wie<!-- [et_pb_line_break_holder] --> häufig empfehlen Sie der Person, um die Sie sich kümmern,<span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'>  </span>folgende Tätigkeiten durchzuführen (oder<!-- [et_pb_line_break_holder] --> wie häufig führen Sie diese Tätigkeiten durch, weil die Person, um die sie<!-- [et_pb_line_break_holder] --> sich kümmern, dazu selbst nicht in der Lage ist)?</span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-left:none;mso-border-top-alt:solid windowtext .5pt;mso-border-bottom-alt:<!-- [et_pb_line_break_holder] --> solid windowtext .5pt;mso-border-right-alt:solid windowtext .5pt;background:<!-- [et_pb_line_break_holder] --> #BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:191;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:1'><!-- [et_pb_line_break_holder] --> <td width=36 valign=top style='width:21.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;mso-border-top-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=262 valign=top style='width:196.4pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.75pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Nie<!-- [et_pb_line_break_holder] --> oder selten<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:72.2pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Manchmal<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.55pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Oft<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.8pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Immer<!-- [et_pb_line_break_holder] --> oder täglich<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;mso-border-top-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:2'><!-- [et_pb_line_break_holder] --> <td width=36 valign=top style='width:21.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>A1<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=262 style='width:196.4pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Sich zu wiegen.<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.75pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:72.2pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.55pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.8pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:3'><!-- [et_pb_line_break_holder] --> <td width=36 valign=top style='width:21.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>A2<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=262 style='width:196.4pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Die Fußknöchel auf<!-- [et_pb_line_break_holder] --> Schwellungen zu überprüfen.<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.75pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:72.2pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.55pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.8pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:4'><!-- [et_pb_line_break_holder] --> <td width=36 valign=top style='width:21.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>A3<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=262 style='width:196.4pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Versuchen, nicht<!-- [et_pb_line_break_holder] --> krank zu werden (z.B. durch Grippeimpfung, Kontakt mit kranken Menschen zu<!-- [et_pb_line_break_holder] --> meiden).<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.75pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:72.2pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.55pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.8pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:5'><!-- [et_pb_line_break_holder] --> <td width=36 valign=top style='width:21.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>A4<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=262 style='width:196.4pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Sich ein wenig<!-- [et_pb_line_break_holder] --> körperlich zu betätigen.<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.75pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:72.2pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.55pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.8pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:6'><!-- [et_pb_line_break_holder] --> <td width=36 valign=top style='width:21.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>A5<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=262 style='width:196.4pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Termine mit dem<!-- [et_pb_line_break_holder] --> Haus-/Facharzt oder dem/der Gesundheits- und Krankenpfleger/in einzuhalten.<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.75pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;mso-hyphenate:none;tab-stops:0in dotted 311.85pt'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:72.2pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;mso-hyphenate:none;tab-stops:0in dotted 311.85pt'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.55pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;mso-hyphenate:none;tab-stops:0in dotted 311.85pt'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.8pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;mso-hyphenate:none;tab-stops:0in dotted 311.85pt'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:7'><!-- [et_pb_line_break_holder] --> <td width=36 valign=top style='width:21.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>A6<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=262 style='width:196.4pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Salzarm zu essen.<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.75pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:72.2pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.55pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.8pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:8'><!-- [et_pb_line_break_holder] --> <td width=36 valign=top style='width:21.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>A7<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=262 style='width:196.4pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Sich 30 Minuten zu<!-- [et_pb_line_break_holder] --> bewegen.<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.75pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:72.2pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.55pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.8pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:9'><!-- [et_pb_line_break_holder] --> <td width=36 valign=top style='width:21.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>A8<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=262 style='width:196.4pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Nicht zu vergessen,<!-- [et_pb_line_break_holder] --> die Medikamente einzunehmen.<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.75pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:72.2pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.55pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.8pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:10'><!-- [et_pb_line_break_holder] --> <td width=36 valign=top style='width:21.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>A9<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=262 style='width:196.4pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Beim Essen auswärts<!-- [et_pb_line_break_holder] --> oder bei Besuchen nach salzarmen Speisen zu fragen.<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.75pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:72.2pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.55pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.8pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:11'><!-- [et_pb_line_break_holder] --> <td width=36 valign=top style='width:21.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>A10<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=262 style='width:196.4pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Ein System<!-- [et_pb_line_break_holder] --> (Tablettenbox, Erinnerungszettel) zur Erinnerung an die Medikamenteneinnahme<!-- [et_pb_line_break_holder] --> zu nutzen.<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.75pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:72.2pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.55pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:71.8pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:12;mso-yfti-lastrow:yes'><!-- [et_pb_line_break_holder] --> <td width=36 valign=top style='width:21.75pt;border-top:none;border-left:<!-- [et_pb_line_break_holder] --> solid windowtext 1.0pt;border-bottom:solid windowtext 1.0pt;border-right:<!-- [et_pb_line_break_holder] --> none;mso-border-left-alt:solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=262 valign=top style='width:196.4pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 valign=top style='width:71.75pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='color:#BFBFBF;<!-- [et_pb_line_break_holder] --> mso-themecolor:background1;mso-themeshade:191'>1<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 valign=top style='width:72.2pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='color:#BFBFBF;<!-- [et_pb_line_break_holder] --> mso-themecolor:background1;mso-themeshade:191'>2<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 valign=top style='width:71.55pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='color:#BFBFBF;<!-- [et_pb_line_break_holder] --> mso-themecolor:background1;mso-themeshade:191'>3<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 valign=top style='width:71.8pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='color:#BFBFBF;<!-- [et_pb_line_break_holder] --> mso-themecolor:background1;mso-themeshade:191'>4<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border-top:none;border-left:<!-- [et_pb_line_break_holder] --> none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;mso-border-right-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --></table><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt'><span<!-- [et_pb_line_break_holder] -->lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><table class=MsoTableGrid border=1 cellspacing=0 cellpadding=0<!-- [et_pb_line_break_holder] --> style='border-collapse:collapse;border:none;mso-border-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> mso-yfti-tbllook:1184;mso-padding-alt:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-right:none;mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:<!-- [et_pb_line_break_holder] --> solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .5pt;background:<!-- [et_pb_line_break_holder] --> #BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:191;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><b><span lang=DE style='font-size:<!-- [et_pb_line_break_holder] --> 12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'>B<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=629 colspan=5 valign=top style='width:6.55in;border-top:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-left:none;border-bottom:solid windowtext 1.0pt;border-right:none;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> background:#BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:<!-- [et_pb_line_break_holder] --> 191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><b><span lang=DE style='font-size:<!-- [et_pb_line_break_holder] --> 12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'>Viele<!-- [et_pb_line_break_holder] --> Patienten haben auf Grund ihrer Herzschwäche Symptome. Atembeschwerden und<!-- [et_pb_line_break_holder] --> geschwollene Fußknöchel sind übliche Symptome der Herzschwäche.<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><b><span lang=DE style='font-size:<!-- [et_pb_line_break_holder] --> 12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'>Hatte im<!-- [et_pb_line_break_holder] --> letzten Monat die Person, um die Sie sich kümmern, Atembeschwerden oder<!-- [et_pb_line_break_holder] --> geschwollene Fußknöchel? Bitte nur eine Antwort einkreisen.</span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.65pt;border:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-left:none;mso-border-top-alt:solid windowtext .5pt;mso-border-bottom-alt:<!-- [et_pb_line_break_holder] --> solid windowtext .5pt;mso-border-right-alt:solid windowtext .5pt;background:<!-- [et_pb_line_break_holder] --> #BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:191;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:1'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;mso-border-top-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=242 valign=top style='width:181.75pt;border:none;border-bottom:<!-- [et_pb_line_break_holder] --> solid #BFBFBF 1.5pt;mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:<!-- [et_pb_line_break_holder] --> 191;mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Nein<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:72.5pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;tab-stops:<!-- [et_pb_line_break_holder] --> dotted 311.85pt'><!--[if supportFields]><span lang=DE style='font-size:12.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:72.45pt;border:none;mso-border-top-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;tab-stops:<!-- [et_pb_line_break_holder] --> dotted 311.85pt'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Arial;color:#BFBFBF;mso-themecolor:background1;mso-themeshade:191'>0<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:72.45pt;border:none;mso-border-top-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:72.45pt;border:none;mso-border-top-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.65pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;mso-border-top-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:2'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=242 valign=top style='width:181.75pt;border:none;border-bottom:<!-- [et_pb_line_break_holder] --> solid #BFBFBF 1.5pt;mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:<!-- [et_pb_line_break_holder] --> 191;mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Ja<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:72.5pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;tab-stops:<!-- [et_pb_line_break_holder] --> dotted 311.85pt'><!--[if supportFields]><span lang=DE style='font-size:12.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:72.45pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;tab-stops:<!-- [et_pb_line_break_holder] --> dotted 311.85pt'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Arial;color:#BFBFBF;mso-themecolor:background1;mso-themeshade:191'>1<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:72.45pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:72.45pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.65pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:3;mso-yfti-lastrow:yes'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border-top:none;border-left:<!-- [et_pb_line_break_holder] --> solid windowtext 1.0pt;border-bottom:solid windowtext 1.0pt;border-right:<!-- [et_pb_line_break_holder] --> none;mso-border-left-alt:solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=242 valign=top style='width:181.75pt;border:none;border-bottom:<!-- [et_pb_line_break_holder] --> solid windowtext 1.0pt;mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:<!-- [et_pb_line_break_holder] --> background1;mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal;page-break-after:avoid;mso-hyphenate:none;tab-stops:0in dotted 311.85pt'><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:72.5pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal;page-break-after:avoid;tab-stops:dotted 311.85pt'><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:72.45pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal;page-break-after:avoid;tab-stops:dotted 311.85pt'><b<!-- [et_pb_line_break_holder] --> style='mso-bidi-font-weight:normal'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:72.45pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal;page-break-after:avoid;tab-stops:dotted 311.85pt'><b<!-- [et_pb_line_break_holder] --> style='mso-bidi-font-weight:normal'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:72.45pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal;page-break-after:avoid;tab-stops:dotted 311.85pt'><b<!-- [et_pb_line_break_holder] --> style='mso-bidi-font-weight:normal'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.65pt;border-top:none;border-left:<!-- [et_pb_line_break_holder] --> none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;mso-border-right-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --></table><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><table class=MsoTableGrid border=1 cellspacing=0 cellpadding=0<!-- [et_pb_line_break_holder] --> style='border-collapse:collapse;border:none;mso-border-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> mso-yfti-tbllook:1184;mso-padding-alt:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-right:none;mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:<!-- [et_pb_line_break_holder] --> solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .5pt;background:<!-- [et_pb_line_break_holder] --> #BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:191;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><b><span lang=DE style='font-size:<!-- [et_pb_line_break_holder] --> 12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'>B<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=629 colspan=5 valign=top style='width:471.75pt;border-top:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-left:none;border-bottom:solid windowtext 1.0pt;border-right:none;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> background:#BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:<!-- [et_pb_line_break_holder] --> 191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><b><span lang=DE style='font-size:<!-- [et_pb_line_break_holder] --> 12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'>Wenn die<!-- [et_pb_line_break_holder] --> Person, um die Sie sich kümmern, im letzten Monat Atembeschwerden oder<!-- [et_pb_line_break_holder] --> geschwollene Fußknöchel hatte….<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><b><span lang=DE style='font-size:<!-- [et_pb_line_break_holder] --> 12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'>Wie<!-- [et_pb_line_break_holder] --> schnell haben Sie dies als Symptom der Herzschwäche erkannt?</span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.5pt;border:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-left:none;mso-border-top-alt:solid windowtext .5pt;mso-border-bottom-alt:<!-- [et_pb_line_break_holder] --> solid windowtext .5pt;mso-border-right-alt:solid windowtext .5pt;background:<!-- [et_pb_line_break_holder] --> #BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:191;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:1'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;mso-border-top-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>B11<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=250 style='width:187.3pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Hatte diese<!-- [et_pb_line_break_holder] --> Beschwerden nicht<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.35pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;tab-stops:<!-- [et_pb_line_break_holder] --> dotted 311.85pt'><!--[if supportFields]><span lang=DE style='font-size:12.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.3pt;border:none;mso-border-top-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;tab-stops:<!-- [et_pb_line_break_holder] --> dotted 311.85pt'><b style='mso-bidi-font-weight:normal'><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-bidi-font-family:Arial;color:#BFBFBF;mso-themecolor:<!-- [et_pb_line_break_holder] --> background1;mso-themeshade:191'>n/a<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:70.9pt;border:none;mso-border-top-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:70.9pt;border:none;mso-border-top-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.5pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;mso-border-top-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:2'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=250 style='width:187.3pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Habe ich nicht<!-- [et_pb_line_break_holder] --> erkannt<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.35pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;tab-stops:<!-- [et_pb_line_break_holder] --> dotted 311.85pt'><!--[if supportFields]><span lang=DE style='font-size:12.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.3pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;tab-stops:<!-- [et_pb_line_break_holder] --> dotted 311.85pt'><b style='mso-bidi-font-weight:normal'><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-bidi-font-family:Arial;color:#BFBFBF;mso-themecolor:<!-- [et_pb_line_break_holder] --> background1;mso-themeshade:191'>0<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:70.9pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:70.9pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.5pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:3'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=250 style='width:187.3pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Nicht schnell<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.35pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.3pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;tab-stops:<!-- [et_pb_line_break_holder] --> dotted 311.85pt'><b style='mso-bidi-font-weight:normal'><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-bidi-font-family:Arial;color:#BFBFBF;mso-themecolor:<!-- [et_pb_line_break_holder] --> background1;mso-themeshade:191'>1<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:70.9pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:70.9pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.5pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:4'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=250 style='width:187.3pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Ziemlich schnell<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.35pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.3pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;tab-stops:<!-- [et_pb_line_break_holder] --> dotted 311.85pt'><b style='mso-bidi-font-weight:normal'><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-bidi-font-family:Arial;color:#BFBFBF;mso-themecolor:<!-- [et_pb_line_break_holder] --> background1;mso-themeshade:191'>2<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:70.9pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:70.9pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.5pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:5'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=250 style='width:187.3pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Schnell<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.35pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.3pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;tab-stops:<!-- [et_pb_line_break_holder] --> dotted 311.85pt'><b style='mso-bidi-font-weight:normal'><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-bidi-font-family:Arial;color:#BFBFBF;mso-themecolor:<!-- [et_pb_line_break_holder] --> background1;mso-themeshade:191'>3<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:70.9pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:70.9pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.5pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:6'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=250 style='width:187.3pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Sehr schnell<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.35pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.3pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;tab-stops:<!-- [et_pb_line_break_holder] --> dotted 311.85pt'><b style='mso-bidi-font-weight:normal'><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-bidi-font-family:Arial;color:#BFBFBF;mso-themecolor:<!-- [et_pb_line_break_holder] --> background1;mso-themeshade:191'>4<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:70.9pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:70.9pt;border:none;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.5pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:7;mso-yfti-lastrow:yes'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border-top:none;border-left:<!-- [et_pb_line_break_holder] --> solid windowtext 1.0pt;border-bottom:solid windowtext 1.0pt;border-right:<!-- [et_pb_line_break_holder] --> none;mso-border-left-alt:solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=250 valign=top style='width:187.3pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal;page-break-after:avoid;mso-hyphenate:none;tab-stops:0in dotted 311.85pt'><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 valign=top style='width:71.35pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.3pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal;page-break-after:avoid;tab-stops:dotted 311.85pt'><b<!-- [et_pb_line_break_holder] --> style='mso-bidi-font-weight:normal'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:70.9pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal;page-break-after:avoid;tab-stops:dotted 311.85pt'><b<!-- [et_pb_line_break_holder] --> style='mso-bidi-font-weight:normal'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:70.9pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal;page-break-after:avoid;tab-stops:dotted 311.85pt'><b<!-- [et_pb_line_break_holder] --> style='mso-bidi-font-weight:normal'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Arial'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.5pt;border-top:none;border-left:none;<!-- [et_pb_line_break_holder] --> border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;mso-border-right-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --></table><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt'><span<!-- [et_pb_line_break_holder] -->lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><table class=MsoTableGrid border=1 cellspacing=0 cellpadding=0<!-- [et_pb_line_break_holder] --> style='border-collapse:collapse;border:none;mso-border-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> mso-yfti-tbllook:1184;mso-padding-alt:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-right:none;mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:<!-- [et_pb_line_break_holder] --> solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .5pt;background:<!-- [et_pb_line_break_holder] --> #BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:191;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><b><span lang=DE style='font-size:<!-- [et_pb_line_break_holder] --> 12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'>B<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=629 colspan=5 valign=top style='width:472.1pt;border-top:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-left:none;border-bottom:solid windowtext 1.0pt;border-right:none;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> background:#BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:<!-- [et_pb_line_break_holder] --> 191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><b><span lang=DE style='font-size:<!-- [et_pb_line_break_holder] --> 12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'>Wenn die<!-- [et_pb_line_break_holder] --> Person, um die Sie sich kümmern, Atembeschwerden oder geschwollene Fußknöchel<!-- [et_pb_line_break_holder] --> hat, wie wahrscheinlich ist es, dass Sie folgende Maßnahmen empfehlen oder<!-- [et_pb_line_break_holder] --> selbst durchführen?</span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=20 valign=top style='width:15.15pt;border:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-left:none;mso-border-top-alt:solid windowtext .5pt;mso-border-bottom-alt:<!-- [et_pb_line_break_holder] --> solid windowtext .5pt;mso-border-right-alt:solid windowtext .5pt;background:<!-- [et_pb_line_break_holder] --> #BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:191;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:1'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;mso-border-top-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=238 valign=top style='width:178.5pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:73.0pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Nicht<!-- [et_pb_line_break_holder] --> wahrscheinlich<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:73.0pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Ziemlich<!-- [et_pb_line_break_holder] --> wahrscheinlich<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=99 style='width:74.6pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Wahrscheinlich<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:73.0pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Sehr<!-- [et_pb_line_break_holder] --> wahrscheinlich<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=20 valign=top style='width:15.15pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;mso-border-top-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:2'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>B12<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=238 style='width:178.5pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Reduzieren von Salz<!-- [et_pb_line_break_holder] --> im Essen.<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:73.0pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;mso-hyphenate:none;tab-stops:0in dotted 311.85pt'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:73.0pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;mso-hyphenate:none;tab-stops:0in dotted 311.85pt'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=99 style='width:74.6pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;mso-hyphenate:none;tab-stops:0in dotted 311.85pt'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:73.0pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;mso-hyphenate:none;tab-stops:0in dotted 311.85pt'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=20 valign=top style='width:15.15pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:3'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>B13<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=238 style='width:178.5pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Reduzieren der<!-- [et_pb_line_break_holder] --> Flüssigkeitsmenge.<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:73.0pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:73.0pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=99 style='width:74.6pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:73.0pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=20 valign=top style='width:15.15pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:4'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>B14<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=238 style='width:178.5pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Einnehmen einer<!-- [et_pb_line_break_holder] --> extra Wassertablette.<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:73.0pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:73.0pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=99 style='width:74.6pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:73.0pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=20 valign=top style='width:15.15pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:5'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>B15<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=238 style='width:178.5pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'>Den Haus-/Facharzt<!-- [et_pb_line_break_holder] --> oder den/die Gesundheits- und Krankenpfleger/in zu konsultieren.<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:73.0pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:73.0pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=99 style='width:74.6pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 style='width:73.0pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=20 valign=top style='width:15.15pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:6;mso-yfti-lastrow:yes'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border-top:none;border-left:<!-- [et_pb_line_break_holder] --> solid windowtext 1.0pt;border-bottom:solid windowtext 1.0pt;border-right:<!-- [et_pb_line_break_holder] --> none;mso-border-left-alt:solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=238 style='width:178.5pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal;page-break-after:avoid;mso-hyphenate:none;tab-stops:0in dotted 311.85pt'><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 valign=top style='width:73.0pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='color:#BFBFBF;<!-- [et_pb_line_break_holder] --> mso-themecolor:background1;mso-themeshade:191'>1<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 valign=top style='width:73.0pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='color:#BFBFBF;<!-- [et_pb_line_break_holder] --> mso-themecolor:background1;mso-themeshade:191'>2<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=99 valign=top style='width:74.6pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='color:#BFBFBF;<!-- [et_pb_line_break_holder] --> mso-themecolor:background1;mso-themeshade:191'>3<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=97 valign=top style='width:73.0pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='color:#BFBFBF;<!-- [et_pb_line_break_holder] --> mso-themecolor:background1;mso-themeshade:191'>4<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=20 valign=top style='width:15.15pt;border-top:none;border-left:<!-- [et_pb_line_break_holder] --> none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;mso-border-right-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --></table><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt'><span<!-- [et_pb_line_break_holder] -->lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><table class=MsoTableGrid border=1 cellspacing=0 cellpadding=0<!-- [et_pb_line_break_holder] --> style='border-collapse:collapse;border:none;mso-border-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> mso-yfti-tbllook:1184;mso-padding-alt:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-right:none;mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:<!-- [et_pb_line_break_holder] --> solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .75pt;<!-- [et_pb_line_break_holder] --> background:#BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:<!-- [et_pb_line_break_holder] --> 191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><b><span lang=DE style='font-size:<!-- [et_pb_line_break_holder] --> 12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'>B<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=629 colspan=6 valign=top style='width:471.7pt;border-top:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-left:none;border-bottom:solid windowtext 1.0pt;border-right:none;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .75pt;<!-- [et_pb_line_break_holder] --> background:#BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:<!-- [et_pb_line_break_holder] --> 191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><b><span lang=DE style='font-size:<!-- [et_pb_line_break_holder] --> 12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'>Denken<!-- [et_pb_line_break_holder] --> Sie an die Maßnahme, die Sie zuletzt versucht haben, als die Person, um die<!-- [et_pb_line_break_holder] --> Sie sich kümmern, Atembeschwerden oder geschwollene Fußknöchel hatte.<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><b><span lang=DE style='font-size:<!-- [et_pb_line_break_holder] --> 12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'>Wie<!-- [et_pb_line_break_holder] --> sicher waren Sie, dass diese Maßnahme geholfen oder nicht geholfen hat?<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-left:none;mso-border-top-alt:solid windowtext .5pt;mso-border-bottom-alt:<!-- [et_pb_line_break_holder] --> solid windowtext .75pt;mso-border-right-alt:solid windowtext .5pt;background:<!-- [et_pb_line_break_holder] --> #BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:191;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:1'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .75pt;mso-border-top-alt:solid windowtext .75pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .75pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>B16</span><b><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:<!-- [et_pb_line_break_holder] --> minor-latin'><o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 valign=top style='width:78.6pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .75pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Trifft<!-- [et_pb_line_break_holder] --> nicht zu<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 valign=top style='width:78.6pt;border-top:none;border-left:<!-- [et_pb_line_break_holder] --> none;border-bottom:solid #BFBFBF 2.25pt;mso-border-bottom-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themeshade:191;border-right:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-right-themecolor:background1;mso-border-right-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .75pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Ich<!-- [et_pb_line_break_holder] --> habe nichts versucht<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 valign=top style='width:78.65pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .75pt;mso-border-left-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-left-themecolor:background1;mso-border-left-themeshade:191;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Nicht<!-- [et_pb_line_break_holder] --> sicher<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 valign=top style='width:78.6pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .75pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Ziemlich<!-- [et_pb_line_break_holder] --> sicher<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 valign=top style='width:78.6pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .75pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Sicher<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 valign=top style='width:78.65pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .75pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Sehr<!-- [et_pb_line_break_holder] --> sicher<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .75pt;mso-border-top-alt:solid windowtext .75pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .75pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:2'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .75pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><b><span lang=DE style='font-size:<!-- [et_pb_line_break_holder] --> 12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 style='width:78.6pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-fareast-language:DE'><span style='mso-element:<!-- [et_pb_line_break_holder] --> field-begin'></span><span style='mso-spacerun:yes'> </span>FORMCHECKBOX <span<!-- [et_pb_line_break_holder] --> style='mso-element:field-separator'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-fareast-language:DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-fareast-language:DE'><span style='mso-element:field-end'></span></span><![endif]--></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 style='width:78.6pt;border-top:none;border-left:none;<!-- [et_pb_line_break_holder] --> border-bottom:solid #BFBFBF 2.25pt;mso-border-bottom-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themeshade:191;border-right:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-right-themecolor:background1;mso-border-right-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-fareast-language:DE'><span style='mso-element:<!-- [et_pb_line_break_holder] --> field-begin'></span><span style='mso-spacerun:yes'> </span>FORMCHECKBOX <span<!-- [et_pb_line_break_holder] --> style='mso-element:field-separator'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-fareast-language:DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-fareast-language:DE'><span style='mso-element:field-end'></span></span><![endif]--></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 style='width:78.65pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-left-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-left-themecolor:background1;mso-border-left-themeshade:191;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-fareast-language:DE'><span style='mso-element:<!-- [et_pb_line_break_holder] --> field-begin'></span><span style='mso-spacerun:yes'> </span>FORMCHECKBOX <span<!-- [et_pb_line_break_holder] --> style='mso-element:field-separator'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-fareast-language:DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-fareast-language:DE'><span style='mso-element:field-end'></span></span><![endif]--></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 style='width:78.6pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-fareast-language:DE'><span style='mso-element:<!-- [et_pb_line_break_holder] --> field-begin'></span><span style='mso-spacerun:yes'> </span>FORMCHECKBOX <span<!-- [et_pb_line_break_holder] --> style='mso-element:field-separator'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-fareast-language:DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-fareast-language:DE'><span style='mso-element:field-end'></span></span><![endif]--></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 style='width:78.6pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-fareast-language:DE'><span style='mso-element:<!-- [et_pb_line_break_holder] --> field-begin'></span><span style='mso-spacerun:yes'> </span>FORMCHECKBOX <span<!-- [et_pb_line_break_holder] --> style='mso-element:field-separator'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-fareast-language:DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-fareast-language:DE'><span style='mso-element:field-end'></span></span><![endif]--></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 style='width:78.65pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-fareast-language:DE'><span style='mso-element:<!-- [et_pb_line_break_holder] --> field-begin'></span><span style='mso-spacerun:yes'> </span>FORMCHECKBOX <span<!-- [et_pb_line_break_holder] --> style='mso-element:field-separator'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-fareast-language:DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-fareast-language:DE'><span style='mso-element:field-end'></span></span><![endif]--></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .75pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:3;mso-yfti-lastrow:yes'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border-top:none;border-left:<!-- [et_pb_line_break_holder] --> solid windowtext 1.0pt;border-bottom:solid windowtext 1.0pt;border-right:<!-- [et_pb_line_break_holder] --> none;mso-border-left-alt:solid windowtext .75pt;mso-border-bottom-alt:solid windowtext .75pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><b><span lang=DE style='font-size:12.0pt;mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin'><o:p> </o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 valign=top style='width:78.6pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .75pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> color:#BFBFBF'>1<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 valign=top style='width:78.6pt;border-top:none;border-left:<!-- [et_pb_line_break_holder] --> none;border-bottom:solid windowtext 1.0pt;border-right:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-right-themecolor:background1;mso-border-right-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .75pt;mso-border-right-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-right-themecolor:background1;mso-border-right-themeshade:191;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> color:#BFBFBF'>2<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 valign=top style='width:78.65pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-left-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-left-themecolor:background1;mso-border-left-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-left-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-left-themecolor:background1;mso-border-left-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .75pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> color:#BFBFBF'>3<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 valign=top style='width:78.6pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .75pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> color:#BFBFBF'>4<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 valign=top style='width:78.6pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .75pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> color:#BFBFBF'>5<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=105 valign=top style='width:78.65pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .75pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> color:#BFBFBF'>6<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=21 valign=top style='width:15.55pt;border-top:none;border-left:<!-- [et_pb_line_break_holder] --> none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .75pt;mso-border-right-alt:solid windowtext .75pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --></table><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><table class=MsoTableGrid border=1 cellspacing=0 cellpadding=0<!-- [et_pb_line_break_holder] --> style='border-collapse:collapse;border:none;mso-border-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> mso-yfti-tbllook:1184;mso-padding-alt:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-right:none;mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:<!-- [et_pb_line_break_holder] --> solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .5pt;background:<!-- [et_pb_line_break_holder] --> #BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:191;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><b><span lang=DE style='font-size:<!-- [et_pb_line_break_holder] --> 12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'>C<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=629 colspan=5 valign=top style='width:471.9pt;border-top:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-left:none;border-bottom:solid windowtext 1.0pt;border-right:none;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> background:#BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:<!-- [et_pb_line_break_holder] --> 191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><b><span lang=DE style='font-size:<!-- [et_pb_line_break_holder] --> 12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin'>Wie<!-- [et_pb_line_break_holder] --> sicher sind Sie sich im Allgemeinen, dass Sie in Bezug auf die Person, um die<!-- [et_pb_line_break_holder] --> Sie sich kümmern, folgende Dinge tun können?<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=20 valign=top style='width:15.35pt;border:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> border-left:none;mso-border-top-alt:solid windowtext .5pt;mso-border-bottom-alt:<!-- [et_pb_line_break_holder] --> solid windowtext .5pt;mso-border-right-alt:solid windowtext .5pt;background:<!-- [et_pb_line_break_holder] --> #BFBFBF;mso-background-themecolor:background1;mso-background-themeshade:191;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:1'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;mso-border-top-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=249 valign=top style='width:186.8pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=94 style='width:70.6pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Nicht<!-- [et_pb_line_break_holder] --> sicher<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.25pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Ziemlich<!-- [et_pb_line_break_holder] --> sicher<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:72.1pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Sehr<!-- [et_pb_line_break_holder] --> sicher<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.15pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:6.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:6.0pt;margin-left:0in;text-align:center;line-height:normal;<!-- [et_pb_line_break_holder] --> page-break-after:avoid;tab-stops:dotted 311.85pt'><b style='mso-bidi-font-weight:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE style='font-size:10.0pt;mso-bidi-font-family:Arial'>Äußerst<!-- [et_pb_line_break_holder] --> sicher<o:p></o:p></span></b></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=20 valign=top style='width:15.35pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid windowtext .5pt;mso-border-top-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 6.0pt;margin-left:0in;line-height:normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:2'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>C17<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=249 style='width:186.8pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE>Sie/ihn von Symptomen der Herzschwäche<!-- [et_pb_line_break_holder] --> freizuhalten.</span><span lang=DE style='font-size:10.0pt;mso-fareast-font-family:<!-- [et_pb_line_break_holder] --> "Times New Roman";mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;<!-- [et_pb_line_break_holder] --> mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=94 style='width:70.6pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.25pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:72.1pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.15pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=20 valign=top style='width:15.35pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:3'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>C18<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=249 style='width:186.8pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span style='mso-ansi-language:EN-US'>Den<!-- [et_pb_line_break_holder] --> <span class=SpellE><span class=GramE>Behandlungsempfehlungen</span></span><span<!-- [et_pb_line_break_holder] --> class=GramE><span style='mso-spacerun:yes'>  </span><span class=SpellE>zu</span></span><!-- [et_pb_line_break_holder] --> <span class=SpellE>folgen</span>.</span><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=94 style='width:70.6pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.25pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 style='width:72.1pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 style='width:71.15pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=20 valign=top style='width:15.35pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:4'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>C19<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=249 style='width:186.8pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE>Die Bedeutung der Symptome einzuschätzen.</span><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=94 valign=top style='width:70.6pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 valign=top style='width:71.25pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 valign=top style='width:72.1pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 valign=top style='width:71.15pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=20 valign=top style='width:15.35pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:5'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>C20<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=249 style='width:186.8pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE>Veränderungen in<!-- [et_pb_line_break_holder] --> ihrer/seiner Gesundheit zu erkennen, wenn sie auftreten.</span><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:10.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=94 valign=top style='width:70.6pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 valign=top style='width:71.25pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 valign=top style='width:72.1pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 valign=top style='width:71.15pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=20 valign=top style='width:15.35pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:6'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>C21<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=249 style='width:186.8pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE>Etwas zu tun, was ihre/seine Symptome lindert.</span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=94 valign=top style='width:70.6pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 valign=top style='width:71.25pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 valign=top style='width:72.1pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 valign=top style='width:71.15pt;border:none;border-bottom:solid #BFBFBF 1.5pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=20 valign=top style='width:15.35pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:7'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border:none;border-left:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-left-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-top:5.0pt;margin-right:0in;margin-bottom:<!-- [et_pb_line_break_holder] --> 5.0pt;margin-left:0in;line-height:normal;page-break-after:avoid;mso-hyphenate:<!-- [et_pb_line_break_holder] --> none;tab-stops:0in dotted 311.85pt'><span lang=DE style='font-size:10.0pt;<!-- [et_pb_line_break_holder] --> mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;<!-- [et_pb_line_break_holder] --> mso-bidi-theme-font:minor-latin;color:#BFBFBF;mso-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-themeshade:191;mso-fareast-language:DE'>C22<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=249 style='width:186.8pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE>Einzuschätzen, wie gut eine Maßnahme wirkt.</span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=94 valign=top style='width:70.6pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 valign=top style='width:71.25pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 valign=top style='width:72.1pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 valign=top style='width:71.15pt;border:none;border-bottom:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-themecolor:background1;mso-border-bottom-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 1.5pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-top:5.0pt;margin-right:0in;<!-- [et_pb_line_break_holder] --> margin-bottom:5.0pt;margin-left:0in;text-align:center;line-height:normal'><!--[if supportFields]><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><span style='mso-element:field-begin'></span><span<!-- [et_pb_line_break_holder] --> style='mso-spacerun:yes'> </span>FORMCHECKBOX <span style='mso-element:field-separator'></span></span><![endif]--><span<!-- [et_pb_line_break_holder] --> lang=DE style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";<!-- [et_pb_line_break_holder] --> mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:<!-- [et_pb_line_break_holder] --> DE'><!--[if gte mso 9]><xml><!-- [et_pb_line_break_holder] --> <w:data>FFFFFFFF650400001C000000000000000000000000000000000000000000000000000000</w:data><!-- [et_pb_line_break_holder] --> </xml><![endif]--></span><!--[if supportFields]><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><span<!-- [et_pb_line_break_holder] --> style='mso-element:field-end'></span></span><![endif]--><span lang=DE<!-- [et_pb_line_break_holder] --> style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:<!-- [et_pb_line_break_holder] --> Calibri;mso-bidi-theme-font:minor-latin;mso-fareast-language:DE'><o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=20 valign=top style='width:15.35pt;border:none;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-right-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr style='mso-yfti-irow:8;mso-yfti-lastrow:yes'><!-- [et_pb_line_break_holder] --> <td width=45 valign=top style='width:33.75pt;border-top:none;border-left:<!-- [et_pb_line_break_holder] --> solid windowtext 1.0pt;border-bottom:solid windowtext 1.0pt;border-right:<!-- [et_pb_line_break_holder] --> none;mso-border-left-alt:solid windowtext .5pt;mso-border-bottom-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=249 style='width:186.8pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=94 valign=top style='width:70.6pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='color:#BFBFBF;<!-- [et_pb_line_break_holder] --> mso-themecolor:background1;mso-themeshade:191'>1<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 valign=top style='width:71.25pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='color:#BFBFBF;<!-- [et_pb_line_break_holder] --> mso-themecolor:background1;mso-themeshade:191'>2<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=96 valign=top style='width:72.1pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='color:#BFBFBF;<!-- [et_pb_line_break_holder] --> mso-themecolor:background1;mso-themeshade:191'>3<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=95 valign=top style='width:71.15pt;border:none;border-bottom:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-top-alt:solid #BFBFBF 2.25pt;mso-border-top-themecolor:background1;<!-- [et_pb_line_break_holder] --> mso-border-top-themeshade:191;mso-border-top-alt:solid #BFBFBF 2.25pt;<!-- [et_pb_line_break_holder] --> mso-border-top-themecolor:background1;mso-border-top-themeshade:191;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt;<!-- [et_pb_line_break_holder] --> text-align:center;line-height:normal'><span lang=DE style='color:#BFBFBF;<!-- [et_pb_line_break_holder] --> mso-themecolor:background1;mso-themeshade:191'>4<o:p></o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> <td width=20 valign=top style='width:15.35pt;border-top:none;border-left:<!-- [et_pb_line_break_holder] --> none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;<!-- [et_pb_line_break_holder] --> mso-border-bottom-alt:solid windowtext .5pt;mso-border-right-alt:solid windowtext .5pt;<!-- [et_pb_line_break_holder] --> padding:0in 5.4pt 0in 5.4pt'><!-- [et_pb_line_break_holder] --> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height:<!-- [et_pb_line_break_holder] --> normal'><span lang=DE><o:p> </o:p></span></p><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --></table><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><p class=MsoNormal><span lang=DE><o:p> </o:p></span></p>