{"id":60432,"date":"2026-09-20T18:23:39","date_gmt":"2026-09-20T16:23:39","guid":{"rendered":"https:\/\/www.ergomotion.nl\/?page_id=60432"},"modified":"2026-09-19T14:50:04","modified_gmt":"2026-09-19T12:50:04","slug":"refer-an-employee","status":"publish","type":"page","link":"https:\/\/www.ergomotion.nl\/en\/refer-an-employee\/","title":{"rendered":"Refer an employee"},"content":{"rendered":"<div class=\"et_pb_section_0 et_pb_section et_section_regular et_block_section\"><div class=\"et_pb_row_0 et_pb_row et_flex_row preset--module--divi-row--default\"><div class=\"et_pb_column_0 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone\"><div class=\"et_pb_text_0 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module preset--module--divi-text--default\"><div class=\"et_pb_text_inner\"><h1 style=\"color: white;\">Refer an employee<\/h1>\n<\/div><\/div><div class=\"et_pb_text_1 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module preset--module--divi-text--default\"><div class=\"et_pb_text_inner\"><p>For employees themselves, and for anyone referring an employee.<\/p>\n<\/div><\/div><\/div><\/div><\/div><div class=\"et_pb_section_1 et_pb_section et_section_regular et_flex_section\"><div class=\"et_pb_row_1 et_pb_row et_flex_row preset--module--divi-row--default\"><div class=\"et_pb_column_1 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone\"><div class=\"et_pb_text_2 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module preset--module--divi-text--default\"><div class=\"et_pb_text_inner\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f54065-o1\" lang=\"nl-NL\" dir=\"ltr\" data-wpcf7-id=\"54065\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/pages\/60432#wpcf7-f54065-o1\" method=\"post\" class=\"wpcf7-form init 908579303954 cmatic-conn cmatic-aud-5 cmatic-mapd0-0 cmatic-098117 cmatic-sent-0 cmatic-total-621\" aria-label=\"Contactformulier\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"54065\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.2.3\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"nl_NL\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f54065-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"herkomst_gclid\" value=\"\" \/><input type=\"hidden\" name=\"herkomst_bron\" value=\"\" \/><input type=\"hidden\" name=\"herkomst_campagne\" value=\"\" \/><input type=\"hidden\" name=\"herkomst_term\" value=\"\" \/><input type=\"hidden\" name=\"herkomst_pagina\" value=\"\" \/><input type=\"hidden\" name=\"herkomst_verwijzer\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div class=\"vf\">\n\t<div class=\"vf-blok\">\n\t\t<p class=\"vf-kop\">1. De aanmelding\n\t\t<\/p>\n\t\t<div class=\"vf-grid\">\n\t\t\t<p><label class=\"vf-veld\"><span class=\"vf-label\">Ik meld aan <em>*<\/em><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"voor-wie\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"voor-wie\"><option value=\"\">&#8212;Kies een optie&#8212;<\/option><option value=\"Voor mezelf\">Voor mezelf<\/option><option value=\"Voor een medewerker\">Voor een medewerker<\/option><\/select><\/span><\/label><br \/>\n<label class=\"vf-veld\"><span class=\"vf-label\">Welke dienst <em>*<\/em><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"dienst\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"dienst\"><option value=\"\">&#8212;Kies een optie&#8212;<\/option><option value=\"Werkplekonderzoek\">Werkplekonderzoek<\/option><option value=\"Belastbaarheidsonderzoek\">Belastbaarheidsonderzoek<\/option><option value=\"Belastbaarheidstraining\">Belastbaarheidstraining<\/option><option value=\"Weet ik nog niet, graag advies\">Weet ik nog niet, graag advies<\/option><\/select><\/span><\/label><br \/>\n<label class=\"vf-veld\"><span class=\"vf-label\">Soort werkplek <em>*<\/em><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"soort-werkplek\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"soort-werkplek\"><option value=\"\">&#8212;Kies een optie&#8212;<\/option><option value=\"Kantoorwerkplek\">Kantoorwerkplek<\/option><option value=\"Thuiswerkplek\">Thuiswerkplek<\/option><option value=\"Dienstauto of ander voertuig\">Dienstauto of ander voertuig<\/option><option value=\"Zorg-, productie- of buitenlocatie\">Zorg-, productie- of buitenlocatie<\/option><option value=\"Online of telefonisch\">Online of telefonisch<\/option><option value=\"Combinatie\">Combinatie<\/option><\/select><\/span><\/label><br \/>\n<label class=\"vf-veld\"><span class=\"vf-label\">Gewenste start<\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"start\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"start\"><option value=\"\">&#8212;Kies een optie&#8212;<\/option><option value=\"Zo snel mogelijk\">Zo snel mogelijk<\/option><option value=\"Binnen twee weken\">Binnen twee weken<\/option><option value=\"Binnen een maand\">Binnen een maand<\/option><option value=\"In overleg\">In overleg<\/option><\/select><\/span><\/label><br \/>\n<label class=\"vf-veld vf-vol\"><span class=\"vf-label\">Aanleiding in het kort <em>*<\/em><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"aanleiding\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"aanleiding\"><\/textarea><\/span><\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<p class=\"vf-letop\">Vul hier geen diagnose of medische gegevens in. Die bespreken we telefonisch.\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"vf-blok\">\n\t\t<p class=\"vf-kop\">2. Wie meldt aan\n\t\t<\/p>\n\t\t<div class=\"vf-grid\">\n\t\t\t<p><label class=\"vf-veld\"><span class=\"vf-label\">Naam <em>*<\/em><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"aanvrager-naam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"aanvrager-naam\" \/><\/span><\/label><br \/>\n<label class=\"vf-veld\"><span class=\"vf-label\">Functie of rol <em>*<\/em><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"aanvrager-rol\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"aanvrager-rol\"><option value=\"\">&#8212;Kies een optie&#8212;<\/option><option value=\"Medewerker\">Medewerker<\/option><option value=\"Leidinggevende\">Leidinggevende<\/option><option value=\"HR of P&amp;O\">HR of P&amp;O<\/option><option value=\"Preventiemedewerker\">Preventiemedewerker<\/option><option value=\"Bedrijfsarts\">Bedrijfsarts<\/option><option value=\"Arbeidsdeskundige\">Arbeidsdeskundige<\/option><option value=\"Casemanager\">Casemanager<\/option><option value=\"Verzuimspecialist\">Verzuimspecialist<\/option><option value=\"Medisch specialist\">Medisch specialist<\/option><option value=\"Anders\">Anders<\/option><\/select><\/span><\/label><br \/>\n<label class=\"vf-veld\"><span class=\"vf-label\">Organisatie<\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"aanvrager-organisatie\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"aanvrager-organisatie\" \/><\/span><\/label><br \/>\n<label class=\"vf-veld\"><span class=\"vf-label\">E-mailadres <em>*<\/em><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"aanvrager-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"aanvrager-email\" \/><\/span><\/label><br \/>\n<label class=\"vf-veld vf-half\"><span class=\"vf-label\">Telefoonnummer <em>*<\/em><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"aanvrager-tel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"aanvrager-tel\" \/><\/span><\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"vf-blok\">\n\t\t<p class=\"vf-kop\">3. Om wie gaat het\n\t\t<\/p>\n\t\t<p class=\"vf-hint\">Alleen invullen als je voor een ander aanmeldt. Meld je jezelf aan, sla dit blok dan over.\n\t\t<\/p>\n\t\t<div class=\"vf-grid\">\n\t\t\t<p><label class=\"vf-veld\"><span class=\"vf-label\">Naam medewerker<\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"medewerker-naam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"medewerker-naam\" \/><\/span><\/label><br \/>\n<label class=\"vf-veld\"><span class=\"vf-label\">Telefoonnummer medewerker<\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"medewerker-tel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"medewerker-tel\" \/><\/span><\/label><br \/>\n<label class=\"vf-veld\"><span class=\"vf-label\">E-mailadres medewerker<\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"medewerker-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-text wpcf7-validates-as-email\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"medewerker-email\" \/><\/span><\/label><br \/>\n<label class=\"vf-veld\"><span class=\"vf-label\">Met wie plannen wij de afspraak? <em>*<\/em><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"contactvoorkeur\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"contactvoorkeur\"><option value=\"\">&#8212;Kies een optie&#8212;<\/option><option value=\"Met mij\">Met mij<\/option><option value=\"Met de contactpersoon bij de werkgever\">Met de contactpersoon bij de werkgever<\/option><option value=\"Rechtstreeks met de medewerker\">Rechtstreeks met de medewerker<\/option><\/select><\/span><\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"vf-blok\">\n\t\t<p class=\"vf-kop\">4. Waar vindt het onderzoek plaats\n\t\t<\/p>\n\t\t<p class=\"vf-hint\">Nodig bij een onderzoek op kantoor, op locatie of in een voertuig. Bij een thuiswerkplek het adres van de medewerker, bij een voertuig het adres waar het voertuig staat. Niet nodig bij een telefonisch of online onderzoek.\n\t\t<\/p>\n\t\t<div class=\"vf-grid\">\n\t\t\t<p><label class=\"vf-veld vf-vol\"><span class=\"vf-label\">Straatnaam en huisnummer<\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"locatie-straat\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"locatie-straat\" \/><\/span><\/label><br \/>\n<label class=\"vf-veld\"><span class=\"vf-label\">Postcode<\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"locatie-postcode\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"locatie-postcode\" \/><\/span><\/label><br \/>\n<label class=\"vf-veld\"><span class=\"vf-label\">Plaats<\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"locatie-plaats\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"locatie-plaats\" \/><\/span><\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"vf-blok\">\n\t\t<p class=\"vf-kop\">5. Werkgever en kosten\n\t\t<\/p>\n\t\t<p class=\"vf-hint\">De werkgever is opdrachtgever en draagt de kosten. De contactpersoon krijgt een bevestiging van deze aanmelding.\n\t\t<\/p>\n\t\t<div class=\"vf-grid\">\n\t\t\t<p><label class=\"vf-veld\"><span class=\"vf-label\">Bedrijfsnaam <em>*<\/em><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"werkgever-naam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"werkgever-naam\" \/><\/span><\/label><br \/>\n<label class=\"vf-veld\"><span class=\"vf-label\">Contactpersoon<\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"werkgever-contact\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"werkgever-contact\" \/><\/span><\/label><br \/>\n<label class=\"vf-veld\"><span class=\"vf-label\">E-mailadres contactpersoon <em>*<\/em><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"werkgever-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"werkgever-email\" \/><\/span><\/label><br \/>\n<label class=\"vf-veld\"><span class=\"vf-label\">Telefoonnummer contactpersoon<\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"werkgever-tel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"werkgever-tel\" \/><\/span><\/label><br \/>\n<label class=\"vf-veld vf-vol\"><span class=\"vf-label\">Inkoop- of ordernummer <em class=\"vf-opt\">als jullie daarmee werken<\/em><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"werkgever-referentie\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"werkgever-referentie\" \/><\/span><\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<p class=\"vf-vink\"><span class=\"wpcf7-form-control-wrap\" data-name=\"akkoord-kosten\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"akkoord-kosten[]\" value=\"De leidinggevende of opdrachtgever gaat akkoord met de kosten.\" \/><span class=\"wpcf7-list-item-label\">De leidinggevende of opdrachtgever gaat akkoord met de kosten.<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"vf-blok vf-afronden\">\n\t\t<p class=\"vf-hint\">Meld je jezelf aan, dan hoef je het tweede vinkje niet aan te zetten. Terugkoppeling sturen we alleen als de medewerker daarmee instemt.\n\t\t<\/p>\n\t\t<p class=\"vf-vink\"><span class=\"wpcf7-form-control-wrap\" data-name=\"op-de-hoogte\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"op-de-hoogte[]\" value=\"De medewerker is op de hoogte.\" \/><span class=\"wpcf7-list-item-label\">De medewerker is op de hoogte.<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t\t<p class=\"vf-vink\"><span class=\"wpcf7-form-control-wrap\" data-name=\"terugkoppeling\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"terugkoppeling[]\" value=\"Ik ontvang graag een terugkoppeling.\" \/><span class=\"wpcf7-list-item-label\">Ik ontvang graag een terugkoppeling.<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t\t<p class=\"vf-vink\"><span class=\"wpcf7-form-control-wrap\" data-name=\"akkoord\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"akkoord\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Ik heb gelezen en begrepen wat er met deze gegevens gebeurt. Ergomotion gebruikt ze om de afspraak te plannen, het onderzoek uit te voeren en de rapportage op te stellen. Zie het <a href=\"\/privacybeleid\/\" target=\"_blank\">privacybeleid<\/a>.<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t\t<p class=\"vf-knop\"><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Aanmelding versturen\" \/>\n\t\t<\/p>\n\t\t<p class=\"vf-na\">Je ontvangt binnen twee werkdagen een reactie.\n\t\t<\/p>\n\t<\/div>\n<\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":1001190,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_seopress_titles_title":"Refer an employee | Ergomotion","_seopress_titles_desc":"Sign up for a workplace assessment, work capacity assessment or work hardening. 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