https://www.bghw.de/assets/bghw/build/assets/CustomSupportForm.5fd835a1.js

1import{a as i,l,r as o,m as u,o as d,j as m,k as c,i as f}from"./vuetify.f1fc8dc3.js";import{n as p,v,f as b,b as h,a as y}from"../index.1924bfa1.js";import"./vendor.ee4c72a6.js";import"./veevalidate.ddfe4b13.js";const g={name:"CustomSupportForm",vuetify:v,components:{VApp:i,VTextField:l,VFileInput:o,VCheckbox:u,VSimpleCheckbox:d,VRadio:m,VRadioGroup:c,VIcon:f},mixins:[b,h,y],props:{formData:{type:String,default:"{}"},formDataErrors:{type:String,default:"{}"},privacyLink:{type:String,default:""},privacyLink2:{type:String,default:""},fieldNamespace:{type:String,default:""},objectName:{type:String,default:""},hash:{type:String,default:""},frcSitekey:{type:String,default:""}},data:()=>({form:{topic:null,privacy:null},formErrors:{}}),mounted(){this.form=JSON.parse(this.formData),this.formErrors=JSON.parse(this.formDataErrors)},methods:{getNamespacedFieldname(s,e=!0){let t="";return this.fieldNamespace!==""&&(t=this.fieldNamespace,this.objectName!==""&&e&&(t=`${t}[${this.objectName}]`)),t!==""?`${t}[${s}]`:s}}};var k=function(){var e=this,t=e._self._c;return t("v-app",{staticClass:"contact-form"},[t("ValidationObserver",{scopedSlots:e._u([{key:"default",fn:function({invalid:n}){return[t("div",[t("div",{staticClass:"row mb-4"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("h3",{staticClass:"headline headline--h3 headline--bold"},[e._v("Angaben zum Unternehmen")])])]),t("div",{staticClass:"row"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("ValidationProvider",{attrs:{name:"Name des Unternehmens",rules:"required"},scopedSlots:e._u([{key:"default",fn:function({errors:r}){return[t("v-text-field",{attrs:{name:e.getNamespacedFieldname("company"),filled:"",label:"Name des 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1):e._e(),t("div",{staticClass:"row"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("ValidationProvider",{attrs:{name:"Vorname der Ansprechperson",rules:"required"},scopedSlots:e._u([{key:"default",fn:function({errors:r}){return[t("v-text-field",{attrs:{name:e.getNamespacedFieldname("contactFirstName"),filled:"",label:"Vorname der Ansprechperson"+e.mandatoryFieldLabelSuffix,"error-messages":e.formErrors.contactFirstName||r},scopedSlots:e._u([{key:"append",fn:function(){},proxy:!0}],null,!0),model:{value:e.form.contactFirstName,callback:function(a){e.$set(e.form,"contactFirstName",a)},expression:"form.contactFirstName"}})]}}],null,!0)})],1)]),t("div",{staticClass:"row"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("ValidationProvider",{attrs:{name:"Nachname der Ansprechperson",rules:"required"},scopedSlots:e._u([{key:"default",fn:function({errors:r}){return[t("v-text-field",{attrs:{name:e.getNamespacedFieldname("contactLastName"),filled:"",label:"Nachname der Ansprechperson"+e.mandatoryFieldLabelSuffix,"error-messages":e.formErrors.contactLastName||r},scopedSlots:e._u([{key:"append",fn:function(){},proxy:!0}],null,!0),model:{value:e.form.contactLastName,callback:function(a){e.$set(e.form,"contactLastName",a)},expression:"form.contactLastName"}})]}}],null,!0)})],1)]),t("div",{staticClass:"row"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("ValidationProvider",{attrs:{name:"Funktion im Unternehmen",rules:"required"},scopedSlots:e._u([{key:"default",fn:function({errors:r}){return[t("v-text-field",{attrs:{name:e.getNamespacedFieldname("contactPosition"),filled:"",label:"Funktion im Unternehmen"+e.mandatoryFieldLabelSuffix,"error-messages":e.formErrors.contactPosition||r},scopedSlots:e._u([{key:"append",fn:function(){},proxy:!0}],null,!0),model:{value:e.form.contactPosition,callback:function(a){e.$set(e.form,"contactPosition",a)},expression:"form.contactPosition"}})]}}],null,!0)})],1)]),t("div",{staticClass:"row"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("ValidationProvider",{attrs:{name:"Telefon",rules:"required"},scopedSlots:e._u([{key:"default",fn:function({errors:r}){return[t("v-text-field",{attrs:{name:e.getNamespacedFieldname("contactPhone"),filled:"",label:"Telefon"+e.mandatoryFieldLabelSuffix,"error-messages":e.formErrors.contactPhone||r},scopedSlots:e._u([{key:"append",fn:function(){},proxy:!0}],null,!0),model:{value:e.form.contactPhone,callback:function(a){e.$set(e.form,"contactPhone",a)},expression:"form.contactPhone"}})]}}],null,!0)})],1)]),t("div",{staticClass:"row"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("ValidationProvider",{attrs:{name:"Ihre E-Mail-Adresse",rules:"required|email",mode:"eager"},scopedSlots:e._u([{key:"default",fn:function({errors:r}){return[t("v-text-field",{attrs:{name:e.getNamespacedFieldname("contactEmail"),filled:"",label:"Ihre E-Mail-Adresse"+e.mandatoryFieldLabelSuffix,"error-messages":e.formErrors.contactEmail||r},scopedSlots:e._u([{key:"append",fn:function(){},proxy:!0}],null,!0),model:{value:e.form.contactEmail,callback:function(a){e.$set(e.form,"contactEmail",a)},expression:"form.contactEmail"}})]}}],null,!0)})],1)]),t("div",{staticClass:"row mb-4 mt-6"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("h3",{staticClass:"headline headline--h3 headline--bold"},[e._v("Gef\xE4hrdungsbeurteilung")])])]),t("div",{staticClass:"row"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("label",[e._v(" Eine Gef\xE4hrdungsbeurteilung f\xFCr traumatische Ereignisse haben wir durchgef\xFChrt"+e._s(e.mandatoryFieldLabelSuffix

1)+" ")]),e.form.riskAssessment?t("input",{attrs:{type:"hidden",name:e.getNamespacedFieldname("riskAssessment")},domProps:{value:e.form.riskAssessment.value||e.form.riskAssessment}}):e._e(),t("ValidationProvider",{attrs:{name:"Gef\xE4hrdungsbeurteilung",rules:"required"},scopedSlots:e._u([{key:"default",fn:function({errors:r}){return[t("v-radio-group",{attrs:{"error-messages":e.formErrors.riskAssessment||r},model:{value:e.form.riskAssessment,callback:function(a){e.$set(e.form,"riskAssessment",a)},expression:"form.riskAssessment"}},[t("v-radio",{attrs:{label:"Ja",value:"ja"}}),t("v-radio",{attrs:{label:"Nein",value:"nein"}})],1)]}}],null,!0)}),t("div",{staticClass:"mb-8"},[e._v(" Um F\xF6rdergelder erhalten zu k\xF6nnen, m\xFCssen Sie \xFCber eine Gef\xE4hrdungsbeurteilung traumatische Ereignisse betreffend verf\xFCgen. Bitte laden Sie Ausz\xFCge aus der Gef\xE4hrdungsbeurteilung betreffend traumatische Ereignisse, Betreuungskonzept, Notfallplan hoch. Weitere Hinweise enth\xE4lt "),t("a",{staticClass:"link link--external mx-2",staticStyle:{display:"inline"},attrs:{href:"https://kompendium.bghw.de/?alias=bghw_dguvi_di206_017_1_",target:"_blank"}},[e._v("DGUV Information 206-017 \u201EGut vorbereitet f\xFCr den Ernstfall! Mit traumatischen Ereignissen im Betrieb umgehen\u201C")])])],1)]),t("div",{staticClass:"row"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("div",{staticClass:"mb-2"},[e._v(" Ausz\xFCge aus der Gef\xE4hrdungsbeurteilung hochladen: "),t("br"),e._v("Hinweise zum Dateiupload: Laden Sie hier bitte den Auszug aus Ihrer Gef\xE4hrdungsbeurteilung in einem Dokument (.pdf oder .jpg) hoch. Die Dateigr\xF6\xDFe darf max. 10 MB betragen. Bitte benennen Sie die Datei mit Firmennamen. ")]),t("ValidationProvider",{attrs:{name:"Datei",rules:"required"},scopedSlots:e._u([{key:"default",fn:function({errors:r}){return[t("v-file-input",{attrs:{"prepend-icon":"",name:e.getNamespacedFieldname("file"),filled:"",label:"Datei hochladen"+e.mandatoryFieldLabelSuffix,"error-messages":e.formErrors.file||r},scopedSlots:e._u([{key:"append",fn:function(){return[t("v-icon",[e._v("attach_file")])]},proxy:!0}],null,!0),model:{value:e.form.file,callback:function(a){e.$set(e.form,"file",a)},expression:"form.file"}})]}}],null,!0)})],1)]),t("div",{staticClass:"row"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("ValidationProvider",{attrs:{name:"Anzahl Erstbetreuer*innen",rules:"required"},scopedSlots:e._u([{key:"default",fn:function({errors:r}){return[t("v-text-field",{attrs:{name:e.getNamespacedFieldname("supervisorCount"),filled:"",label:"Wie viele Erstbetreuer*innen sollen ausgebildet werden?"+e.mandatoryFieldLabelSuffix,"error-messages":e.formErrors.supervisorCount||r},scopedSlots:e._u([{key:"append",fn:function(){},proxy:!0}],null,!0),model:{value:e.form.supervisorCount,callback:function(a){e.$set(e.form,"supervisorCount",a)},expression:"form.supervisorCount"}})]}}],null,!0)})],1)]),t("div",{staticClass:"row mb-4 mt-6"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("h3",{staticClass:"headline headline--h3 headline--bold"},[e._v("Bankverbindung")]),t("p",[e._v("Zur \xDCberweisung der F\xF6rdergelder an Sie ben\xF6tigen wir Ihre Bankverbindung")])])]),t("div",{staticClass:"row"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("ValidationProvider",{attrs:{name:"IBAN",rules:"required"},scopedSlots:e._u([{key:"default",fn:function({errors:r}){return[t("v-text-field",{attrs:{name:e.getNamespacedFieldname("iban"),filled:"",label:"IBAN"+e.mandatoryFieldLabelSuffix,"error-messages":e.formErrors.iban||r},scopedSlots:e._u([{key:"append",fn:function(){},proxy:!0}],null,!0),model:{value:e.form.iban,callback:function(a){e.$set(e.form,"iban",a)},expression:"form.iban"}})]}}],null,!0)})],1)]),t("div",{staticClass:"row"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("ValidationProvider",{attrs:{name:"Kreditinstitut",rules:"required"},scopedSlots:e._u([{key:"default",fn:function({errors:r}){return[t("v-text-field",{attrs:{name:e.getNamespacedFieldname("bank"),filled:"",label:"Kreditinstitut"+e.mandatoryFieldLabelSuffix,"error-messages":e.formErrors.bank||r},scopedSlots:e._u([{key:"append",fn:function(){},proxy:!0}],null,!0),model:{value:e.form.bank,callback:function(a){e.$set(e.form,"bank",a)},expression:"form.bank"}})]}}],null,!0)})],1)]),t("div",{staticClass:"row"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("ValidationProvider",{attrs:{name:"Kostenstelle / Stichwort"},scopedSlots:e._u([{key:"default",fn:function({errors:r}){return[t("v-text-field",{attrs:{name:e.getNamespacedFieldname("keyword"),filled:"",label:"Kostenstelle / Stichwort",hint:"Falls erforderlich geben Sie eine Kostenstelle oder ein Stichwort an.","error-messages":e.formErrors.keyword||r}

1,model:{value:e.form.keyword,callback:function(a){e.$set(e.form,"keyword",a)},expression:"form.keyword"}})]}}],null,!0)})],1)]),t("div",{staticClass:"row mt-6"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("h3",{staticClass:"headline headline--h4 headline--bold"},[e._v("Datenschutz")])])]),t("div",{staticClass:"row"},[t("div",{staticClass:"col w-full md:w-1/2"},[e.form.privacy?t("input",{attrs:{type:"hidden",name:e.getNamespacedFieldname("privacy")},domProps:{value:e.form.privacy}}):e._e(),t("ValidationProvider",{attrs:{name:"Datenschutzbestimmungen",rules:"required"},scopedSlots:e._u([{key:"default",fn:function({errors:r}){return[t("v-checkbox",{attrs:{name:e.getNamespacedFieldname("privacy"),"true-value":"true","false-value":null,value:"true","error-messages":e.formErrors.privacy||r,label:"Ich versichere, die Datenschutzbestimmungen der BGHW gelesen zu haben. Der Nutzung meiner Daten gem\xE4\xDF der Datenschutzerkl\xE4rung stimme ich zu."+e.mandatoryFieldLabelSuffix},model:{value:e.form.privacy,callback:function(a){e.$set(e.form,"privacy",a)},expression:"form.privacy"}})]}}],null,!0)})],1)]),e.privacyLink!==""||e.privacyLink2!==""?t("div",{staticClass:"row mb-12"},[t("div",{staticClass:"col w-full md:w-1/2"},[e._v(" Unter den folgenden Links finden Sie unsere Datenschutzbestimmungen: "),t("ul",[e.privacyLink!==""?t("li",[t("a",{staticClass:"link link--block",attrs:{href:e.privacyLink,target:"_blank"}},[e._v("Datenschutz")])]):e._e(),e.privacyLink2!==""?t("li",[t("a",{staticClass:"link link--block",attrs:{href:e.privacyLink2,target:"_blank"}},[e._v("Datenschutzhinweise zur Verarbeitung Ihrer personenbezogenen Daten bei der Ausbildung betrieblicher Erstbetreuer und Erstbetreuerinnen")])]):e._e()])])]):e._e(),t("div",{staticClass:"row mb-14"},[t("div",{staticClass:"col w-full md:w-1/2"},[t("custom-friendly-captcha",{attrs:{"frc-public-key":e.frcSitekey,start:"focus",lang:"de","error-message":"Bitte warten Sie bis die automatische Verifizierung durch Friendly Captcha abgeschlossen ist"}})],1)]),t("div",{staticClass:"row"},[t("div",{staticClass:"col w-full text-right md:w-1/2"},[t("button",{staticClass:"button mr-0",class:{"button--disabled":n},attrs:{type:"submit",disabled:n,"aria-disabled":n}},[e._v(" Absenden ")])])])])]}}])})],1)},w=[],_=p(g,k,w,!1,null,null,null,null);const F=_.exports;export{F as default};