

<HTML>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="de-de" lang="de-de" >


<HEAD>
<!-- ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
     ++      ZPEM -  Zentrum fuer Pathologie Essen-Mitte       ++
     ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++//-->
	
	
	<META HTTP-EQUIV="content-type" content="text/html; charset=utf-8" />
	
	<META HTTP-EQUIV="Expires" content="0">		
	
	<meta http-equiv="cache-control" content="no-cache">
	
	<meta http-equiv="pragma" content="no-cache">

	<META NAME="Publisher" content="Zentrum fï¿½r Pathologie Essen-Mitte">
	<META NAME="Copyright" content="T. Hempen">
	<meta name="author" content="Hiob" >
	<META NAME="Language" CONTENT="DE">
	
	
			<TITLE>Anmeldung</TITLE>
			<META NAME="Keywords" content="ZPEM,Pathologie,Essen,Genopath,Obduktionen,Schnellschnitte,Molekularpathologie,DAkkS,Diagnostik,Histopathologie,Dermapathologie,In-Situ-Hybridisierung,Ebel,Heikaus,Grabllus,Erler,Dr. med. T. Ebel,Dr. med. A. Erler,PD Dr. med. F. Grabellus,PD Dr. med. S. Heikaus">	
			<META NAME="Description" content="ZPEM - Zentrum f&uuml;r Pathologie Essen-Mitte - Fach&auml;rztliche Gemeinschaftspraxis">
			
			
	<meta name="date" content="2021-04-05T15:35:20+0200" >
	<META NAME="Robots" content="index,follow,noimageindex">
	<META NAME="no-email-collection" value="[http://www.unspam.com/noemailcollection]">
	<META NAME="Revisit-After" content="30 days">
	
	
	<link rel="shortcut icon" type="image/x-icon" href="images/sonstige/favicon.ico">
	<link rel="stylesheet" type="text/css" media="screen" id="CSS" href="styles/screen.css">
	
	<!-- overLIB (c) Erik Bosrup -->
	<script type="text/javascript" src="javascripts/overlib.js"></script>
		
					
	<link rel="stylesheet" type="text/css" href="dsgvo.css" />
	<script src="dsgvo.js"></script> 
			
					
	<!-- Google - Universal Analytics -->			
	

<script>
var gaProperty = 'UA-73220724-1';
var disableStr = 'ga-disable-' + gaProperty;
if (document.cookie.indexOf(disableStr + '=true') > -1) {
  window[disableStr] = true;
}
function gaOptout() {
  document.cookie = disableStr + '=true; expires=Thu, 31 Dec 2099 23:59:59 UTC; path=/';
  window[disableStr] = true;
}
</script>


<script>
(function(i,s,o,g,r,a,m){i['GoogleAnalyticsObject']=r;i[r]=i[r]||function(){
(i[r].q=i[r].q||[]).push(arguments)},i[r].l=1*new Date();a=s.createElement(o),
m=s.getElementsByTagName(o)[0];a.async=1;a.src=g;m.parentNode.insertBefore(a,m)
})(window,document,'script','//www.google-analytics.com/analytics.js','ga');

ga('create', 'UA-73220724-1', 'pathologie-essen.com');
ga('set', 'anonymizeIp', true);
ga('require', 'linkid');
ga('send', 'pageview');
</script>


	<link rel="stylesheet" type="text/css" href="cookieconsent.min.css" />
	<script src="cookieconsent.min.js"></script>
	<script>
		window.addEventListener("load", function(){
		window.cookieconsent.initialise({
  		"palette": {
    		"popup": {
      		"background": "#28290e",
			"text": "#99cccc"
    		},
    		"button": {
      		"background": "#fff"
    		}
  		},
  		"theme": "classic",
  		"position": "bottom-left",
  		"content": {
    		"message": "Diese Seite verwendet nur funktionale Cookies",
			"link": "mehr erfahren",
    		"dismiss": "zustimmen"
  		}
		})});
	</script>
	

	<style> 
	
		.text {font-family:Verdana,Arial,Sans-serif; font-size:12px; color:#000000; font-weight:normal;}	
		.text-grau {font-family:Verdana,Arial,Sans-serif; font-size:12px; color:#888888; font-weight:bold;}
		.text-fett {font-family:Verdana,Arial,Sans-serif; font-size:12px; color:#000000; font-weight:bold;}
		.text-gross {font-family:Verdana,Arial,Sans-serif; font-size:12+3px; color:#000000}	
		.text-klein {font-family:Verdana,Arial,Sans-serif; font-size:12-3px; color:#000000}	

		.text-foto {font-family:Verdana,Arial,Sans-serif; font-size:12-1px; color:#666666}	
		.text-kopf {font-family:Verdana,Arial,Sans-serif; font-size:12px; color:#000000}	
		.text-name {font-family:Verdana,Arial,Sans-serif; font-size:12+5px; color:#000000}


		.text-color {font-family:Verdana,Arial,Sans-serif; font-size:12px; color:#1794d4}
		.text-marker {font-family:Verdana,Arial,Sans-serif; font-size:12px; background-color:#FFFF00}

		h1 {font-family:Verdana,Arial,Sans-serif; font-size:12+3px; color:#b0ba42; margin:0;}
		h2 {font-family:Verdana,Arial,Sans-serif; font-size:12+1px; color:#1794d4; margin:0;}


		.copyright {font-family:Verdana,Arial,Sans-serif; font-size:12-3px; color:#888888;}
		.copyright-link	{ font-family:Verdana,Arial,Sans-serif; font-size:12-3px; color:#888888; text-decoration:underline; }
		.schriftzug {font-family:Lucida,Verdana; font-size:12+7px; color:#73cfff;}		
		.people {font-family:Sans-serif; font-size:12-1px; color:#000000}	
	
			
		.menu_horizontal {word-wrap:break-word; font-size: 12px; font-family: Georgia, Arial, sans-serif; color:#FFFFFF;}		
	
		#navigation{word-wrap:break-word; font-size: 12px; font-family:Arial, sans-serif;} 
		
	</style>	
				
						
</HEAD>


<BODY topmargin=0 leftmargin=0 marginwidth=0 marginheight=0 width=100% height=100% bgcolor="d9e738">

<table border=0 cellspacing=0 cellpadding=0 width=100% height=100%>
<tr height=20 valign=top><td>&nbsp;</td></tr>
<tr>
<td width=5%></td>
<td align=center>


<table border=0 cellspacing=0 cellpadding=0 width=100% height=100%>
<tr valign=top>
	<td>&nbsp;</td>
	
	
	<td width=200 align=right>

		<table border=0 cellspacing=0 cellpadding=0 width=100%>
		<tr valign=top height=290><td align=center>&nbsp;</td></tr>		
		<tr valign=top height=300>
		<td>			

				
<div id="navigation" class="tglsty_arrow sub_dynamic">
<ul id="mainNav" role="navigation">			
	
	
	<li class="mainNav " style="z-index:1"><a href="zpem_einsendungen.cfm?CFID=59021302-f37d-4121-aa9f-675db136a6ae&CFTOKEN=0&">Einsendungen</a></li>
	<li class="mainNav " style="z-index:2"><a href="zpem_befundauskunft.cfm?CFID=59021302-f37d-4121-aa9f-675db136a6ae&CFTOKEN=0&">Befundauskunft</a></li>
	<li class="mainNav" style="z-index:3">&nbsp;</li>
	<li class="mainNav " style="z-index:4"><a href="zpem_formulare.cfm?CFID=59021302-f37d-4121-aa9f-675db136a6ae&CFTOKEN=0&">Formular Download</a></li>
	
	<li class="mainNav active" style="z-index:6"><a href="zpem_ma_auswahl.cfm?CFID=59021302-f37d-4121-aa9f-675db136a6ae&CFTOKEN=0&">Material Anforderung</a></li> 	
	
	
</ul>
</div>	


		</td>
		</tr>
		</table>	
		
	</td>
	

	<td width=25>&nbsp;</td>


	<td width=800>
	
		<table border=0 cellspacing=0 cellpadding=5 width=800 height=100% bgcolor="FFFFFF">
		<tr>
		<td>
		<table border=0 cellspacing=0 cellpadding=0 width=100% height=100%>
		<tr>
		<td>	
			
			<table border=0.5 cellspacing=0 cellpadding=0 width=100% height=100%>
			<tr height=180>
			<td>	  			
				
				
				<table border=0 cellspacing=0 cellpadding=0 width=100% height=100%>
				<tr>
				<td width=400 rowspan=3>
		
					<a href="zpem_fotos.cfm?CFID=59021302-f37d-4121-aa9f-675db136a6ae&CFTOKEN=0&"				
						onmouseover="return overlib('Urat-Kristalle bei Gicht (Polarisationsfilter) (Bild 2)');" 
						onmouseout="return nd();"><img src="images/galerie/Urat-Kristalle bei Gicht (Polarisationsfilter) (Bild 2).jpg" 
						height=180 width=400 border=0 alt="Urat-Kristalle bei Gicht (Polarisationsfilter) (Bild 2)" style="border-color: 000000">
						</a>
									
				
				</td><td width=45% align=right>	
				
				
					<table border=0 cellspacing=0 cellpadding=0 width=100% height=100%>				
					<tr valign=top>	
					<td align=left>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
					

					<a href="zpem_akkreditierung.cfm?CFID=59021302-f37d-4121-aa9f-675db136a6ae&CFTOKEN=0&?menu=15"				
						onmouseover="return overlib('akkreditiert nach DIN EN ISO/IEC 17020 <br>f&uuml;r mehr Info - bitte klicken!');" 
						onmouseout="return nd();"><img src="images/logos/DAkkS_Symbol_ILAC_grau_2.1 .gif" height=70 border=0></a>	
				
			
					</td>
					<td align=right>
						<img src="images/logos/Logo_ZPEM.jpg" height=85 border=0 hspace=17 vspace=10>
					</td>
					</tr>			
					</table>			
				
				</td>
				</tr>	
				<tr>
				
				<td align=right class="schriftzug">
					ZENTRUM F&Uuml;R PATHOLOGIE &nbsp;<br> ESSEN-MITTE &nbsp; 
				</td>
				
				
				</tr>	
				<tr height=2><td></td></tr>		
				</table>
					
			</td>
			</tr>		
						
			<tr height=2><td></td></tr>
			
			<tr height=45 bgcolor="999999">
			<td>


				<div id="menu" align=center>
				<div id="menuout">
           	<ul class="menu">
				
				
					<li id="current2" class="item4"><a href="index.cfm?CFID=59021302-f37d-4121-aa9f-675db136a6ae&CFTOKEN=0&"><span>HOME</span></a></li>
				
				
					<li id="current2" class="item3"><a href="zpem_leistungsspektrum.cfm?CFID=59021302-f37d-4121-aa9f-675db136a6ae&CFTOKEN=0&"><span>LEISTUNG</span></a></li>
				
				
					<li id="current2" class="item2"><a href="zpem_qualitaetspolitik.cfm?CFID=59021302-f37d-4121-aa9f-675db136a6ae&CFTOKEN=0&"><span>QUALIT&Auml;T</span></a></li>
						
				
					<li id="current" class="active item1"><a href="zpem_einsendungen.cfm?CFID=59021302-f37d-4121-aa9f-675db136a6ae&CFTOKEN=0&"><span>SERVICE</span></a></li>
						
							
				<li id="current2"><a>&nbsp;&nbsp;&nbsp;&nbsp;</a></li>									
				<li id="current2"><a href="zpem_registrierung.cfm?CFID=59021302-f37d-4121-aa9f-675db136a6ae&CFTOKEN=0&&fs=1"><span>A+</span></a></li>
				<li id="current2"><font color="FFFFFF" size="2">Schriftgr&ouml;sse</font></li>							
				<li id="current2"><a href="zpem_registrierung.cfm?CFID=59021302-f37d-4121-aa9f-675db136a6ae&CFTOKEN=0&&fs=-1"><span>A-</span></a></li>				
							
								
				</ul>
				</div>
				</div>
				
					
			</td>
			</tr>	
						
			<tr height=90%>
			<td>	
					
				<table border=0 cellspacing=0 cellpadding=0 width=100% height=100%>
				<tr height=40 valign=top background="images/sonstige/content-top.png">
				<td width=3%></td>
				<td width=20%></td>
				<td width=72%></td>
				<td width=5%></td>
				</tr>	
				
				
				<tr bgcolor="edefef" valign=top>
				<td>&nbsp;</td>
				<td>&nbsp;</td>
				<td style="font-family:Verdana,Arial,Sans-serif; font-size:14px; color:444444">
					<span class="text">			
					<br>	
				
				
<h1>Registrierung</h1>
<br><br>


<script language = "JavaScript" type="text/javascript" src="/lucee/formtag-form.cfm"></script><script language = "JavaScript" type="text/javascript">
function _CF_checkform_customer() { return lucee_form_k6m.check();}

</script><form onsubmit="return lucee_form_k6m.check();" name="form_customer" action="zpem_registrierung_action.cfm?CFID=59021302-f37d-4121-aa9f-675db136a6ae&CFTOKEN=0&" method="post">
	
<table ID=inner border=0 cellspacing=0 cellpadding=0 width=100% class="text">
	<tr height=0><td width="5%"></td><td width="15%"></td><td width="15%"></td><td width="60%"></td><td width="5%"></td></tr>
		
		
		<tr><td></td><td colspan=3 class="text">
			<span class="text-fett">Lieferanschrift:</span>
			
			
		<tr height=30><td colspan=5></td></tr>
		<tr valign=top><td></td>
			
				<td colspan=2 class="text-color" align=right>Kunden-Art &nbsp;&nbsp;</TD>
			
				
			<td class="text">
			  
			  	  <input name="kind" type="radio" class="input" value="K"> Krankenhaus / Klinik &nbsp; <br>
				  <input name="kind" type="radio" class="input" value="P"> Arztpraxis, die per Post versendet &nbsp; <br>
				  <input name="kind" type="radio" class="input" value="B"> Arztpraxis, die per Kurier versendet &nbsp; <br>
				  <input name="kind" type="radio" class="input" value="D"> Dermatologie &nbsp;					  			  
			   </td><td></td></tr>		
	
				
		<tr height=30><td colspan=5></td></tr>
		
			<tr><td></td><td colspan=2 class="text-color" align=right>
			Firma &nbsp;&nbsp;</TD>
					
			<td><input maxLength="40" size="45" name="company1" type="text" class="input" value="">
			</td><td></td></tr>
	
	
		<tr height=8><td colspan=3></td></tr>
		
			<tr><td></td><td colspan=2 class="text" align=right>
			Firma &nbsp;&nbsp;</TD>
			
			<td><input maxLength="40" size="45" name="company2" type="text" class="input" value="">
			</td><td></td></tr>

			
		<tr height=8><td colspan=3></td></tr>	
		
			<tr><td></td><td colspan=2 class="text-color" align=right>
			Strasse / Nr. &nbsp;&nbsp;</TD>
						
			<td>
				<input maxLength="40" size="38" name="street" type="text" class="input" value="">
				<input maxLength="6" size="3" name="number" type="text" class="input" value="">
			</td><td></td></tr>
		
		
		<tr height=8><td colspan=3></td></tr>
		
			<tr><td></td><td colspan=2 class="text-color" align=right>
			Stadt &nbsp;&nbsp;</TD>
					
			<td><input maxLength="40" size="45" name="city" type="text" class="input" value="">
			</td><td></td></tr>
			
		
		<tr height=8><td colspan=3></td></tr>
		
			<tr><td></td><td colspan=2 class="text-color" align=right>
			Land / Postleitzahl &nbsp;&nbsp;</TD>
					
			<td>
				<input maxLength="2" size="2" name="country" type="text" class="input" value="D">
				<input maxLength="15" size="18" name="zipcode" type="text" class="input" value="">
			</td><td></td></tr>
		

		<tr height=65 valign=center><td colspan=2></td><td colspan=3><hr size=1 color=CCCCAA width=60%></td></tr>
		<tr><td></td><td colspan=3 class="text">
			<span class="text-fett">Pers&ouml;nliche Daten:</span>
			
			
		<tr height=26><td colspan=5></td></tr>
		<tr><td></td>
			
				<td colspan=2 class="text-color" align=right>Anrede &nbsp;&nbsp;</TD>
			
				
			<td class="text">
			  
				  <input name="gender" type="radio" class="input" value="Herr"> Herr &nbsp;&nbsp;&nbsp;
				  <input name="gender" type="radio" class="input" value="Frau"> Frau	
			   </td><td></td></tr>		
		
		
		<tr height=8><td colspan=3></td></tr>
		<tr><td></td><td colspan=2 class="text" align=right>
			Titel &nbsp;&nbsp;</TD>
			<td><input maxLength="40" size="45" name="title" type="text" class="input" value="">
			</td><td></td></tr>
					
					
		<tr height=8><td colspan=3></td></tr>
		
			<tr><td></td><td colspan=2 class="text-color" align=right>
			Vorname &nbsp;&nbsp;</TD>
		
			<td><input maxLength="40" size="45" name="first_name" type="text" class="input" value="">
			</td><td></td></tr>
		
		
		<tr height=8><td colspan=3></td></tr>
		
			<tr><td></td><td colspan=2 class="text-color" align=right>
			Familienname &nbsp;&nbsp;</TD>
				
			<td><input maxLength="40" size="45" name="last_name" type="text" class="input" value="">
			</td><td></td></tr>
			
			
		<tr height=8><td colspan=3></td></tr>
		
			<tr><td></td><td colspan=2 class="text-color" align=right>
			Telefon &nbsp;&nbsp;</TD>
						
			<td><input maxLength="25" size="25" name="phone1" type="text" class="input" value="">
			</td><td></td></tr>			
		
		
		<tr height=65 valign=center><td colspan=2></td><td colspan=3><hr size=1 color=CCCCAA width=60%></td></tr>
		<tr><td></td><td colspan=3 class="text">
			<span class="text-fett">Login-Daten:</span>
			
		<tr height=8 valign=bottom><td colspan=5></td></tr>
		<tr><td colspan=2></td><td colspan=2 class=tekstzwart>
				Mit diesen Daten melden Sie sich in Zukunft bei uns an:	<td><td></td></tr>		
		
		
		<tr height=26 valign=bottom><td colspan=5></td></tr>
		
			<tr><td></td><td colspan=2 class="text-color" align=right>
			eMail-Adresse &nbsp;&nbsp;</TD>
				
			<td><input maxLength="70" size="28" name="email" type="text" class="input" value="">
				</td><td></td></tr>
			
			
		<tr height=26 valign=bottom><td colspan=5></td></tr>
		<tr><td colspan=2></td><td colspan=2 class=tekstzwart>
				Ihr Kennwort muss mindestens 6 Zeichen lang sein. </td><td></td></tr>	
				
				
		<tr height=16 valign=bottom><td colspan=5></td></tr>
		
			<tr><td></td><td colspan=2 class="text-color" align=right>
			Kennwort &nbsp;&nbsp;</TD>
				
			<td><input maxLength="15" size="28" name="passwd" type="password" class="input" value=""></td><td></td></tr>
	
	
		<tr height=8><td colspan=5></td></tr>
		
			<tr><td></td><td colspan=2 class="text-color" align=right>
			Wiederholung &nbsp;&nbsp;</TD>
			
			<td><input maxLength="15" size="28" name="passwd2" type="password" class="input" value=""></td><td></td></tr>

			
		<tr height=50><td colspan=5></td></tr>
		<tr><td></td><td colspan=3 class="text-grau">
			Die farblich gekennzeichneten Felder d&uuml;rfen nicht leer bleiben			
			</td></tr>
			
			
		<INPUT TYPE="hidden" NAME="phone2" VALUE= "">			
 		<INPUT TYPE="hidden" NAME="phone3" VALUE= "">
		
		
		<tr height=50><td colspan=5></td></tr>
		<tr valign=top>
			<td>
				
					<input name="datenschutz" type="checkbox" class="input" value="">
				
			</td>
			<td colspan=3 class="text">Ich bin damit einverstanden, dass meine Daten entsprechend den
				<a href="zpem_datenschutz.cfm?CFID=59021302-f37d-4121-aa9f-675db136a6ae&CFTOKEN=0&" style="color:000000;">Datenschutzbestimmungen</a> 
				gespeichert werden.	
			</td></tr>
	
		
</table>
		
		
<table ID=inner border=0 cellspacing=0 cellpadding=0 width="100%" class="text">
	<tr height=0><td width="5%"></td><td width="15%"></td><td width="15%"></td><td width="60%"></td><td width="5%"></td></tr>
	<tr height=5><td colspan=5></td></tr>			
	<tr height=100 valign=center><td colspan=5 align=middle>
		<input type="submit" name="dummy" value=" weiter " class="button"></TD></TR>
</TABLE>
		
</form><!-- name:form_customer --><script>
lucee_form_k6m=new LuceeForms('form_customer',null);
lucee_form_k6m.addInput('kind',false,1,14,null,null,null,null,null,null,-1);
lucee_form_k6m.addInput('company1',false,0,14,null,null,null,null,null,null,40);
lucee_form_k6m.addInput('company2',false,0,14,null,null,null,null,null,null,40);
lucee_form_k6m.addInput('street',false,0,14,null,null,null,null,null,null,40);
lucee_form_k6m.addInput('number',false,0,14,null,null,null,null,null,null,6);
lucee_form_k6m.addInput('city',false,0,14,null,null,null,null,null,null,40);
lucee_form_k6m.addInput('country',false,0,14,null,null,null,null,null,null,2);
lucee_form_k6m.addInput('zipcode',false,0,14,null,null,null,null,null,null,15);
lucee_form_k6m.addInput('gender',false,1,14,null,null,null,null,null,null,-1);
lucee_form_k6m.addInput('title',false,0,14,null,null,null,null,null,null,40);
lucee_form_k6m.addInput('first_name',false,0,14,null,null,null,null,null,null,40);
lucee_form_k6m.addInput('last_name',false,0,14,null,null,null,null,null,null,40);
lucee_form_k6m.addInput('phone1',false,0,14,null,null,null,null,null,null,25);
lucee_form_k6m.addInput('email',false,0,14,null,null,null,null,null,null,70);
lucee_form_k6m.addInput('passwd',false,3,14,null,null,null,null,null,null,15);
lucee_form_k6m.addInput('passwd2',false,3,14,null,null,null,null,null,null,15);
lucee_form_k6m.addInput('datenschutz',false,2,14,null,null,null,null,null,null,-1);
</script>
		

					<br><br><br>
					</span>
				</td>
				<td>&nbsp;</td>
				</tr>	
				<tr height=40 valign=bottom background="images/sonstige/content-bottom.png">
				<td>&nbsp;</td>
				
				<td colspan=2 align=center class="copyright">&nbsp;
				
					<a href="zpem_copyright.cfm#querystring#"><span class="copyright-link">Copyright</span></a> 
					<span>&copy; 2012-2021 Zentrum f&uuml;r Pathologie Essen-Mitte</span>	
					<br>	
									
					Wir verwenden Cookies,um die Zugriffe auf unsere Webseite zu analysieren. Mehr unter 
					<a href="zpem_impressum.cfm#querystring#"><span class="copyright-link">Impressum</span></a>
					/
					<a href="zpem_datenschutz.cfm#querystring#"><span class="copyright-link">Datenschutz</span></a>
					<span style="font-size:4px"><br>&nbsp;</span>
					</td>
				<td>&nbsp;</td>
				</tr>	
				</table>				

				
			</td>
			</tr>	
			</table>

		</td>	
		</tr>
		</table>
		
		</td>
		</tr>
		</table>
		

	</td>	
	
	
	<td width=25%>
	
			
		<table height=100% border=0 cellspacing=0 cellpadding=0>
			<tr height=100%>
				<td width=3 align=left background="images/color_rand_rechts.png"></td>
				<td></td>
			</tr>
		</table>
		
	
	</td>	
	</tr>
	
	
	<!-- unterer Bildrand -->
	<tr height=8 valign=bottom>
		<td colspan=3></td>
		<td background="images/color_rand_oben.png"></td>
		<td></td>
	</tr>
	</table>

	
</td>
</tr>


<tr>
	<td></td>
	<td>
		<table border=0 cellspacing=0 cellpadding=0> 
			<tr>
				<td width=225>&nbsp;</td>
				<td width=800 style="font-family:Arial; font-size:8px; color:#d9e738;">
					
				</td>			
			</tr>
		</table>
	</td>
	<td>&nbsp;</td>
</tr>


</table>


</BODY>
</HTML>