{"id":4885,"date":"2022-06-21T10:55:44","date_gmt":"2022-06-21T09:55:44","guid":{"rendered":"https:\/\/laboratoriojulianaandre.pt\/formulario-de-solicitud\/"},"modified":"2022-06-21T10:56:27","modified_gmt":"2022-06-21T09:56:27","slug":"formulario-de-solicitud","status":"publish","type":"page","link":"https:\/\/laboratoriojulianaandre.pt\/es\/formulario-de-solicitud\/","title":{"rendered":"Formulario de Solicitud"},"content":{"rendered":"<section id=\"bt_bb_section69e8e10c701b3\" class=\"bt_bb_section bt_bb_layout_boxed_1200 bt_bb_vertical_align_top bt_bb_top_spacing_normal\"  data-bt-override-class=\"null\"><div class=\"bt_bb_port\"><div class=\"bt_bb_cell\"><div class=\"bt_bb_cell_inner\"><div class=\"bt_bb_row \"  data-bt-override-class=\"{}\"><div class=\"bt_bb_row_holder\" ><div  class=\"bt_bb_column col-xxl-12 col-xl-12 col-xs-12 col-sm-12 col-md-12 col-lg-12 bt_bb_vertical_align_top bt_bb_align_left bt_bb_padding_normal\"  data-width=\"12\" data-bt-override-class=\"{}\"><div class=\"bt_bb_column_content\"><div class=\"bt_bb_contact_form_7\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f4884-o1\" lang=\"pt-PT\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/es\/wp-json\/wp\/v2\/pages\/4885#wpcf7-f4884-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formul\u00e1rio de contacto\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"4884\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.9.6\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"pt_PT\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f4884-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<p><label> Cl\u00ednica<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-clinic-name\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-clinic-name\" \/><\/span> <\/label>\n<\/p>\n<p><label> Dr\u00aa\/Dr\u00ba<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-doctor-name\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-doctor-name\" \/><\/span> <\/label>\n<\/p>\n<p><label> Nombre del paciente<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span> <\/label>\n<\/p>\n<p><label> E-mail<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"80\" 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=\"your-email\" \/><\/span> <\/label>\n<\/p>\n<p><label> Edad<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-age\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-age\" \/><\/span> <\/label>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-gender\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><span class=\"wpcf7-list-item-label\">Masculino<\/span><input type=\"checkbox\" name=\"checkbox-gender\" value=\"Masculino\" \/><\/label><\/span><span class=\"wpcf7-list-item\"><label><span class=\"wpcf7-list-item-label\">Femenino<\/span><input type=\"checkbox\" name=\"checkbox-gender\" value=\"Femenino\" \/><\/label><\/span><span class=\"wpcf7-list-item last\"><label><span class=\"wpcf7-list-item-label\">Otro<\/span><input type=\"checkbox\" name=\"checkbox-gender\" value=\"Otro\" \/><\/label><\/span><\/span><\/span>\n<\/p>\n<p><label> Escala<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-scale\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-scale\" \/><\/span> <\/label>\n<\/p>\n<p><label> Color del Diente<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-color\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-color\" \/><\/span> <\/label>\n<\/p>\n<p><label> Tipo de trabajo<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-work-type-message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"your-work-type-message\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label><br \/>\nSi el trabajo es de Implantolog\u00eda, necesitamos saberlo:<br \/>\n- Descripci\u00f3n del (de los) implante(s) (Marca, plataforma...)<br \/>\n- Informar si la cl\u00ednica env\u00eda componentes o si el laboratorio procede con el pedido<br \/>\nImplantolog\u00eda - informaci\u00f3n sobre los implantes<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"your-message\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Protocolo fotogr\u00e1fico:<br \/>\n- escala de colores<br \/>\n- de pie, mirando con una sonrisa relajada<br \/>\n- de pie, mirando con una sonrisa espont\u00e1nea<br \/>\n- de perfil<br \/>\n<\/label>\n<\/p>\n<p><label> Protocolo de envio:<br \/>\n- Env\u00edo de STL(s): superior, inferior, articulaci\u00f3n<br \/>\n- si est\u00e1 disponible, env\u00ede el STL provisional<br \/>\n<\/label>\n<\/p>\n<p>Elegir archivo<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"file-100\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\"audio\/*,video\/*,image\/*\" aria-invalid=\"false\" type=\"file\" name=\"file-100\" \/><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"acceptance-929\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-929\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Al suscribirme al bolet\u00edn acepto el tratamiento de los datos personales de acuerdo con la <a href='\/es\/politica-de-privacidad'>pol\u00edtica \nde privacidad<\/a>.<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Enviar\" \/>\n<\/p><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"114\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><input type='hidden' class='wpcf7-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><div class=\"bt_bb_row \"  data-bt-override-class=\"{}\"><div class=\"bt_bb_row_holder\" ><div  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