{"id":11364,"date":"2022-01-31T19:24:15","date_gmt":"2022-01-31T18:24:15","guid":{"rendered":"https:\/\/cabolanao.com\/?page_id=11364"},"modified":"2022-05-03T17:49:39","modified_gmt":"2022-05-03T15:49:39","slug":"formulario-medico","status":"publish","type":"page","link":"https:\/\/cabolanao.com\/en\/formulario-medico\/","title":{"rendered":"Medical Form"},"content":{"rendered":"<p>[et_pb_section fb_built=\u00bb1&#8243; admin_label=\u00bbFeatures\u00bb _builder_version=\u00bb4.16&#8243; custom_margin=\u00bb0px||0px||true|false\u00bb custom_padding=\u00bb0px||0px||true|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_row _builder_version=\u00bb4.16&#8243; global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.16&#8243; custom_padding=\u00bb|||\u00bb global_colors_info=\u00bb{}\u00bb custom_padding__hover=\u00bb|||\u00bb][et_pb_text _builder_version=\u00bb4.16&#8243; text_font=\u00bb|||on|||||\u00bb text_font_size=\u00bb16px\u00bb text_line_height=\u00bb2em\u00bb header_2_font=\u00bbRubik|500||on|||||\u00bb header_2_text_color=\u00bb#ff8f00&#8243; header_2_font_size=\u00bb14px\u00bb header_2_letter_spacing=\u00bb1px\u00bb header_2_line_height=\u00bb1.5em\u00bb header_3_font=\u00bbRubik|500|||||||\u00bb header_3_font_size=\u00bb38px\u00bb header_3_line_height=\u00bb1.4em\u00bb text_orientation=\u00bbcenter\u00bb max_width=\u00bb700px\u00bb module_alignment=\u00bbcenter\u00bb header_2_font_size_tablet=\u00bb42px\u00bb header_2_font_size_phone=\u00bb32px\u00bb header_2_font_size_last_edited=\u00bboff|desktop\u00bb header_3_font_size_tablet=\u00bb28px\u00bb header_3_font_size_phone=\u00bb20px\u00bb header_3_font_size_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n<h3>Formulario m\u00e9dico<\/h3>\n<p>[\/et_pb_text][dvppl_cf7_styler form_padding=\u00bb0px|0px|0px|0px|false|false\u00bb use_form_button_fullwidth=\u00bbon\u00bb cf7=\u00bb7202&#8243; form_background_color=\u00bbrgba(12,113,195,0.06)\u00bb form_field_spacing=\u00bb17px\u00bb _builder_version=\u00bb4.16&#8243; _module_preset=\u00bbdefault\u00bb form_field_font_font_size=\u00bb15px\u00bb form_field_font_line_height=\u00bb1.1em\u00bb border_radii_field=\u00bbon|6px|6px|6px|6px\u00bb saved_tabs=\u00bball\u00bb global_colors_info=\u00bb{}\u00bb][\/dvppl_cf7_styler][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Formulario m\u00e9dico<div class=\"et_pb_module dvppl_cf7_styler dvppl_cf7_styler_0\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<div class=\"et_pb_module_inner\">\n\t\t\t\t\t<div class=\"dipe-cf7-container dipe-cf7-button-fullwidth\">\n\t\t\t\t\n\t\t\t\t<div class=\"dipe-cf7 dipe-cf7-styler \">\n\t\t\t\t\t\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f7202-o1\" lang=\"es-ES\" dir=\"ltr\" data-wpcf7-id=\"7202\">\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\/11364#wpcf7-f7202-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formulario de contacto\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"7202\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"es_ES\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f7202-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\" \/><input type=\"hidden\" name=\"_wpcf7cf_options\" value=\"{&quot;form_id&quot;:7202,&quot;conditions&quot;:[{&quot;then_field&quot;:&quot;cuadro-A&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-pulmones&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-1-No&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-pulmones&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;cirugia-toracica&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;asma&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;angina-pecho&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;bronquitis&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-1-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-pulmones&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;cirugia-toracica&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-1-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-pulmones&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;asma&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-1-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-pulmones&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;angina-pecho&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-1-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-pulmones&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;bronquitis&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-pulmones&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;cirugia-toracica&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q1-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-pulmones&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;asma&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q1-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-pulmones&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;angina-pecho&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q1-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-pulmones&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;bronquitis&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q1-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;cuadro-B&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;mas-45&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-2-No&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;mas-45&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;fumo&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;colesterol&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;presion-arterial&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;muerte-subita&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-2-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;mas-45&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;fumo&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-2-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;mas-45&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;colesterol&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-2-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;mas-45&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;presion-arterial&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-2-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;mas-45&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;muerte-subita&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;mas-45&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;fumo&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q2-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;mas-45&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;colesterol&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q2-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;mas-45&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;presion-arterial&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q2-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;mas-45&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;muerte-subita&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q2-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;cuadro-C&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;ojos-oidos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-4-No&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;ojos-oidos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;cirugia-nasal&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;cirugia-oido&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;sinusitis&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;cirugia-ocular&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-4-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;ojos-oidos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;cirugia-nasal&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-4-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;ojos-oidos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;cirugia-oido&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-4-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;ojos-oidos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;sinusitis&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-4-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;ojos-oidos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;cirugia-ocular&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;ojos-oidos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;cirugia-nasal&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q4-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;ojos-oidos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;cirugia-oido&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q4-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;ojos-oidos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;sinusitis&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q4-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;ojos-oidos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;cirugia-ocular&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q4-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;cuadro-D&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;perdida-conocimiento&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-6-No&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;perdida-conocimiento&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;lesiones-cabeza&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;enfermedades-neurologicas&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;dolores-cabeza&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;desvanecimientos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;epilepsia&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-6-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;perdida-conocimiento&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;lesiones-cabeza&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-6-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;perdida-conocimiento&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;enfermedades-neurologicas&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-6-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;perdida-conocimiento&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;dolores-cabeza&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-6-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;perdida-conocimiento&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;desvanecimientos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-6-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;perdida-conocimiento&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;epilepsia&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;perdida-conocimiento&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;lesiones-cabeza&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q6-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;perdida-conocimiento&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;enfermedades-neurologicas&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q6-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;perdida-conocimiento&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;dolores-cabeza&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q6-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;perdida-conocimiento&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;desvanecimientos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q6-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;perdida-conocimiento&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;epilepsia&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q6-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;cuadro-E&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-psicologicos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-7-No&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;salud-conductual&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;depresion-mayor&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;salud-mental&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;adiccion-drogas-alcohol&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-7-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-psicologicos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;salud-conductual&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-7-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-psicologicos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;depresion-mayor&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-7-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-psicologicos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;salud-mental&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-7-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-psicologicos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;adiccion-drogas-alcohol&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-psicologicos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;salud-conductual&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q7-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-psicologicos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;depresion-mayor&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q7-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-psicologicos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;salud-mental&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q7-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-psicologicos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;adiccion-drogas-alcohol&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q7-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;cuadro-F&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-8-No&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;recurrentes-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;cirugia-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;diabetes&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;hernia&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;ulceras&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-8-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;recurrentes-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-8-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;cirugia-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-8-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;diabetes&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-8-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;hernia&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-8-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;ulceras&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;recurrentes-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q8-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;cirugia-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q8-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;diabetes&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q8-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;hernia&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q8-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;ulceras&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q8-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;cuadro-G&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-estomacales&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-9-No&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;cirugia-ostomia&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;deshidratacion&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;ulcera-estomacal&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;ardor-estomago&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;colitis&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;cirugia-bariatrica&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-9-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-estomacales&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;cirugia-ostomia&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-9-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-estomacales&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;deshidratacion&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-9-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-estomacales&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;ulcera-estomacal&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-9-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-estomacales&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;ardor-estomago&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-9-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-estomacales&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;colitis&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;Pregunta-9-Si&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-estomacales&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;cirugia-bariatrica&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-estomacales&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;cirugia-ostomia&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q9-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-estomacales&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;deshidratacion&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q9-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-estomacales&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;ulcera-estomacal&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q9-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-estomacales&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;ardor-estomago&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q9-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-estomacales&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;colitis&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q9-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-estomacales&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;cirugia-bariatrica&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;},{&quot;if_field&quot;:&quot;Q9-Si&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Vaya, has respondido Si a alguna o todas las preguntas.&quot;}]},{&quot;then_field&quot;:&quot;answer-no&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;problemas-pulmones&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;problemas-pulmones&quot;,&quot;operator&quot;:&quot;not equals&quot;,&quot;if_value&quot;:&quot;&quot;},{&quot;if_field&quot;:&quot;mas-45&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;ejercicio-moderado&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;ojos-oidos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;cirugia-12&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;perdida-conocimiento&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;problemas-psicologicos&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;problemas-espalda&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;problemas-estomacales&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;medicamentos-recetados&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;ejercicio-moderado&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;cirugia-12&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;answer-yes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;medicamentos-recetados&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Si&quot;}]},{&quot;then_field&quot;:&quot;menor-edad&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;mayor-edad&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;},{&quot;if_field&quot;:&quot;mas-45&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;}]}],&quot;settings&quot;:{&quot;animation&quot;:&quot;yes&quot;,&quot;animation_intime&quot;:200,&quot;animation_outtime&quot;:200,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:false,&quot;repeater_remove_button&quot;:&quot;bottom&quot;}}\" \/><input type=\"hidden\" name=\"redirect_nonce\" value=\"123bdea050\" \/><input type=\"hidden\" name=\"wpcf7cfpdf_hidden_name\" value=\"document-pdf\" \/><input type=\"hidden\" name=\"wpcf7cfpdf_hidden_reference\" value=\"e0c5347c\" \/><input type=\"hidden\" name=\"wpcf7cfpdf_hidden_date\" value=\"07282026\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div class=\"cf7m-row\">\n<div class=\"cf7m-col cf7m-col-12\"><h3><b>Cuestionario sobre el estado de salud para la pr\u00e1ctica del buceo recreativo<\/b><\/h3><\/div>\n<\/div>\n\n<div class=\"cf7m-row\">\n<div class=\"cf7m-col cf7m-col-12\">El buceo requiere una buena salud f\u00edsica y mental. Hay alguna condiciones m\u00e9dicas que pueden ser peligrosas durante la pr\u00e1ctica del buceo, y que se enumeran a continuaci\u00f3n. Aquellos que tienen o est\u00e1n predispuestos a cualquiera de estas condiciones, deben ser evaluados por un m\u00e9dico. Este Cuestionario de M\u00e9dico del Buceador proporciona una base para determinar si Ud. debe buscar esa evaluaci\u00f3n. Si tiene alguna inquietud acerca de su estado f\u00edsico para la pr\u00e1ctica del buceo y no est\u00e1n representadas en este formulario, consulte con su m\u00e9dico antes de bucear. Las referencias a \"buceo\" en este formualrio abarcan tanto al buceo recreativo con equ\u00edpo aut\u00f3nomo como al buceo en apnea. Este formulario est\u00e1 dise\u00f1ado principalmente como un examen m\u00e9dico inicial para los nuevos buceadores, pero tambi\u00e9n es apropiado para los buceadores que reciben educaci\u00f3n continua. Por su seguridad y la de otras personas que pueden bucear con usted, responda a todas las pregunatas honestamente.<\/div>\n<\/div>\n\n<div class=\"cf7m-row\">\n<div class=\"cf7m-col cf7m-col-12\"><h4><b>INSTRUCCIONES<\/b><\/h4><\/div>\n<\/div>\n\n<div class=\"cf7m-row\">\n<div class=\"cf7m-col cf7m-col-12\">Complete este cuestionario como requisito previo para el entrenamiento de apnea o de buceo con equipo aut\u00f3nomo.<\/div>\n<div class=\"cf7m-col cf7m-col-12\">Nota para las mujeres: Si usted est\u00e1 embarazada, o intenta quedar embarazada, no bucee.<\/div>\n<\/div>\n\n<div class=\"cf7m-row\">\n<div class=\"cf7m-col cf7m-col-12 cf7m-col-md-6 cf7m-col-lg-6\"><b>Fecha de la declaraci\u00f3n de este formulario:<\/b>  <span class=\"wpcf7-form-control-wrap\" data-name=\"fecha\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date date\" id=\"date\" min=\"2026-07-28\" max=\"2026-07-28\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"fecha\" \/><\/span><\/div>\n<div class=\"cf7m-col cf7m-col-12 cf7m-col-md-6 cf7m-col-lg-6\"><b>Fecha de nacimiento:<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"birthdate\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date date\" max=\"2026-07-28\" step=\"1\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"birthdate\" \/><\/span><\/div>\n<\/div>\n\n<div class=\"cf7m-row\">\n<div class=\"cf7m-col cf7m-col-12 cf7m-col-md-4 cf7m-col-lg-4\"><span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Nombre\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span><\/div>\n<div class=\"cf7m-col cf7m-col-12 cf7m-col-md-4 cf7m-col-lg-4\"><span class=\"wpcf7-form-control-wrap\" data-name=\"last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Apellidos\" value=\"\" type=\"text\" name=\"last-name\" \/><\/span><\/div>\n<div class=\"cf7m-col cf7m-col-12 cf7m-col-md-4 cf7m-col-lg-4\"><span class=\"wpcf7-form-control-wrap\" data-name=\"your-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\" placeholder=\"Email\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span><\/div>\n<\/div>\n\n<div class=\"cf7m-row\">\n<div class=\"cf7m-col cf7m-col-12\"><h4><b>Informaci\u00f3n m\u00e9dica<\/b><\/h4><\/div>\n<\/div>\n\n<div class=\"form-row\">\n<ol>\n<div class=\"column-full\"><li><b>He tenido problemas con mis pulmones o respiraci\u00f3n, coraz\u00f3n o sangre<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"problemas-pulmones\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"problemas-pulmones\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"problemas-pulmones\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div data-id=\"cuadro-A\" data-orig_data_id=\"cuadro-A\"  class=\"\" data-class=\"wpcf7cf_group\">\n<ul>\n<div class=\"column-full\"><li><b>Cirug\u00eda tor\u00e1cica, cirug\u00eda de v\u00e1lvula cardiaca, colocaci\u00f3n de \"stent\" o neumot\u00f3rax (pulmon colapsado).<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"cirugia-toracica\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"cirugia-toracica\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"cirugia-toracica\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Asma, sibilancias, alergias graves, fiebres del heno o v\u00edas respiratorias congestionadas en los \u00faltimos 12 meses que limite mi actividad f\u00edsica o ejercicio.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"asma\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"asma\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"asma\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Un problema o enfermedad que involucra mi coraz\u00f3n como: angina de pecho, dolor en el pecho en el esfuerzo, insuficiencia card\u00edaca, edema pulmonar, miocardiopat\u00eda o accidente cerebrovascular, o estoy tomando medicamentospara cualquier afecci\u00f3n card\u00edaca.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"angina-pecho\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"angina-pecho\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"angina-pecho\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Bronquitis recurrente y tos persistente en los \u00faltimos 12 meses, o han sido diagnosticados con enfisema.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"bronquitis\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"bronquitis\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"bronquitis\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<\/ul>\n<\/div>\n<div data-id=\"Pregunta-1-No\" data-orig_data_id=\"Pregunta-1-No\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"form-row\">\n<div class=\"column-full\" style=\"color:#33CC33\"><b><span class=\"wpcf7-form-control-wrap\" data-name=\"Q1-No\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"Bien, has respondido No a todas las preguntas. Aunque ser\u00eda aconsejable una evaluaci\u00f3n m\u00e9dica (\u201ccertificado\u201d)&lt;\/b&gt;\" type=\"text\" name=\"Q1-No\" \/><\/span><\/div>\n<\/div>\n<\/div>\n\n<div data-id=\"Pregunta-1-Si\" data-orig_data_id=\"Pregunta-1-Si\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"form-row\">\n<div class=\"column-full\" style=\"color:#FF0000\"><b><span class=\"wpcf7-form-control-wrap\" data-name=\"Q1-Si\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"Vaya, has respondido Si a alguna o todas las preguntas.\" type=\"text\" name=\"Q1-Si\" \/><\/span><\/b><\/div>\n<\/div>\n<\/div>\n\n<div class=\"column-full\"><li><b>Tengo m\u00e1s de 45 a\u00f1os<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"mas-45\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"mas-45\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"mas-45\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div data-id=\"cuadro-B\" data-orig_data_id=\"cuadro-B\"  class=\"\" data-class=\"wpcf7cf_group\">\n<ul>\n<div class=\"column-full\"><li><b>Actualmente fumo o inhalo nicotina por otros medios.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"fumo\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"fumo\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"fumo\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Tengo un nivel alto de colesterol.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"colesterol\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"colesterol\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"colesterol\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Tengo presi\u00f3n arterial alta.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"presion-arterial\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"presion-arterial\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"presion-arterial\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>He tenido un familiar (de primer o segundo grado de consanguinidad) que muri\u00f3 de muerte s\u00fabita o de enfermedad card\u00edaca o accidente cerebrovascular antes de los 50 a\u00f1os (incluidos ritmos card\u00edacos anormales, enfermedad de las arterias coronarias o cardiomiopat\u00eda).<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"muerte-subita\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"muerte-subita\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"muerte-subita\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<\/ul>\n<\/div>\n<div data-id=\"Pregunta-2-No\" data-orig_data_id=\"Pregunta-2-No\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"form-row\">\n<div class=\"column-full\" style=\"color:#33CC33\"><b><span class=\"wpcf7-form-control-wrap\" data-name=\"Q2-No\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"Bien, has respondido No a todas las preguntas.\" type=\"text\" name=\"Q2-No\" \/><\/span><\/b><\/div>\n<\/div>\n<\/div>\n\n<div data-id=\"Pregunta-2-Si\" data-orig_data_id=\"Pregunta-2-Si\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"form-row\">\n<div class=\"column-full\" style=\"color:#FF0000\"><b><span class=\"wpcf7-form-control-wrap\" data-name=\"Q2-Si\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"Vaya, has respondido Si a alguna o todas las preguntas.\" type=\"text\" name=\"Q2-Si\" \/><\/span><\/b><\/div>\n<\/div>\n<\/div>\n\n<div class=\"column-full\"><li><b>Me cuesta realizar ejercicio moderado (por ejemplo, caminar 1,6 Kil\u00f3metros en 12 minutos o nadar 200 metros sin descansar), o no he podido participar en una actividad f\u00edsica normal debido a razones de estado f\u00edsico o de salud en los \u00faltimos 12 meses.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"ejercicio-moderado\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"ejercicio-moderado\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"ejercicio-moderado\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>He tenido problemas con mis ojos, o\u00eddos, o fosas nasales o senos paranasales<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"ojos-oidos\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"ojos-oidos\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"ojos-oidos\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n\n<div data-id=\"cuadro-C\" data-orig_data_id=\"cuadro-C\"  class=\"\" data-class=\"wpcf7cf_group\">\n<ul>\n<div class=\"column-full\"><li><b>Cirug\u00eda nasal en los \u00faltimos 6 meses.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"cirugia-nasal\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"cirugia-nasal\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"cirugia-nasal\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Enfermedades del o\u00eddo o cirug\u00eda de o\u00eddo, p\u00e9rdida de audici\u00f3n o alteraciones de equilibrio.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"cirugia-oido\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"cirugia-oido\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"cirugia-oido\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Sinusitis recurrentes en los \u00faltimos 12 meses.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"sinusitis\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"sinusitis\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"sinusitis\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Cirug\u00eda ocular en los \u00faltimos 3 meses.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"cirugia-ocular\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"cirugia-ocular\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"cirugia-ocular\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<\/ul>\n<\/div>\n<div data-id=\"Pregunta-4-No\" data-orig_data_id=\"Pregunta-4-No\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"form-row\">\n<div class=\"column-full\"><b style=\"color:#33CC33\"><span class=\"wpcf7-form-control-wrap\" data-name=\"Q4-No\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"Bien, has respondido No a todas las preguntas.\" type=\"text\" name=\"Q4-No\" \/><\/span><\/b><\/div>\n<\/div>\n<\/div>\n\n<div data-id=\"Pregunta-4-Si\" data-orig_data_id=\"Pregunta-4-Si\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"form-row\">\n<div class=\"column-full\"><b style=\"color:#FF0000\"><span class=\"wpcf7-form-control-wrap\" data-name=\"Q4-Si\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"Vaya, has respondido Si a alguna o todas las preguntas.\" type=\"text\" name=\"Q4-Si\" \/><\/span><\/b><\/div>\n<\/div>\n<\/div>\n\n<div class=\"column-full\"><li><b>He tenido una cirug\u00eda en los \u00faltimos 12 meses, o tengo problemas continuos relacionados con una cirug\u00eda anterior<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"cirugia-12\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"cirugia-12\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"cirugia-12\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n\n<div class=\"column-full\"><li><b>He perdido el conocimiento, he tenido dolores de cabeza por migra\u00f1a, convulsiones, accidente cerebrovascular, lesi\u00f3n significativa en la cabeza o he sufrido de lesi\u00f3n o enfermedad neurol\u00f3gica persistente<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"perdida-conocimiento\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"perdida-conocimiento\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"perdida-conocimiento\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div data-id=\"cuadro-D\" data-orig_data_id=\"cuadro-D\"  class=\"\" data-class=\"wpcf7cf_group\">\n<ul>\n<div class=\"column-full\"><li><b>Lesi\u00f3n en la cabeza con p\u00e9rdida de conciencia en los \u00faltimos 5 a\u00f1os.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"lesiones-cabeza\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"lesiones-cabeza\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"lesiones-cabeza\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Lesi\u00f3n o enfermedades neurol\u00f3gicas persistentes.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"enfermedades-neurologicas\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"enfermedades-neurologicas\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"enfermedades-neurologicas\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Dolores de cabeza recurrentes por migra\u00f1a en los \u00faltimos 12 meses o tomo medicamentos para prevenirlos.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"dolores-cabeza\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"dolores-cabeza\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"dolores-cabeza\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Desvanecimientos o desmayos (p\u00e9rdida total\/parcial de la conciencia) en los \u00faltimos 5 a\u00f1os.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"desvanecimientos\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"desvanecimientos\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"desvanecimientos\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Epilepsia, ataques o convulsiones, o tomo medicamentos para prevenirlos.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"epilepsia\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"epilepsia\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"epilepsia\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<\/ul>\n<\/div>\n<div data-id=\"Pregunta-6-No\" data-orig_data_id=\"Pregunta-6-No\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"form-row\">\n<div class=\"column-full\" style=\"color:#33CC33\"><b><span class=\"wpcf7-form-control-wrap\" data-name=\"Q6-No\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"Bien, has respondido No a todas las preguntas.\" type=\"text\" name=\"Q6-No\" \/><\/span><\/b><\/div>\n<\/div>\n<\/div>\n\n<div data-id=\"Pregunta-6-Si\" data-orig_data_id=\"Pregunta-6-Si\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"form-row\">\n<div class=\"column-full\" style=\"color:#FF0000\"><b><span class=\"wpcf7-form-control-wrap\" data-name=\"Q6-Si\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"Vaya, has respondido Si a alguna o todas las preguntas.\" type=\"text\" name=\"Q6-Si\" \/><\/span><\/b><\/div>\n<\/div>\n<\/div>\n\n<div class=\"column-full\"><li><b>He tenido problemas psicol\u00f3gicos, me diagnosticaron una discapacidad del aprendizaje, trastorno de la personalidad, ataques de p\u00e1nico o una adicci\u00f3n de las drogas o el alcohol<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"problemas-psicologicos\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"problemas-psicologicos\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"problemas-psicologicos\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div data-id=\"cuadro-E\" data-orig_data_id=\"cuadro-E\"  class=\"\" data-class=\"wpcf7cf_group\">\n<ul>\n<div class=\"column-full\"><li><b>Salud conductual, problemas mentales o psicol\u00f3gicos que requieran tratamiento m\u00e9dico o psiqui\u00e1trico.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"salud-conductual\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"salud-conductual\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"salud-conductual\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Depresi\u00f3n Mayor, tendencia suicida, ataques de p\u00e1nico, trastorno bipolar descontrolado que requiere medicaci\u00f3n\/tratamiento psiqui\u00e1trico.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"depresion-mayor\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"depresion-mayor\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"depresion-mayor\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>He sido diagnosticado con una condici\u00f3n de salud mental o trastorno de aprendizaje o desarrollo que requiere atenci\u00f3n continua.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"salud-mental\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"salud-mental\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"salud-mental\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Una adicci\u00f3n a las drogas o al alcohol que requiere tratamiento en los \u00faltimos 5 a\u00f1os.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"adiccion-drogas-alcohol\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"adiccion-drogas-alcohol\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"adiccion-drogas-alcohol\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<\/ul>\n<\/div>\n<div data-id=\"Pregunta-7-No\" data-orig_data_id=\"Pregunta-7-No\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"form-row\">\n<div class=\"column-full\" style=\"color:#33CC33\"><b><span class=\"wpcf7-form-control-wrap\" data-name=\"Q7-No\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"Bien, has respondido No a todas las preguntas.\" type=\"text\" name=\"Q7-No\" \/><\/span><\/b><\/div>\n<\/div>\n<\/div>\n\n<div data-id=\"Pregunta-7-Si\" data-orig_data_id=\"Pregunta-7-Si\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"form-row\">\n<div class=\"column-full\" style=\"color:#FF0000\"><b><span class=\"wpcf7-form-control-wrap\" data-name=\"Q7-Si\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"Vaya, has respondido Si a alguna o todas las preguntas.\" type=\"text\" name=\"Q7-Si\" \/><\/span><\/b><\/div>\n<\/div>\n<\/div>\n\n<div class=\"column-full\"><li><b>He tenido problemas de espalda, hernia, ulceras o diabetes<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"problemas-espalda\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"problemas-espalda\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"problemas-espalda\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div data-id=\"cuadro-F\" data-orig_data_id=\"cuadro-F\"  class=\"\" data-class=\"wpcf7cf_group\">\n<ul>\n<div class=\"column-full\"><li><b>Problemas recurrentes de espalda en los \u00faltimos 6 meses que limitan mi actividad diaria.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"recurrentes-espalda\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"recurrentes-espalda\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"recurrentes-espalda\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Cirug\u00eda de espalda o columna vertebral en los \u00faltimos 2 meses.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"cirugia-espalda\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"cirugia-espalda\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"cirugia-espalda\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Diabetes, ya sea controlada por insulina o por dieta, o diabetes gestacional en los \u00faltimos 12 meses.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"diabetes\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"diabetes\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"diabetes\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Una hernia no corregida que limita mis habilidades f\u00edsicas.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"hernia\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"hernia\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"hernia\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>\u00dalceras actives o no tratadas, heridas problem\u00e1ticas o cirug\u00eda de \u00falceras en los \u00faltimos 6 meses.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"ulceras\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"ulceras\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"ulceras\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<\/ul>\n<\/div>\n<div data-id=\"Pregunta-8-No\" data-orig_data_id=\"Pregunta-8-No\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"form-row\">\n<div class=\"column-full\" style=\"color:#33CC33\"><b><span class=\"wpcf7-form-control-wrap\" data-name=\"Q8-No\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"Bien, has respondido No a todas las preguntas.\" type=\"text\" name=\"Q8-No\" \/><\/span><\/b><\/div>\n<\/div>\n<\/div>\n\n<div data-id=\"Pregunta-8-Si\" data-orig_data_id=\"Pregunta-8-Si\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"form-row\">\n<div class=\"column-full\" style=\"color:#FF0000\"><b><span class=\"wpcf7-form-control-wrap\" data-name=\"Q8-Si\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"Vaya, has respondido Si a alguna o todas las preguntas.\" type=\"text\" name=\"Q8-Si\" \/><\/span><\/b><\/div>\n<\/div>\n<\/div>\n\n<div class=\"column-full\"><li><b>He tenido problemas estomacales o intestinales, incluyendo diarrea reciente<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"problemas-estomacales\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"problemas-estomacales\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"problemas-estomacales\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div data-id=\"cuadro-G\" data-orig_data_id=\"cuadro-G\"  class=\"\" data-class=\"wpcf7cf_group\">\n<ul>\n<div class=\"column-full\"><li><b>Cirug\u00eda de ostom\u00eda y no tengo autorizaci\u00f3n m\u00e9dica para nadar o participar en actividad f\u00edsica.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"cirugia-ostomia\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"cirugia-ostomia\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"cirugia-ostomia\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Deshidrataci\u00f3n que requiere intervenci\u00f3n m\u00e9dica en los \u00faltimos 7 d\u00edas.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"deshidratacion\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"deshidratacion\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"deshidratacion\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>\u00dalceras estomacales o intestinales activas o no tratadas o cirug\u00eda de \u00falceras en los \u00faltimos 6 meses.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"ulcera-estomacal\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"ulcera-estomacal\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"ulcera-estomacal\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Ardor de est\u00f3mago frecuenta, regurgitaci\u00f3n o enfermedad por reflujo gasoestrof\u00e1gico (ERGE).<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"ardor-estomago\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"ardor-estomago\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"ardor-estomago\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Colitis ulcerosa activa o no controlada o enfermedad de Crohn.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"colitis\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"colitis\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"colitis\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<div class=\"column-full\"><li><b>Cirug\u00eda bari\u00e1trica en los \u00faltimos 12 meses.<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"cirugia-bariatrica\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"cirugia-bariatrica\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"cirugia-bariatrica\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n<\/ul>\n<\/div>\n<div data-id=\"Pregunta-9-No\" data-orig_data_id=\"Pregunta-9-No\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"form-row\">\n<div class=\"column-full\" style=\"color:#33CC33\"><b><span class=\"wpcf7-form-control-wrap\" data-name=\"Q9-No\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"Bien, has respondido No a todas las preguntas.\" type=\"text\" name=\"Q9-No\" \/><\/span><\/b><\/div>\n<\/div>\n<\/div>\n\n<div data-id=\"Pregunta-9-Si\" data-orig_data_id=\"Pregunta-9-Si\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"form-row\">\n<div class=\"column-full\" style=\"color:#FF0000\"><b><span class=\"wpcf7-form-control-wrap\" data-name=\"Q9-Si\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"Vaya, has respondido Si a alguna o todas las preguntas.\" type=\"text\" name=\"Q9-Si\" \/><\/span><\/b><\/div>\n<\/div>\n<\/div>\n\n<div class=\"column-full\"><li><b>Estoy tomando medicamentos recetados (con la excepci\u00f3n de anticonceptivos o los medicamentos antipal\u00fadicos)<\/b> <span class=\"wpcf7-form-control-wrap\" data-name=\"medicamentos-recetados\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"medicamentos-recetados\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"medicamentos-recetados\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/li><\/div>\n\n<\/ol>\n<\/div>\n<div data-id=\"answer-no\" data-orig_data_id=\"answer-no\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"form-row\">\n<div class=\"column-full\" style=\"color:#33CC33\"><b><span class=\"wpcf7-form-control-wrap\" data-name=\"No\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"No\" value=\"Honestamente he respondido NO a las 10 preguntas anteriores. Entiendo que no se requiere una evaluaci\u00f3n m\u00e9dica (\u201ccertificado\u201d)\" \/><span class=\"wpcf7-list-item-label\">Honestamente he respondido NO a las 10 preguntas anteriores. Entiendo que no se requiere una evaluaci\u00f3n m\u00e9dica (\u201ccertificado\u201d)<\/span><\/span><\/span><\/span><\/b><\/div>\n<\/div>\n<\/div>\n\n<div data-id=\"answer-yes\" data-orig_data_id=\"answer-yes\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"form-row\">\n<div class=\"column-full\" style=\"color:#FF0000\"><b><span class=\"wpcf7-form-control-wrap\" data-name=\"Yes\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"Yes\" value=\"He respondido SI a una o m\u00e1s de las preguntas anteriores. Acepto y entiendo que necesitar\u00e9 traer un certificado m\u00e9dico antes de venir a bucear con Buceo Cabo la Nao.\" \/><span class=\"wpcf7-list-item-label\">He respondido SI a una o m\u00e1s de las preguntas anteriores. Acepto y entiendo que necesitar\u00e9 traer un certificado m\u00e9dico antes de venir a bucear con Buceo Cabo la Nao.<\/span><\/span><\/span><\/span><\/b><\/div>\n<\/div>\n<\/div>\n\n\n<\/fieldset>\n\n<fieldset>\n<div class=\"column-full\"><b> He respondido a todas las preguntas honestamente, y entiendo que acepto la responsabilidad por cualquier consecuencia resultante de cualquier pregunta que pueda haber respondido inexactamente o por no haber revelado cualquier condici\u00f3n de salud existente o pasada.<\/b><\/div>\n<div class=\"column-full\"><b> He le\u00eddo y acepto la <a href=\"https:\/\/cabolanao.com\/wp-content\/uploads\/2022\/01\/BuceoCaboLaNaoSLPoliticadePRIVACIDAD.pdf\" rel=\"nofollow\" target=\"_blank\">Pol\u00edtica de Privacidad y Cookies<\/a>.<\/b><\/div>\n<div class=\"column-full\"><b> Soy mayor de edad: <span class=\"wpcf7-form-control-wrap\" data-name=\"mayor-edad\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"mayor-edad\" value=\"Si\" \/><span class=\"wpcf7-list-item-label\">Si<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"mayor-edad\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/b><\/div>\n<\/fieldset>\n\n<div class=\"cf7m-row\">\n<div class=\"cf7m-col cf7m-col-12 cf7m-col-md-4 cf7m-col-lg-4\">Firma electr\u00f3nica:<div class=\"wpcf7-form-control-signature-global-wrap\" data-field-id=\"firma\">\n\t\t\t\t<div class=\"wpcf7-form-control-signature-wrap\" style=\"width:300px;height:200px;\">\n\t\t\t\t\t<div class=\"wpcf7-form-control-signature-body\">\n\t\t\t\t\t\t<canvas data-color=\"#000000\" data-background=\"#d8d8d8\" id=\"wpcf7_firma_signature\" class=\"firma\"><\/canvas>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"wpcf7-form-control-clear-wrap\">\n\t\t\t\t\t<input id=\"wpcf7_firma_clear\" type=\"button\" value=\"Restablecer\"\/>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<span class=\"wpcf7-form-control-wrap wpcf7-form-control-signature-input-wrap firma\">\n\t\t\t\t<input aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"hidden\" name=\"firma\" id=\"wpcf7_input_firma\"\/><input type=\"hidden\" name=\"firma-attachment\" id=\"wpcf7_input_firma_attachment\"\/><input type=\"hidden\" name=\"firma-inline\" id=\"wpcf7_input_firma_inline\"\/>\n\t\t\t<\/span>\n\t\t\t<\/div>\n<div data-id=\"menor-edad\" data-orig_data_id=\"menor-edad\"  class=\"\" data-class=\"wpcf7cf_group\">\n<div class=\"cf7m-col cf7m-col-12 cf7m-col-md-8 cf7m-col-lg-8\">Firma electr\u00f3nica del Padre o Tutor:<div class=\"wpcf7-form-control-signature-global-wrap\" data-field-id=\"firma-padre-tutor\">\n\t\t\t\t<div class=\"wpcf7-form-control-signature-wrap\" style=\"width:300px;height:200px;\">\n\t\t\t\t\t<div class=\"wpcf7-form-control-signature-body\">\n\t\t\t\t\t\t<canvas data-color=\"#000000\" data-background=\"#d8d8d8\" id=\"wpcf7_firma-padre-tutor_signature\" class=\"firma-padre-tutor\"><\/canvas>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"wpcf7-form-control-clear-wrap\">\n\t\t\t\t\t<input id=\"wpcf7_firma-padre-tutor_clear\" type=\"button\" value=\"Restablecer\"\/>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<span class=\"wpcf7-form-control-wrap wpcf7-form-control-signature-input-wrap firma-padre-tutor\">\n\t\t\t\t<input aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"hidden\" name=\"firma-padre-tutor\" id=\"wpcf7_input_firma-padre-tutor\"\/><input type=\"hidden\" name=\"firma-padre-tutor-attachment\" id=\"wpcf7_input_firma-padre-tutor_attachment\"\/><input type=\"hidden\" name=\"firma-padre-tutor-inline\" id=\"wpcf7_input_firma-padre-tutor_inline\"\/>\n\t\t\t<\/span>\n\t\t\t<\/div>\n<\/div>\n<\/div>\n\n<div class=\"cf7m-row\">\n<div class=\"cf7m-col cf7m-col-12\"><span class=\"wpcf7-form-control-wrap\" data-name=\"acceptance\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">&nbsp;Al enviar este formulario, acepto que podemos recopilar, almacenar y procesar los datos que nos has proporcionado.<\/span><\/label><\/span><\/span><\/span><\/div>\n<\/div>\n\n<div class=\"cf7m-row\">\n<div class=\"cf7m-col cf7m-col-12\"><button class=\"wpcf7-form-control wpcf7-submit has-spinner et_pb_button et_pb_bg_layout_light\" type=\"submit\" value=\"Enviar\">Enviar<\/button><\/div>\n<\/div><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=\"129\"\/><script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div><\/p>\n","protected":false},"author":717,"featured_media":0,"parent":0,"menu_order":93,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-11364","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/cabolanao.com\/en\/wp-json\/wp\/v2\/pages\/11364","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cabolanao.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cabolanao.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cabolanao.com\/en\/wp-json\/wp\/v2\/users\/717"}],"replies":[{"embeddable":true,"href":"https:\/\/cabolanao.com\/en\/wp-json\/wp\/v2\/comments?post=11364"}],"version-history":[{"count":0,"href":"https:\/\/cabolanao.com\/en\/wp-json\/wp\/v2\/pages\/11364\/revisions"}],"wp:attachment":[{"href":"https:\/\/cabolanao.com\/en\/wp-json\/wp\/v2\/media?parent=11364"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}