{"id":7788,"date":"2018-12-13T14:48:57","date_gmt":"2018-12-13T22:48:57","guid":{"rendered":"http:\/\/pmtest.passy-muir.com\/?page_id=7788"},"modified":"2018-12-27T10:18:51","modified_gmt":"2018-12-27T18:18:51","slug":"centers-of-excellence-form","status":"publish","type":"page","link":"http:\/\/142.11.238.239\/es\/centers-of-excellence-form\/","title":{"rendered":"Centers of Excellence Application Form"},"content":{"rendered":"<div class=\"l2-header-con  no-banner\">\n<div class=\"l2-header-icon\">\n\t\t<img decoding=\"async\"  src=\"\/wp-content\/uploads\/2017\/05\/COE_1.jpg\" alt=\"products\" \/>\n\t<\/div>\n<div class=\"l2-header-text\" >\n\t\t\tCentros de Excelencia\n                         <\/div>\n<\/p><\/div>\n<div style=\"clear:both\"><\/div>\n<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-7789\"><form id=\"wpforms-form-7789\" class=\"wpforms-validate wpforms-form\" data-formid=\"7789\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/es\/wp-json\/wp\/v2\/pages\/7788?wpforms_form_id=7789\" data-token=\"69371f6ade2cda606c46902f444f392e\" data-trp-original-action=\"\/es\/wp-json\/wp\/v2\/pages\/7788?wpforms_form_id=7789\"><noscript class=\"wpforms-error-noscript\">Por favor, activa JavaScript en tu navegador para completar este formulario.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-7789-field_23-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"23\"><div id=\"wpforms-7789-field_23\"><p><strong>Thank you for considering the Passy Muir Centers of Excellence program. For your application, please provide the following information and supporting documents and videos to showcase your facility. Prior to beginning the application, you must have all documentation for phase one ready for uploading in one sitting. When submitting for phase two, you will be provided a link by the COE administrator for submission of additional required materials.\r\n\r\nPlease note: There may be file size limitations to the requested documentation. Videos, photos, and presentations will be uploaded to an external link provided by the COE administrator. If file sizes exceed these limitations, please ZIP files, export documentation in smaller file sizes, or compress them.<\/strong><\/p><\/div><\/div><div id=\"wpforms-7789-field_0-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"0\"><label class=\"wpforms-field-label\" for=\"wpforms-7789-field_0\">Nombre de la instalaci\u00f3n <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-7789-field_0\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][0]\" required><\/div><div id=\"wpforms-7789-field_3-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-7789-field_3\">Direcci\u00f3n de la instalaci\u00f3n<\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-7789-field_3\" class=\"wpforms-field-address-address1\" name=\"wpforms[fields][3][address1]\" ><label for=\"wpforms-7789-field_3\" class=\"wpforms-field-sublabel after\">Direcci\u00f3n (l\u00ednea 1)<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-7789-field_3-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][3][address2]\" ><label for=\"wpforms-7789-field_3-address2\" class=\"wpforms-field-sublabel after\">Direcci\u00f3n 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-7789-field_3-city\" class=\"wpforms-field-address-city\" name=\"wpforms[fields][3][city]\" ><label for=\"wpforms-7789-field_3-city\" class=\"wpforms-field-sublabel after\">Ciudad<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-7789-field_3-state\" class=\"wpforms-field-address-state\" name=\"wpforms[fields][3][state]\" ><label for=\"wpforms-7789-field_3-state\" class=\"wpforms-field-sublabel after\">Estado \/ Provincia \/ Regi\u00f3n<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-7789-field_3-postal\" class=\"wpforms-field-address-postal\" name=\"wpforms[fields][3][postal]\" ><label for=\"wpforms-7789-field_3-postal\" class=\"wpforms-field-sublabel after\">C\u00f3digo postal<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-7789-field_3-country\" class=\"wpforms-field-address-country\" name=\"wpforms[fields][3][country]\" ><option value=\"AF\" >Afganist\u00e1n<\/option><option value=\"AL\" >Albania<\/option><option value=\"DE\" >Alemania<\/option><option value=\"AD\" >Andorra<\/option><option value=\"AO\" >Angola<\/option><option value=\"AI\" >Anguila<\/option><option value=\"AG\" >Antigua y Barbuda<\/option><option value=\"AQ\" >Ant\u00e1rtica<\/option><option value=\"DZ\" >Argelia<\/option><option value=\"AR\" >Argentina<\/option><option value=\"AM\" >Armenia<\/option><option value=\"AW\" >Aruba<\/option><option value=\"AU\" >Australia<\/option><option value=\"AT\" >Austria<\/option><option value=\"AZ\" >Azerbaiy\u00e1n<\/option><option value=\"BS\" >Bahamas<\/option><option value=\"BD\" >Bangladesh<\/option><option value=\"BB\" >Barbados<\/option><option value=\"BH\" >Bar\u00e9in<\/option><option value=\"BZ\" >Belize<\/option><option value=\"BJ\" >Ben\u00edn<\/option><option value=\"BM\" >Bermudas<\/option><option value=\"BY\" >Bielorrusia<\/option><option value=\"BO\" >Bolivia (Estado Plurinacional de)<\/option><option value=\"BQ\" >Bonaire, San Eustaquio y Saba<\/option><option value=\"BA\" >Bosnia y Herzegovina<\/option><option value=\"BW\" >Botsuana<\/option><option value=\"BR\" >Brasil<\/option><option value=\"BN\" >Brunei Darussalam<\/option><option value=\"BG\" >Bulgaria<\/option><option value=\"BF\" >Burkina Faso<\/option><option value=\"BI\" >Burundi<\/option><option value=\"BT\" >But\u00e1n<\/option><option value=\"BE\" >B\u00e9lgica<\/option><option value=\"CV\" >Cabo Verde<\/option><option value=\"KH\" >Camboya<\/option><option value=\"CM\" >Camer\u00fan<\/option><option value=\"CA\" >Canad\u00e1<\/option><option value=\"TD\" >Chad<\/option><option value=\"CL\" >Chile<\/option><option value=\"CN\" >China<\/option><option value=\"CY\" >Chipre<\/option><option value=\"CO\" >Colombia<\/option><option value=\"KM\" >Comoras<\/option><option value=\"CG\" >Congo<\/option><option value=\"CD\" >Congo (Rep\u00fablica Democr\u00e1tica del)<\/option><option value=\"KR\" >Corea (Rep\u00fablica de)<\/option><option value=\"KP\" >Corea del Norte<\/option><option value=\"CR\" >Costa Rica<\/option><option value=\"CI\" >Costa de Marfil<\/option><option value=\"HR\" >Croacia<\/option><option value=\"CU\" >Cuba<\/option><option value=\"CW\" >Curazao<\/option><option value=\"DK\" >Dinamarca<\/option><option value=\"DM\" >Dominica<\/option><option value=\"EC\" >Ecuador<\/option><option value=\"EG\" >Egipto<\/option><option value=\"SV\" >El Salvador<\/option><option value=\"AE\" >Emiratos \u00c1rabes Unidos<\/option><option value=\"ER\" >Eritrea<\/option><option value=\"SK\" >Eslovaquia<\/option><option value=\"SI\" >Eslovenia<\/option><option value=\"ES\" >Espa\u00f1a<\/option><option value=\"VA\" >Estado de la Ciudad del Vaticano<\/option><option value=\"US\" >Estados Unidos de America<\/option><option value=\"EE\" >Estonia<\/option><option value=\"ET\" >Etiop\u00eda<\/option><option value=\"RU\" >Federaci\u00f3n Rusa<\/option><option value=\"FJ\" >Fiji<\/option><option value=\"PH\" >Filipinas<\/option><option value=\"FI\" >Finlandia<\/option><option value=\"FR\" >Francia<\/option><option value=\"GA\" >Gab\u00f3n<\/option><option value=\"GM\" >Gambia<\/option><option value=\"GE\" >Georgia<\/option><option value=\"GH\" >Ghana<\/option><option value=\"GI\" >Gibraltar<\/option><option value=\"GD\" >Granada<\/option><option value=\"GR\" >Grecia<\/option><option value=\"GL\" >Groenlandia<\/option><option value=\"GP\" >Guadalupe<\/option><option value=\"GU\" >Guam<\/option><option value=\"GT\" >Guatemala<\/option><option value=\"GF\" >Guayana Francesa<\/option><option value=\"GG\" >Guernsey<\/option><option value=\"GN\" >Guinea<\/option><option value=\"GQ\" >Guinea Ecuatorial<\/option><option value=\"GW\" >Guinea-Bis\u00e1u<\/option><option value=\"GY\" >Guyana<\/option><option value=\"HT\" >Hait\u00ed<\/option><option value=\"HN\" >Honduras<\/option><option value=\"HK\" >Hong Kong<\/option><option value=\"HU\" >Hungr\u00eda<\/option><option value=\"IN\" >India<\/option><option value=\"ID\" >Indonesia<\/option><option value=\"IQ\" >Iraq<\/option><option value=\"IE\" >Irlanda (Rep\u00fablica de)<\/option><option value=\"IR\" >Ir\u00e1n (Rep\u00fablica Isl\u00e1mica de)<\/option><option value=\"BV\" >Isla Bouvet<\/option><option value=\"NF\" >Isla Norfolk<\/option><option value=\"IM\" >Isla de Man<\/option><option value=\"CX\" >Isla de Navidad<\/option><option value=\"IS\" >Islandia<\/option><option value=\"KY\" >Islas Caim\u00e1n<\/option><option value=\"CC\" >Islas Cocos<\/option><option value=\"CK\" >Islas Cook<\/option><option value=\"FO\" >Islas Faroe<\/option><option value=\"HM\" >Islas Heard y McDonald<\/option><option value=\"FK\" >Islas Malvinas (Falkland)<\/option><option value=\"MP\" >Islas Marianas del Norte<\/option><option value=\"MH\" >Islas Marshall<\/option><option value=\"SB\" >Islas Salom\u00f3n<\/option><option value=\"TC\" >Islas Turcas y Caicos<\/option><option value=\"UM\" >Islas Ultramarinas Menores de Estados Unidos<\/option><option value=\"VI\" >Islas V\u00edrgenes (EE.UU.)<\/option><option value=\"VG\" >Islas V\u00edrgenes (brit\u00e1nicas)<\/option><option value=\"GS\" >Islas del sur de Georgia y del sur de Sandwich<\/option><option value=\"AX\" >Islas \u00c5land<\/option><option value=\"IL\" >Israel<\/option><option value=\"IT\" >Italia<\/option><option value=\"JM\" >Jamaica<\/option><option value=\"JP\" >Jap\u00f3n<\/option><option value=\"JE\" >Jersey<\/option><option value=\"JO\" >Jordania<\/option><option value=\"QA\" >Katar<\/option><option value=\"KZ\" >Kazajist\u00e1n<\/option><option value=\"KE\" >Kenia<\/option><option value=\"KG\" >Kirguist\u00e1n<\/option><option value=\"KI\" >Kiribati<\/option><option value=\"XK\" >Kosovo<\/option><option value=\"KW\" >Kuwait<\/option><option value=\"LS\" >Lesoto<\/option><option value=\"LV\" >Letonia<\/option><option value=\"LR\" >Liberia<\/option><option value=\"LY\" >Libia<\/option><option value=\"LI\" >Liechtenstein<\/option><option value=\"LT\" >Lituania<\/option><option value=\"LU\" >Luxemburgo<\/option><option value=\"LB\" >L\u00edbano<\/option><option value=\"MO\" >Macao<\/option><option value=\"MK\" >Macedonia del Norte (Rep\u00fablica de)<\/option><option value=\"MG\" >Madagascar<\/option><option value=\"MY\" >Malasia<\/option><option value=\"MW\" >Malaui<\/option><option value=\"MV\" >Maldivas<\/option><option value=\"ML\" >Mali<\/option><option value=\"MT\" >Malta<\/option><option value=\"MA\" >Marruecos<\/option><option value=\"MQ\" >Martinica<\/option><option value=\"MU\" >Mauricio<\/option><option value=\"MR\" >Mauritania<\/option><option value=\"YT\" >Mayotte<\/option><option value=\"FM\" >Micronesia (Estados Federados de)<\/option><option value=\"MD\" >Moldavia (Rep\u00fablica de)<\/option><option value=\"MN\" >Mongolia<\/option><option value=\"ME\" >Montenegro<\/option><option value=\"MS\" >Montserrat<\/option><option value=\"MZ\" >Mozambique<\/option><option value=\"MM\" >Myanmar<\/option><option value=\"MX\" >M\u00e9xico<\/option><option value=\"MC\" >M\u00f3naco<\/option><option value=\"NA\" >Namibia<\/option><option value=\"NR\" >Nauru<\/option><option value=\"NP\" >Nepal<\/option><option value=\"NI\" >Nicaragua<\/option><option value=\"NG\" >Nigeria<\/option><option value=\"NU\" >Niue<\/option><option value=\"NO\" >Noruega<\/option><option value=\"NC\" >Nueva Caledonia<\/option><option value=\"NZ\" >Nueva Zelanda<\/option><option value=\"NE\" >N\u00edger<\/option><option value=\"OM\" >Om\u00e1n<\/option><option value=\"PK\" >Pakist\u00e1n<\/option><option value=\"PW\" >Palau<\/option><option value=\"PS\" >Palestina (Estado de)<\/option><option value=\"PA\" >Panam\u00e1<\/option><option value=\"PG\" >Pap\u00faa Nueva Guinea<\/option><option value=\"PY\" >Paraguay<\/option><option value=\"NL\" >Pa\u00edses Bajos<\/option><option value=\"PE\" >Per\u00fa<\/option><option value=\"PN\" >Pitcairn<\/option><option value=\"PF\" >Polinesia Francesa<\/option><option value=\"PL\" >Polonia<\/option><option value=\"PT\" >Portugal<\/option><option value=\"PR\" >Puerto Rico<\/option><option value=\"GB\" >Reino Unido de Gran Breta\u00f1a e Irlanda del Norte<\/option><option value=\"CF\" >Rep\u00fablica Central de \u00c1frica<\/option><option value=\"CZ\" >Rep\u00fablica Checa<\/option><option value=\"DO\" >Rep\u00fablica Dominicana<\/option><option value=\"LA\" >Rep\u00fablica Popular Democr\u00e1tica de Laos<\/option><option value=\"SY\" >Rep\u00fablica \u00c1rabe Siria<\/option><option value=\"RE\" >Reuni\u00f3n<\/option><option value=\"RW\" >Ruanda<\/option><option value=\"RO\" >Ruman\u00eda<\/option><option value=\"KN\" >Saint Kitts y Nevis<\/option><option value=\"WS\" >Samoa<\/option><option value=\"AS\" >Samoa Americana<\/option><option value=\"BL\" >San Bartolom\u00e9<\/option><option value=\"SM\" >San Marino<\/option><option value=\"MF\" >San Mart\u00edn (parte francesa)<\/option><option value=\"SX\" >San Mart\u00edn (parte holandesa)<\/option><option value=\"PM\" >San Pedro y Miquel\u00f3n<\/option><option value=\"VC\" >San Vicente y las Granadinas<\/option><option value=\"SH\" >Santa Elena, Ascensi\u00f3n y Trist\u00e1n de Acu\u00f1a<\/option><option value=\"LC\" >Santa Luc\u00eda<\/option><option value=\"ST\" >Santo Tom\u00e9 y Pr\u00edncipe<\/option><option value=\"SA\" >Saud\u00ed Arabia<\/option><option value=\"SN\" >Senegal<\/option><option value=\"RS\" >Serbia<\/option><option value=\"SC\" >Seychelles<\/option><option value=\"SL\" >Sierra Leona<\/option><option value=\"SG\" >Singapur<\/option><option value=\"SO\" >Somalia<\/option><option value=\"LK\" >Sri Lanka<\/option><option value=\"SZ\" >Suazilandia (Reino de)<\/option><option value=\"ZA\" >Sud\u00e1frica<\/option><option value=\"SD\" >Sud\u00e1n<\/option><option value=\"SS\" >Sud\u00e1n del sur<\/option><option value=\"SE\" >Suecia<\/option><option value=\"CH\" >Suiza<\/option><option value=\"SR\" >Surinam<\/option><option value=\"SJ\" >Svalbard y Jan Mayen<\/option><option value=\"EH\" >S\u00e1hara Occidental<\/option><option value=\"TH\" >Tailandia<\/option><option value=\"TW\" >Taiw\u00e1n, Rep\u00fablica de China<\/option><option value=\"TZ\" >Tanzania (Rep\u00fablica Unida de)<\/option><option value=\"TJ\" >Tayikist\u00e1n<\/option><option value=\"IO\" >Territorio Brit\u00e1nico del Oc\u00e9ano \u00cdndico<\/option><option value=\"TF\" >Tierras Australes y Ant\u00e1rticas Francesas<\/option><option value=\"TL\" >Timor-Leste<\/option><option value=\"TG\" >Togo<\/option><option value=\"TK\" >Tokelau<\/option><option value=\"TO\" >Tonga<\/option><option value=\"TT\" >Trinidad y Tobago<\/option><option value=\"TM\" >Turkmenist\u00e1n<\/option><option value=\"TV\" >Tuvalu<\/option><option value=\"TN\" >T\u00fanez<\/option><option value=\"TR\" >T\u00fcrkiye<\/option><option value=\"UA\" >Ucrania<\/option><option value=\"UG\" >Uganda<\/option><option value=\"UY\" >Uruguay<\/option><option value=\"UZ\" >Uzbekist\u00e1n<\/option><option value=\"VU\" >Vanuatu<\/option><option value=\"VE\" >Venezuela (Rep\u00fablica Bolivariana de)<\/option><option value=\"VN\" >Vietnam<\/option><option value=\"WF\" >Wallis y Futuna<\/option><option value=\"YE\" >Yemen<\/option><option value=\"DJ\" >Yibuti<\/option><option value=\"ZM\" >Zambia<\/option><option value=\"ZW\" >Zimbabue<\/option><\/select><label for=\"wpforms-7789-field_3-country\" class=\"wpforms-field-sublabel after\">Pa\u00eds<\/label><\/div><\/div><\/div><div id=\"wpforms-7789-field_4-container\" class=\"wpforms-field wpforms-field-url\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-7789-field_4\">P\u00e1gina web \/ URL<\/label><input type=\"url\" id=\"wpforms-7789-field_4\" class=\"wpforms-field-medium\" name=\"wpforms[fields][4]\" ><\/div><div id=\"wpforms-7789-field_6-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-7789-field_6\">Informaci\u00f3n de contacto del representante cl\u00ednico<\/label><input type=\"text\" id=\"wpforms-7789-field_6\" class=\"wpforms-field-medium\" name=\"wpforms[fields][6]\" ><\/div><div id=\"wpforms-7789-field_5-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-7789-field_5\">Tel\u00e9fono<\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-7789-field_5\" class=\"wpforms-field-medium\" name=\"wpforms[fields][5]\" ><\/div><div id=\"wpforms-7789-field_1-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-7789-field_1\">Correo electr\u00f3nico <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-7789-field_1\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][1]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-7789-field_2-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-7789-field_2\">Description of your facility, including what makes your program excellent for the tracheostomy and ventilator population and how the Passy Muir Valve is part of your program (approximately 300 words). Write this description as you would want it to appear if posted on a webpage that spotlights your facility. <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-7789-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" required><\/textarea><\/div><div id=\"wpforms-7789-field_20-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"20\"><div id=\"wpforms-7789-field_20\"><p><strong><font color=\"purple\">Por favor, cargue los siguientes documentos\nrequeridos. Al nombrar sus archivos, siga el\nsiguiente procedimiento. Comience con COE,\nluego un gui\u00f3n bajo seguido por el nombre de su\ninstalaci\u00f3n, luego otro gui\u00f3n bajo seguido por la\nfecha de env\u00edo. Ejemplo: COE_Barlow_4.23.2019\nSi est\u00e1 enviando m\u00e1s de un archivo, comience la\nnumeraci\u00f3n antes del primer gui\u00f3n bajo.\nEjemplos: COE_Barlow_4.23.2019\nCOE2_Barlow_4.23.2019\r\n\r\n<\/font><\/p><\/strong><\/div><\/div><div id=\"wpforms-7789-field_7-container\" class=\"wpforms-field wpforms-field-file-upload\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-7789-field_7\">Foto del equipo<\/label><input type=\"file\" id=\"wpforms-7789-field_7\" data-rule-extension=\"jpg,jpeg,jpe,gif,png,bmp,tiff,tif,webp,ico,heic,asf,asx,wmv,wmx,wm,avi,divx,mov,qt,mpeg,mpg,mpe,mp4,m4v,ogv,webm,mkv,3gp,3gpp,3g2,3gp2,txt,asc,c,cc,h,srt,csv,tsv,ics,rtx,css,vtt,mp3,m4a,m4b,aac,ra,ram,wav,ogg,oga,flac,mid,midi,wma,wax,mka,rtf,pdf,class,tar,zip,gz,gzip,rar,7z,psd,xcf,doc,pot,pps,ppt,wri,xla,xls,xlt,xlw,mpp,docx,docm,dotx,dotm,xlsx,xlsm,xlsb,xltx,xltm,xlam,pptx,pptm,ppsx,ppsm,potx,potm,ppam,sldx,sldm,onetoc,onetoc2,onepkg,oxps,xps,odt,odp,ods,odg,odc,odb,odf,wp,wpd,key,numbers,pages,svg\" data-rule-maxsize=\"26214400\" name=\"wpforms_7789_7\" accept=\".jpg,.jpeg,.jpe,.gif,.png,.bmp,.tiff,.tif,.webp,.ico,.heic,.asf,.asx,.wmv,.wmx,.wm,.avi,.divx,.mov,.qt,.mpeg,.mpg,.mpe,.mp4,.m4v,.ogv,.webm,.mkv,.3gp,.3gpp,.3g2,.3gp2,.txt,.asc,.c,.cc,.h,.srt,.csv,.tsv,.ics,.rtx,.css,.vtt,.mp3,.m4a,.m4b,.aac,.ra,.ram,.wav,.ogg,.oga,.flac,.mid,.midi,.wma,.wax,.mka,.rtf,.pdf,.class,.tar,.zip,.gz,.gzip,.rar,.7z,.psd,.xcf,.doc,.pot,.pps,.ppt,.wri,.xla,.xls,.xlt,.xlw,.mpp,.docx,.docm,.dotx,.dotm,.xlsx,.xlsm,.xlsb,.xltx,.xltm,.xlam,.pptx,.pptm,.ppsx,.ppsm,.potx,.potm,.ppam,.sldx,.sldm,.onetoc,.onetoc2,.onepkg,.oxps,.xps,.odt,.odp,.ods,.odg,.odc,.odb,.odf,.wp,.wpd,.key,.numbers,.pages,.svg\" ><\/div><div id=\"wpforms-7789-field_8-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-7789-field_8\">Nombres, credenciales y t\u00edtulos de las personas\nque aparecen en la foto del equipo.<\/label><textarea id=\"wpforms-7789-field_8\" class=\"wpforms-field-medium\" name=\"wpforms[fields][8]\" ><\/textarea><\/div><div id=\"wpforms-7789-field_10-container\" class=\"wpforms-field wpforms-field-file-upload\" data-field-id=\"10\"><label class=\"wpforms-field-label\" for=\"wpforms-7789-field_10\">Consents for every person used in any uploaded media.<\/label><input type=\"file\" id=\"wpforms-7789-field_10\" data-rule-extension=\"jpg,jpeg,jpe,gif,png,bmp,tiff,tif,webp,ico,heic,asf,asx,wmv,wmx,wm,avi,divx,mov,qt,mpeg,mpg,mpe,mp4,m4v,ogv,webm,mkv,3gp,3gpp,3g2,3gp2,txt,asc,c,cc,h,srt,csv,tsv,ics,rtx,css,vtt,mp3,m4a,m4b,aac,ra,ram,wav,ogg,oga,flac,mid,midi,wma,wax,mka,rtf,pdf,class,tar,zip,gz,gzip,rar,7z,psd,xcf,doc,pot,pps,ppt,wri,xla,xls,xlt,xlw,mpp,docx,docm,dotx,dotm,xlsx,xlsm,xlsb,xltx,xltm,xlam,pptx,pptm,ppsx,ppsm,potx,potm,ppam,sldx,sldm,onetoc,onetoc2,onepkg,oxps,xps,odt,odp,ods,odg,odc,odb,odf,wp,wpd,key,numbers,pages,svg\" data-rule-maxsize=\"26214400\" name=\"wpforms_7789_10\" accept=\".jpg,.jpeg,.jpe,.gif,.png,.bmp,.tiff,.tif,.webp,.ico,.heic,.asf,.asx,.wmv,.wmx,.wm,.avi,.divx,.mov,.qt,.mpeg,.mpg,.mpe,.mp4,.m4v,.ogv,.webm,.mkv,.3gp,.3gpp,.3g2,.3gp2,.txt,.asc,.c,.cc,.h,.srt,.csv,.tsv,.ics,.rtx,.css,.vtt,.mp3,.m4a,.m4b,.aac,.ra,.ram,.wav,.ogg,.oga,.flac,.mid,.midi,.wma,.wax,.mka,.rtf,.pdf,.class,.tar,.zip,.gz,.gzip,.rar,.7z,.psd,.xcf,.doc,.pot,.pps,.ppt,.wri,.xla,.xls,.xlt,.xlw,.mpp,.docx,.docm,.dotx,.dotm,.xlsx,.xlsm,.xlsb,.xltx,.xltm,.xlam,.pptx,.pptm,.ppsx,.ppsm,.potx,.potm,.ppam,.sldx,.sldm,.onetoc,.onetoc2,.onepkg,.oxps,.xps,.odt,.odp,.ods,.odg,.odc,.odb,.odf,.wp,.wpd,.key,.numbers,.pages,.svg\" ><\/div><div id=\"wpforms-7789-field_21-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"21\"><div id=\"wpforms-7789-field_21\"><strong>Download the consents form <a href=\"https:\/\/www.passy-muir.com\/wp-content\/uploads\/2019\/02\/consent_form2.pdf\">here<\/a>, then scan to PDF or graphic file.<\/strong><\/div><\/div><div id=\"wpforms-7789-field_11-container\" class=\"wpforms-field wpforms-field-file-upload\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-7789-field_11\">Facility Passy Muir Valve policy and procedure (including use of a PMV for patients on mechanical ventilation, if those patients are served in the facility).<\/label><input type=\"file\" id=\"wpforms-7789-field_11\" data-rule-extension=\"jpg,jpeg,jpe,gif,png,bmp,tiff,tif,webp,ico,heic,asf,asx,wmv,wmx,wm,avi,divx,mov,qt,mpeg,mpg,mpe,mp4,m4v,ogv,webm,mkv,3gp,3gpp,3g2,3gp2,txt,asc,c,cc,h,srt,csv,tsv,ics,rtx,css,vtt,mp3,m4a,m4b,aac,ra,ram,wav,ogg,oga,flac,mid,midi,wma,wax,mka,rtf,pdf,class,tar,zip,gz,gzip,rar,7z,psd,xcf,doc,pot,pps,ppt,wri,xla,xls,xlt,xlw,mpp,docx,docm,dotx,dotm,xlsx,xlsm,xlsb,xltx,xltm,xlam,pptx,pptm,ppsx,ppsm,potx,potm,ppam,sldx,sldm,onetoc,onetoc2,onepkg,oxps,xps,odt,odp,ods,odg,odc,odb,odf,wp,wpd,key,numbers,pages,svg\" data-rule-maxsize=\"26214400\" name=\"wpforms_7789_11\" accept=\".jpg,.jpeg,.jpe,.gif,.png,.bmp,.tiff,.tif,.webp,.ico,.heic,.asf,.asx,.wmv,.wmx,.wm,.avi,.divx,.mov,.qt,.mpeg,.mpg,.mpe,.mp4,.m4v,.ogv,.webm,.mkv,.3gp,.3gpp,.3g2,.3gp2,.txt,.asc,.c,.cc,.h,.srt,.csv,.tsv,.ics,.rtx,.css,.vtt,.mp3,.m4a,.m4b,.aac,.ra,.ram,.wav,.ogg,.oga,.flac,.mid,.midi,.wma,.wax,.mka,.rtf,.pdf,.class,.tar,.zip,.gz,.gzip,.rar,.7z,.psd,.xcf,.doc,.pot,.pps,.ppt,.wri,.xla,.xls,.xlt,.xlw,.mpp,.docx,.docm,.dotx,.dotm,.xlsx,.xlsm,.xlsb,.xltx,.xltm,.xlam,.pptx,.pptm,.ppsx,.ppsm,.potx,.potm,.ppam,.sldx,.sldm,.onetoc,.onetoc2,.onepkg,.oxps,.xps,.odt,.odp,.ods,.odg,.odc,.odb,.odf,.wp,.wpd,.key,.numbers,.pages,.svg\" ><\/div><div id=\"wpforms-7789-field_24-container\" class=\"wpforms-field wpforms-field-file-upload\" data-field-id=\"24\"><label class=\"wpforms-field-label\" for=\"wpforms-7789-field_24\">Team members resumes or curricula vitae and a 50-word bio of each team member. These should provide evidence of their qualifications to work with patients following tracheostomy or mechanical ventilation.<\/label><input type=\"file\" id=\"wpforms-7789-field_24\" data-rule-extension=\"jpg,jpeg,jpe,gif,png,bmp,tiff,tif,webp,ico,heic,asf,asx,wmv,wmx,wm,avi,divx,mov,qt,mpeg,mpg,mpe,mp4,m4v,ogv,webm,mkv,3gp,3gpp,3g2,3gp2,txt,asc,c,cc,h,srt,csv,tsv,ics,rtx,css,vtt,mp3,m4a,m4b,aac,ra,ram,wav,ogg,oga,flac,mid,midi,wma,wax,mka,rtf,pdf,class,tar,zip,gz,gzip,rar,7z,psd,xcf,doc,pot,pps,ppt,wri,xla,xls,xlt,xlw,mpp,docx,docm,dotx,dotm,xlsx,xlsm,xlsb,xltx,xltm,xlam,pptx,pptm,ppsx,ppsm,potx,potm,ppam,sldx,sldm,onetoc,onetoc2,onepkg,oxps,xps,odt,odp,ods,odg,odc,odb,odf,wp,wpd,key,numbers,pages,svg\" data-rule-maxsize=\"26214400\" name=\"wpforms_7789_24\" accept=\".jpg,.jpeg,.jpe,.gif,.png,.bmp,.tiff,.tif,.webp,.ico,.heic,.asf,.asx,.wmv,.wmx,.wm,.avi,.divx,.mov,.qt,.mpeg,.mpg,.mpe,.mp4,.m4v,.ogv,.webm,.mkv,.3gp,.3gpp,.3g2,.3gp2,.txt,.asc,.c,.cc,.h,.srt,.csv,.tsv,.ics,.rtx,.css,.vtt,.mp3,.m4a,.m4b,.aac,.ra,.ram,.wav,.ogg,.oga,.flac,.mid,.midi,.wma,.wax,.mka,.rtf,.pdf,.class,.tar,.zip,.gz,.gzip,.rar,.7z,.psd,.xcf,.doc,.pot,.pps,.ppt,.wri,.xla,.xls,.xlt,.xlw,.mpp,.docx,.docm,.dotx,.dotm,.xlsx,.xlsm,.xlsb,.xltx,.xltm,.xlam,.pptx,.pptm,.ppsx,.ppsm,.potx,.potm,.ppam,.sldx,.sldm,.onetoc,.onetoc2,.onepkg,.oxps,.xps,.odt,.odp,.ods,.odg,.odc,.odb,.odf,.wp,.wpd,.key,.numbers,.pages,.svg\" ><\/div><div id=\"wpforms-7789-field_9-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-7789-field_9\">I, the undersigned, hereby consent for Passy-Muir, Inc., to the use of names, likenesses, statements, quotations, images, photographs, and\/or videos from the above-mentioned facility submitted for the Passy Muir Centers of Excellence program. Please type your name to consent for use of all submissions for the COE program.<\/label><input type=\"text\" id=\"wpforms-7789-field_9\" class=\"wpforms-field-medium\" name=\"wpforms[fields][9]\" ><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-field wpforms-field-hp\"><label for=\"wpforms-7789-field-hp\" class=\"wpforms-field-label\">Nombre<\/label><input type=\"text\" name=\"wpforms[hp]\" id=\"wpforms-7789-field-hp\" class=\"wpforms-field-medium\"><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"7789\"><input type=\"hidden\" name=\"wpforms[author]\" value=\"7\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-7789\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Enviar<\/button><\/div><input type=\"hidden\" name=\"trp-form-language\" value=\"es\"\/><\/form><\/div>  <!-- .wpforms-container -->","protected":false},"excerpt":{"rendered":"Centros de Excelencia","protected":false},"author":7,"featured_media":631,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"yst_prominent_words":[832,1398,1390,415,1400,1394,65,1392,72,62,1388,1396,1391,1387,1395,1399,1393,1401,1397,1389],"_links":{"self":[{"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/pages\/7788"}],"collection":[{"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/comments?post=7788"}],"version-history":[{"count":0,"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/pages\/7788\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/media\/631"}],"wp:attachment":[{"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/media?parent=7788"}],"wp:term":[{"taxonomy":"yst_prominent_words","embeddable":true,"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/yst_prominent_words?post=7788"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}