{"id":7872,"date":"2018-12-14T10:02:17","date_gmt":"2018-12-14T18:02:17","guid":{"rendered":"http:\/\/pmtest.passy-muir.com\/?page_id=7872"},"modified":"2019-02-15T10:02:03","modified_gmt":"2019-02-15T18:02:03","slug":"share-your-story","status":"publish","type":"page","link":"http:\/\/142.11.238.239\/es\/share-your-story\/","title":{"rendered":"Comparta su historia"},"content":{"rendered":"<div class=\"l3-header-con no-banner\">\n<div class=\"l3-header-text\">\n\t\t\tComparta su historia\n                         <\/div>\n<\/p><\/div>\n<div style=\"clear:both\"><\/div>\n<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-7726\"><form id=\"wpforms-form-7726\" class=\"wpforms-validate wpforms-form\" data-formid=\"7726\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/es\/wp-json\/wp\/v2\/pages\/7872?wpforms_form_id=7726\" data-token=\"eaaca56bad5c19fbf98c1e11a33a4783\" data-trp-original-action=\"\/es\/wp-json\/wp\/v2\/pages\/7872?wpforms_form_id=7726\"><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-7726-field_0-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"0\"><label class=\"wpforms-field-label\" for=\"wpforms-7726-field_0\">Nombre <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-7726-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" required><label for=\"wpforms-7726-field_0\" class=\"wpforms-field-sublabel after\">Nombre<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-7726-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" required><label for=\"wpforms-7726-field_0-last\" class=\"wpforms-field-sublabel after\">Apellidos<\/label><\/div><\/div><\/div><div id=\"wpforms-7726-field_3-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-7726-field_3\">Tel\u00e9fono<\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-7726-field_3\" class=\"wpforms-field-medium\" name=\"wpforms[fields][3]\" ><\/div><div id=\"wpforms-7726-field_7-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-7726-field_7\">Direcci\u00f3n<\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-7726-field_7\" class=\"wpforms-field-address-address1\" name=\"wpforms[fields][7][address1]\" ><label for=\"wpforms-7726-field_7\" 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-7726-field_7-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][7][address2]\" ><label for=\"wpforms-7726-field_7-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-7726-field_7-city\" class=\"wpforms-field-address-city\" name=\"wpforms[fields][7][city]\" ><label for=\"wpforms-7726-field_7-city\" class=\"wpforms-field-sublabel after\">Ciudad<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-7726-field_7-state\" class=\"wpforms-field-address-state\" name=\"wpforms[fields][7][state]\" ><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >Distrito de Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawai<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Luisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >M\u00edchigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Misisip\u00ed<\/option><option value=\"MO\" >Misuri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >Nuevo Hampshire<\/option><option value=\"NJ\" >Nueva Jersey<\/option><option value=\"NM\" >Nuevo M\u00e9xico<\/option><option value=\"NY\" >Nueva York<\/option><option value=\"NC\" >Carolina del norte<\/option><option value=\"ND\" >Dakota del norte<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oreg\u00f3n<\/option><option value=\"PA\" >Pensilvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >Carolina del Sur<\/option><option value=\"SD\" >Dakota del Sur<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >Virginia Occidental<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-7726-field_7-state\" class=\"wpforms-field-sublabel after\">Estado<\/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-7726-field_7-postal\" class=\"wpforms-field-address-postal wpforms-masked-input\" data-inputmask-mask=\"(99999)|(99999-9999)\" data-inputmask-keepstatic=\"true\" data-rule-inputmask-incomplete=\"1\" name=\"wpforms[fields][7][postal]\" ><label for=\"wpforms-7726-field_7-postal\" class=\"wpforms-field-sublabel after\">C\u00f3digo Postal<\/label><\/div><\/div><\/div><div id=\"wpforms-7726-field_1-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-7726-field_1\">Correo electr\u00f3nico <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-7726-field_1\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][1]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-7726-field_2-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-7726-field_2\">Nos encantar\u00eda conocer su experiencia con la V\u00e1lvula\n<span class=\"pm_ws\">Passy Muir<\/span><sup>\u00ae<\/sup>. \u00bfCu\u00e1les fueron sus primeras palabras\nusando la v\u00e1lvula? \u00bfTiene algo que quiera decirle a otras\npersonas que est\u00e9n interesadas en usar la V\u00e1lvula <span class=\"pm_ws\">Passy\nMuir<\/span>? <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-7726-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" required><\/textarea><\/div><div id=\"wpforms-7726-field_4-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-7726-field_4\">El abajo firmante autoriza a Passy-Muir, Inc. para:<\/label><ul id=\"wpforms-7726-field_4\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-7726-field_4_1\" name=\"wpforms[fields][4][]\" value=\"include patient&#039;s full name in media produced by Passy-Muir Inc.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7726-field_4_1\">include patient's full name in media produced by Passy-Muir Inc.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-7726-field_4_2\" name=\"wpforms[fields][4][]\" value=\"include patient&#039;s image in media produced by Passy-Muir Inc.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7726-field_4_2\">include patient's image in media produced by Passy-Muir Inc.<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-7726-field_4_3\" name=\"wpforms[fields][4][]\" value=\"include my statements in media produced by Passy-Muir Inc.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7726-field_4_3\">include my statements in media produced by Passy-Muir Inc.<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-7726-field_4_4\" name=\"wpforms[fields][4][]\" value=\"Do not include patient&#039;s name in media produced by Passy-Muir Inc.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7726-field_4_4\">Do not include patient's name in media produced by Passy-Muir Inc.<\/label><\/li><\/ul><\/div><div id=\"wpforms-7726-field_5-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-7726-field_5\">Por medio de la presente, el abajo firmante autoriza a\nPassy-Muir, Inc. para utilizar im\u00e1genes o videos de\npacientes en anuncios de <span class=\"pm_ws\">Passy Muir<\/span> y otros materiales\neducativos y de mercadeo. (Firma del tutor o padre, si el\npaciente es menor de edad) <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-7726-field_5\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][5][first]\" required><label for=\"wpforms-7726-field_5\" class=\"wpforms-field-sublabel after\">Nombre<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-7726-field_5-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][5][last]\" required><label for=\"wpforms-7726-field_5-last\" class=\"wpforms-field-sublabel after\">Apellidos<\/label><\/div><\/div><\/div><div id=\"wpforms-7726-field_6-container\" class=\"wpforms-field wpforms-field-file-upload\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-7726-field_6\">Subir un archivo<\/label><div\n\t\tclass=\"wpforms-uploader\"\n\t\tdata-field-id=\"6\"\n\t\tdata-form-id=\"7726\"\n\t\tdata-input-name=\"wpforms_7726_6\"\n\t\tdata-extensions=\"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\"\n\t\tdata-max-size=\"26214400\"\n\t\tdata-max-file-number=\"1\"\n\t\tdata-post-max-size=\"2097152\"\n\t\tdata-max-parallel-uploads=\"4\"\n\t\tdata-parallel-uploads=\"true\"\n\t\tdata-file-chunk-size=\"2097152\">\n\t<div class=\"dz-message\">\n\t\t<svg viewbox=\"0 0 1024 1024\" focusable=\"false\" data-icon=\"inbox\" width=\"50px\" height=\"50px\" fill=\"currentColor\" aria-hidden=\"true\">\n\t\t\t<path d=\"M885.2 446.3l-.2-.8-112.2-285.1c-5-16.1-19.9-27.2-36.8-27.2H281.2c-17 0-32.1 11.3-36.9 27.6L139.4 443l-.3.7-.2.8c-1.3 4.9-1.7 9.9-1 14.8-.1 1.6-.2 3.2-.2 4.8V830a60.9 60.9 0 0 0 60.8 60.8h627.2c33.5 0 60.8-27.3 60.9-60.8V464.1c0-1.3 0-2.6-.1-3.7.4-4.9 0-9.6-1.3-14.1zm-295.8-43l-.3 15.7c-.8 44.9-31.8 75.1-77.1 75.1-22.1 0-41.1-7.1-54.8-20.6S436 441.2 435.6 419l-.3-15.7H229.5L309 210h399.2l81.7 193.3H589.4zm-375 76.8h157.3c24.3 57.1 76 90.8 140.4 90.8 33.7 0 65-9.4 90.3-27.2 22.2-15.6 39.5-37.4 50.7-63.6h156.5V814H214.4V480.1z\"><\/path>\n\t\t<\/svg>\n\t\t<span class=\"modern-title\">Haz clic o arrastra un archivo a este \u00e1rea para subirlo.<\/span>\n\n\t\t\t<\/div>\n<\/div>\n<input\n\t\ttype=\"text\"\n\t\tautocomplete=\"off\"\n\t\tclass=\"dropzone-input\"\n\t\tstyle=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\"\n\t\tid=\"wpforms-7726-field_6\"\n\t\tname=\"wpforms_7726_6\" \t\tvalue=\"\">\n<\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-field wpforms-field-hp\"><label for=\"wpforms-7726-field-hp\" class=\"wpforms-field-label\">Nombre<\/label><input type=\"text\" name=\"wpforms[hp]\" id=\"wpforms-7726-field-hp\" class=\"wpforms-field-medium\"><\/div><div class=\"wpforms-recaptcha-container wpforms-is-recaptcha\" ><div class=\"g-recaptcha\" data-sitekey=\"6Lfbq6EUAAAAAAAeOkk0L5llow9kBiBOJnnFUEo5\" data-size=\"invisible\"><\/div><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"7726\"><input type=\"hidden\" name=\"wpforms[author]\" value=\"7\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-7726\" 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":"Comparta su historia","protected":false},"author":7,"featured_media":10512,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"yst_prominent_words":[836,832,2336,2334,2337,2338,833,829,828,87,835,2335,2333,86,72,193,2339,831,830,81],"_links":{"self":[{"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/pages\/7872"}],"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=7872"}],"version-history":[{"count":1,"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/pages\/7872\/revisions"}],"predecessor-version":[{"id":11334,"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/pages\/7872\/revisions\/11334"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/media\/10512"}],"wp:attachment":[{"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/media?parent=7872"}],"wp:term":[{"taxonomy":"yst_prominent_words","embeddable":true,"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/yst_prominent_words?post=7872"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}