{"id":1297,"date":"2018-05-03T14:54:39","date_gmt":"2018-05-03T14:54:39","guid":{"rendered":"http:\/\/colegiomedicocat.com.ar\/med\/?page_id=1297"},"modified":"2023-09-13T19:31:57","modified_gmt":"2023-09-13T19:31:57","slug":"formulario-reporte","status":"publish","type":"page","link":"https:\/\/colegiomedicocat.com.ar\/med\/formulario-reporte\/","title":{"rendered":"Reporte Violencia"},"content":{"rendered":"<p>* Completar todos los campos<\/p>\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1346-o1\" lang=\"es-ES\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/med\/wp-json\/wp\/v2\/pages\/1297#wpcf7-f1346-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formulario de contacto\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"1346\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.7.7\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"es_ES\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1346-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<p>Formulario de Reporte de Agresi\u00f3n en \u00c1mbito laboral\n<\/p>\n<p>DATOS DEL MATRICULADO\n<\/p>\n<p><label>Nombre y Apellido (requerido)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span> <\/label>\n<\/p>\n<p><label> Tu correo electr\u00f3nico (requerido)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span> <\/label><br \/>\n<label> Domicilio (requerido)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-domicilio\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"textarea-domicilio\"><\/textarea><\/span><\/label><br \/>\n<label> Telefono o Celular<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel-TelCel\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"tel-TelCel\" \/><\/span><\/label><br \/>\n<label>Matricula Profesional (requerido)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"number-matricula\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-required wpcf7-validates-as-number\" min=\"0\" max=\"3000\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"number-matricula\" \/><\/span><\/label><br \/>\n-----------------------------------------------------------<br \/>\nTESTIGO<br \/>\n<label>Nombre y Apellido<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-testigo\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"textarea-testigo\"><\/textarea><\/span><\/label><br \/>\n<label>Contacto Tel.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel-telTestigo\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"tel-telTestigo\" \/><\/span><\/label>\n<\/p>\n<p>------------------------------------------------------------<br \/>\nINTERVENCI\u00d3N<br \/>\nTiene que responder Si o No<br \/>\n<label>Personal de Seguridad <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-PersonalSeg\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-PersonalSeg\"><option value=\"\">&#8212;Por favor, elige una opci\u00f3n&#8212;<\/option><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Policia <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-Policia\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-Policia\"><option value=\"\">&#8212;Por favor, elige una opci\u00f3n&#8212;<\/option><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label>\n<\/p>\n<p>--------------------------------------------<br \/>\nDETALLES DEL EVENTOS SUFRIDO<br \/>\nTiene que completar\n<\/p>\n<p><label>D\u00eda de Evento Sufrido <span class=\"wpcf7-form-control-wrap\" data-name=\"date-diaEventoSufrido\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" min=\"2018-01-01\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-diaEventoSufrido\" \/><\/span><\/label><br \/>\n<label>Insultos <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-insultos\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-insultos\"><option value=\"\">&#8212;Por favor, elige una opci\u00f3n&#8212;<\/option><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Amenazas <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-Amenazas\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-Amenazas\"><option value=\"\">&#8212;Por favor, elige una opci\u00f3n&#8212;<\/option><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Agresi\u00f3n f\u00edsica\t<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-AgresionFi\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-AgresionFi\"><option value=\"\">&#8212;Por favor, elige una opci\u00f3n&#8212;<\/option><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Difamaciones <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-difamacion\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-difamacion\"><option value=\"\">&#8212;Por favor, elige una opci\u00f3n&#8212;<\/option><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Divulgaciones en Redes Sociales <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-DivulgaRS\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-DivulgaRS\"><option value=\"\">&#8212;Por favor, elige una opci\u00f3n&#8212;<\/option><option value=\"SI\">SI<\/option><option value=\"No\">No<\/option><\/select><\/span><\/label><br \/>\n<label>Grabaci\u00f3n y\/o divulgaci\u00f3n audiovisual no consentida de acto m\u00e9dico<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-ViActoMed\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-ViActoMed\"><option value=\"\">&#8212;Por favor, elige una opci\u00f3n&#8212;<\/option><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Grabaci\u00f3n y\/o divulgaci\u00f3n audiovisual no consentida de informes m\u00e9dicos<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-ViinformeMed\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-ViinformeMed\"><option value=\"\">&#8212;Por favor, elige una opci\u00f3n&#8212;<\/option><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Destrucci\u00f3n de Elementos de Trabajos<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-DesElementra\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-DesElementra\"><option value=\"\">&#8212;Por favor, elige una opci\u00f3n&#8212;<\/option><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Destrucci\u00f3n Bienes del \u00c1mbito de Trabajo<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-DesbienAmbiTrabajo\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-DesbienAmbiTrabajo\"><option value=\"\">&#8212;Por favor, elige una opci\u00f3n&#8212;<\/option><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label>\n<\/p>\n<p>---------------------------------<br \/>\n<label>LUGAR AGRESI\u00d3N<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-lugarAgresion\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-lugarAgresion\"><option value=\"\">&#8212;Por favor, elige una opci\u00f3n&#8212;<\/option><option value=\"Consultorio Privado\">Consultorio Privado<\/option><option value=\"Cl\u00ednica Privada\">Cl\u00ednica Privada<\/option><option value=\"Domicilio del Profesional\">Domicilio del Profesional<\/option><option value=\"Centro de Atenci\u00f3n\">Centro de Atenci\u00f3n<\/option><option value=\"CAPS\">CAPS<\/option><option value=\"Hospital P\u00fablico\">Hospital P\u00fablico<\/option><option value=\"SAME\">SAME<\/option><option value=\"Ser. de Ate. Pre Hos. Priv.\">Ser. de Ate. Pre Hos. Priv.<\/option><\/select><\/span><\/label>\n<\/p>\n<p>--------------------------------------<br \/>\nANTECEDENTES DEL AGRESOR<br \/>\n<label>Antecedente T\u00f3xicos <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-antecedenteToxico\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-antecedenteToxico\"><option value=\"Consumo de Alcohol\">Consumo de Alcohol<\/option><option value=\"Drogas Ilicitas\">Drogas Ilicitas<\/option><\/select><\/span><\/label><br \/>\n<label>Antecedentes Psiqui\u00e1tricos<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-AntcPsico\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-AntcPsico\"><option value=\"NO\">NO<\/option><option value=\"SI\">SI<\/option><\/select><\/span><\/label><br \/>\n<label>Enfermedad Org\u00e1nica <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-enfeorganica\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-enfeorganica\"><option value=\"NO\">NO<\/option><option value=\"SI\">SI<\/option><\/select><\/span><\/label>\n<\/p>\n<p>-------------------------------------\n<\/p>\n<p>CAUSAS DE LA AGRESI\u00d3N<br \/>\n<label>No recetar medicamento propuesto\/ esperado por el paciente<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-norecetar\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-norecetar\"><option value=\"NO\">NO<\/option><option value=\"SI\">SI<\/option><\/select><\/span><\/label><br \/>\n<label>No indicar estudio reclamado\/ esperado por el paciente<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-noindicarest\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-noindicarest\"><option value=\"NO\">NO<\/option><option value=\"SI\">SI<\/option><\/select><\/span><\/label><br \/>\n<label>Tiempo de espera en ser atendido\t<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-tiespera\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-tiespera\"><option value=\"NO\">NO<\/option><option value=\"SI\">SI<\/option><\/select><\/span><\/label><br \/>\n<label>Disconformidad en la atenci\u00f3n m\u00e9dica <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-disconformidamedica\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-disconformidamedica\"><option value=\"NO\">NO<\/option><option value=\"SI\">SI<\/option><\/select><\/span><\/label><br \/>\n<label>Discrepancias personales\t<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-discrepanciapersonales\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-discrepanciapersonales\"><option value=\"NO\">NO<\/option><option value=\"SI\">SI<\/option><\/select><\/span><\/label><br \/>\n<label>Disconformidad por el funcionamiento interno de la instituci\u00f3n<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-disconintitucion\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-disconintitucion\"><option value=\"NO\">NO<\/option><option value=\"SI\">SI<\/option><\/select><\/span><\/label><br \/>\n<label>Disconformidad por certificaciones varias <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-discoforcertificaionevarias\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-discoforcertificaionevarias\"><option value=\"NO\">NO<\/option><option value=\"SI\">SI<\/option><\/select><\/span><\/label><br \/>\n<label>Disconformidad por el informe medico recibido<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-discofoinformemedico\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-discofoinformemedico\"><option value=\"NO\">NO<\/option><option value=\"SI\">SI<\/option><\/select><\/span><\/label><br \/>\n<label>Grabaci\u00f3n audiovisual no consentida del acto<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-gravacionnoconcentida\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-gravacionnoconcentida\"><option value=\"NO\">NO<\/option><option value=\"SI\">SI<\/option><\/select><\/span><\/label>\n<\/p>\n<p>-------------------------------<br \/>\n<label> TRAMITES POSTERIOR AL HECHO <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-tramitedespusdelecho\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-tramitedespusdelecho\"><option value=\"Ante jefe de guardia\">Ante jefe de guardia<\/option><option value=\"Jefe de servicio\">Jefe de servicio<\/option><option value=\"Director de la Instituci\u00f3n\">Director de la Instituci\u00f3n<\/option><option value=\"Ministerio de Salud\">Ministerio de Salud<\/option><option value=\"Polic\u00eda\">Polic\u00eda<\/option><option value=\"Unidad Judicial\">Unidad Judicial<\/option><\/select><\/span><\/label><br \/>\n<label>Se registr\u00f3 el hecho en la Historia Cl\u00ednica?<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-seregistro\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-seregistro\"><option value=\"NO\">NO<\/option><option value=\"SI\">SI<\/option><\/select><\/span><\/label><br \/>\n<label>Recibi\u00f3 apoyo o asesoramiento de parte de la instituci\u00f3n<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-apoyoinstitucio\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-apoyoinstitucio\"><option value=\"NO\">NO<\/option><option value=\"SI\">SI<\/option><\/select><\/span><\/label><br \/>\n<label>Recibi\u00f3 apoyo por parte de compa\u00f1eros<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-apoyocompaero\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-apoyocompaero\"><option value=\"NO\">NO<\/option><option value=\"SI\">SI<\/option><\/select><\/span><\/label><br \/>\n-----------------------------\n<\/p>\n<p>CONSECUENCIAS DE LA AGRESI\u00d3N\n<\/p>\n<p><label>Existieron lesiones <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-lesiones\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-lesiones\"><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Existe informe de lesiones<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-informlesiones\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-informlesiones\"><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Ha estado en tratamiento como consecuencia de las mismas\t<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-tratamiento\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-tratamiento\"><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Existieron da\u00f1os materiales<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-damateria\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-damateria\"><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Ha sufrido agresiones previas <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-agresionprbia\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-agresionprbia\"><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Por mismo agresor<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-mismoagres\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-mismoagres\"><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Hubo otras agresiones anteriores en la instituci\u00f3n<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-agresioninstitu\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-agresioninstitu\"><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Fueron denunciadas<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-denunciadas\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-denunciadas\"><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Se ha identificado al agresor<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-idintefiagreso\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-idintefiagreso\"><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Sigue atendiendo profesionalmente al agresor<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-sigueatendienagreso\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-sigueatendienagreso\"><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label>\n<\/p>\n<p>------------------------------<br \/>\nN\u00daMERO DE AGRESIONES ANTERIORES\n<\/p>\n<p>Relaciones con el paciente y familiares<br \/>\n<label>Paciente frecuente <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-pacientefrecuent\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-pacientefrecuent\"><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Paciente circunstancial<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-pacientecircuntacial\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-pacientecircuntacial\"><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label><br \/>\n<label>Existe vinculo con familiares del paciente<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-vinculoconpaciente\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-vinculoconpaciente\"><option value=\"SI\">SI<\/option><option value=\"NO\">NO<\/option><\/select><\/span><\/label>\n<\/p>\n<p>------------------------<br \/>\n<label>Califique la relaci\u00f3n con el paciente antes de hecho<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-calificque\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-calificque\"><option value=\"Excelente\">Excelente<\/option><option value=\"Muy bueno\">Muy bueno<\/option><option value=\"Bueno\">Bueno<\/option><option value=\"Regular\">Regular<\/option><option value=\"Malo\">Malo<\/option><option value=\"Sin relaci\u00f3n\">Sin relaci\u00f3n<\/option><\/select><\/span><\/label>\n<\/p>\n<p>----------------------------<br \/>\n<label>Califique la relaci\u00f3n con familiares antes de hecho <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-calificquefamilia\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-calificquefamilia\"><option value=\"Excelente\">Excelente<\/option><option value=\"Muy bueno\">Muy bueno<\/option><option value=\"Bueno\">Bueno<\/option><option value=\"Regular\">Regular<\/option><option value=\"Malo\">Malo<\/option><option value=\"Sin relaci\u00f3n\">Sin relaci\u00f3n<\/option><\/select><\/span><\/label>\n<\/p>\n<p>----------------------\n<\/p>\n<p><label>Detallar Brevemente lo Ocurrido el Incidente de Agresi\u00f3n<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"DetallarBreveFinal\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"DetallarBreveFinal\"><\/textarea><\/span><\/label>\n<\/p>\n<p><input class=\"wpcf7-form-control has-spinner wpcf7-submit\" type=\"submit\" value=\"Enviar\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>* Completar todos los campos<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_joinchat":[],"footnotes":""},"class_list":["post-1297","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/colegiomedicocat.com.ar\/med\/wp-json\/wp\/v2\/pages\/1297","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/colegiomedicocat.com.ar\/med\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/colegiomedicocat.com.ar\/med\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/colegiomedicocat.com.ar\/med\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/colegiomedicocat.com.ar\/med\/wp-json\/wp\/v2\/comments?post=1297"}],"version-history":[{"count":3,"href":"https:\/\/colegiomedicocat.com.ar\/med\/wp-json\/wp\/v2\/pages\/1297\/revisions"}],"predecessor-version":[{"id":5366,"href":"https:\/\/colegiomedicocat.com.ar\/med\/wp-json\/wp\/v2\/pages\/1297\/revisions\/5366"}],"wp:attachment":[{"href":"https:\/\/colegiomedicocat.com.ar\/med\/wp-json\/wp\/v2\/media?parent=1297"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}