{"id":19240,"date":"2023-02-14T11:00:33","date_gmt":"2023-02-14T09:00:33","guid":{"rendered":"https:\/\/ticsalutsocial.atoom.space\/mhealth\/formulari-de-contacte\/"},"modified":"2023-11-08T10:41:44","modified_gmt":"2023-11-08T08:41:44","slug":"formulari-de-contacte","status":"publish","type":"page","link":"https:\/\/ticsalutsocial.atoom.space\/en\/que-fem\/digital-assets-for-citizens\/formulari-de-contacte\/","title":{"rendered":"Contact Form"},"content":{"rendered":"\n<p><\/p>\n\n\n\n<div class=\"wp-block-contact-form-7-contact-form-selector\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f19214-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"19214\">\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\/19240#wpcf7-f19214-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"19214\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f19214-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<section class=\"page-section transformacio-cnt contact-div\">\n\t<div class=\"row\">\n\t\t<div class=\"contact-div trans-rgt persona-contacte\">\n\t\t\t<div class=\"trans-two-col\">\n\t\t\t\t<h4>Contact person\n\t\t\t\t<\/h4>\n\t\t\t\t<ul>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>First and last name <sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"nom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Write the full name\" value=\"\" type=\"text\" name=\"nom\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>Email <sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"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=\"email\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/section>\n<section class=\"page-section transformacio-cnt contact-div contact-select idiomes\" id=\"5\">\n\t<div class=\"row\">\n\t\t<div class=\"trans-rgt\">\n\t\t\t<div class=\"trans-two-col\">\n\t\t\t\t<h4>Developer\n\t\t\t\t<\/h4>\n\t\t\t\t<ul>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>App company or developer <sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"nomEmpresa\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Enter the name of the company or developer\" value=\"\" type=\"text\" name=\"nomEmpresa\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>Phone<sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"telefon\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Enter the company&#039;s phone number\" value=\"\" type=\"text\" name=\"telefon\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>Company email<sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"mailContacte\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Enter the company email\" value=\"\" type=\"text\" name=\"mailContacte\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/section>\n<section class=\"page-section transformacio-cnt contact-div\" id=\"2\">\n\t<div class=\"row\">\n\t\t<div class=\"trans-rgt\">\n\t\t\t<div class=\"trans-two-col\">\n\t\t\t\t<h4>App Information\n\t\t\t\t<\/h4>\n\t\t\t\t<ul>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>Name of the App<sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"nomApp\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Enter the name of the app...\" value=\"\" type=\"text\" name=\"nomApp\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>Description<sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"descripcio\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Describe your app...\" name=\"descripcio\"><\/textarea><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/section>\n<section class=\"page-section transformacio-cnt contact-div\" id=\"3\">\n\t<div class=\"row\">\n\t\t<div class=\"trans-rgt\">\n\t\t\t<div class=\"trans-two-col\">\n\t\t\t\t<h4>Professionals and centers involved\n\t\t\t\t<\/h4>\n\t\t\t\t<ul>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>Participation of renowned centers <sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"participacioCentres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Write the participation in recognized centers...\" value=\"\" type=\"text\" name=\"participacioCentres\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>Participation of renowed profesionals <sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"participacioProfessionals\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Write the participation of recognized professionals...\" value=\"\" type=\"text\" name=\"participacioProfessionals\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>Participation of professional associations <sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"participacioAssociacions\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Write the participation of professional associations...\" value=\"\" type=\"text\" name=\"participacioAssociacions\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>Participation of patient associations <sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"participacioAssociacionsPacients\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Write the participation of patient associations...\" value=\"\" type=\"text\" name=\"participacioAssociacionsPacients\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/section>\n<section class=\"page-section transformacio-cnt contact-div contact-select\" id=\"4\">\n\t<div class=\"row\">\n\t\t<div class=\"trans-rgt\">\n\t\t\t<div class=\"trans-two-col\">\n\t\t\t\t<h4>Options\n\t\t\t\t<\/h4>\n\t\t\t\t<ul>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>Addressed to <sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"adrecat\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"adrecat\"><option value=\"\">Addressed to<\/option><option value=\"Citizenship\">Citizenship<\/option><option value=\"Caregiver\">Caregiver<\/option><option value=\"Pharmacist\">Pharmacist<\/option><option value=\"Nurse\">Nurse<\/option><option value=\"Medical professional\">Medical professional<\/option><option value=\"Patient\">Patient<\/option><\/select><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>Country where it has been developed <sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"paisDesenvolupat\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Country where it has been developed\" value=\"\" type=\"text\" name=\"paisDesenvolupat\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>Operation System <sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sistemaOperatiu\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"sistemaOperatiu\"><option value=\"\">Operating System<\/option><option value=\"iOS\">iOS<\/option><option value=\"Android\">Android<\/option><option value=\"Android and iOS\">Android and iOS<\/option><option value=\"Others\">Others<\/option><\/select><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>The App is a medical device <sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"producteSanitari\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"producteSanitari\"><option value=\"\">Sanitary product<\/option><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>Languages in which the App is available<sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"idiomes\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"idiomes\"><option value=\"\">Languages<\/option><option value=\"Catalan\">Catalan<\/option><option value=\"Spanish\">Spanish<\/option><option value=\"English\">English<\/option><option value=\"Catalan and Spanish\">Catalan and Spanish<\/option><option value=\"Spanish and English\">Spanish and English<\/option><option value=\"All of the above\">All of the above<\/option><\/select><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t<\/ul>\n\t\t\t\t<h5>Cost <sup>*<\/sup>\n\t\t\t\t<\/h5>\n\t\t\t\t<ul class=\"pagement-list\">\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"gratuit\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"gratuit[]\" value=\"Free\" \/><span class=\"wpcf7-list-item-label\">Free<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"premium\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"premium[]\" value=\"Free, with premium options within the app\" \/><span class=\"wpcf7-list-item-label\">Free, with premium options within the app<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"pagament\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"pagament[]\" value=\"Single payment\" \/><span class=\"wpcf7-list-item-label\">Single payment<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"mensual\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"mensual[]\" value=\"Monthly\" \/><span class=\"wpcf7-list-item-label\">Monthly<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t<\/ul>\n\t\t\t\t<div class=\"opt-textarea\">\n\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"comentari\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Comments\" name=\"comentari\"><\/textarea><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/section>\n<section class=\"page-section transformacio-cnt contact-div\" id=\"6\">\n\t<div class=\"row\">\n\t\t<div class=\"trans-rgt\">\n\t\t\t<div class=\"trans-two-col\">\n\t\t\t\t<h4>Category\n\t\t\t\t<\/h4>\n\t\t\t\t<ul class=\"pagement-list half-wid\">\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"tot\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"tot[]\" value=\"All specialties in the health field\" \/><span class=\"wpcf7-list-item-label\">All specialties in the health field<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"one\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"one[]\" value=\"Accessibility\" \/><span class=\"wpcf7-list-item-label\">Accessibility<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"two\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"two[]\" value=\"Community action and volunteering\" \/><span class=\"wpcf7-list-item-label\">Community action and volunteering<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"three\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"three[]\" value=\"Fostering and adoptions\" \/><span class=\"wpcf7-list-item-label\">Fostering and adoptions<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"four\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"four[]\" value=\"Allergology\" \/><span class=\"wpcf7-list-item-label\">Allergology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"five\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"five[]\" value=\"Anesthesiology and Reanimation\" \/><span class=\"wpcf7-list-item-label\">Anesthesiology and Reanimation<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"six\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"six[]\" value=\"Angiology\" \/><span class=\"wpcf7-list-item-label\">Angiology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"seven\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"seven[]\" value=\"Sexual harassment and male violence\" \/><span class=\"wpcf7-list-item-label\">Sexual harassment and male violence<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"eight\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"eight[]\" value=\"Home care\" \/><span class=\"wpcf7-list-item-label\">Home care<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"nine\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"nine[]\" value=\"Cardiology\" \/><span class=\"wpcf7-list-item-label\">Cardiology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"ten\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"ten[]\" value=\"General surgery\" \/><span class=\"wpcf7-list-item-label\">General surgery<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"eleven\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"eleven[]\" value=\"Plastic surgery\" \/><span class=\"wpcf7-list-item-label\">Plastic surgery<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"twelve\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"twelve[]\" value=\"Civility and values\" \/><span class=\"wpcf7-list-item-label\">Civility and values<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"thirteen\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"thirteen[]\" value=\"Critical Care\" \/><span class=\"wpcf7-list-item-label\">Critical Care<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fourteen\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fourteen[]\" value=\"Dependency\" \/><span class=\"wpcf7-list-item-label\">Dependency<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fifteen\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fifteen[]\" value=\"Functional diversity or disability\" \/><span class=\"wpcf7-list-item-label\">Functional diversity or disability<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"sixteen\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"sixteen[]\" value=\"Drug addiction and other addictions\" \/><span class=\"wpcf7-list-item-label\">Drug addiction and other addictions<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"seventeen\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"seventeen[]\" value=\"Dermatology\" \/><span class=\"wpcf7-list-item-label\">Dermatology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"eighteen\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"eighteen[]\" value=\"Endocrinology\" \/><span class=\"wpcf7-list-item-label\">Endocrinology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"nineteen\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"nineteen[]\" value=\"Aging\" \/><span class=\"wpcf7-list-item-label\">Aging<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"twenty\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"twenty[]\" value=\"Families\" \/><span class=\"wpcf7-list-item-label\">Families<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"twentyone\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"twentyone[]\" value=\"Housing and residential support\" \/><span class=\"wpcf7-list-item-label\">Housing and residential support<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"twnetytwo\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"twnetytwo[]\" value=\"Pharmacology\" \/><span class=\"wpcf7-list-item-label\">Pharmacology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"twentythree\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"twentythree[]\" value=\"Physiotherapy\" \/><span class=\"wpcf7-list-item-label\">Physiotherapy<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"twentyfour\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"twentyfour[]\" value=\"Gastroenterology and Hepatology\" \/><span class=\"wpcf7-list-item-label\">Gastroenterology and Hepatology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"twentyfive\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"twentyfive[]\" value=\"Genetics\" \/><span class=\"wpcf7-list-item-label\">Genetics<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"twentysix\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"twentysix[]\" value=\"Geriatrics\" \/><span class=\"wpcf7-list-item-label\">Geriatrics<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"twentyseven\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"twentyseven[]\" value=\"Hospital management\" \/><span class=\"wpcf7-list-item-label\">Hospital management<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"twentyeight\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"twentyeight[]\" value=\"Gynecology and obstetrics\" \/><span class=\"wpcf7-list-item-label\">Gynecology and obstetrics<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"twentynine\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"twentynine[]\" value=\"Hematology\" \/><span class=\"wpcf7-list-item-label\">Hematology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"thirty\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"thirty[]\" value=\"Histology\" \/><span class=\"wpcf7-list-item-label\">Histology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"thirtyone\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"thirtyone[]\" value=\"Hospice and palliative care\" \/><span class=\"wpcf7-list-item-label\">Hospice and palliative care<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"thirtytwo\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"thirtytwo[]\" value=\"Hospitalization\" \/><span class=\"wpcf7-list-item-label\">Hospitalization<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"thirtythree\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"thirtythree[]\" value=\"Immunology\" \/><span class=\"wpcf7-list-item-label\">Immunology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"thirtyfour\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"thirtyfour[]\" value=\"Language and communication\" \/><span class=\"wpcf7-list-item-label\">Language and communication<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"thirtyfive\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"thirtyfive[]\" value=\"Infectious diseases\" \/><span class=\"wpcf7-list-item-label\">Infectious diseases<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"thirtysix\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"thirtysix[]\" value=\"Rare diseases\" \/><span class=\"wpcf7-list-item-label\">Rare diseases<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"thirtyseven\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"thirtyseven[]\" value=\"Pain medicine\" \/><span class=\"wpcf7-list-item-label\">Pain medicine<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"thirtyeight\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"thirtyeight[]\" value=\"Family and community medicine\" \/><span class=\"wpcf7-list-item-label\">Family and community medicine<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"thirtynine\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"thirtynine[]\" value=\"Physical medicine and rehabilitation\" \/><span class=\"wpcf7-list-item-label\">Physical medicine and rehabilitation<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fourty\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fourty[]\" value=\"Forensic medicine\" \/><span class=\"wpcf7-list-item-label\">Forensic medicine<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fourtyone\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fourtyone[]\" value=\"Internal medicine\" \/><span class=\"wpcf7-list-item-label\">Internal medicine<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fourtytwo\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fourtytwo[]\" value=\"Occupational medicine\" \/><span class=\"wpcf7-list-item-label\">Occupational medicine<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fourtythree\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fourtythree[]\" value=\"Nephrology\" \/><span class=\"wpcf7-list-item-label\">Nephrology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fourtyfour\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fourtyfour[]\" value=\"Neurology\" \/><span class=\"wpcf7-list-item-label\">Neurology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fourtyfive\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fourtyfive[]\" value=\"Nutrition and dietetics\" \/><span class=\"wpcf7-list-item-label\">Nutrition and dietetics<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fourtysix\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fourtysix[]\" value=\"Ophthalmology\" \/><span class=\"wpcf7-list-item-label\">Ophthalmology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fourtyseven\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fourtyseven[]\" value=\"Oncology\" \/><span class=\"wpcf7-list-item-label\">Oncology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fourtyeight\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fourtyeight[]\" value=\"Orthopedics\" \/><span class=\"wpcf7-list-item-label\">Orthopedics<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fourtynine\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fourtynine[]\" value=\"Osteopathy\" \/><span class=\"wpcf7-list-item-label\">Osteopathy<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fifty\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fifty[]\" value=\"Otorhinolaryngology\" \/><span class=\"wpcf7-list-item-label\">Otorhinolaryngology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fiftyone\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fiftyone[]\" value=\"Pediatrics\" \/><span class=\"wpcf7-list-item-label\">Pediatrics<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fiftytwo\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fiftytwo[]\" value=\"Pneumology\" \/><span class=\"wpcf7-list-item-label\">Pneumology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fiftythree\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fiftythree[]\" value=\"Psychiatry\" \/><span class=\"wpcf7-list-item-label\">Psychiatry<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fiftyfour\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fiftyfour[]\" value=\"Poverty and social inclusion\" \/><span class=\"wpcf7-list-item-label\">Poverty and social inclusion<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fiftyfive\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fiftyfive[]\" value=\"Patient - center relationship\" \/><span class=\"wpcf7-list-item-label\">Patient - center relationship<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fiftysix\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fiftysix[]\" value=\"Radiology\" \/><span class=\"wpcf7-list-item-label\">Radiology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fiftyseven\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fiftyseven[]\" value=\"Rheumatology\" \/><span class=\"wpcf7-list-item-label\">Rheumatology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fiftyeight\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fiftyeight[]\" value=\"Women&#039;s health\" \/><span class=\"wpcf7-list-item-label\">Women&#039;s health<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fiftynine\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"fiftynine[]\" value=\"Health and sport\" \/><span class=\"wpcf7-list-item-label\">Health and sport<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"sixty\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"sixty[]\" value=\"General health\" \/><span class=\"wpcf7-list-item-label\">General health<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"sixtyone\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"sixtyone[]\" value=\"Mental health\" \/><span class=\"wpcf7-list-item-label\">Mental health<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"sixtytwo\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"sixtytwo[]\" value=\"Public health and prevention\" \/><span class=\"wpcf7-list-item-label\">Public health and prevention<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"sixtythree\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"sixtythree[]\" value=\"Reproductive health\" \/><span class=\"wpcf7-list-item-label\">Reproductive health<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"sixtyfour\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"sixtyfour[]\" value=\"All specialties in the social field\" \/><span class=\"wpcf7-list-item-label\">All specialties in the social field<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"sixtyfive\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"sixtyfive[]\" value=\"Traumatology\" \/><span class=\"wpcf7-list-item-label\">Traumatology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"sixtysix\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"sixtysix[]\" value=\"Work\" \/><span class=\"wpcf7-list-item-label\">Work<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"sixtyseven\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"sixtyseven[]\" value=\"Emergencies\" \/><span class=\"wpcf7-list-item-label\">Emergencies<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"sixtyeight\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"sixtyeight[]\" value=\"Urology\" \/><span class=\"wpcf7-list-item-label\">Urology<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<div class=\"form-group\">\n\t\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"sixtynine\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"sixtynine[]\" value=\"Other categories of the social field\" \/><span class=\"wpcf7-list-item-label\">Other categories of the social field<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/section>\n<section class=\"page-section transformacio-cnt contact-div imagtes-last\" id=\"7\">\n\t<div class=\"row\">\n\t\t<div class=\"trans-rgt\">\n\t\t\t<div class=\"trans-two-col\">\n\t\t\t\t<h4>Images\n\t\t\t\t<\/h4>\n\t\t\t\t<ul>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>Images 1 <sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"imatge1\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\"audio\/*,video\/*,image\/*\" aria-invalid=\"false\" type=\"file\" name=\"imatge1\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>Images 2 <sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"imatge2\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\"audio\/*,video\/*,image\/*\" aria-invalid=\"false\" type=\"file\" name=\"imatge2\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t\t<li>\n\t\t\t\t\t\t<p><label>Images 3 <sup>*<\/sup><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"imatge3\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\"audio\/*,video\/*,image\/*\" aria-invalid=\"false\" type=\"file\" name=\"imatge3\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/li>\n\t\t\t\t<\/ul>\n\t\t\t\t<div class=\"terms-sec\">\n\t\t\t\t\t<p><span>Activity of the Treatment:<\/span> Management of communication\n\t\t\t\t\t<\/p>\n\t\t\t\t\t<p><span>Responsible for the Contract:<\/span> Fundacio TIC Salut Social.\n\t\t\t\t\t<\/p>\n\t\t\t\t\t<p><span>Purpose:<\/span> Donate responses to requests for information. The LOPD is kept for the times necessary to attend and manage these sol.licituds.\n\t\t\t\t\t<\/p>\n\t\t\t\t\t<p><span>Legitimacy:<\/span> Legitimate interes according to Art. 6 GDPR. according to which income can maintain a communication with information solicitants.\n\t\t\t\t\t<\/p>\n\t\t\t\t\t<p><span>Recipients:<\/span> Other recipients are not expected to be responsible for the contract.\n\t\t\t\t\t<\/p>\n\t\t\t\t\t<p><span>Rights:<\/span> You can exercise your rights at <a href=\"mailto:dpd-FTSait@ticsalutsocial.cat\">dpd-FTSaitticsalutsocial.cat<\/a>\n\t\t\t\t\t<\/p>\n\t\t\t\t\t<p><span>Additional information:<\/span> You can find the detailed information on our web page: <a href=\"https:\/\/ticsalutsocial.atoom.space\/avis-legal\/\">https:\/\/ticsalutsocial.atoom.space\/avis-legal\/<\/a>\n\t\t\t\t\t<\/p>\n\t\t\t\t\t<div class=\"clear\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"clear\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"terms-checkbox mt-20\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"privacitat\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"privacitat\" value=\"1\" class=\"acceptance\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">I have read and accept the <a href='javascript:void(0);'>privacy policy <\/a><\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"contact-btn\">\n\t\t\t\t\t\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/section><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":21,"featured_media":0,"parent":12968,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-templates\/formulari-contacte.php","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"tipus":[],"class_list":["post-19240","page","type-page","status-publish","hentry"],"acf":{"camps":[{"titol":"Contact person","anchor":"#1"},{"titol":"Developer","anchor":"#5"},{"titol":"Basic Information","anchor":"#2"},{"titol":"Professionals and centers involved","anchor":"#3"},{"titol":"Caracteristics","anchor":"#4"},{"titol":"Category","anchor":"#6"},{"titol":"Screenshots","anchor":"#7"}]},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.1.1 - 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