{"id":9,"date":"2024-08-29T00:37:30","date_gmt":"2024-08-29T04:37:30","guid":{"rendered":"https:\/\/acquachi.com\/frequency\/?page_id=9"},"modified":"2024-10-03T18:26:00","modified_gmt":"2024-10-03T22:26:00","slug":"frequecy","status":"publish","type":"page","link":"https:\/\/acquachi.com\/frequency\/","title":{"rendered":"Informacion Cliente \/ Client Info"},"content":{"rendered":"<div class=\"wpforms-container wpforms-container-full wpforms-block wpforms-block-916b755c-38e7-4a61-90b3-06a5ab22f440 wpforms-render-modern\" id=\"wpforms-6\"><form id=\"wpforms-form-6\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"6\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/frequency\/wp-json\/wp\/v2\/pages\/9\" data-token=\"88167843ad1c443c467926ae6e4439ae\" data-token-time=\"1775520016\"><noscript class=\"wpforms-error-noscript\">Por favor, activa JavaScript en tu navegador para completar este formulario.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Por favor, activa JavaScript en tu navegador para completar este formulario.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-6-field_5-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-6-field_5\">Fecha \/ Date<\/label><input type=\"text\" id=\"wpforms-6-field_5\" class=\"wpforms-field-medium\" name=\"wpforms[fields][5]\" aria-errormessage=\"wpforms-6-field_5-error\" ><\/div>\t\t<div id=\"wpforms-6-field_4-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"4\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-6-field_4\" >\/ alg\u00fan \/<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-6-field_4\" class=\"wpforms-field-medium\" name=\"wpforms[fields][4]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-6-field_1-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"1\"><fieldset><legend class=\"wpforms-field-label\">Nombre \/ Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-6-field_1\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][1][first]\" aria-errormessage=\"wpforms-6-field_1-error\" required><label for=\"wpforms-6-field_1\" class=\"wpforms-field-sublabel after\">Nombre<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-6-field_1-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][1][last]\" aria-errormessage=\"wpforms-6-field_1-last-error\" required><label for=\"wpforms-6-field_1-last\" class=\"wpforms-field-sublabel after\">Apellidos<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-6-field_6-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-6-field_6\">Fecha de Nacimiento \/ Date of Birth<\/label><input type=\"text\" id=\"wpforms-6-field_6\" class=\"wpforms-field-medium\" name=\"wpforms[fields][6]\" aria-errormessage=\"wpforms-6-field_6-error\" ><\/div><div id=\"wpforms-6-field_15-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-6-field_15\">Telefono movil \/ Cell Phone<\/label><input type=\"text\" id=\"wpforms-6-field_15\" class=\"wpforms-field-medium\" name=\"wpforms[fields][15]\" aria-errormessage=\"wpforms-6-field_15-error\" ><\/div><div id=\"wpforms-6-field_2-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-6-field_2\">Correo electr\u00f3nico \/ email <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-6-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" spellcheck=\"false\" aria-errormessage=\"wpforms-6-field_2-error\" required><\/div><div id=\"wpforms-6-field_7-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-6-field_7\">Ciudad, Pais \/ City, Country<\/label><input type=\"text\" id=\"wpforms-6-field_7\" class=\"wpforms-field-medium\" name=\"wpforms[fields][7]\" aria-errormessage=\"wpforms-6-field_7-error\" ><\/div><div id=\"wpforms-6-field_8-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-6-field_8\">Profesi\u00f3n \/ Occupation<\/label><input type=\"text\" id=\"wpforms-6-field_8\" class=\"wpforms-field-medium\" name=\"wpforms[fields][8]\" aria-errormessage=\"wpforms-6-field_8-error\" ><\/div><div id=\"wpforms-6-field_9-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-6-field_9\">Persona que lo refiere \/ Referrals<\/label><input type=\"text\" id=\"wpforms-6-field_9\" class=\"wpforms-field-medium\" name=\"wpforms[fields][9]\" aria-errormessage=\"wpforms-6-field_9-error\" ><\/div><div id=\"wpforms-6-field_14-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-6-field_14\">Usa Marcapasos \/ Do you use a Pacemaker ?<\/label><select id=\"wpforms-6-field_14\" class=\"wpforms-field-medium\" name=\"wpforms[fields][14]\"><option value=\"Si\"  class=\"choice-1 depth-1\"  >Si<\/option><option value=\"No\"  selected='selected' class=\"choice-2 depth-1\"  >No<\/option><\/select><\/div><div id=\"wpforms-6-field_11-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"11\"><fieldset><legend class=\"wpforms-field-label\">Selecione cual de estos problemas de salud padece principalmente<\/legend><ul id=\"wpforms-6-field_11\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-6-field_11_1\" name=\"wpforms[fields][11]\" value=\"Dolor de Espalda \/ Back Pain\" aria-errormessage=\"wpforms-6-field_11_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6-field_11_1\">Dolor de Espalda \/ Back Pain<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-6-field_11_2\" name=\"wpforms[fields][11]\" value=\"Dolor Articulaciones \/ Joint Pain\" aria-errormessage=\"wpforms-6-field_11_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6-field_11_2\">Dolor Articulaciones \/ Joint Pain<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"radio\" id=\"wpforms-6-field_11_7\" name=\"wpforms[fields][11]\" value=\"Nivel de Estres diario \/ Stress Level\" aria-errormessage=\"wpforms-6-field_11_7-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6-field_11_7\">Nivel de Estres diario \/ Stress Level<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-6-field_11_6\" name=\"wpforms[fields][11]\" value=\"Hernias \/ Disc Blockages\" aria-errormessage=\"wpforms-6-field_11_6-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6-field_11_6\">Hernias \/ Disc Blockages<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-6-field_11_5\" name=\"wpforms[fields][11]\" value=\"Hemorroides \/ Hemorrhoids\" aria-errormessage=\"wpforms-6-field_11_5-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6-field_11_5\">Hemorroides \/ Hemorrhoids<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-6-field_11_4\" name=\"wpforms[fields][11]\" value=\"Golpes de Calor \/ Heat Strokes\" aria-errormessage=\"wpforms-6-field_11_4-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6-field_11_4\">Golpes de Calor \/ Heat Strokes<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-6-field_11_3\" name=\"wpforms[fields][11]\" value=\"Tos o Respiracion Forzada \/ Cough\" aria-errormessage=\"wpforms-6-field_11_3-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6-field_11_3\">Tos o Respiracion Forzada \/ Cough<\/label><\/li><li class=\"choice-9 depth-1\"><input type=\"radio\" id=\"wpforms-6-field_11_9\" name=\"wpforms[fields][11]\" value=\"Convulsiones \/ Convulsions\" aria-errormessage=\"wpforms-6-field_11_9-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6-field_11_9\">Convulsiones \/ Convulsions<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"radio\" id=\"wpforms-6-field_11_8\" name=\"wpforms[fields][11]\" value=\"Otros \/ Others\" aria-errormessage=\"wpforms-6-field_11_8-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-6-field_11_8\">Otros \/ Others<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-6-field_3-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-6-field_3\">Otros \/ Others (Especifique\/ Specify)<\/label><textarea id=\"wpforms-6-field_3\" class=\"wpforms-field-medium\" name=\"wpforms[fields][3]\" aria-errormessage=\"wpforms-6-field_3-error\" ><\/textarea><\/div><div id=\"wpforms-6-field_16-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-6-field_16\">Se esta efectuando alg\u00fan tratamiento \/ Under any Treatment (copia)<\/label><select id=\"wpforms-6-field_16\" class=\"wpforms-field-medium\" name=\"wpforms[fields][16]\"><option value=\"Si\"  selected='selected' class=\"choice-1 depth-1\"  >Si<\/option><option value=\"No\"  class=\"choice-2 depth-1\"  >No<\/option><\/select><\/div><div id=\"wpforms-6-field_13-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-6-field_13\">Tratamiento \/ Treatment (Especifique \/ Specify)<\/label><textarea id=\"wpforms-6-field_13\" class=\"wpforms-field-medium\" name=\"wpforms[fields][13]\" aria-errormessage=\"wpforms-6-field_13-error\" ><\/textarea><\/div><div id=\"wpforms-6-field_12-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-6-field_12\">Que Desea Trabajar en la sesion \/ What you Want to Work on the session ?<\/label><textarea id=\"wpforms-6-field_12\" class=\"wpforms-field-large\" name=\"wpforms[fields][12]\" aria-errormessage=\"wpforms-6-field_12-error\" ><\/textarea><\/div><script>\n\t\t\t\t( function() {\n\t\t\t\t\tconst style = document.createElement( 'style' );\n\t\t\t\t\tstyle.appendChild( document.createTextNode( '#wpforms-6-field_4-container { position: absolute !important; overflow: hidden !important; display: inline !important; height: 1px !important; width: 1px 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src=\"https:\/\/acquachi.com\/frequency\/wp-content\/plugins\/wpforms-lite\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Cargando\"><\/div><\/form><\/div>  <!-- .wpforms-container -->\n\n\n<div class=\"wp-block-group alignfull\" style=\"margin-top:0;margin-bottom:0;padding-top:var(--wp--preset--spacing--50);padding-right:var(--wp--preset--spacing--50);padding-bottom:var(--wp--preset--spacing--50);padding-left:var(--wp--preset--spacing--50)\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-container-core-group-is-layout-d89aad35 wp-block-group-is-layout-constrained\">\n<div class=\"wp-block-columns alignwide are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-47c06fe3 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<h2 class=\"wp-block-heading\"><\/h2>\n\n\n\n<ul style=\"line-height:1.75\" class=\"wp-block-list is-style-checkmark-list\">\n<li>La sesion de ACQUA CHI FFRECUENCIAS no conlleva en principio riesgo alguno para la salud.<br>No obstante, de padecer usted alguno de los trastornos o problemas arriba expuestos, se requerira la autorizacion<br>por parte de su m\u00e9dico para poder hacer uso de nuestras instalaciones.<\/li>\n\n\n\n<li>En caso, de que quiera usted omitir este requisito, firmar\u00e1 al pie de la presente hoja que asume usted, toda<br>la responsabilidad por el uso de nuestras instaciones, exonerandonos<br>de cualquier trastorno que pueda sobrevenir mientras este en uso de nuestros equipos.<\/li>\n\n\n\n<li>la responsabilidad por el uso de nuestras instaciones, exonerandonos de cualquier trastorno que pueda sobrevenir mientras este en uso de nuestros equipos.<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/acquachi.com\/\">Home<\/a><\/div>\n\n\n\n<div class=\"wp-block-button is-style-outline is-style-outline--1\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/acquachi.com\/store\">Store<\/a><\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img loading=\"lazy\" decoding=\"async\" width=\"1218\" height=\"822\" src=\"https:\/\/acquachi.com\/frequency\/wp-content\/uploads\/2024\/08\/ACQUA-CHI-RAIN-2024-2.png\" alt=\"\" class=\"wp-image-23\" style=\"aspect-ratio:4\/3;object-fit:cover\" srcset=\"https:\/\/acquachi.com\/frequency\/wp-content\/uploads\/2024\/08\/ACQUA-CHI-RAIN-2024-2.png 1218w, https:\/\/acquachi.com\/frequency\/wp-content\/uploads\/2024\/08\/ACQUA-CHI-RAIN-2024-2-300x202.png 300w, 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\/><\/figure>\n<\/div>\n<\/div>\n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-9","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/acquachi.com\/frequency\/wp-json\/wp\/v2\/pages\/9","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/acquachi.com\/frequency\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/acquachi.com\/frequency\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/acquachi.com\/frequency\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/acquachi.com\/frequency\/wp-json\/wp\/v2\/comments?post=9"}],"version-history":[{"count":16,"href":"https:\/\/acquachi.com\/frequency\/wp-json\/wp\/v2\/pages\/9\/revisions"}],"predecessor-version":[{"id":61,"href":"https:\/\/acquachi.com\/frequency\/wp-json\/wp\/v2\/pages\/9\/revisions\/61"}],"wp:attachment":[{"href":"https:\/\/acquachi.com\/frequency\/wp-json\/wp\/v2\/media?parent=9"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}