{"id":97779,"date":"2025-10-14T11:42:54","date_gmt":"2025-10-14T16:42:54","guid":{"rendered":"https:\/\/arl-iowa.org\/socio-comunitario-de-therapets\/"},"modified":"2026-08-18T13:30:22","modified_gmt":"2026-08-18T18:30:22","slug":"socio-comunitario-de-therapets","status":"publish","type":"page","link":"https:\/\/arl-iowa.org\/es\/participe\/programa-therapets-blumenthal\/socio-comunitario-de-therapets\/","title":{"rendered":"Socio Comunitario de TheraPets"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row full_width=\u00bbstretch_row\u00bb css=\u00bb.vc_custom_1755268464663{background-color: #E8E1D4 !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}\u00bb][vc_column css=\u00bb.vc_custom_1759879488861{padding-top: 0px !important;}\u00bb][vc_custom_heading source=\u00bbpost_title\u00bb font_container=\u00bbtag:h1|text_align:left|color:%23652D89&#8243; use_theme_fonts=\u00bbyes\u00bb css=\u00bb.vc_custom_1760465959486{margin-top: 20px !important;margin-bottom: 20px !important;}\u00bb el_class=\u00bbsub-child\u00bb][\/vc_column][\/vc_row][vc_row gap=\u00bb35&#8243;][vc_column][vc_custom_heading text=\u00bbPor favor, revise lo siguiente antes de enviar su solicitud:\u00bb use_theme_fonts=\u00bbyes\u00bb css=\u00bb\u00bb][vc_column_text css=\u00bb\u00bb]<\/p>\n<p>Por favor, revise lo siguiente antes de enviar su solicitud:<\/p>\n<ul>\n<li>La solicitud debe proceder de un representante del centro que desee convertirse en Socio Comunitario de TheraPets.<\/li>\n<li>En este momento, solo podemos considerar centros situados en el centro de Iowa.<\/li>\n<li>Tenga en cuenta que puede haber una lista de espera para las visitas.<\/li>\n<li>La cumplimentaci\u00f3n de este formulario no garantiza nuestra capacidad para colaborar con usted.<\/li>\n<li>Tras el env\u00edo, nuestro equipo se pondr\u00e1 en contacto con usted para tratar los detalles.<\/li>\n<\/ul>\n<p><em>Como organizaci\u00f3n sin \u00e1nimo de lucro, la ARL depende exclusivamente de las donaciones para financiar nuestro programa TheraPets. Para realizar una donaci\u00f3n puntual o mensual y ayudar a mantener la programaci\u00f3n de TheraPets en nuestra comunidad, haga clic <strong><a href=\"https:\/\/secure3.convio.net\/arli\/site\/Donation2?idb=1056385178&amp;DONATION_LEVEL_ID_SELECTED=1&amp;df_id=3302&amp;3302.donation=form1&amp;mfc_pref=T&amp;idb=[[S76:idb]]&amp;ipve=1427\" target=\"_blank\" rel=\"noopener\">aqu\u00ed<\/a><\/strong> e indique la referencia \u201cTheraPets\u201d. <\/em><\/p>\n<p>[\/vc_column_text][vc_separator border_width=\u00bb3&#8243; css=\u00bb\u00bb][vc_column_text css=\u00bb\u00bb]<\/p>\n<p><strong>Nota:<\/strong> Debido a las normativas de los seguros, los equipos de TheraPets nunca tienen permitido visitar residencias privadas, a menos que sea bajo la direcci\u00f3n y supervisi\u00f3n directa de una agencia de atenci\u00f3n sanitaria a domicilio que sea socia actual de TheraPets y solicite la visita en nombre de su cliente.<\/p>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_separator border_width=\u00bb3&#8243; css=\u00bb\u00bb][\/vc_column][\/vc_row][vc_row][vc_column]<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 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var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-btn-bg-color-hover-tertiary: #EBEBEB;--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><div id='gf_8' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_8' id='gform_8'  action='\/es\/wp-json\/wp\/v2\/pages\/97779#gf_8' data-formid='8' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_8' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_8_1\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Informaci\u00f3n del centro<\/h3><\/div><div id=\"field_8_3\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_3'><span class='gform-field-label__text'>Nombre del centro<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_8_3' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_4\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_4'><span class='gform-field-label__text'>\u00bfEs este centro u organizaci\u00f3n sin \u00e1nimo de lucro?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_4' id='input_8_4' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='S\u00ed' >S\u00ed<\/option><option value='No' >No<\/option><option value='No aplicable' >No aplicable<\/option><\/select><\/div><\/div><fieldset id=\"field_8_5\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Direcci\u00f3n<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_8_5' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_8_5_1_container' >\n                                        <input type='text' name='input_5.1' id='input_8_5_1' value=''    aria-required='true'    \/>\n                                        <label for='input_8_5_1' id='input_8_5_1_label' class='gform-field-label gform-field-label--type-sub '>Direcci\u00f3n<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_8_5_3_container' >\n                                    <input type='text' name='input_5.3' id='input_8_5_3' value=''    aria-required='true'    \/>\n                                    <label for='input_8_5_3' id='input_8_5_3_label' class='gform-field-label gform-field-label--type-sub '>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_8_5_4_container' >\n                                        <select name='input_5.4' id='input_8_5_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Samoa Americana' >Samoa Americana<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' selected='selected'>Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Islas Marianas del Norte' >Islas Marianas del Norte<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Islas V\u00edrgenes de los Estados Unidos' >Islas V\u00edrgenes de los Estados Unidos<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_8_5_4' id='input_8_5_4_label' class='gform-field-label gform-field-label--type-sub '>Provincia<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_8_5_5_container' >\n                                    <input type='text' name='input_5.5' id='input_8_5_5' value=''    aria-required='true'    \/>\n                                    <label for='input_8_5_5' id='input_8_5_5_label' class='gform-field-label gform-field-label--type-sub '>C\u00f3digo Postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_5.6' id='input_8_5_6' value='US' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_8_7\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_3col gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Tipo de centro<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_8_7'><div class='gchoice gchoice_8_7_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.4' type='checkbox'  value='Hospital'  id='choice_8_7_1'   aria-describedby=\"gfield_description_8_7\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_1' id='label_8_7_1' class='gform-field-label gform-field-label--type-inline'>Hospital<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.5' type='checkbox'  value='Hospital infantil'  id='choice_8_7_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_2' id='label_8_7_2' class='gform-field-label gform-field-label--type-inline'>Hospital infantil<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.6' type='checkbox'  value='Tratamiento residencial - Salud mental'  id='choice_8_7_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_3' id='label_8_7_3' class='gform-field-label gform-field-label--type-inline'>Tratamiento residencial - Salud mental<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.7' type='checkbox'  value='Tratamiento residencial - Adicciones'  id='choice_8_7_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_4' id='label_8_7_4' class='gform-field-label gform-field-label--type-inline'>Tratamiento residencial - Adicciones<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.8' type='checkbox'  value='Programa de habilitaci\u00f3n de d\u00eda'  id='choice_8_7_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_5' id='label_8_7_5' class='gform-field-label gform-field-label--type-inline'>Programa de habilitaci\u00f3n de d\u00eda<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.9' type='checkbox'  value='Vida asistida \/ Cuidado de la memoria'  id='choice_8_7_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_6' id='label_8_7_6' class='gform-field-label gform-field-label--type-inline'>Vida asistida \/ Cuidado de la memoria<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.11' type='checkbox'  value='Residencia de ancianos \/ Cuidados a largo plazo'  id='choice_8_7_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_7' id='label_8_7_7' class='gform-field-label gform-field-label--type-inline'>Residencia de ancianos \/ Cuidados a largo plazo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.12' type='checkbox'  value='Hospital de veteranos \/ Centro de cuidados'  id='choice_8_7_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_8' id='label_8_7_8' class='gform-field-label gform-field-label--type-inline'>Hospital de veteranos \/ Centro de cuidados<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.13' type='checkbox'  value='Centro de d\u00eda terap\u00e9utico para mayores\/adultos'  id='choice_8_7_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_9' id='label_8_7_9' class='gform-field-label gform-field-label--type-inline'>Centro de d\u00eda terap\u00e9utico para mayores\/adultos<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.14' type='checkbox'  value='Cuidados paliativos'  id='choice_8_7_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_11' id='label_8_7_11' class='gform-field-label gform-field-label--type-inline'>Cuidados paliativos<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.15' type='checkbox'  value='Refugio'  id='choice_8_7_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_12' id='label_8_7_12' class='gform-field-label gform-field-label--type-inline'>Refugio<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.16' type='checkbox'  value='Biblioteca'  id='choice_8_7_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_13' id='label_8_7_13' class='gform-field-label gform-field-label--type-inline'>Biblioteca<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.17' type='checkbox'  value='Aeropuerto'  id='choice_8_7_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_14' id='label_8_7_14' class='gform-field-label gform-field-label--type-inline'>Aeropuerto<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.18' type='checkbox'  value='Preescolar \/ Guarder\u00eda'  id='choice_8_7_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_15' id='label_8_7_15' class='gform-field-label gform-field-label--type-inline'>Preescolar \/ Guarder\u00eda<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.19' type='checkbox'  value='Escuela primaria'  id='choice_8_7_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_16' id='label_8_7_16' class='gform-field-label gform-field-label--type-inline'>Escuela primaria<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.21' type='checkbox'  value='Escuela secundaria'  id='choice_8_7_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_17' id='label_8_7_17' class='gform-field-label gform-field-label--type-inline'>Escuela secundaria<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.22' type='checkbox'  value='Instituto'  id='choice_8_7_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_18' id='label_8_7_18' class='gform-field-label gform-field-label--type-inline'>Instituto<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.23' type='checkbox'  value='Aula de educaci\u00f3n especial'  id='choice_8_7_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_19' id='label_8_7_19' class='gform-field-label gform-field-label--type-inline'>Aula de educaci\u00f3n especial<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_7_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.24' type='checkbox'  value='Vida con apoyo'  id='choice_8_7_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_7_21' id='label_8_7_21' class='gform-field-label gform-field-label--type-inline'>Vida con apoyo<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_8_7'>(marque todas las opciones que correspondan)<\/div><\/fieldset><div id=\"field_8_8\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Persona de contacto<\/h3><\/div><fieldset id=\"field_8_9\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Nombre<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_8_9'>\n                            \n                            <span id='input_8_9_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_9.3' id='input_8_9_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_8_9_3' class='gform-field-label gform-field-label--type-sub '>Nombre<\/label>\n                                                <\/span>\n                            \n                            <span id='input_8_9_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_9.6' id='input_8_9_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_8_9_6' class='gform-field-label gform-field-label--type-sub '>Apellidos<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_8_10\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_10'><span class='gform-field-label__text'>Cargo<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_8_10' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_11\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_11'><span class='gform-field-label__text'>Tel\u00e9fono<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_11' id='input_8_11' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/div><div id=\"field_8_12\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_12'><span class='gform-field-label__text'>Correo electr\u00f3nico<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_12' id='input_8_12' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_8_13\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Informaci\u00f3n de la visita<\/h3><\/div><fieldset id=\"field_8_14\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-radio gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>D\u00edas disponibles para visitas<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_14'>\n\t\t\t<div class='gchoice gchoice_8_14_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Domingo'  id='choice_8_14_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_14_0' id='label_8_14_0' class='gform-field-label gform-field-label--type-inline'>Domingo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_14_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Lunes'  id='choice_8_14_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_14_1' id='label_8_14_1' class='gform-field-label gform-field-label--type-inline'>Lunes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_14_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Martes'  id='choice_8_14_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_14_2' id='label_8_14_2' class='gform-field-label gform-field-label--type-inline'>Martes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_14_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Mi\u00e9rcoles'  id='choice_8_14_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_14_3' id='label_8_14_3' class='gform-field-label gform-field-label--type-inline'>Mi\u00e9rcoles<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_14_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Jueves'  id='choice_8_14_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_14_4' id='label_8_14_4' class='gform-field-label gform-field-label--type-inline'>Jueves<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_14_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Viernes'  id='choice_8_14_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_14_5' id='label_8_14_5' class='gform-field-label gform-field-label--type-inline'>Viernes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_14_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='S\u00e1bado'  id='choice_8_14_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_14_6' id='label_8_14_6' class='gform-field-label gform-field-label--type-inline'>S\u00e1bado<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_8_15\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-radio gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Momento del d\u00eda<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_15'>\n\t\t\t<div class='gchoice gchoice_8_15_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Ma\u00f1ana, 9-11 h'  id='choice_8_15_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_15_0' id='label_8_15_0' class='gform-field-label gform-field-label--type-inline'>Ma\u00f1ana, 9-11 h<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_15_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Mediod\u00eda, 12-15 h'  id='choice_8_15_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_15_1' id='label_8_15_1' class='gform-field-label gform-field-label--type-inline'>Mediod\u00eda, 12-15 h<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_15_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Tarde, 15-17 h'  id='choice_8_15_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_15_2' id='label_8_15_2' class='gform-field-label gform-field-label--type-inline'>Tarde, 15-17 h<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_15_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Noche, 17-19 h'  id='choice_8_15_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_15_3' id='label_8_15_3' class='gform-field-label gform-field-label--type-inline'>Noche, 17-19 h<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_15_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='A cualquier hora'  id='choice_8_15_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_15_4' id='label_8_15_4' class='gform-field-label gform-field-label--type-inline'>A cualquier hora<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_8_16\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-checkbox gfield--width-third gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Idealmente, \u00bfcon qu\u00e9 frecuencia le gustar\u00eda recibir visitas?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_8_16'><div class='gchoice gchoice_8_16_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.17' type='checkbox'  value='Cuando est\u00e9 disponible'  id='choice_8_16_1'   aria-describedby=\"gfield_description_8_16\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_8_16_1' id='label_8_16_1' class='gform-field-label gform-field-label--type-inline'>Cuando est\u00e9 disponible<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_16_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.18' type='checkbox'  value='Mensualmente'  id='choice_8_16_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_16_2' id='label_8_16_2' class='gform-field-label gform-field-label--type-inline'>Mensualmente<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_16_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.19' type='checkbox'  value='Quincenalmente'  id='choice_8_16_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_16_3' id='label_8_16_3' class='gform-field-label gform-field-label--type-inline'>Quincenalmente<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_16_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.21' type='checkbox'  value='Semanalmente'  id='choice_8_16_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_16_4' id='label_8_16_4' class='gform-field-label gform-field-label--type-inline'>Semanalmente<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_16_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.22' type='checkbox'  value='Dos veces por semana'  id='choice_8_16_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_16_5' id='label_8_16_5' class='gform-field-label gform-field-label--type-inline'>Dos veces por semana<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_8_16'>Marque todas las que correspondan (la elecci\u00f3n no garantiza disponibilidad)<\/div><\/fieldset><div id=\"field_8_17\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_17'><span class='gform-field-label__text'>Describa el \u00e1rea donde se realizar\u00e1n nuestras visitas<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_17' id='input_8_17' class='textarea small'  aria-describedby=\"gfield_description_8_17\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_8_17'>(ubicaci\u00f3n centralizada, habitaciones individuales, etc.)<\/div><\/div><fieldset id=\"field_8_18\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Especie preferida de TheraPet visitante<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_18'>\n\t\t\t<div class='gchoice gchoice_8_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Perros'  id='choice_8_18_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_18_0' id='label_8_18_0' class='gform-field-label gform-field-label--type-inline'>Perros<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Gatos'  id='choice_8_18_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_18_1' id='label_8_18_1' class='gform-field-label gform-field-label--type-inline'>Gatos<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_18_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Conejo\/Cobaya'  id='choice_8_18_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_18_2' id='label_8_18_2' class='gform-field-label gform-field-label--type-inline'>Conejo\/Cobaya<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_18_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Ave'  id='choice_8_18_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_18_3' id='label_8_18_3' class='gform-field-label gform-field-label--type-inline'>Ave<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_18_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Cualquier animal'  id='choice_8_18_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_18_4' id='label_8_18_4' class='gform-field-label gform-field-label--type-inline'>Cualquier animal<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_8_19\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-checkbox gfield--width-full gf_list_3col gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Descripci\u00f3n de los clientes<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_8_19'><div class='gchoice gchoice_8_19_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.17' type='checkbox'  value='Personas mayores'  id='choice_8_19_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_19_1' id='label_8_19_1' class='gform-field-label gform-field-label--type-inline'>Personas mayores<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_19_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.18' type='checkbox'  value='Deterioro de la memoria'  id='choice_8_19_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_19_2' id='label_8_19_2' class='gform-field-label gform-field-label--type-inline'>Deterioro de la memoria<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_19_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.19' type='checkbox'  value='Salud fr\u00e1gil'  id='choice_8_19_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_19_3' id='label_8_19_3' class='gform-field-label gform-field-label--type-inline'>Salud fr\u00e1gil<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_19_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.21' type='checkbox'  value='Lesi\u00f3n cerebral traum\u00e1tica'  id='choice_8_19_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_19_4' id='label_8_19_4' class='gform-field-label gform-field-label--type-inline'>Lesi\u00f3n cerebral traum\u00e1tica<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_19_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.22' type='checkbox'  value='Discapacidades f\u00edsicas'  id='choice_8_19_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_19_5' id='label_8_19_5' class='gform-field-label gform-field-label--type-inline'>Discapacidades f\u00edsicas<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_19_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.23' type='checkbox'  value='Trastornos de ansiedad'  id='choice_8_19_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_19_6' id='label_8_19_6' class='gform-field-label gform-field-label--type-inline'>Trastornos de ansiedad<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_19_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.24' type='checkbox'  value='Condiciones de salud mental'  id='choice_8_19_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_19_7' id='label_8_19_7' class='gform-field-label gform-field-label--type-inline'>Condiciones de salud mental<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_19_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.25' type='checkbox'  value='Discapacidades del desarrollo'  id='choice_8_19_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_19_8' id='label_8_19_8' class='gform-field-label gform-field-label--type-inline'>Discapacidades del desarrollo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_19_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.26' type='checkbox'  value='Discapacidades intelectuales'  id='choice_8_19_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_19_9' id='label_8_19_9' class='gform-field-label gform-field-label--type-inline'>Discapacidades intelectuales<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_19_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.27' type='checkbox'  value='Ni\u00f1os (infantil)'  id='choice_8_19_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_19_11' id='label_8_19_11' class='gform-field-label gform-field-label--type-inline'>Ni\u00f1os (infantil)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_19_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.28' type='checkbox'  value='Ni\u00f1os (1.\u00ba-2.\u00ba primaria)'  id='choice_8_19_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_19_12' id='label_8_19_12' class='gform-field-label gform-field-label--type-inline'>Ni\u00f1os (1.\u00ba-2.\u00ba primaria)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_19_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.29' type='checkbox'  value='Ni\u00f1os (3.\u00ba-5.\u00ba primaria)'  id='choice_8_19_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_19_13' id='label_8_19_13' class='gform-field-label gform-field-label--type-inline'>Ni\u00f1os (3.\u00ba-5.\u00ba primaria)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_19_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.31' type='checkbox'  value='Ni\u00f1os (secundaria)'  id='choice_8_19_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_19_14' id='label_8_19_14' class='gform-field-label gform-field-label--type-inline'>Ni\u00f1os (secundaria)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_19_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.32' type='checkbox'  value='Ni\u00f1os (bachillerato)'  id='choice_8_19_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_19_15' id='label_8_19_15' class='gform-field-label gform-field-label--type-inline'>Ni\u00f1os (bachillerato)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_19_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.33' type='checkbox'  value='Adultos'  id='choice_8_19_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_19_16' id='label_8_19_16' class='gform-field-label gform-field-label--type-inline'>Adultos<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_8_20\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_20'><span class='gform-field-label__text'>\u00bfCu\u00e1ntas personas (de media) espera que participen en nuestras visitas?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_8_20' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_8_21\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_21'><span class='gform-field-label__text'>\u00bfReside alguna mascota en su centro? (gato\/perro del centro, mascotas de los residentes, etc.) En caso afirmativo, \u00bfde qu\u00e9 especie, cu\u00e1ntas y d\u00f3nde se encuentran?  <\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_21' id='input_8_21' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_8_22\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_22'><span class='gform-field-label__text'>\u00bfReciben otras visitas de mascotas? En caso afirmativo, \u00bfde qui\u00e9n y con qu\u00e9 frecuencia? <\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_22' id='input_8_22' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_8_23\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_23'><span class='gform-field-label__text'>Describa sus requisitos para los nuevos voluntarios (orientaci\u00f3n, comprobaci\u00f3n de antecedentes, examen de salud, etc.)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_23' id='input_8_23' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_8_24\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_24'><span class='gform-field-label__text'>\u00bfC\u00f3mo cree que las visitas de TheraPets beneficiar\u00e1n a su centro? (por favor, sea espec\u00edfico para que podamos asignarle el equipo que mejor se adapte a sus necesidades) <\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_24' id='input_8_24' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_8_25\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_25'><span class='gform-field-label__text'>Por favor, comparta cualquier otra informaci\u00f3n sobre su centro que considere \u00fatil para nosotros y nuestros voluntarios (aparcamiento, entrada al edificio, etc.)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_25' id='input_8_25' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_8_26\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_26'><span class='gform-field-label__text'>\u00bfC\u00f3mo se enter\u00f3 de ARL TheraPets?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_26' id='input_8_26' class='large gfield_select'     aria-invalid=\"false\" ><option value='Sitio web de ARL' >Sitio web de ARL<\/option><option value='Redes sociales' >Redes sociales<\/option><option value='TV' >TV<\/option><option value='Voluntario de TheraPets' >Voluntario de TheraPets<\/option><option value='Personal de ARL' >Personal de ARL<\/option><option value='Recomendaci\u00f3n de un socio actual' >Recomendaci\u00f3n de un socio actual<\/option><option value='Evento\/Visita de TheraPets' >Evento\/Visita de TheraPets<\/option><option value='Otros' >Otros<\/option><\/select><\/div><\/div><div id=\"field_8_27\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h4>Aunque nos esforzamos por responder a cada solicitud de visita y hacerlo de manera oportuna, el continuo aumento de la demanda de los servicios de nuestro programa ha dificultado, en ocasiones, la consecuci\u00f3n de este objetivo. \nPor favor, t\u00e9ngalo en cuenta al enviar su solicitud.<\/h4><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_8' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Enviar<\/button> <input type='hidden' name='gform_ajax' value='form_id=8&amp;title=&amp;description=&amp;tabindex=0&amp;theme=orbital&amp;styles=[]&amp;hash=6ce2a498a7006fa7b95b4eee7b7d4557' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_8' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_8' id='gform_theme_8' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_8' id='gform_style_settings_8' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_8' value='1' \/>\n            <input 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