{"id":7872,"date":"2018-12-14T10:02:17","date_gmt":"2018-12-14T18:02:17","guid":{"rendered":"http:\/\/pmtest.passy-muir.com\/?page_id=7872"},"modified":"2019-02-15T10:02:03","modified_gmt":"2019-02-15T18:02:03","slug":"share-your-story","status":"publish","type":"page","link":"http:\/\/1.passy-muir.com\/es\/share-your-story\/","title":{"rendered":"Comparta su historia"},"content":{"rendered":"<div class=\"l3-header-con no-banner\">\n<div class=\"l3-header-text\">\n\t\t\tShare Your Story\n                         <\/div>\n<\/p><\/div>\n<div style=\"clear:both\"><\/div>\n<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-7726\"><form id=\"wpforms-form-7726\" class=\"wpforms-validate wpforms-form\" data-formid=\"7726\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/es\/wp-json\/wp\/v2\/pages\/7872?wpforms_form_id=7726\" data-token=\"3f89088403c2741ef271c18a2c7b81a4\" data-token-time=\"1779649936\"><noscript class=\"wpforms-error-noscript\">Por favor, activa JavaScript en tu navegador para completar este formulario.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-7726-field_0-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"0\"><label class=\"wpforms-field-label\">Name <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-7726-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" required><label for=\"wpforms-7726-field_0\" class=\"wpforms-field-sublabel after\">Nombre<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-7726-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" required><label for=\"wpforms-7726-field_0-last\" class=\"wpforms-field-sublabel after\">Apellidos<\/label><\/div><\/div><\/div><div id=\"wpforms-7726-field_3-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-7726-field_3\">Phone Number<\/label><input type=\"number\" id=\"wpforms-7726-field_3\" class=\"wpforms-field-medium\" name=\"wpforms[fields][3]\" step=\"any\" ><\/div><div id=\"wpforms-7726-field_7-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"7\"><label class=\"wpforms-field-label\">Address<\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-7726-field_7\" class=\"wpforms-field-address-address1\" name=\"wpforms[fields][7][address1]\" ><label for=\"wpforms-7726-field_7\" class=\"wpforms-field-sublabel after\">Direcci\u00f3n (l\u00ednea 1)<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-7726-field_7-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][7][address2]\" ><label for=\"wpforms-7726-field_7-address2\" class=\"wpforms-field-sublabel after\">Direcci\u00f3n 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-7726-field_7-city\" class=\"wpforms-field-address-city\" name=\"wpforms[fields][7][city]\" ><label for=\"wpforms-7726-field_7-city\" class=\"wpforms-field-sublabel after\">Ciudad<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-7726-field_7-state\" class=\"wpforms-field-address-state\" name=\"wpforms[fields][7][state]\" ><option class=\"placeholder\" value=\"\" selected disabled>--- Selecciona state ---<\/option><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >Distrito de Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawai<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Luisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >M\u00edchigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Misisip\u00ed<\/option><option value=\"MO\" >Misuri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >Nuevo Hampshire<\/option><option value=\"NJ\" >Nueva Jersey<\/option><option value=\"NM\" >Nuevo M\u00e9xico<\/option><option value=\"NY\" >Nueva York<\/option><option value=\"NC\" >Carolina del norte<\/option><option value=\"ND\" >Dakota del norte<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oreg\u00f3n<\/option><option value=\"PA\" >Pensilvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >Carolina del Sur<\/option><option value=\"SD\" >Dakota del Sur<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >Virginia Occidental<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-7726-field_7-state\" class=\"wpforms-field-sublabel after\">Provincia<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-7726-field_7-postal\" class=\"wpforms-field-address-postal wpforms-masked-input\" data-inputmask-mask=\"(99999)|(99999-9999)\" data-inputmask-keepstatic=\"true\" data-rule-inputmask-incomplete=\"1\" name=\"wpforms[fields][7][postal]\" ><label for=\"wpforms-7726-field_7-postal\" class=\"wpforms-field-sublabel after\">C\u00f3digo Postal<\/label><\/div><\/div><\/div><div id=\"wpforms-7726-field_1-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-7726-field_1\">Email <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-7726-field_1\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][1]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-7726-field_2-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-7726-field_2\">We&#039;d love to hear about your experience using the Passy-Muir\u00ae Valve. What were your first words using the Valve? Do you have anything you&#039;d like to tell other people who are interested in using the Passy-Muir Valve? <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-7726-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" required><\/textarea><\/div><div id=\"wpforms-7726-field_4-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"4\"><label class=\"wpforms-field-label\">The undersigned hereby authorizes Passy-Muir, Inc. to<\/label><ul id=\"wpforms-7726-field_4\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-7726-field_4_1\" name=\"wpforms[fields][4][]\" value=\"include patient&#039;s full name in media produced by Passy-Muir Inc.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7726-field_4_1\">include patient's full name in media produced by Passy-Muir Inc.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-7726-field_4_2\" name=\"wpforms[fields][4][]\" value=\"include patient&#039;s image in media produced by Passy-Muir Inc.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7726-field_4_2\">include patient's image in media produced by Passy-Muir Inc.<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-7726-field_4_3\" name=\"wpforms[fields][4][]\" value=\"include my statements in media produced by Passy-Muir Inc.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7726-field_4_3\">include my statements in media produced by Passy-Muir Inc.<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-7726-field_4_4\" name=\"wpforms[fields][4][]\" value=\"Do not include patient&#039;s name in media produced by Passy-Muir Inc.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7726-field_4_4\">Do not include patient's name in media produced by Passy-Muir Inc.<\/label><\/li><\/ul><\/div><div id=\"wpforms-7726-field_5-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"5\"><label class=\"wpforms-field-label\">The undersigned hereby authorizes Passy-Muir, Inc. to use images or video of patient in Passy Muir advertisements and other educational and marketing materials. (Guardian or parent&#039;s signature, if patient is a minor) <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-7726-field_5\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][5][first]\" required><label for=\"wpforms-7726-field_5\" class=\"wpforms-field-sublabel after\">Nombre<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-7726-field_5-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][5][last]\" required><label for=\"wpforms-7726-field_5-last\" class=\"wpforms-field-sublabel after\">Apellidos<\/label><\/div><\/div><\/div><div id=\"wpforms-7726-field_6-container\" class=\"wpforms-field wpforms-field-file-upload\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-7726-field_6\">Upload a file<\/label><div\n\t\tclass=\"wpforms-uploader \"\n\t\tdata-field-id=\"6\"\n\t\tdata-form-id=\"7726\"\n\t\tdata-input-name=\"wpforms_7726_6\"\n\t\tdata-extensions=\"jpg,jpeg,jpe,gif,png,bmp,tiff,tif,webp,avif,ico,heic,heif,heics,heifs,asf,asx,wmv,wmx,wm,avi,divx,mov,qt,mpeg,mpg,mpe,mp4,m4v,ogv,webm,mkv,3gp,3gpp,3g2,3gp2,txt,asc,c,cc,h,srt,csv,tsv,ics,rtx,css,vtt,mp3,m4a,m4b,aac,ra,ram,wav,x-wav,ogg,oga,flac,mid,midi,wma,wax,mka,rtf,pdf,class,tar,zip,gz,gzip,rar,7z,psd,xcf,doc,pot,pps,ppt,wri,xla,xls,xlt,xlw,mpp,docx,docm,dotx,dotm,xlsx,xlsm,xlsb,xltx,xltm,xlam,pptx,pptm,ppsx,ppsm,potx,potm,ppam,sldx,sldm,onetoc,onetoc2,onepkg,oxps,xps,odt,odp,ods,odg,odc,odb,odf,wp,wpd,key,numbers,pages,svg\"\n\t\tdata-max-size=\"26214400\"\n\t\tdata-max-file-number=\"1\"\n\t\tdata-post-max-size=\"8388608\"\n\t\tdata-max-parallel-uploads=\"4\"\n\t\tdata-parallel-uploads=\"true\"\n\t\tdata-file-chunk-size=\"2097152\">\n\t<div class=\"dz-message\">\n\t\t<svg  viewBox=\"0 0 640 640\" focusable=\"false\" data-icon=\"inbox\" width=\"50px\" height=\"50px\" fill=\"currentColor\" aria-hidden=\"true\">\n\t\t\t<path d=\"M352 173.3L352 384C352 401.7 337.7 416 320 416C302.3 416 288 401.7 288 384L288 173.3L246.6 214.7C234.1 227.2 213.8 227.2 201.3 214.7C188.8 202.2 188.8 181.9 201.3 169.4L297.3 73.4C309.8 60.9 330.1 60.9 342.6 73.4L438.6 169.4C451.1 181.9 451.1 202.2 438.6 214.7C426.1 227.2 405.8 227.2 393.3 214.7L352 173.3zM320 464C364.2 464 400 428.2 400 384L480 384C515.3 384 544 412.7 544 448L544 480C544 515.3 515.3 544 480 544L160 544C124.7 544 96 515.3 96 480L96 448C96 412.7 124.7 384 160 384L240 384C240 428.2 275.8 464 320 464zM464 488C477.3 488 488 477.3 488 464C488 450.7 477.3 440 464 440C450.7 440 440 450.7 440 464C440 477.3 450.7 488 464 488z\"\/>\n\t\t<\/svg>\n\n\t\t<span class=\"modern-title\">\n\t\t\t\t\t\t\tDrag &amp; Drop Files, \t\t\t\t<span>Choose Files to Upload<\/span>\n\t\t\t\t\t<\/span>\n\n\t\t\t<\/div>\n<\/div>\n\n<input\n\t\ttype=\"text\"\n\t\tautocomplete=\"off\"\n\t\treadonly\n\t\tclass=\"dropzone-input\"\n\t\tstyle=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\"\n\t\tid=\"wpforms-7726-field_6\"\n\t\tname=\"wpforms_7726_6\" \t\tvalue=\"\">\n<\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-field wpforms-field-hp\"><label for=\"wpforms-7726-field-hp\" class=\"wpforms-field-label\">Comment<\/label><input type=\"text\" name=\"wpforms[hp]\" id=\"wpforms-7726-field-hp\" class=\"wpforms-field-medium\"><\/div>\r\n\t\t\t<script>\r\n\t\t\tif ( typeof huOptions !== 'undefined' ) {\r\n\t\t\t\tvar huFormData = {\"source\":\"wpforms\",\"id\":7726,\"title\":\"Share Your Story\",\"fields\":{\"subject\":{\"first_name\":\"\",\"last_name\":\"\"}}};\r\n\t\t\t\tvar huFormNode = document.querySelector( '[id=\"wpforms-7726\"] form' );\r\n\r\n\t\t\t\tvar firstName = huFormNode.querySelector( 'input.wpforms-field-name-first' );\r\n\t\t\t\tvar lastName = huFormNode.querySelector( 'input.wpforms-field-name-last' );\r\n\r\n\t\t\t\tif ( firstName )\r\n\t\t\t\t\thuFormData['fields']['subject']['first_name'] = firstName.getAttribute( 'name' );\r\n\r\n\t\t\t\tif ( lastName )\r\n\t\t\t\t\thuFormData['fields']['subject']['last_name'] = lastName.getAttribute( 'name' );\r\n\r\n\t\t\t\thuFormData['node'] = huFormNode;\r\n\t\t\t\thuOptions['forms'].push( huFormData );\r\n\t\t\t}\r\n\t\t\t<\/script><div class=\"wpforms-recaptcha-container wpforms-is-recaptcha wpforms-is-recaptcha-type-invisible\" ><div class=\"g-recaptcha\" data-sitekey=\"6Lfbq6EUAAAAAAAeOkk0L5llow9kBiBOJnnFUEo5\" data-size=\"invisible\"><\/div><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"7726\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"http:\/\/1.passy-muir.com\/es\/wp-json\/wp\/v2\/pages\/7872\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-7726\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->\n","protected":false},"excerpt":{"rendered":"Comparta su historia","protected":false},"author":7,"featured_media":10512,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"yst_prominent_words":[836,832,2336,2334,2337,2338,833,829,828,87,835,2335,2333,86,72,193,2339,831,830,81],"class_list":["post-7872","page","type-page","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"http:\/\/1.passy-muir.com\/es\/wp-json\/wp\/v2\/pages\/7872","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/1.passy-muir.com\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/1.passy-muir.com\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/1.passy-muir.com\/es\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"http:\/\/1.passy-muir.com\/es\/wp-json\/wp\/v2\/comments?post=7872"}],"version-history":[{"count":1,"href":"http:\/\/1.passy-muir.com\/es\/wp-json\/wp\/v2\/pages\/7872\/revisions"}],"predecessor-version":[{"id":11334,"href":"http:\/\/1.passy-muir.com\/es\/wp-json\/wp\/v2\/pages\/7872\/revisions\/11334"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/1.passy-muir.com\/es\/wp-json\/wp\/v2\/media\/10512"}],"wp:attachment":[{"href":"http:\/\/1.passy-muir.com\/es\/wp-json\/wp\/v2\/media?parent=7872"}],"wp:term":[{"taxonomy":"yst_prominent_words","embeddable":true,"href":"http:\/\/1.passy-muir.com\/es\/wp-json\/wp\/v2\/yst_prominent_words?post=7872"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}