{"id":2320,"date":"2024-06-13T19:45:41","date_gmt":"2024-06-13T23:45:41","guid":{"rendered":"https:\/\/carolinadarts.wpenginepowered.com\/?page_id=2320"},"modified":"2024-06-13T19:45:41","modified_gmt":"2024-06-13T23:45:41","slug":"auto-draft","status":"publish","type":"page","link":"https:\/\/www.carolinadentalarts.com\/es\/auto-draft\/","title":{"rendered":"Auto Draft"},"content":{"rendered":"<div class=\"wpcf7 no-js\" id=\"wpcf7-f2319-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"2319\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/es\/wp-json\/wp\/v2\/pages\/2320#wpcf7-f2319-o1\" method=\"post\" class=\"wpcf7-form init cf7mls-no-scroll cf7mls-no-moving-animation\" aria-label=\"Formulario de contacto\" novalidate=\"novalidate\" data-status=\"init\" data-trp-original-action=\"\/es\/wp-json\/wp\/v2\/pages\/2320#wpcf7-f2319-o1\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"2319\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f2319-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\" \/><input type=\"hidden\" name=\"_wpcf7cf_options\" value=\"{&quot;form_id&quot;:2319,&quot;conditions&quot;:[],&quot;settings&quot;:{&quot;animation&quot;:&quot;yes&quot;,&quot;animation_intime&quot;:200,&quot;animation_outtime&quot;:200,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:false,&quot;repeater_remove_button&quot;:&quot;bottom&quot;}}\" \/>\n<\/fieldset>\n<!-- Contact Form 7 Configuration -->\n<form>\n\t<p><input type=\"hidden\" name=\"_wpcf7\" value=\"589\" \/><br \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.9.4\" \/><br \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><br \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f589-p590-o1\" \/><br \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"590\" \/><br \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><br \/>\n<input type=\"hidden\" name=\"redirect_nonce\" value=\"357e120694\" \/><br \/>\n<input type=\"hidden\" name=\"wpcf7cfpdf_hidden_name\" value=\"newpatient-june72024\" \/><br \/>\n<input type=\"hidden\" name=\"wpcf7cfpdf_hidden_reference\" value=\"7ca96609\" \/><br \/>\n<input type=\"hidden\" name=\"wpcf7cfpdf_hidden_date\" value=\"June7,2024\" \/><br \/>\n<input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n\t<\/p>\n\t<h3>1. 1. Informaci\u00f3n al paciente\n\t<\/h3>\n\t<div class=\"column-half\">\n\t\t<p>Ubicaci\u00f3n de la cl\u00ednica que desea seleccionar* <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-867\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"menu-867\"><option value=\"\">-Por favor, elija una opci\u00f3n-<\/option><option value=\"Raleigh Glenwood South\">Raleigh Glenwood Sur<\/option><option value=\"New Bern Ave\">Avenida New Bern<\/option><option value=\"Goldsboro\">Goldsboro<\/option><option value=\"Durham\">Durham<\/option><\/select><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Su nombre <span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Direcci\u00f3n* <span class=\"wpcf7-form-control-wrap\" data-name=\"address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"address\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<div class=\"column-third\">\n\t\t\t<p>Ciudad* <span class=\"wpcf7-form-control-wrap\" data-name=\"city\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"city\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"column-third\">\n\t\t\t<p>Estado <span class=\"wpcf7-form-control-wrap\" data-name=\"state\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"state\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"column-third\">\n\t\t\t<p>C\u00f3digo postal <span class=\"wpcf7-form-control-wrap\" data-name=\"zip\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zip\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<div class=\"column-third\">\n\t\t\t<p>Fecha de nacimiento <span class=\"wpcf7-form-control-wrap\" data-name=\"birthday\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"birthday\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"column-third\">\n\t\t\t<p>Edad <span class=\"wpcf7-form-control-wrap\" data-name=\"age\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"age\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"column-third\">\n\t\t\t<p>Sexo <span class=\"wpcf7-form-control-wrap\" data-name=\"sex\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"sex\"><option value=\"Male\">Hombre<\/option><option value=\"Female\">Mujer<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Estado civil <span class=\"wpcf7-form-control-wrap\" data-name=\"status\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"status\"><option value=\"Single\">\u00danico<\/option><option value=\"Married\">Casado<\/option><option value=\"Divorced\">Divorciado<\/option><option value=\"Widowed\">Viuda<\/option><option value=\"Partner\">Socio<\/option><\/select><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Seguridad Social # <span class=\"wpcf7-form-control-wrap\" data-name=\"socialsec\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"socialsec\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Ocupaci\u00f3n <span class=\"wpcf7-form-control-wrap\" data-name=\"occupation\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"occupation\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Empresario <span class=\"wpcf7-form-control-wrap\" data-name=\"employer\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"employer\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Nombre del c\u00f3nyuge <span class=\"wpcf7-form-control-wrap\" data-name=\"spouse\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"spouse\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Profesi\u00f3n del c\u00f3nyuge <span class=\"wpcf7-form-control-wrap\" data-name=\"spouseocc\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"spouseocc\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Empleador del c\u00f3nyuge <span class=\"wpcf7-form-control-wrap\" data-name=\"spouseemp\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"spouseemp\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<h3>Ni\u00f1os\n\t<\/h3>\n\t<h4>Ni\u00f1o 1\n\t<\/h4>\n\t<div class=\"column-half\">\n\t\t<p>Nombre <span class=\"wpcf7-form-control-wrap\" data-name=\"childonename\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"childonename\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Fecha de nacimiento <span class=\"wpcf7-form-control-wrap\" data-name=\"childonebirth\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"childonebirth\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<h4>Ni\u00f1o 2\n\t<\/h4>\n\t<div class=\"column-half\">\n\t\t<p>Nombre <span class=\"wpcf7-form-control-wrap\" data-name=\"childtwoname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"childtwoname\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Fecha de nacimiento <span class=\"wpcf7-form-control-wrap\" data-name=\"childtwobirth\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"childtwobirth\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<h4>Ni\u00f1o 3\n\t<\/h4>\n\t<div class=\"column-half\">\n\t\t<p>Nombre <span class=\"wpcf7-form-control-wrap\" data-name=\"childthreename\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"childthreename\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Fecha de nacimiento <span class=\"wpcf7-form-control-wrap\" data-name=\"childthreebirth\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"childthreebirth\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<h4>Ni\u00f1o 4\n\t<\/h4>\n\t<div class=\"column-half\">\n\t\t<p>Nombre <span class=\"wpcf7-form-control-wrap\" data-name=\"childfourname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"childfourname\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Fecha de nacimiento <span class=\"wpcf7-form-control-wrap\" data-name=\"childfourbirth\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"childfourbirth\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<h4>Ni\u00f1o 5\n\t<\/h4>\n\t<div class=\"column-half\">\n\t\t<p>Nombre <span class=\"wpcf7-form-control-wrap\" data-name=\"childfivename\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"childfivename\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Fecha de nacimiento <span class=\"wpcf7-form-control-wrap\" data-name=\"childfivebirth\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"childfivebirth\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<h4>Ni\u00f1o 6\n\t<\/h4>\n\t<div class=\"column-half\">\n\t\t<p>Nombre <span class=\"wpcf7-form-control-wrap\" data-name=\"childsixname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"childsixname\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Fecha de nacimiento <span class=\"wpcf7-form-control-wrap\" data-name=\"childsixbirth\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"childsixbirth\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<h3>2. Seguros\n\t<\/h3>\n\t<div class=\"column-half\">\n\t\t<p>Responsable <span class=\"wpcf7-form-control-wrap\" data-name=\"insurancepro\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"insurancepro\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<div class=\"column-half\">\n\t\t\t<p>SS # <span class=\"wpcf7-form-control-wrap\" data-name=\"insssno\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"insssno\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"column-half\">\n\t\t\t<p>Fecha de nacimiento <span class=\"wpcf7-form-control-wrap\" data-name=\"insbirth\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"insbirth\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Relaci\u00f3n con el paciente <span class=\"wpcf7-form-control-wrap\" data-name=\"insrel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"insrel\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Compa\u00f1\u00eda de seguros <span class=\"wpcf7-form-control-wrap\" data-name=\"insco\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"insco\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>N\u00famero de identificaci\u00f3n <span class=\"wpcf7-form-control-wrap\" data-name=\"insid\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"insid\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>N\u00famero de grupo <span class=\"wpcf7-form-control-wrap\" data-name=\"insgrpno\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"insgrpno\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<h3>3. 3. N\u00fameros de tel\u00e9fono\n\t<\/h3>\n\t<div class=\"column-half\">\n\t\t<p>Inicio <span class=\"wpcf7-form-control-wrap\" data-name=\"home-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"home-phone\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<div class=\"column-half\">\n\t\t\t<p>Trabajo <span class=\"wpcf7-form-control-wrap\" data-name=\"business-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"business-phone\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"column-third\">\n\t\t\t<p>Ext. <span class=\"wpcf7-form-control-wrap\" data-name=\"workext\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"workext\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Tel\u00e9fono m\u00f3vil <span class=\"wpcf7-form-control-wrap\" data-name=\"cell-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"cell-phone\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Su correo electr\u00f3nico <span class=\"wpcf7-form-control-wrap\" data-name=\"your-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\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"form-row\">\n\t\t<p><strong>\u00bfC\u00f3mo desea que nos pongamos en contacto con usted?<\/strong><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-contact\"><br \/>\n<span class=\"wpcf7-form-control wpcf7-checkbox\"><br \/>\n<span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"checkbox-contact[]\" value=\"Home Phone\" \/><span class=\"wpcf7-list-item-label\">Tel\u00e9fono de casa<\/span><\/span><br \/>\n<span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-contact[]\" value=\"Work Phone\" \/><span class=\"wpcf7-list-item-label\">Tel\u00e9fono de trabajo<\/span><\/span><br \/>\n<span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-contact[]\" value=\"Cell Phone\" \/><span class=\"wpcf7-list-item-label\">Tel\u00e9fono m\u00f3vil<\/span><\/span><br \/>\n<span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"checkbox-contact[]\" value=\"Email\" \/><span class=\"wpcf7-list-item-label\">Correo electr\u00f3nico<\/span><\/span><br \/>\n<\/span><br \/>\n<\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Trabajo del c\u00f3nyuge <span class=\"wpcf7-form-control-wrap\" data-name=\"spouseworkno\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"spouseworkno\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>M\u00e9dico de familia <span class=\"wpcf7-form-control-wrap\" data-name=\"famdoc\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"famdoc\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Tel\u00e9fono del m\u00e9dico <span class=\"wpcf7-form-control-wrap\" data-name=\"provider\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"provider\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<h4>En caso de emergencia, p\u00f3ngase en contacto con\n\t<\/h4>\n\t<div class=\"column-half\">\n\t\t<p>Nombre <span class=\"wpcf7-form-control-wrap\" data-name=\"icename\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"icename\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Relaci\u00f3n <span class=\"wpcf7-form-control-wrap\" data-name=\"icerel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"icerel\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Tel\u00e9fono de casa <span class=\"wpcf7-form-control-wrap\" data-name=\"icehomeno\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"icehomeno\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"column-half\">\n\t\t<p>Tel\u00e9fono de trabajo <span class=\"wpcf7-form-control-wrap\" data-name=\"iceworkno\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"iceworkno\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<h3>4. Asignaci\u00f3n y liberaci\u00f3n\n\t<\/h3>\n\t<p>Certifico que yo (o la persona a mi cargo) tengo la cobertura de seguro indicada y cedo directamente a esta oficina todas las prestaciones del seguro que de otro modo me corresponder\u00edan por\n\t<\/p>\n<\/form><input\n                    class=\"apbct_special_field apbct_email_id__wp_contact_form_7\"\n                    name=\"apbct__email_id__wp_contact_form_7\"\n                    aria-label=\"apbct__label_id__wp_contact_form_7\"\n                    type=\"text\" size=\"30\" maxlength=\"200\" autocomplete=\"off\"\n                    value=\"\"\n                \/><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<input type=\"hidden\" name=\"trp-form-language\" value=\"es\"\/><\/form>\n<\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":11,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"rop_custom_images_group":[],"rop_custom_messages_group":[],"rop_publish_now":"initial","rop_publish_now_accounts":{"gmb_109265489736877664202_accounts\/109265489736877664202\/locations\/3741120012718067982":"","gmb_109265489736877664202_accounts\/109265489736877664202\/locations\/5868158823831226262":"","gmb_109265489736877664202_accounts\/109265489736877664202\/locations\/13276431108783951976":"","gmb_109265489736877664202_accounts\/109265489736877664202\/locations\/6661601348989402108":"","twitter_1801704355030044672_1801704355030044672":""},"rop_publish_now_history":[],"rop_publish_now_status":"pending","footnotes":""},"class_list":["post-2320","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Auto Draft | Carolina Dental Arts<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.carolinadentalarts.com\/es\/auto-draft\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Auto Draft | Carolina Dental Arts\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.carolinadentalarts.com\/es\/auto-draft\/\" \/>\n<meta property=\"og:site_name\" content=\"Carolina Dental Arts\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/carolinadentalartsnc\/\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@carolinadarts\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.carolinadentalarts.com\\\/auto-draft\\\/\",\"url\":\"https:\\\/\\\/www.carolinadentalarts.com\\\/auto-draft\\\/\",\"name\":\"Auto Draft | Carolina Dental Arts\",\"isPartOf\":{\"@id\":\"\\\/#website\"},\"datePublished\":\"2024-06-13T23:45:41+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.carolinadentalarts.com\\\/auto-draft\\\/#breadcrumb\"},\"inLanguage\":\"es\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.carolinadentalarts.com\\\/auto-draft\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.carolinadentalarts.com\\\/auto-draft\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.carolinadentalarts.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Auto Draft\"}]},{\"@type\":\"WebSite\",\"@id\":\"\\\/#website\",\"url\":\"\\\/\",\"name\":\"Carolina Dental Arts\",\"description\":\"North Carolina Dentists Serving Raleigh, Durham &amp; Goldsboro\",\"publisher\":{\"@id\":\"\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"es\"},{\"@type\":\"Organization\",\"@id\":\"\\\/#organization\",\"name\":\"Carolina Dental Arts\",\"url\":\"\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"es\",\"@id\":\"\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/www.carolinadentalarts.com\\\/wp-content\\\/uploads\\\/2024\\\/06\\\/Carolina-Dental-Arts-Logo.png\",\"contentUrl\":\"https:\\\/\\\/www.carolinadentalarts.com\\\/wp-content\\\/uploads\\\/2024\\\/06\\\/Carolina-Dental-Arts-Logo.png\",\"width\":1200,\"height\":1000,\"caption\":\"Carolina Dental Arts\"},\"image\":{\"@id\":\"\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/carolinadentalartsnc\\\/\",\"https:\\\/\\\/x.com\\\/carolinadarts\",\"https:\\\/\\\/www.instagram.com\\\/carolinadentalartsnc\\\/\",\"https:\\\/\\\/www.youtube.com\\\/@carolinadentalarts790\\\/featured\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Auto Draft | Carolina Dental Arts","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.carolinadentalarts.com\/es\/auto-draft\/","og_locale":"es_ES","og_type":"article","og_title":"Auto Draft | Carolina Dental Arts","og_url":"https:\/\/www.carolinadentalarts.com\/es\/auto-draft\/","og_site_name":"Carolina Dental Arts","article_publisher":"https:\/\/www.facebook.com\/carolinadentalartsnc\/","twitter_card":"summary_large_image","twitter_site":"@carolinadarts","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.carolinadentalarts.com\/auto-draft\/","url":"https:\/\/www.carolinadentalarts.com\/auto-draft\/","name":"Auto Draft | Carolina Dental Arts","isPartOf":{"@id":"\/#website"},"datePublished":"2024-06-13T23:45:41+00:00","breadcrumb":{"@id":"https:\/\/www.carolinadentalarts.com\/auto-draft\/#breadcrumb"},"inLanguage":"es","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.carolinadentalarts.com\/auto-draft\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.carolinadentalarts.com\/auto-draft\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.carolinadentalarts.com\/"},{"@type":"ListItem","position":2,"name":"Auto Draft"}]},{"@type":"WebSite","@id":"\/#website","url":"\/","name":"Carolina Dental Arts","description":"Dentistas de Carolina del Norte al servicio de Raleigh, Durham y Goldsboro","publisher":{"@id":"\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"es"},{"@type":"Organization","@id":"\/#organization","name":"Carolina Dental Arts","url":"\/","logo":{"@type":"ImageObject","inLanguage":"es","@id":"\/#\/schema\/logo\/image\/","url":"https:\/\/www.carolinadentalarts.com\/wp-content\/uploads\/2024\/06\/Carolina-Dental-Arts-Logo.png","contentUrl":"https:\/\/www.carolinadentalarts.com\/wp-content\/uploads\/2024\/06\/Carolina-Dental-Arts-Logo.png","width":1200,"height":1000,"caption":"Carolina Dental Arts"},"image":{"@id":"\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/carolinadentalartsnc\/","https:\/\/x.com\/carolinadarts","https:\/\/www.instagram.com\/carolinadentalartsnc\/","https:\/\/www.youtube.com\/@carolinadentalarts790\/featured"]}]}},"_links":{"self":[{"href":"https:\/\/www.carolinadentalarts.com\/es\/wp-json\/wp\/v2\/pages\/2320","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.carolinadentalarts.com\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.carolinadentalarts.com\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.carolinadentalarts.com\/es\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/www.carolinadentalarts.com\/es\/wp-json\/wp\/v2\/comments?post=2320"}],"version-history":[{"count":0,"href":"https:\/\/www.carolinadentalarts.com\/es\/wp-json\/wp\/v2\/pages\/2320\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.carolinadentalarts.com\/es\/wp-json\/wp\/v2\/media?parent=2320"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}