{"id":404,"date":"2014-08-21T11:26:55","date_gmt":"2014-08-21T11:26:55","guid":{"rendered":"http:\/\/www.jesvertit.com\/?page_id=404"},"modified":"2014-08-21T11:26:55","modified_gmt":"2014-08-21T11:26:55","slug":"formulario-seguro-colectivo-de-salud","status":"publish","type":"page","link":"https:\/\/www.jesvertit.com\/es\/formulario-seguro-colectivo-de-salud\/","title":{"rendered":"Formulario Seguro colectivo de salud"},"content":{"rendered":"[et_pb_section fullwidth=\u00bboff\u00bb specialty=\u00bboff\u00bb][et_pb_row][et_pb_column type=\u00bb4_4&#8243;][et_pb_text admin_label=\u00bbText\u00bb background_layout=\u00bblight\u00bb text_orientation=\u00bbleft\u00bb]\n<h1>Formulario Seguro colectivo de salud<\/h1>\n<p>\u00a0<\/p>\n[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section][et_pb_row][et_pb_column type=\u00bb1_2&#8243;][et_pb_text admin_label=\u00bbText\u00bb background_layout=\u00bblight\u00bb text_orientation=\u00bbleft\u00bb]\n<p>Rellene los campos de este formulario y pulse el bot\u00f3n de enviar.<\/p>\n<p>Nosotros recibiremos toda la informaci\u00f3n y tan pronto como nos sea posible nos pondremos en contacto con vosotros, para dar respuesta a sus dudas y proporcionarle toda la informaci\u00f3n necesaria para llevar a cabo el seguro requerida.<\/p>\n<blockquote>\n<p>SU TRANQUILIDAD ES NUESTRO COMPROMISO<\/p>\n<\/blockquote>\n<p>\u00a0<\/p>\n<p>\u00a0<\/p>\n[\/et_pb_text][\/et_pb_column][et_pb_column type=\u00bb1_2&#8243;][et_pb_text admin_label=\u00bbText\u00bb background_layout=\u00bblight\u00bb text_orientation=\u00bbleft\u00bb]\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f343-o1\" lang=\"ca\" dir=\"ltr\" data-wpcf7-id=\"343\">\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\/404#wpcf7-f343-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formulari de contacte\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"343\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.7\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"ca\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f343-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<p><strong>Datos del negocio<\/strong>\n<\/p>\n<p>Nombre \/Raz\u00f3n social *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"nom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nom\" \/><\/span>\n<\/p>\n<p>NIF \/ CIF *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"nif\"><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=\"nif\" \/><\/span>\n<\/p>\n<p>Direcci\u00f3n fiscal *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"adresa\"><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=\"adresa\" \/><\/span>\n<\/p>\n<p>Poblaci\u00f3n *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"poblacio\"><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=\"poblacio\" \/><\/span>\n<\/p>\n<p>C.P. *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"cp\"><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=\"cp\" \/><\/span>\n<\/p>\n<p>Prov\u00edncia *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"provincia\"><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=\"provincia\" \/><\/span>\n<\/p>\n<p>Persona de contacto *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"persona\"><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=\"persona\" \/><\/span>\n<\/p>\n<p>Cargo *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"carrec\"><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=\"carrec\" \/><\/span>\n<\/p>\n<p>Tel\u00e9fono *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"telefon\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"telefon\" \/><\/span>\n<\/p>\n<p>Email *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email\" \/><\/span>\n<\/p>\n<p>Fax\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fax\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"fax\" \/><\/span>\n<\/p>\n<p><strong>Datos de los asegurados<\/strong>\n<\/p>\n<p>Descripci\u00f3n de la actividad del colectivo a asegurar:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"activitat\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"activitat\"><\/textarea><\/span>\n<\/p>\n<p>N\u00famero de personas a asegurar:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"treballadors\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"treballadors\" \/><\/span>\n<\/p>\n<p>Archivo con relaci\u00f3n de personas, indicando sexo, fecha de nacimiento y NIF:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"persones_file\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\"audio\/*,video\/*,image\/*\" aria-invalid=\"false\" type=\"file\" name=\"persones_file\" \/><\/span>\n<\/p>\n<p><strong>Coberturas<\/strong>\n<\/p>\n<p>Elecci\u00f3n m\u00e9dica:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"medica\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"medica\"><option value=\"\">&#8212;Trieu una opci\u00f3&#8212;<\/option><option value=\"Libre elecci\u00f3n de cuadro m\u00e9dico\">Libre elecci\u00f3n de cuadro m\u00e9dico<\/option><option value=\"Cuadro m\u00e9dico cerrado\">Cuadro m\u00e9dico cerrado<\/option><\/select><\/span>\n<\/p>\n<p>P\u00f3liza:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"poliza\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"poliza\"><option value=\"\">&#8212;Trieu una opci\u00f3&#8212;<\/option><option value=\"Se contrata una \u00fanica p\u00f3liza colectiva\">Se contrata una \u00fanica p\u00f3liza colectiva<\/option><option value=\"Se contrata en base a p\u00f3lizas individuales\">Se contrata en base a p\u00f3lizas individuales<\/option><\/select><\/span>\n<\/p>\n<p>Los campos con * son obligatorios\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"clausula\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"clausula\" value=\"1\" aria-invalid=\"false\" \/><\/span><\/span><\/span>He leido y acepto la <a href=\"http:\/\/www.jesvertit.com\/informacio-legal\" target=\"_blank\" >cl\u00e1usula de confidencialidad <\/a>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Enviar\" \/>\n<\/p><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"162\"\/><script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]\n","protected":false},"excerpt":{"rendered":"<p><div class=\"et_pb_row et_pb_row_0 et_pb_row_empty\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>Formulario Seguro colectivo de salud\u00a0<div class=\"et_pb_section et_pb_section_0 et_section_regular\" >\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div><div class=\"et_pb_row et_pb_row_1 et_pb_row_empty\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>Rellene los campos de este formulario y pulse el bot\u00f3n de enviar.Nosotros recibiremos toda la informaci\u00f3n y tan pronto como nos sea posible nos pondremos en contacto con vosotros, para dar respuesta a sus dudas y proporcionarle toda la informaci\u00f3n necesaria para llevar a cabo el seguro requerida.SU TRANQUILIDAD ES NUESTRO [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":25,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"<p>[et_pb_section fullwidth=\"off\" specialty=\"off\"][et_pb_row][et_pb_column type=\"4_4\"][et_pb_text admin_label=\"Text\" background_layout=\"light\" text_orientation=\"left\"]<\/p><h1>Formulari Asseguran\u00e7a col\u00b7lectiu de salut<\/h1><p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section][et_pb_row][et_pb_column type=\"1_2\"][et_pb_text admin_label=\"Text\" background_layout=\"light\" text_orientation=\"left\"]<\/p><p>Empleneu els camps d'aquest formulari i cliqueu el bot\u00f3 d'enviar.<\/p><p>Nosaltres rebrem tota la informaci\u00f3 i tan aviat com ens sigui possible ens posarem en contacte amb vosaltres, per tal de donar resposta als vostres dubtes i proporcionar-vos tota la informaci\u00f3 necess\u00e0ria per portar a terme l'asseguran\u00e7a requerida.<\/p><blockquote><p>LA SEVA TRANQUILITAT \u00c9S EL NOSTRE COMPROM\u00cdS<\/p><\/blockquote><p>\u00a0<\/p><p>[\/et_pb_text][\/et_pb_column][et_pb_column type=\"1_2\"][et_pb_text admin_label=\"Text\" background_layout=\"light\" text_orientation=\"left\"]<\/p><p>[contact-form-7 id=\"342\" title=\"Formulari Asseguran\u00e7a col\u00b7lectiu de salut CAT\"]<\/p><p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>","_et_gb_content_width":"","footnotes":""},"class_list":["post-404","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.jesvertit.com\/es\/wp-json\/wp\/v2\/pages\/404","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.jesvertit.com\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.jesvertit.com\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.jesvertit.com\/es\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.jesvertit.com\/es\/wp-json\/wp\/v2\/comments?post=404"}],"version-history":[{"count":1,"href":"https:\/\/www.jesvertit.com\/es\/wp-json\/wp\/v2\/pages\/404\/revisions"}],"predecessor-version":[{"id":405,"href":"https:\/\/www.jesvertit.com\/es\/wp-json\/wp\/v2\/pages\/404\/revisions\/405"}],"wp:attachment":[{"href":"https:\/\/www.jesvertit.com\/es\/wp-json\/wp\/v2\/media?parent=404"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}