{"id":157,"date":"2015-05-10T14:17:14","date_gmt":"2015-05-10T19:17:14","guid":{"rendered":"https:\/\/siouxcountychp.org\/?page_id=157"},"modified":"2020-03-26T17:50:25","modified_gmt":"2020-03-26T22:50:25","slug":"register","status":"publish","type":"page","link":"https:\/\/siouxcountychp.org\/es\/register\/","title":{"rendered":"Registro de la Cl\u00ednica de Vacunaci\u00f3n"},"content":{"rendered":"<div class=\"wpcf7 no-js\" id=\"wpcf7-f159-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"159\">\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\/157#wpcf7-f159-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formulario de contacto\" novalidate=\"novalidate\" data-status=\"init\" data-trp-original-action=\"\/es\/wp-json\/wp\/v2\/pages\/157#wpcf7-f159-o1\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"159\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.0.6\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f159-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/div>\n<p class=\"firstname\"><label for=\"firstname\">Primer nombre<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"firstname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required firstname\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"firstname\" \/><\/span>\n<\/p>\n<p class=\"lastname\"><label for=\"lastname\">Apellido<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"lastname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required lastname\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"lastname\" \/><\/span>\n<\/p>\n<p class=\"dob\"><label for=\"dob\">Fecha de cumplea\u00f1os<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"dob\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required dob\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"dob\" \/><\/span> (MM\/DD\/AAAA)\n<\/p>\n<p class=\"parentname\"><label for=\"parentname\">Nombre del padre<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"parentname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required parentname\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"parentname\" \/><\/span>\n<\/p>\n<p class=\"address\"><label for=\"address\">Habla a<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"address\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required address\" aria-required=\"true\" aria-invalid=\"false\" name=\"address\"><\/textarea><\/span>\n<\/p>\n<p class=\"email\"><label for=\"email\">Correo electr\u00f3nico<\/label><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 email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email\" \/><\/span>\n<\/p>\n<p class=\"phone\"><label for=\"phone\">Tel\u00e9fono<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required phone\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"phone\" \/><\/span>\n<\/p>\n<p class=\"date\"><label for=\"date\">Cl\u00ednica Fecha<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"date\"><select class=\"wpcf7-form-control wpcf7-select date\" aria-invalid=\"false\" name=\"date\"><option value=\"\">-Por favor, elija una opci\u00f3n-<\/option><option value=\"Thursday, April 16, 2:30-5:00pm\">Jueves, 16 de abril, 2:30-5:00pm<\/option><option value=\"Tuesday, May 19, 2:30-5:00pm\">Martes, 19 de mayo, 2:30-5:00pm<\/option><\/select><\/span>\n<\/p>\n<p class=\"language\"><label for=\"language\">Idioma preferido<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"language\"><span class=\"wpcf7-form-control wpcf7-radio language\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"language\" value=\"English\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">ingl\u00e9s<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"language\" value=\"Spanish\" \/><span class=\"wpcf7-list-item-label\">espa\u00f1ol<\/span><\/span><\/span><\/span>\n<\/p>\n<p class=\"communication\"><label for=\"communication\">M\u00e9todo de comunicaci\u00f3n preferido<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"communication\"><select class=\"wpcf7-form-control wpcf7-select communication\" aria-invalid=\"false\" name=\"communication\"><option value=\"Phone\">Tel\u00e9fono<\/option><option value=\"Text\">Texto<\/option><option value=\"Email\">Correo electr\u00f3nico<\/option><\/select><\/span>\n<\/p>\n<p class=\"eligibility\"><label for=\"eligibility\">Seleccione la raz\u00f3n por la que su hijo es elegible para VFC<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"eligibility\"><select class=\"wpcf7-form-control wpcf7-select eligibility\" aria-invalid=\"false\" name=\"eligibility\"><option value=\"Child has no health Insurance\">El ni\u00f1o no tiene seguro m\u00e9dico<\/option><option value=\"Child is on Medicaid\">El ni\u00f1o tiene Medicaid<\/option><option value=\"Child has health insurance that does not cover immunizations\">El ni\u00f1o tiene un seguro de salud que no cubre vacunas.<\/option><option value=\"Child is American Indian or Alaskan Native\">El ni\u00f1o es indio americano o nativo de Alaska<\/option><\/select><\/span>\n<\/p>\n<p class=\"warning\">Los ni\u00f1os con seguro de salud que cubre inmunizaciones o Hawk-I no son elegibles para VFC; vaya a su cl\u00ednica m\u00e9dica para vacunarse.\n<\/p>\n<p class=\"warning\">Por favor imprima nuestro <a href=\"https:\/\/siouxcountychp.org\/wp-content\/uploads\/2018\/04\/Immunization-Intake-Form-2018.pdf\">formulario de admisi\u00f3n<\/a> si puede, ya que ahorrar\u00e1 tiempo durante el proceso de registro.\n<\/p>\n<p>\n\n<\/p>\n<p class=\"submit\"><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Enviar confirmaci\u00f3n de asistencia\" \/>\n<\/p><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":"<p>\u2026 <a href=\"https:\/\/siouxcountychp.org\/es\/register\/\" class=\"more-link\">Lee mas &quot;<\/a><\/p>","protected":false},"author":1,"featured_media":148,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-157","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/siouxcountychp.org\/es\/wp-json\/wp\/v2\/pages\/157","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/siouxcountychp.org\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/siouxcountychp.org\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/siouxcountychp.org\/es\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/siouxcountychp.org\/es\/wp-json\/wp\/v2\/comments?post=157"}],"version-history":[{"count":5,"href":"https:\/\/siouxcountychp.org\/es\/wp-json\/wp\/v2\/pages\/157\/revisions"}],"predecessor-version":[{"id":2870,"href":"https:\/\/siouxcountychp.org\/es\/wp-json\/wp\/v2\/pages\/157\/revisions\/2870"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/siouxcountychp.org\/es\/wp-json\/wp\/v2\/media\/148"}],"wp:attachment":[{"href":"https:\/\/siouxcountychp.org\/es\/wp-json\/wp\/v2\/media?parent=157"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}