{"id":1910,"date":"2026-06-17T12:43:39","date_gmt":"2026-06-17T12:43:39","guid":{"rendered":"https:\/\/airmedical.com\/?page_id=1910"},"modified":"2026-09-18T22:14:44","modified_gmt":"2026-09-18T22:14:44","slug":"cotizacion-avion-ambulancia","status":"publish","type":"page","link":"https:\/\/airmedical.com\/es\/cotizacion-avion-ambulancia\/","title":{"rendered":"Cotizaci\u00f3n de Avi\u00f3n Ambulancia"},"content":{"rendered":"<div class=\"et_pb_section_0 et_pb_section et_section_regular et_flex_section\">\n<div class=\"et_pb_row_0 et_pb_row et_flex_row\">\n<div class=\"et_pb_column_0 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone\">\n<div class=\"et_pb_text_0 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module\"><div class=\"et_pb_text_inner\"><h1 style=\"text-align: center;\">Solicitar Cotizaci\u00f3n de Avi\u00f3n Ambulancia<\/h1>\n<\/div><\/div>\n\n<div class=\"et_pb_text_1 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module\"><div class=\"et_pb_text_inner\"><p style=\"text-align: center;\"><strong>Coordinaci\u00f3n clara. Planificaci\u00f3n cuidadosa. Comunicaci\u00f3n serena.<\/strong><\/p>\n<p>Cuando se est\u00e1 considerando un traslado en avi\u00f3n ambulancia, las familias y los centros de atenci\u00f3n m\u00e9dica necesitan informaci\u00f3n clara, opciones realistas y orientaci\u00f3n serena. Air Medical Transport ofrece gesti\u00f3n completa de traslados de cama a cama en avi\u00f3n ambulancia dentro de Estados Unidos, desde y hacia Estados Unidos, y en todo el mundo entre ubicaciones internacionales.<\/p>\n<p><a href=\"https:\/\/airmedical.com\/\">Air Medical Transport<\/a> se enfoca en la gesti\u00f3n de traslados en avi\u00f3n ambulancia de pago privado.<\/p>\n<p>Nuestros Especialistas en Coordinaci\u00f3n de Traslados en Avi\u00f3n Ambulancia gestionan cada caso a trav\u00e9s de operadores seleccionados de avi\u00f3n ambulancia con certificaci\u00f3n FAA Part 135 y\/o EASA. Cada solicitud se revisa individualmente para que las opciones de avi\u00f3n ambulancia, los factores de tiempo y los requisitos de planificaci\u00f3n puedan explicarse con claridad antes de decidir c\u00f3mo avanzar.<\/p>\n<p>Los m\u00e9dicos tratantes del paciente gu\u00edan las decisiones cl\u00ednicas. Nuestro equipo utiliza la informaci\u00f3n proporcionada para revisar opciones de avi\u00f3n ambulancia, requisitos de planificaci\u00f3n del traslado y pr\u00f3ximos pasos claros.<\/p>\n<p style=\"text-align: center;\"><strong>Los Especialistas en Coordinaci\u00f3n de Traslados en Avi\u00f3n Ambulancia est\u00e1n disponibles 24\/7 para orientar solicitudes de cotizaci\u00f3n y responder preguntas de planificaci\u00f3n del traslado.<\/strong><\/p>\n<p style=\"text-align: center;\"><strong>USA y Canad\u00e1:<\/strong> <a href=\"tel:+1-800-872-6667\">+1-800-872-6667<\/a><br \/><strong>Internacional:<\/strong> <a href=\"tel:+1-832-872-2222\">+1-832-872-2222<\/a><\/p>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"et_pb_section_1 et_pb_section et_section_regular et_block_section\">\n<div class=\"et_pb_row_1 et_pb_row et_flex_row\">\n<div class=\"et_pb_column_1 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone\">\n<div class=\"et_pb_text_2 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module\"><div class=\"et_pb_text_inner\"><h2>Antes de comenzar<\/h2>\n<\/div><\/div>\n\n<div class=\"et_pb_text_3 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module\"><div class=\"et_pb_text_inner\"><p>Este es un formulario breve de cotizaci\u00f3n de avi\u00f3n ambulancia. Solo se requiere la informaci\u00f3n esencial para comenzar.<\/p>\n<p>Compartir los tiempos esperados, origen, destino, tipo de paciente y lo que m\u00e1s importa nos ayuda a revisar opciones apropiadas de avi\u00f3n ambulancia y responder con orientaci\u00f3n m\u00e1s clara.<\/p>\n<p>Para una explicaci\u00f3n de la secuencia completa del traslado, consulte nuestro <a href=\"https:\/\/airmedical.com\/es\/proceso-avion-ambulancia\/\">proceso de avi\u00f3n ambulancia<\/a>.<\/p>\n<\/div><\/div>\n\n<div class=\"et_pb_text_4 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module\"><div class=\"et_pb_text_inner\"><p><strong>Para pacientes de 300 lb (136 kg) o m\u00e1s, complete nuestro formulario de evaluaci\u00f3n para traslados bari\u00e1tricos para ayudarnos a evaluar las opciones de traslado m\u00e1s apropiadas.<\/strong><\/p>\n<\/div><\/div>\n\n<div class=\"et_pb_module et_pb_button_module_wrapper et_pb_button_0_wrapper\"><a class=\"et_pb_button_0 et_pb_button et_pb_bg_layout_light et_pb_module et_flex_module\" href=\"https:\/\/airmedical.com\/wp-content\/uploads\/2026\/07\/3.-Evaluacion-para-Transportes-Bariatricos-Rellenable.pdf\" target=\"_blank\">Descargar formulario para Evaluaci\u00f3n de  Transportes Bari\u00e1tricos<\/a><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"et_pb_section_2 et_pb_section et_section_regular et_block_section\">\n<div class=\"et_pb_row_2 et_pb_row et_flex_row\">\n<div class=\"et_pb_column_2 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone\">\n<div class=\"et_pb_text_5 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module\"><div class=\"et_pb_text_inner\"><h2>Formulario de solicitud de cotizaci\u00f3n<\/h2>\n<\/div><\/div>\n<\/div>\n<\/div>\n\n<div class=\"et_pb_row_3 et_pb_row et_flex_row\">\n<div class=\"et_pb_column_3 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone\">\n<div class=\"et_pb_text_6 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module\"><div class=\"et_pb_text_inner\"><p>Cada solicitud es revisada por un Especialista en Coordinaci\u00f3n de Traslados en Avi\u00f3n Ambulancia antes de presentar opciones de avi\u00f3n ambulancia.<\/p>\n<\/div><\/div>\n<\/div>\n<\/div>\n\n<div class=\"et_pb_row_4 et_pb_row et_flex_row\">\n<div class=\"et_pb_column_4 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone\">\n<div class=\"et_pb_code_0 et_pb_code et_pb_module\"><div class=\"et_pb_code_inner\"><div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_3_container\" data-token=\"992c09f12d4d16554b8d29b0d93daaa9\">\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_requestforquote1\" data-token=\"992c09f12d4d16554b8d29b0d93daaa9\">\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">SOLICITAR COTIZACI\u00d3N<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"3\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_3\" id=\"frm_hide_fields_3\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"requestforquote1\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_3\" name=\"frm_submit_entry_3\" value=\"e8743b5271\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/es\/wp-json\/wp\/v2\/pages\/1910\" \/><div id=\"frm_field_14_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Informaci\u00f3n de contacto<\/h3>\r\n\r\n\r\n<div id=\"frm_field_15_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4 frm_first\">\r\n    <label for=\"field_4b7ye\" id=\"field_4b7ye_label\" class=\"frm_primary_label\">Nombre de contacto\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_4b7ye\" name=\"item_meta[15]\" value=\"\"  data-sectionid=\"14\"  data-reqmsg=\"Este campo es obligatorio.\" aria-required=\"true\" data-invmsg=\"El texto no es v\u00e1lido.\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_16_container\" class=\"frm_form_field form-field  frm_top_container frm4\">\r\n    <label for=\"field_6aymn\" id=\"field_6aymn_label\" class=\"frm_primary_label\">Relaci\u00f3n con el paciente\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_6aymn\" name=\"item_meta[16]\" value=\"\"  data-sectionid=\"14\"  data-invmsg=\"El texto no es v\u00e1lido.\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_17_container\" class=\"frm_form_field form-field  frm_top_container frm4\">\r\n    <label for=\"field_2mve5\" id=\"field_2mve5_label\" class=\"frm_primary_label\">Organizaci\u00f3n o centro m\u00e9dico\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_2mve5\" name=\"item_meta[17]\" value=\"\"  data-sectionid=\"14\"  data-invmsg=\"El texto no es v\u00e1lido.\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_18_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3 frm_first\">\r\n    <label for=\"field_9czr2\" id=\"field_9czr2_label\" class=\"frm_primary_label\">Tel\u00e9fono\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_9czr2\" name=\"item_meta[18]\" value=\"\"  data-sectionid=\"14\"  placeholder=\"+C\u00f3digo de pa\u00eds (c\u00f3digo de \u00e1rea) #\" data-reqmsg=\"Este campo es obligatorio.\" aria-required=\"true\" data-invmsg=\"Tel\u00e9fono no es v\u00e1lido\" class=\"frm-intl-tel-input\" aria-invalid=\"false\" pattern=\"\\+?\\d{1,4}[\\s\\-]?(?:\\(\\d{1,3}\\)[\\s\\-]?)?\\d{1,4}[\\s\\-]?\\d{1,4}[\\s\\-]?\\d{1,4}$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_19_container\" class=\"frm_form_field form-field  frm_top_container frm3\">\r\n    <label for=\"field_k9l91\" id=\"field_k9l91_label\" class=\"frm_primary_label\">M\u00f3vil \/ WhatsApp\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_k9l91\" name=\"item_meta[19]\" value=\"\"  data-sectionid=\"14\"  placeholder=\"+C\u00f3digo de pa\u00eds (c\u00f3digo de \u00e1rea) #\" data-invmsg=\"El texto no es v\u00e1lido.\" class=\"frm-intl-tel-input\" aria-invalid=\"false\" pattern=\"\\+?\\d{1,4}[\\s\\-]?(?:\\(\\d{1,3}\\)[\\s\\-]?)?\\d{1,4}[\\s\\-]?\\d{1,4}[\\s\\-]?\\d{1,4}$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_20_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_9z2u\" id=\"field_9z2u_label\" class=\"frm_primary_label\">Correo electr\u00f3nico\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_9z2u\" name=\"item_meta[20]\" value=\"\"  data-sectionid=\"14\"  data-reqmsg=\"Este campo es obligatorio.\" aria-required=\"true\" data-invmsg=\"Correo electr\u00f3nico no es v\u00e1lido\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_21_container\" class=\"frm_form_field form-field  frm_top_container frm3\">\r\n    <label for=\"field_fkxsy\" id=\"field_fkxsy_label\" class=\"frm_primary_label\">N\u00famero de caso o referencia\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_fkxsy\" name=\"item_meta[21]\" value=\"\"  data-sectionid=\"14\"  data-invmsg=\"El texto no es v\u00e1lido.\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_23_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Detalles del traslado<\/h3>\r\n\r\n\r\n<div id=\"frm_field_24_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3 frm_first\">\r\n    <label for=\"field_v9ubu\" id=\"field_v9ubu_label\" class=\"frm_primary_label\">Fecha estimada del traslado\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_v9ubu\" name=\"item_meta[24]\" value=\"\"  data-sectionid=\"23\"  style=\"width:40%\" maxlength=\"10\" data-reqmsg=\"Este campo es obligatorio.\" aria-required=\"true\" data-invmsg=\"La fecha no es v\u00e1lida.\" class=\"frm_date auto_width\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_25_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm3\">\r\n    <label for=\"field_x3zfr\" id=\"field_x3zfr_label\" class=\"frm_primary_label\">Tipo de paciente\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[25]\" id=\"field_x3zfr\"  data-sectionid=\"23\"  data-frmval=\"Adult\" data-reqmsg=\"Este campo es obligatorio.\" aria-required=\"true\" data-invmsg=\"Tipo de paciente no es v\u00e1lido.\" class=\"auto_width\" aria-invalid=\"false\"  >\n\t\t<option  value=\"Adult\" selected='selected'>Adulto<\/option><option  value=\"Pediatric\">Pedi\u00e1trico<\/option><option  value=\"Geriatric\">Geri\u00e1trico<\/option><option  value=\"Neonate\">Neonato<\/option><option  value=\"Bariatric\">Bari\u00e1trico<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_26_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_whate\" id=\"field_whate_label\" class=\"frm_primary_label\">\u00bfIncluir traslado de cama a cama?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[26]\" id=\"field_whate\"  data-sectionid=\"23\"  data-reqmsg=\"\u00bfIncluir traslado de cama a cama? cannot be blank.\" aria-required=\"true\" data-invmsg=\"\u00bfIncluir traslado de cama a cama? no es v\u00e1lido.\" class=\"auto_width\" aria-invalid=\"false\"  >\n\t\t<option  value=\"Yes, include ground transportation at origin and destination\">S\u00ed, incluir traslado terrestre en origen y destino<\/option><option  value=\"No, fixed-wing air ambulance only\">No, solo avi\u00f3n ambulancia<\/option><option  value=\"Not sure \/ need guidance\">No estoy seguro \/ necesito orientaci\u00f3n<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n\t\t<input  type=\"hidden\" name=\"item_meta[27]\" id=\"field_mvaqn\" value=\"fixed-wing-air-ambulance\"  data-sectionid=\"23\"  data-frmval=\"fixed-wing-air-ambulance\"   \/>\n\t\t<\/div>\n<div id=\"frm_field_29_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Prioridad principal (opcional, pero \u00fatil)<\/h3>\r\n\r\n\r\n<div id=\"frm_field_30_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first vertical_radio\">\r\n\t<div  id=\"field_5erjp_label\" class=\"frm_primary_label\">\u00bfQu\u00e9 es lo m\u00e1s importante para este traslado?\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_5erjp_label\" role=\"radiogroup\">\t\t<div class=\"frm_radio\" id=\"frm_radio_30-29-0\">\t\t\t<label  for=\"field_5erjp-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[30]\" id=\"field_5erjp-0\" value=\"Lowest overall cost\"\n\t\t data-sectionid=\"29\"  data-invmsg=\"\u00bfQu\u00e9 es lo m\u00e1s importante para este traslado? no es v\u00e1lido.\"   \/> Menor costo total<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_30-29-1\">\t\t\t<label  for=\"field_5erjp-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[30]\" id=\"field_5erjp-1\" value=\"Earliest available option\"\n\t\t data-sectionid=\"29\"  data-invmsg=\"\u00bfQu\u00e9 es lo m\u00e1s importante para este traslado? no es v\u00e1lido.\"   \/> Opci\u00f3n disponible m\u00e1s pr\u00f3xima<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_30-29-2\">\t\t\t<label  for=\"field_5erjp-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[30]\" id=\"field_5erjp-2\" value=\"Fewer stops \/ shorter routing\"\n\t\t data-sectionid=\"29\"  data-invmsg=\"\u00bfQu\u00e9 es lo m\u00e1s importante para este traslado? no es v\u00e1lido.\"   \/> Menos escalas \/ ruta m\u00e1s corta<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_30-29-3\">\t\t\t<label  for=\"field_5erjp-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[30]\" id=\"field_5erjp-3\" value=\"Ability to travel with family members\"\n\t\t data-sectionid=\"29\"  data-invmsg=\"\u00bfQu\u00e9 es lo m\u00e1s importante para este traslado? no es v\u00e1lido.\"   \/> Posibilidad de viajar con familiares<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_30-29-4\">\t\t\t<label  for=\"field_5erjp-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[30]\" id=\"field_5erjp-4\" value=\"Larger aircraft \/ more space and comfort\"\n\t\t data-sectionid=\"29\"  data-invmsg=\"\u00bfQu\u00e9 es lo m\u00e1s importante para este traslado? no es v\u00e1lido.\"   \/> Aeronave m\u00e1s grande \/ m\u00e1s espacio y comodidad<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_30-29-5\">\t\t\t<label  for=\"field_5erjp-5\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[30]\" id=\"field_5erjp-5\" value=\"Flexible timing\"\n\t\t data-sectionid=\"29\"  data-invmsg=\"\u00bfQu\u00e9 es lo m\u00e1s importante para este traslado? no es v\u00e1lido.\"   \/> Flexibilidad de tiempos<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_30-29-6\">\t\t\t<label  for=\"field_5erjp-6\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[30]\" id=\"field_5erjp-6\" value=\"Not sure yet \/ need guidance\"\n\t\t data-sectionid=\"29\"  data-invmsg=\"\u00bfQu\u00e9 es lo m\u00e1s importante para este traslado? no es v\u00e1lido.\"   \/> A\u00fan no estoy seguro \/ necesito orientaci\u00f3n<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_31_container\" class=\"frm_form_field form-field  frm_top_container frm6 vertical_radio\">\r\n\t<div  id=\"field_u4vk3_label\" class=\"frm_primary_label\">\u00bfQu\u00e9 es esencial para este traslado?\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_u4vk3_label\" role=\"radiogroup\">\t\t<div class=\"frm_radio\" id=\"frm_radio_31-29-0\">\t\t\t<label  for=\"field_u4vk3-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[31]\" id=\"field_u4vk3-0\" value=\"Patient only\"\n\t\t data-sectionid=\"29\"  data-frmval=\"Patient only\" data-invmsg=\"\u00bfQu\u00e9 es esencial para este traslado? no es v\u00e1lido.\"  checked=\"checked\" aria-describedby=\"frm_desc_field_u4vk3\" \/> Solo paciente<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_31-29-1\">\t\t\t<label  for=\"field_u4vk3-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[31]\" id=\"field_u4vk3-1\" value=\"Patient + 1 family member\"\n\t\t data-sectionid=\"29\"  data-frmval=\"Patient only\" data-invmsg=\"\u00bfQu\u00e9 es esencial para este traslado? no es v\u00e1lido.\" aria-describedby=\"frm_desc_field_u4vk3\"   \/> Paciente + 1 familiar<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_31-29-2\">\t\t\t<label  for=\"field_u4vk3-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[31]\" id=\"field_u4vk3-2\" value=\"Patient + 2 family members\"\n\t\t data-sectionid=\"29\"  data-frmval=\"Patient only\" data-invmsg=\"\u00bfQu\u00e9 es esencial para este traslado? no es v\u00e1lido.\" aria-describedby=\"frm_desc_field_u4vk3\"   \/> Paciente + 2 familiares<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_31-29-3\">\t\t\t<label  for=\"field_u4vk3-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[31]\" id=\"field_u4vk3-3\" value=\"Patient + 3 or more family members\"\n\t\t data-sectionid=\"29\"  data-frmval=\"Patient only\" data-invmsg=\"\u00bfQu\u00e9 es esencial para este traslado? no es v\u00e1lido.\" aria-describedby=\"frm_desc_field_u4vk3\"   \/> Paciente + 3 o m\u00e1s familiares<\/label><\/div>\n<\/div>\r\n\t<div class=\"frm_description\" id=\"frm_desc_field_u4vk3\">El n\u00famero de familiares acompa\u00f1antes puede afectar las opciones de aeronave, la configuraci\u00f3n de asientos, la ruta y el costo total.<\/div>\r\n\t\r\n<\/div>\n<\/div>\n<div id=\"frm_field_33_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Ubicaci\u00f3n de origen<\/h3>\r\n\r\n\r\n<div id=\"frm_field_34_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first\">\r\n    <label for=\"field_twscp\" id=\"field_twscp_label\" class=\"frm_primary_label\">Tipo de centro o ubicaci\u00f3n\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[34]\" id=\"field_twscp\"  data-sectionid=\"33\"  data-frmval=\"Hospital\" data-reqmsg=\"Este campo es obligatorio.\" aria-required=\"true\" data-invmsg=\"Tipo de centro o ubicaci\u00f3n no es v\u00e1lido.\" class=\"auto_width\" aria-invalid=\"false\"  >\n\t\t<option  value=\"Hospital\" selected='selected'>Hospital<\/option><option  value=\"Rehabilitation Center\">Centro de rehabilitaci\u00f3n<\/option><option  value=\"Residence\">Residencia<\/option><option  value=\"Other\">Otro<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_35_container\" class=\"frm_form_field form-field  frm_top_container frm12\">\r\n\t<div  id=\"field_xc4st_label\" class=\"frm_primary_label\">Centro hospitalario, centro de atenci\u00f3n m\u00e9dica o direcci\u00f3n de origen\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/div>\r\n\t<fieldset aria-labelledby=\"field_xc4st_label\">\n<legend class=\"frm_screen_reader frm_hidden\">\n\tCentro hospitalario, centro de atenci\u00f3n m\u00e9dica o direcci\u00f3n de origen<\/legend>\n<div class=\"frm_combo_inputs_container\">\n<div id=\"frm_field_35-line1_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_xc4st_line1\" class=\"frm_screen_reader frm_hidden\">\n\t\tCentro hospitalario, centro de atenci\u00f3n m\u00e9dica o direcci\u00f3n de origen\t<\/label>\n\t\t<input type=\"text\" id=\"field_xc4st_line1\" value=\"\" name=\"item_meta[35][line1]\"  placeholder=\"Ingrese una ubicaci\u00f3n\" data-placeholder=\"Ingrese una ubicaci\u00f3n\" data-sectionid=\"33\"  data-invmsg=\"Centro hospitalario, centro de atenci\u00f3n m\u00e9dica o direcci\u00f3n de origen no es v\u00e1lido\" aria-invalid=\"false\" data-geoautocomplete=\"1\" data-geofieldid=\"35\" data-geoisaddress=\"1\"   autocomplete=\"address-line1\" \/>\n\t<\/div>\n<div id=\"frm_field_35-line2_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_xc4st_line2\" class=\"frm_screen_reader frm_hidden\">\n\t\tCentro hospitalario, centro de atenci\u00f3n m\u00e9dica o direcci\u00f3n de origen\t<\/label>\n\t\t<input type=\"text\" id=\"field_xc4st_line2\" value=\"\" name=\"item_meta[35][line2]\"  placeholder=\"\" data-placeholder=\"\" data-sectionid=\"33\"  data-invmsg=\"Centro hospitalario, centro de atenci\u00f3n m\u00e9dica o direcci\u00f3n de origen no es v\u00e1lido\" class=\"frm_optional\" aria-invalid=\"false\" data-geoautocomplete=\"1\" data-geofieldid=\"35\" data-geoisaddress=\"1\"   autocomplete=\"address-line2\" \/>\n\t<\/div>\n<div id=\"frm_field_35-city_container\" class=\"frm_form_field form-field frm_third frm_first\">\n\t<label for=\"field_xc4st_city\" class=\"frm_screen_reader frm_hidden\">\n\t\tCiudad\t<\/label>\n\t\t<input type=\"text\" id=\"field_xc4st_city\" value=\"\" name=\"item_meta[35][city]\"  placeholder=\"\" data-placeholder=\"\" data-sectionid=\"33\"  data-invmsg=\"Centro hospitalario, centro de atenci\u00f3n m\u00e9dica o direcci\u00f3n de origen no es v\u00e1lido\" aria-invalid=\"false\" data-geoautocomplete=\"1\" data-geofieldid=\"35\" data-geoisaddress=\"1\"   autocomplete=\"address-level2\" \/>\n\t<div class=\"frm_description\">Ciudad<\/div><\/div>\n<div id=\"frm_field_35-state_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_xc4st_state\" class=\"frm_screen_reader frm_hidden\">\n\t\tEstado \/ provincia\t<\/label>\n\t\t<input type=\"text\" id=\"field_xc4st_state\" value=\"\" name=\"item_meta[35][state]\"  placeholder=\"\" data-placeholder=\"\" data-sectionid=\"33\"  data-invmsg=\"Centro hospitalario, centro de atenci\u00f3n m\u00e9dica o direcci\u00f3n de origen no es v\u00e1lido\" aria-invalid=\"false\" data-geoautocomplete=\"1\" data-geofieldid=\"35\" data-geoisaddress=\"1\"   autocomplete=\"address-level1\" \/>\n\t<div class=\"frm_description\">Estado \/ provincia<\/div><\/div>\n<div id=\"frm_field_35-zip_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_xc4st_zip\" class=\"frm_screen_reader frm_hidden\">\n\t\tC\u00f3digo postal\t<\/label>\n\t\t<input type=\"text\" id=\"field_xc4st_zip\" value=\"\" name=\"item_meta[35][zip]\"  placeholder=\"\" data-placeholder=\"\" data-sectionid=\"33\"  data-invmsg=\"Centro hospitalario, centro de atenci\u00f3n m\u00e9dica o direcci\u00f3n de origen no es v\u00e1lido\" aria-invalid=\"false\" data-geoautocomplete=\"1\" data-geofieldid=\"35\" data-geoisaddress=\"1\"   autocomplete=\"postal-code\" \/>\n\t<div class=\"frm_description\">C\u00f3digo postal<\/div><\/div>\n<div id=\"frm_field_35-country_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_xc4st_country\" class=\"frm_screen_reader frm_hidden\">\n\t\tPa\u00eds\t<\/label>\n\t\t\t<select name=\"item_meta[35][country]\" id=\"field_xc4st_country\"  placeholder=\"\" data-placeholder=\"\" data-sectionid=\"33\"  data-invmsg=\"Centro hospitalario, centro de atenci\u00f3n m\u00e9dica o direcci\u00f3n de origen no es v\u00e1lido\" aria-invalid=\"false\" data-geoautocomplete=\"1\" data-geofieldid=\"35\" data-geoisaddress=\"1\"   autocomplete=\"country-name\">\n\t\t\t<option value=\"\" class=\"\">\n\t\t\t\t\t\t\t<\/option>\n\t\t\t<option  value=\"Afganist\u00e1n\">Afganist\u00e1n<\/option><option  value=\"Albania\" data-code=\"AL\">Albania<\/option><option  value=\"Alemania\">Alemania<\/option><option  value=\"Andorra\" data-code=\"AD\">Andorra<\/option><option  value=\"Angola\" data-code=\"AO\">Angola<\/option><option  value=\"Anguila\">Anguila<\/option><option  value=\"Antigua y Barbuda\">Antigua y Barbuda<\/option><option  value=\"Ant\u00e1rtica\">Ant\u00e1rtica<\/option><option  value=\"Argelia\">Argelia<\/option><option  value=\"Argentina\" data-code=\"AR\">Argentina<\/option><option  value=\"Armenia\" data-code=\"AM\">Armenia<\/option><option  value=\"Aruba\" data-code=\"AW\">Aruba<\/option><option  value=\"Australia\" data-code=\"AU\">Australia<\/option><option  value=\"Austria\" data-code=\"AT\">Austria<\/option><option  value=\"Azerbaiy\u00e1n\">Azerbaiy\u00e1n<\/option><option  value=\"Bahamas\" data-code=\"BS\">Bahamas<\/option><option  value=\"Bangladesh\" data-code=\"BD\">Bangladesh<\/option><option  value=\"Barbados\" data-code=\"BB\">Barbados<\/option><option  value=\"Bar\u00e9in\">Bar\u00e9in<\/option><option  value=\"Belize\" data-code=\"BZ\">Belize<\/option><option  value=\"Ben\u00edn\">Ben\u00edn<\/option><option  value=\"Bermudas\">Bermudas<\/option><option  value=\"Bielorrusia\">Bielorrusia<\/option><option  value=\"Bolivia\" data-code=\"BO\">Bolivia<\/option><option  value=\"Bonaire, San Eustaquio y Saba\">Bonaire, San Eustaquio y Saba<\/option><option  value=\"Bosnia y Herzegovina\">Bosnia y Herzegovina<\/option><option  value=\"Botsuana\">Botsuana<\/option><option  value=\"Brasil\">Brasil<\/option><option  value=\"Brun\u00e9i\">Brun\u00e9i<\/option><option  value=\"Bulgaria\" data-code=\"BG\">Bulgaria<\/option><option  value=\"Burkina Faso\" data-code=\"BF\">Burkina Faso<\/option><option  value=\"Burundi\" data-code=\"BI\">Burundi<\/option><option  value=\"But\u00e1n\">But\u00e1n<\/option><option  value=\"B\u00e9lgica\">B\u00e9lgica<\/option><option  value=\"Cabo Verde\">Cabo Verde<\/option><option  value=\"Camboya\">Camboya<\/option><option  value=\"Camer\u00fan\">Camer\u00fan<\/option><option  value=\"Canad\u00e1\">Canad\u00e1<\/option><option  value=\"Chad\" data-code=\"TD\">Chad<\/option><option  value=\"Chile\" data-code=\"CL\">Chile<\/option><option  value=\"China\" data-code=\"CN\">China<\/option><option  value=\"Chipre\">Chipre<\/option><option  value=\"Ciudad del Vaticano\">Ciudad del Vaticano<\/option><option  value=\"Colombia\" data-code=\"CO\">Colombia<\/option><option  value=\"Comoras\">Comoras<\/option><option  value=\"Congo\">Congo<\/option><option  value=\"Corea del Norte\">Corea del Norte<\/option><option  value=\"Corea del Sur\">Corea del Sur<\/option><option  value=\"Costa Rica\" data-code=\"CR\">Costa Rica<\/option><option  value=\"Costa de Marfil\">Costa de Marfil<\/option><option  value=\"Croacia\">Croacia<\/option><option  value=\"Cuba\" data-code=\"CU\">Cuba<\/option><option  value=\"Curazao\">Curazao<\/option><option  value=\"Dinamarca\">Dinamarca<\/option><option  value=\"Dominica\" data-code=\"DM\">Dominica<\/option><option  value=\"Ecuador\" data-code=\"EC\">Ecuador<\/option><option  value=\"Egipto\">Egipto<\/option><option  value=\"El Salvador\" data-code=\"SV\">El Salvador<\/option><option  value=\"Emiratos \u00c1rabes Unidos\">Emiratos \u00c1rabes Unidos<\/option><option  value=\"Eritrea\" data-code=\"ER\">Eritrea<\/option><option  value=\"Eslovaquia\">Eslovaquia<\/option><option  value=\"Eslovenia\">Eslovenia<\/option><option  value=\"Espa\u00f1a\">Espa\u00f1a<\/option><option  value=\"Estados Unidos\">Estados Unidos<\/option><option  value=\"Estonia\" data-code=\"EE\">Estonia<\/option><option  value=\"Etiop\u00eda\">Etiop\u00eda<\/option><option  value=\"Fiji\" data-code=\"FJ\">Fiji<\/option><option  value=\"Filipinas\">Filipinas<\/option><option  value=\"Finlandia\">Finlandia<\/option><option  value=\"Francia\">Francia<\/option><option  value=\"Gab\u00f3n\">Gab\u00f3n<\/option><option  value=\"Gambia\" data-code=\"GM\">Gambia<\/option><option  value=\"Georgia\" data-code=\"GE\">Georgia<\/option><option  value=\"Ghana\" data-code=\"GH\">Ghana<\/option><option  value=\"Gibraltar\" data-code=\"GI\">Gibraltar<\/option><option  value=\"Granada\">Granada<\/option><option  value=\"Grecia\">Grecia<\/option><option  value=\"Groenlandia\">Groenlandia<\/option><option  value=\"Guadalupe\">Guadalupe<\/option><option  value=\"Guam\" data-code=\"GU\">Guam<\/option><option  value=\"Guatemala\" data-code=\"GT\">Guatemala<\/option><option  value=\"Guayana Francesa\">Guayana Francesa<\/option><option  value=\"Guernsey\" data-code=\"GG\">Guernsey<\/option><option  value=\"Guinea\" data-code=\"GN\">Guinea<\/option><option  value=\"Guinea Ecuatorial\">Guinea Ecuatorial<\/option><option  value=\"Guinea-Bis\u00e1u\">Guinea-Bis\u00e1u<\/option><option  value=\"Guyana\" data-code=\"GY\">Guyana<\/option><option  value=\"Hait\u00ed\">Hait\u00ed<\/option><option  value=\"Honduras\" data-code=\"HN\">Honduras<\/option><option  value=\"Hong Kong\" data-code=\"HK\">Hong Kong<\/option><option  value=\"Hungr\u00eda\">Hungr\u00eda<\/option><option  value=\"India\" data-code=\"IN\">India<\/option><option  value=\"Indonesia\" data-code=\"ID\">Indonesia<\/option><option  value=\"Iraq\" data-code=\"IQ\">Iraq<\/option><option  value=\"Irlanda\">Irlanda<\/option><option  value=\"Ir\u00e1n\">Ir\u00e1n<\/option><option  value=\"Isla Bouvet\">Isla Bouvet<\/option><option  value=\"Isla Norfolk\">Isla Norfolk<\/option><option  value=\"Isla de Man\">Isla de Man<\/option><option  value=\"Isla de Navidad\">Isla de Navidad<\/option><option  value=\"Islandia\">Islandia<\/option><option  value=\"Islas Aland\">Islas Aland<\/option><option  value=\"Islas Caim\u00e1n\">Islas Caim\u00e1n<\/option><option  value=\"Islas Cocos (Keeling)\">Islas Cocos (Keeling)<\/option><option  value=\"Islas Cook\">Islas Cook<\/option><option  value=\"Islas Feroe\">Islas Feroe<\/option><option  value=\"Islas Georgias del Sur y Sandwich del Sur\">Islas Georgias del Sur y Sandwich del Sur<\/option><option  value=\"Islas Heard y McDonald\">Islas Heard y McDonald<\/option><option  value=\"Islas Malvinas (Falkland)\">Islas Malvinas (Falkland)<\/option><option  value=\"Islas Marianas del Norte\">Islas Marianas del Norte<\/option><option  value=\"Islas Marshall\">Islas Marshall<\/option><option  value=\"Islas Salom\u00f3n\">Islas Salom\u00f3n<\/option><option  value=\"Islas Turcas y Caicos\">Islas Turcas y Caicos<\/option><option  value=\"Islas Ultramarinas Menores de los Estados Unidos\">Islas Ultramarinas Menores de los Estados Unidos<\/option><option  value=\"Islas V\u00edrgenes  EE.UU.\">Islas V\u00edrgenes  EE.UU.<\/option><option  value=\"Islas V\u00edrgenes Brit\u00e1nicas\">Islas V\u00edrgenes Brit\u00e1nicas<\/option><option  value=\"Israel\" data-code=\"IL\">Israel<\/option><option  value=\"Italia\">Italia<\/option><option  value=\"Jamaica\" data-code=\"JM\">Jamaica<\/option><option  value=\"Jap\u00f3n\">Jap\u00f3n<\/option><option  value=\"Jersey\" data-code=\"JE\">Jersey<\/option><option  value=\"Jordania\">Jordania<\/option><option  value=\"Katar\">Katar<\/option><option  value=\"Kazajist\u00e1n\">Kazajist\u00e1n<\/option><option  value=\"Kenia\">Kenia<\/option><option  value=\"Kirguist\u00e1n\">Kirguist\u00e1n<\/option><option  value=\"Kiribati\" data-code=\"KI\">Kiribati<\/option><option  value=\"Kosovo\" data-code=\"XK\">Kosovo<\/option><option  value=\"Kuwait\" data-code=\"KW\">Kuwait<\/option><option  value=\"Laos\" data-code=\"LA\">Laos<\/option><option  value=\"Lesoto\">Lesoto<\/option><option  value=\"Letonia\">Letonia<\/option><option  value=\"Liberia\" data-code=\"LR\">Liberia<\/option><option  value=\"Libia\">Libia<\/option><option  value=\"Liechtenstein\" data-code=\"LI\">Liechtenstein<\/option><option  value=\"Lituania\">Lituania<\/option><option  value=\"Luxemburgo\">Luxemburgo<\/option><option  value=\"L\u00edbano\">L\u00edbano<\/option><option  value=\"Macao\" data-code=\"MO\">Macao<\/option><option  value=\"Madagascar\" data-code=\"MG\">Madagascar<\/option><option  value=\"Malasia\">Malasia<\/option><option  value=\"Malaui\">Malaui<\/option><option  value=\"Maldivas\">Maldivas<\/option><option  value=\"Mali\" data-code=\"ML\">Mali<\/option><option  value=\"Malta\" data-code=\"MT\">Malta<\/option><option  value=\"Marruecos\">Marruecos<\/option><option  value=\"Martinica\">Martinica<\/option><option  value=\"Mauricio\">Mauricio<\/option><option  value=\"Mauritania\" data-code=\"MR\">Mauritania<\/option><option  value=\"Mayotte\" data-code=\"YT\">Mayotte<\/option><option  value=\"Micronesia\" data-code=\"FM\">Micronesia<\/option><option  value=\"Moldava\">Moldava<\/option><option  value=\"Mongolia\" data-code=\"MN\">Mongolia<\/option><option  value=\"Montenegro\" data-code=\"ME\">Montenegro<\/option><option  value=\"Montserrat\" data-code=\"MS\">Montserrat<\/option><option  value=\"Mozambique\" data-code=\"MZ\">Mozambique<\/option><option  value=\"Myanmar\" data-code=\"MM\">Myanmar<\/option><option  value=\"M\u00e9xico\">M\u00e9xico<\/option><option  value=\"M\u00f3naco\">M\u00f3naco<\/option><option  value=\"Namibia\" data-code=\"NA\">Namibia<\/option><option  value=\"Nauru\" data-code=\"NR\">Nauru<\/option><option  value=\"Nepal\" data-code=\"NP\">Nepal<\/option><option  value=\"Nicaragua\" data-code=\"NI\">Nicaragua<\/option><option  value=\"Nigeria\" data-code=\"NG\">Nigeria<\/option><option  value=\"Niue\" data-code=\"NU\">Niue<\/option><option  value=\"Noruega\">Noruega<\/option><option  value=\"Nueva Caledonia\">Nueva Caledonia<\/option><option  value=\"Nueva Zelanda \">Nueva Zelanda <\/option><option  value=\"N\u00edger\">N\u00edger<\/option><option  value=\"Om\u00e1n\">Om\u00e1n<\/option><option  value=\"Pakist\u00e1n\">Pakist\u00e1n<\/option><option  value=\"Palau\" data-code=\"PW\">Palau<\/option><option  value=\"Palestina\">Palestina<\/option><option  value=\"Panam\u00e1\">Panam\u00e1<\/option><option  value=\"Pap\u00faa Nueva Guinea\">Pap\u00faa Nueva Guinea<\/option><option  value=\"Paraguay\" data-code=\"PY\">Paraguay<\/option><option  value=\"Pa\u00edses Bajos\">Pa\u00edses Bajos<\/option><option  value=\"Per\u00fa\">Per\u00fa<\/option><option  value=\"Pitcairn\" data-code=\"PN\">Pitcairn<\/option><option  value=\"Polinesia Francesa\">Polinesia Francesa<\/option><option  value=\"Polonia\">Polonia<\/option><option  value=\"Portugal\" data-code=\"PT\">Portugal<\/option><option  value=\"Puerto Rico\" data-code=\"PR\">Puerto Rico<\/option><option  value=\"Reino Unido\">Reino Unido<\/option><option  value=\"Rep\u00fablica Central de \u00c1frica \">Rep\u00fablica Central de \u00c1frica <\/option><option  value=\"Rep\u00fablica Checa\">Rep\u00fablica Checa<\/option><option  value=\"Rep\u00fablica Dominicana\">Rep\u00fablica Dominicana<\/option><option  value=\"Rep\u00fablica de Macedonia\">Rep\u00fablica de Macedonia<\/option><option  value=\"Reuni\u00f3n\">Reuni\u00f3n<\/option><option  value=\"Ruanda\">Ruanda<\/option><option  value=\"Ruman\u00eda\">Ruman\u00eda<\/option><option  value=\"Rusia\">Rusia<\/option><option  value=\"Sahara Occidental\">Sahara Occidental<\/option><option  value=\"Saint Kitts y Nevis\">Saint Kitts y Nevis<\/option><option  value=\"Samoa\" data-code=\"WS\">Samoa<\/option><option  value=\"Samoa Americana\">Samoa Americana<\/option><option  value=\"San Bartolom\u00e9\">San Bartolom\u00e9<\/option><option  value=\"San Marino\" data-code=\"SM\">San Marino<\/option><option  value=\"San Mart\u00edn (parte francesa)\">San Mart\u00edn (parte francesa)<\/option><option  value=\"San Mart\u00edn\u200b (parte holandesa)\">San Mart\u00edn\u200b (parte holandesa)<\/option><option  value=\"San Pedro y Miquel\u00f3n\">San Pedro y Miquel\u00f3n<\/option><option  value=\"San Vicente y las Granadinas \">San Vicente y las Granadinas <\/option><option  value=\"Santa Elena, Ascensi\u00f3n y Trist\u00e1n de Acu\u00f1a\">Santa Elena, Ascensi\u00f3n y Trist\u00e1n de Acu\u00f1a<\/option><option  value=\"Santa Luc\u00eda\">Santa Luc\u00eda<\/option><option  value=\"Santa Sede\">Santa Sede<\/option><option  value=\"Santo Tom\u00e9 y Pr\u00edncipe\">Santo Tom\u00e9 y Pr\u00edncipe<\/option><option  value=\"Saud\u00ed Arabia\">Saud\u00ed Arabia<\/option><option  value=\"Senegal\" data-code=\"SN\">Senegal<\/option><option  value=\"Serbia\" data-code=\"RS\">Serbia<\/option><option  value=\"Seychelles\" data-code=\"SC\">Seychelles<\/option><option  value=\"Sierra Leona\">Sierra Leona<\/option><option  value=\"Singapur\">Singapur<\/option><option  value=\"Siria\">Siria<\/option><option  value=\"Somalia\" data-code=\"SO\">Somalia<\/option><option  value=\"Sri Lanka\" data-code=\"LK\">Sri Lanka<\/option><option  value=\"Suazilandia\">Suazilandia<\/option><option  value=\"Sud\u00e1frica\">Sud\u00e1frica<\/option><option  value=\"Sud\u00e1n\">Sud\u00e1n<\/option><option  value=\"Sud\u00e1n del sur\">Sud\u00e1n del sur<\/option><option  value=\"Suecia\">Suecia<\/option><option  value=\"Suiza\">Suiza<\/option><option  value=\"Surinam\">Surinam<\/option><option  value=\"Svalbard y Jan Mayen\">Svalbard y Jan Mayen<\/option><option  value=\"Tailandia\">Tailandia<\/option><option  value=\"Taiw\u00e1n\">Taiw\u00e1n<\/option><option  value=\"Tanzania\" data-code=\"TZ\">Tanzania<\/option><option  value=\"Tayikist\u00e1n\">Tayikist\u00e1n<\/option><option  value=\"Territorio Brit\u00e1nico del Oc\u00e9ano \u00cdndico\">Territorio Brit\u00e1nico del Oc\u00e9ano \u00cdndico<\/option><option  value=\"Territorios Australes Franceses\">Territorios Australes Franceses<\/option><option  value=\"Timor Oriental\">Timor Oriental<\/option><option  value=\"Timor Oriental\">Timor Oriental<\/option><option  value=\"Togo\" data-code=\"TG\">Togo<\/option><option  value=\"Tokelau\" data-code=\"TK\">Tokelau<\/option><option  value=\"Tonga\" data-code=\"TO\">Tonga<\/option><option  value=\"Trinidad y Tobago\">Trinidad y Tobago<\/option><option  value=\"Turkmenist\u00e1n\">Turkmenist\u00e1n<\/option><option  value=\"Turqu\u00eda\">Turqu\u00eda<\/option><option  value=\"Tuvalu\" data-code=\"TV\">Tuvalu<\/option><option  value=\"T\u00fanez\">T\u00fanez<\/option><option  value=\"Ucrania\">Ucrania<\/option><option  value=\"Uganda\" data-code=\"UG\">Uganda<\/option><option  value=\"Uruguay\" data-code=\"UY\">Uruguay<\/option><option  value=\"Uzbekist\u00e1n\">Uzbekist\u00e1n<\/option><option  value=\"Vanuatu\" data-code=\"VU\">Vanuatu<\/option><option  value=\"Venezuela\" data-code=\"VE\">Venezuela<\/option><option  value=\"Vietnam\" data-code=\"VN\">Vietnam<\/option><option  value=\"Wallis y Futuna\">Wallis y Futuna<\/option><option  value=\"Yemen\" data-code=\"YE\">Yemen<\/option><option  value=\"Yibuti\">Yibuti<\/option><option  value=\"Zambia\" data-code=\"ZM\">Zambia<\/option><option  value=\"Zimbabue\">Zimbabue<\/option>\t\t<\/select>\n\t<div class=\"frm_description\">Pa\u00eds<\/div><\/div>\n<div id=\"frm_field_35-state_abbreviation_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_xc4st_state_abbreviation\" class=\"frm_screen_reader frm_hidden\">\n\t\tCentro hospitalario, centro de atenci\u00f3n m\u00e9dica o direcci\u00f3n de origen\t<\/label>\n\t\t<input type=\"hidden\" id=\"field_xc4st_state_abbreviation\" value=\"\" name=\"item_meta[35][state_abbreviation]\"  placeholder=\"\" data-placeholder=\"\" data-sectionid=\"33\"  data-invmsg=\"Centro hospitalario, centro de atenci\u00f3n m\u00e9dica o direcci\u00f3n de origen no es v\u00e1lido\" class=\"frm_optional\" aria-invalid=\"false\" data-geoautocomplete=\"1\" data-geofieldid=\"35\" data-geoisaddress=\"1\"   \/>\n\t<\/div>\n<\/div>\n<\/fieldset>\n\r\n\t\r\n\t<input id=\"geo-lat-35\" name=\"geo_lat[35]\" class=\"frm-geo-lat\" type=\"hidden\" value=\"\"><input id=\"geo-lng-35\" name=\"geo_lng[35]\" class=\"frm-geo-lng\" type=\"hidden\" value=\"\">\r\n<\/div>\n<\/div>\n<div id=\"frm_field_37_container\" class=\"frm_form_field frm_section_heading form-field  frm12 frm_first\">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Ubicaci\u00f3n de destino<\/h3>\r\n\r\n\r\n<div id=\"frm_field_38_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm12 frm_first\">\r\n    <label for=\"field_3qowi\" id=\"field_3qowi_label\" class=\"frm_primary_label\">Tipo de centro o ubicaci\u00f3n\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[38]\" id=\"field_3qowi\"  data-sectionid=\"37\"  data-frmval=\"Hospital\" data-reqmsg=\"Este campo es obligatorio.\" aria-required=\"true\" data-invmsg=\"Tipo de centro o ubicaci\u00f3n no es v\u00e1lido.\" class=\"auto_width\" aria-invalid=\"false\"  >\n\t\t<option  value=\"Hospital\" selected='selected'>Hospital<\/option><option  value=\"Rehabilitation Center\">Centro de rehabilitaci\u00f3n<\/option><option  value=\"Other\">Otro<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_39_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n\t<div  id=\"field_gmwru_label\" class=\"frm_primary_label\">Centro hospitalario receptor o direcci\u00f3n de destino\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<fieldset aria-labelledby=\"field_gmwru_label\">\n<legend class=\"frm_screen_reader frm_hidden\">\n\tCentro hospitalario receptor o direcci\u00f3n de destino<\/legend>\n<div class=\"frm_combo_inputs_container\">\n<div id=\"frm_field_39-line1_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_gmwru_line1\" class=\"frm_screen_reader frm_hidden\">\n\t\tCentro hospitalario receptor o direcci\u00f3n de destino\t<\/label>\n\t\t<input type=\"text\" id=\"field_gmwru_line1\" value=\"\" name=\"item_meta[39][line1]\"  placeholder=\"Ingrese una ubicaci\u00f3n\" data-placeholder=\"Ingrese una ubicaci\u00f3n\" data-sectionid=\"37\"  data-reqmsg=\"Centro hospitalario receptor o direcci\u00f3n de destino es obligatorio.\" aria-required=\"true\" data-invmsg=\"Centro hospitalario receptor o direcci\u00f3n de destino no es v\u00e1lido\" aria-invalid=\"false\" data-geoautocomplete=\"1\" data-geofieldid=\"39\" data-geoisaddress=\"1\"   autocomplete=\"address-line1\" \/>\n\t<\/div>\n<div id=\"frm_field_39-line2_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_gmwru_line2\" class=\"frm_screen_reader frm_hidden\">\n\t\tCentro hospitalario receptor o direcci\u00f3n de destino\t<\/label>\n\t\t<input type=\"text\" id=\"field_gmwru_line2\" value=\"\" name=\"item_meta[39][line2]\"  placeholder=\"\" data-placeholder=\"\" data-sectionid=\"37\"  data-reqmsg=\"Centro hospitalario receptor o direcci\u00f3n de destino es obligatorio.\" aria-required=\"true\" data-invmsg=\"Centro hospitalario receptor o direcci\u00f3n de destino no es v\u00e1lido\" class=\"frm_optional\" aria-invalid=\"false\" data-geoautocomplete=\"1\" data-geofieldid=\"39\" data-geoisaddress=\"1\"   autocomplete=\"address-line2\" \/>\n\t<\/div>\n<div id=\"frm_field_39-city_container\" class=\"frm_form_field form-field frm_third frm_first\">\n\t<label for=\"field_gmwru_city\" class=\"frm_screen_reader frm_hidden\">\n\t\tCiudad\t<\/label>\n\t\t<input type=\"text\" id=\"field_gmwru_city\" value=\"\" name=\"item_meta[39][city]\"  placeholder=\"\" data-placeholder=\"\" data-sectionid=\"37\"  data-reqmsg=\"Centro hospitalario receptor o direcci\u00f3n de destino es obligatorio.\" aria-required=\"true\" data-invmsg=\"Centro hospitalario receptor o direcci\u00f3n de destino no es v\u00e1lido\" aria-invalid=\"false\" data-geoautocomplete=\"1\" data-geofieldid=\"39\" data-geoisaddress=\"1\"   autocomplete=\"address-level2\" \/>\n\t<div class=\"frm_description\">Ciudad<\/div><\/div>\n<div id=\"frm_field_39-state_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_gmwru_state\" class=\"frm_screen_reader frm_hidden\">\n\t\tEstado \/ provincia\t<\/label>\n\t\t<input type=\"text\" id=\"field_gmwru_state\" value=\"\" name=\"item_meta[39][state]\"  placeholder=\"\" data-placeholder=\"\" data-sectionid=\"37\"  data-reqmsg=\"Centro hospitalario receptor o direcci\u00f3n de destino es obligatorio.\" aria-required=\"true\" data-invmsg=\"Centro hospitalario receptor o direcci\u00f3n de destino no es v\u00e1lido\" aria-invalid=\"false\" data-geoautocomplete=\"1\" data-geofieldid=\"39\" data-geoisaddress=\"1\"   autocomplete=\"address-level1\" \/>\n\t<div class=\"frm_description\">Estado \/ provincia<\/div><\/div>\n<div id=\"frm_field_39-zip_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_gmwru_zip\" class=\"frm_screen_reader frm_hidden\">\n\t\tC\u00f3digo postal\t<\/label>\n\t\t<input type=\"text\" id=\"field_gmwru_zip\" value=\"\" name=\"item_meta[39][zip]\"  placeholder=\"\" data-placeholder=\"\" data-sectionid=\"37\"  data-reqmsg=\"Centro hospitalario receptor o direcci\u00f3n de destino es obligatorio.\" aria-required=\"true\" data-invmsg=\"Centro hospitalario receptor o direcci\u00f3n de destino no es v\u00e1lido\" aria-invalid=\"false\" data-geoautocomplete=\"1\" data-geofieldid=\"39\" data-geoisaddress=\"1\"   autocomplete=\"postal-code\" \/>\n\t<div class=\"frm_description\">C\u00f3digo postal<\/div><\/div>\n<div id=\"frm_field_39-country_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_gmwru_country\" class=\"frm_screen_reader frm_hidden\">\n\t\tPa\u00eds\t<\/label>\n\t\t\t<select name=\"item_meta[39][country]\" id=\"field_gmwru_country\"  placeholder=\"\" data-placeholder=\"\" data-sectionid=\"37\"  data-reqmsg=\"Centro hospitalario receptor o direcci\u00f3n de destino es obligatorio.\" aria-required=\"true\" data-invmsg=\"Centro hospitalario receptor o direcci\u00f3n de destino no es v\u00e1lido\" aria-invalid=\"false\" data-geoautocomplete=\"1\" data-geofieldid=\"39\" data-geoisaddress=\"1\"   autocomplete=\"country-name\">\n\t\t\t<option value=\"\" class=\"\">\n\t\t\t\t\t\t\t<\/option>\n\t\t\t<option  value=\"Afganist\u00e1n\">Afganist\u00e1n<\/option><option  value=\"Albania\" data-code=\"AL\">Albania<\/option><option  value=\"Alemania\">Alemania<\/option><option  value=\"Andorra\" data-code=\"AD\">Andorra<\/option><option  value=\"Angola\" data-code=\"AO\">Angola<\/option><option  value=\"Anguila\">Anguila<\/option><option  value=\"Antigua y Barbuda\">Antigua y Barbuda<\/option><option  value=\"Ant\u00e1rtica\">Ant\u00e1rtica<\/option><option  value=\"Argelia\">Argelia<\/option><option  value=\"Argentina\" data-code=\"AR\">Argentina<\/option><option  value=\"Armenia\" data-code=\"AM\">Armenia<\/option><option  value=\"Aruba\" data-code=\"AW\">Aruba<\/option><option  value=\"Australia\" data-code=\"AU\">Australia<\/option><option  value=\"Austria\" data-code=\"AT\">Austria<\/option><option  value=\"Azerbaiy\u00e1n\">Azerbaiy\u00e1n<\/option><option  value=\"Bahamas\" data-code=\"BS\">Bahamas<\/option><option  value=\"Bangladesh\" data-code=\"BD\">Bangladesh<\/option><option  value=\"Barbados\" data-code=\"BB\">Barbados<\/option><option  value=\"Bar\u00e9in\">Bar\u00e9in<\/option><option  value=\"Belize\" data-code=\"BZ\">Belize<\/option><option  value=\"Ben\u00edn\">Ben\u00edn<\/option><option  value=\"Bermudas\">Bermudas<\/option><option  value=\"Bielorrusia\">Bielorrusia<\/option><option  value=\"Bolivia\" data-code=\"BO\">Bolivia<\/option><option  value=\"Bonaire, San Eustaquio y Saba\">Bonaire, San Eustaquio y Saba<\/option><option  value=\"Bosnia y Herzegovina\">Bosnia y Herzegovina<\/option><option  value=\"Botsuana\">Botsuana<\/option><option  value=\"Brasil\">Brasil<\/option><option  value=\"Brun\u00e9i\">Brun\u00e9i<\/option><option  value=\"Bulgaria\" data-code=\"BG\">Bulgaria<\/option><option  value=\"Burkina Faso\" data-code=\"BF\">Burkina Faso<\/option><option  value=\"Burundi\" data-code=\"BI\">Burundi<\/option><option  value=\"But\u00e1n\">But\u00e1n<\/option><option  value=\"B\u00e9lgica\">B\u00e9lgica<\/option><option  value=\"Cabo Verde\">Cabo Verde<\/option><option  value=\"Camboya\">Camboya<\/option><option  value=\"Camer\u00fan\">Camer\u00fan<\/option><option  value=\"Canad\u00e1\">Canad\u00e1<\/option><option  value=\"Chad\" data-code=\"TD\">Chad<\/option><option  value=\"Chile\" data-code=\"CL\">Chile<\/option><option  value=\"China\" data-code=\"CN\">China<\/option><option  value=\"Chipre\">Chipre<\/option><option  value=\"Ciudad del Vaticano\">Ciudad del Vaticano<\/option><option  value=\"Colombia\" data-code=\"CO\">Colombia<\/option><option  value=\"Comoras\">Comoras<\/option><option  value=\"Congo\">Congo<\/option><option  value=\"Corea del Norte\">Corea del Norte<\/option><option  value=\"Corea del Sur\">Corea del Sur<\/option><option  value=\"Costa Rica\" data-code=\"CR\">Costa Rica<\/option><option  value=\"Costa de Marfil\">Costa de Marfil<\/option><option  value=\"Croacia\">Croacia<\/option><option  value=\"Cuba\" data-code=\"CU\">Cuba<\/option><option  value=\"Curazao\">Curazao<\/option><option  value=\"Dinamarca\">Dinamarca<\/option><option  value=\"Dominica\" data-code=\"DM\">Dominica<\/option><option  value=\"Ecuador\" data-code=\"EC\">Ecuador<\/option><option  value=\"Egipto\">Egipto<\/option><option  value=\"El Salvador\" data-code=\"SV\">El Salvador<\/option><option  value=\"Emiratos \u00c1rabes Unidos\">Emiratos \u00c1rabes Unidos<\/option><option  value=\"Eritrea\" data-code=\"ER\">Eritrea<\/option><option  value=\"Eslovaquia\">Eslovaquia<\/option><option  value=\"Eslovenia\">Eslovenia<\/option><option  value=\"Espa\u00f1a\">Espa\u00f1a<\/option><option  value=\"Estados Unidos\">Estados Unidos<\/option><option  value=\"Estonia\" data-code=\"EE\">Estonia<\/option><option  value=\"Etiop\u00eda\">Etiop\u00eda<\/option><option  value=\"Fiji\" data-code=\"FJ\">Fiji<\/option><option  value=\"Filipinas\">Filipinas<\/option><option  value=\"Finlandia\">Finlandia<\/option><option  value=\"Francia\">Francia<\/option><option  value=\"Gab\u00f3n\">Gab\u00f3n<\/option><option  value=\"Gambia\" data-code=\"GM\">Gambia<\/option><option  value=\"Georgia\" data-code=\"GE\">Georgia<\/option><option  value=\"Ghana\" data-code=\"GH\">Ghana<\/option><option  value=\"Gibraltar\" data-code=\"GI\">Gibraltar<\/option><option  value=\"Granada\">Granada<\/option><option  value=\"Grecia\">Grecia<\/option><option  value=\"Groenlandia\">Groenlandia<\/option><option  value=\"Guadalupe\">Guadalupe<\/option><option  value=\"Guam\" data-code=\"GU\">Guam<\/option><option  value=\"Guatemala\" data-code=\"GT\">Guatemala<\/option><option  value=\"Guayana Francesa\">Guayana Francesa<\/option><option  value=\"Guernsey\" data-code=\"GG\">Guernsey<\/option><option  value=\"Guinea\" data-code=\"GN\">Guinea<\/option><option  value=\"Guinea Ecuatorial\">Guinea Ecuatorial<\/option><option  value=\"Guinea-Bis\u00e1u\">Guinea-Bis\u00e1u<\/option><option  value=\"Guyana\" data-code=\"GY\">Guyana<\/option><option  value=\"Hait\u00ed\">Hait\u00ed<\/option><option  value=\"Honduras\" data-code=\"HN\">Honduras<\/option><option  value=\"Hong Kong\" data-code=\"HK\">Hong Kong<\/option><option  value=\"Hungr\u00eda\">Hungr\u00eda<\/option><option  value=\"India\" data-code=\"IN\">India<\/option><option  value=\"Indonesia\" data-code=\"ID\">Indonesia<\/option><option  value=\"Iraq\" data-code=\"IQ\">Iraq<\/option><option  value=\"Irlanda\">Irlanda<\/option><option  value=\"Ir\u00e1n\">Ir\u00e1n<\/option><option  value=\"Isla Bouvet\">Isla Bouvet<\/option><option  value=\"Isla Norfolk\">Isla Norfolk<\/option><option  value=\"Isla de Man\">Isla de Man<\/option><option  value=\"Isla de Navidad\">Isla de Navidad<\/option><option  value=\"Islandia\">Islandia<\/option><option  value=\"Islas Aland\">Islas Aland<\/option><option  value=\"Islas Caim\u00e1n\">Islas Caim\u00e1n<\/option><option  value=\"Islas Cocos (Keeling)\">Islas Cocos (Keeling)<\/option><option  value=\"Islas Cook\">Islas Cook<\/option><option  value=\"Islas Feroe\">Islas Feroe<\/option><option  value=\"Islas Georgias del Sur y Sandwich del Sur\">Islas Georgias del Sur y Sandwich del Sur<\/option><option  value=\"Islas Heard y McDonald\">Islas Heard y McDonald<\/option><option  value=\"Islas Malvinas (Falkland)\">Islas Malvinas (Falkland)<\/option><option  value=\"Islas Marianas del Norte\">Islas Marianas del Norte<\/option><option  value=\"Islas Marshall\">Islas Marshall<\/option><option  value=\"Islas Salom\u00f3n\">Islas Salom\u00f3n<\/option><option  value=\"Islas Turcas y Caicos\">Islas Turcas y Caicos<\/option><option  value=\"Islas Ultramarinas Menores de los Estados Unidos\">Islas Ultramarinas Menores de los Estados Unidos<\/option><option  value=\"Islas V\u00edrgenes  EE.UU.\">Islas V\u00edrgenes  EE.UU.<\/option><option  value=\"Islas V\u00edrgenes Brit\u00e1nicas\">Islas V\u00edrgenes Brit\u00e1nicas<\/option><option  value=\"Israel\" data-code=\"IL\">Israel<\/option><option  value=\"Italia\">Italia<\/option><option  value=\"Jamaica\" data-code=\"JM\">Jamaica<\/option><option  value=\"Jap\u00f3n\">Jap\u00f3n<\/option><option  value=\"Jersey\" data-code=\"JE\">Jersey<\/option><option  value=\"Jordania\">Jordania<\/option><option  value=\"Katar\">Katar<\/option><option  value=\"Kazajist\u00e1n\">Kazajist\u00e1n<\/option><option  value=\"Kenia\">Kenia<\/option><option  value=\"Kirguist\u00e1n\">Kirguist\u00e1n<\/option><option  value=\"Kiribati\" data-code=\"KI\">Kiribati<\/option><option  value=\"Kosovo\" data-code=\"XK\">Kosovo<\/option><option  value=\"Kuwait\" data-code=\"KW\">Kuwait<\/option><option  value=\"Laos\" data-code=\"LA\">Laos<\/option><option  value=\"Lesoto\">Lesoto<\/option><option  value=\"Letonia\">Letonia<\/option><option  value=\"Liberia\" data-code=\"LR\">Liberia<\/option><option  value=\"Libia\">Libia<\/option><option  value=\"Liechtenstein\" data-code=\"LI\">Liechtenstein<\/option><option  value=\"Lituania\">Lituania<\/option><option  value=\"Luxemburgo\">Luxemburgo<\/option><option  value=\"L\u00edbano\">L\u00edbano<\/option><option  value=\"Macao\" data-code=\"MO\">Macao<\/option><option  value=\"Madagascar\" data-code=\"MG\">Madagascar<\/option><option  value=\"Malasia\">Malasia<\/option><option  value=\"Malaui\">Malaui<\/option><option  value=\"Maldivas\">Maldivas<\/option><option  value=\"Mali\" data-code=\"ML\">Mali<\/option><option  value=\"Malta\" data-code=\"MT\">Malta<\/option><option  value=\"Marruecos\">Marruecos<\/option><option  value=\"Martinica\">Martinica<\/option><option  value=\"Mauricio\">Mauricio<\/option><option  value=\"Mauritania\" data-code=\"MR\">Mauritania<\/option><option  value=\"Mayotte\" data-code=\"YT\">Mayotte<\/option><option  value=\"Micronesia\" data-code=\"FM\">Micronesia<\/option><option  value=\"Moldava\">Moldava<\/option><option  value=\"Mongolia\" data-code=\"MN\">Mongolia<\/option><option  value=\"Montenegro\" data-code=\"ME\">Montenegro<\/option><option  value=\"Montserrat\" data-code=\"MS\">Montserrat<\/option><option  value=\"Mozambique\" data-code=\"MZ\">Mozambique<\/option><option  value=\"Myanmar\" data-code=\"MM\">Myanmar<\/option><option  value=\"M\u00e9xico\">M\u00e9xico<\/option><option  value=\"M\u00f3naco\">M\u00f3naco<\/option><option  value=\"Namibia\" data-code=\"NA\">Namibia<\/option><option  value=\"Nauru\" data-code=\"NR\">Nauru<\/option><option  value=\"Nepal\" data-code=\"NP\">Nepal<\/option><option  value=\"Nicaragua\" data-code=\"NI\">Nicaragua<\/option><option  value=\"Nigeria\" data-code=\"NG\">Nigeria<\/option><option  value=\"Niue\" data-code=\"NU\">Niue<\/option><option  value=\"Noruega\">Noruega<\/option><option  value=\"Nueva Caledonia\">Nueva Caledonia<\/option><option  value=\"Nueva Zelanda \">Nueva Zelanda <\/option><option  value=\"N\u00edger\">N\u00edger<\/option><option  value=\"Om\u00e1n\">Om\u00e1n<\/option><option  value=\"Pakist\u00e1n\">Pakist\u00e1n<\/option><option  value=\"Palau\" data-code=\"PW\">Palau<\/option><option  value=\"Palestina\">Palestina<\/option><option  value=\"Panam\u00e1\">Panam\u00e1<\/option><option  value=\"Pap\u00faa Nueva Guinea\">Pap\u00faa Nueva Guinea<\/option><option  value=\"Paraguay\" data-code=\"PY\">Paraguay<\/option><option  value=\"Pa\u00edses Bajos\">Pa\u00edses Bajos<\/option><option  value=\"Per\u00fa\">Per\u00fa<\/option><option  value=\"Pitcairn\" data-code=\"PN\">Pitcairn<\/option><option  value=\"Polinesia Francesa\">Polinesia Francesa<\/option><option  value=\"Polonia\">Polonia<\/option><option  value=\"Portugal\" data-code=\"PT\">Portugal<\/option><option  value=\"Puerto Rico\" data-code=\"PR\">Puerto Rico<\/option><option  value=\"Reino Unido\">Reino Unido<\/option><option  value=\"Rep\u00fablica Central de \u00c1frica \">Rep\u00fablica Central de \u00c1frica <\/option><option  value=\"Rep\u00fablica Checa\">Rep\u00fablica Checa<\/option><option  value=\"Rep\u00fablica Dominicana\">Rep\u00fablica Dominicana<\/option><option  value=\"Rep\u00fablica de Macedonia\">Rep\u00fablica de Macedonia<\/option><option  value=\"Reuni\u00f3n\">Reuni\u00f3n<\/option><option  value=\"Ruanda\">Ruanda<\/option><option  value=\"Ruman\u00eda\">Ruman\u00eda<\/option><option  value=\"Rusia\">Rusia<\/option><option  value=\"Sahara Occidental\">Sahara Occidental<\/option><option  value=\"Saint Kitts y Nevis\">Saint Kitts y Nevis<\/option><option  value=\"Samoa\" data-code=\"WS\">Samoa<\/option><option  value=\"Samoa Americana\">Samoa Americana<\/option><option  value=\"San Bartolom\u00e9\">San Bartolom\u00e9<\/option><option  value=\"San Marino\" data-code=\"SM\">San Marino<\/option><option  value=\"San Mart\u00edn (parte francesa)\">San Mart\u00edn (parte francesa)<\/option><option  value=\"San Mart\u00edn\u200b (parte holandesa)\">San Mart\u00edn\u200b (parte holandesa)<\/option><option  value=\"San Pedro y Miquel\u00f3n\">San Pedro y Miquel\u00f3n<\/option><option  value=\"San Vicente y las Granadinas \">San Vicente y las Granadinas <\/option><option  value=\"Santa Elena, Ascensi\u00f3n y Trist\u00e1n de Acu\u00f1a\">Santa Elena, Ascensi\u00f3n y Trist\u00e1n de Acu\u00f1a<\/option><option  value=\"Santa Luc\u00eda\">Santa Luc\u00eda<\/option><option  value=\"Santa Sede\">Santa Sede<\/option><option  value=\"Santo Tom\u00e9 y Pr\u00edncipe\">Santo Tom\u00e9 y Pr\u00edncipe<\/option><option  value=\"Saud\u00ed Arabia\">Saud\u00ed Arabia<\/option><option  value=\"Senegal\" data-code=\"SN\">Senegal<\/option><option  value=\"Serbia\" data-code=\"RS\">Serbia<\/option><option  value=\"Seychelles\" data-code=\"SC\">Seychelles<\/option><option  value=\"Sierra Leona\">Sierra Leona<\/option><option  value=\"Singapur\">Singapur<\/option><option  value=\"Siria\">Siria<\/option><option  value=\"Somalia\" data-code=\"SO\">Somalia<\/option><option  value=\"Sri Lanka\" data-code=\"LK\">Sri Lanka<\/option><option  value=\"Suazilandia\">Suazilandia<\/option><option  value=\"Sud\u00e1frica\">Sud\u00e1frica<\/option><option  value=\"Sud\u00e1n\">Sud\u00e1n<\/option><option  value=\"Sud\u00e1n del sur\">Sud\u00e1n del sur<\/option><option  value=\"Suecia\">Suecia<\/option><option  value=\"Suiza\">Suiza<\/option><option  value=\"Surinam\">Surinam<\/option><option  value=\"Svalbard y Jan Mayen\">Svalbard y Jan Mayen<\/option><option  value=\"Tailandia\">Tailandia<\/option><option  value=\"Taiw\u00e1n\">Taiw\u00e1n<\/option><option  value=\"Tanzania\" data-code=\"TZ\">Tanzania<\/option><option  value=\"Tayikist\u00e1n\">Tayikist\u00e1n<\/option><option  value=\"Territorio Brit\u00e1nico del Oc\u00e9ano \u00cdndico\">Territorio Brit\u00e1nico del Oc\u00e9ano \u00cdndico<\/option><option  value=\"Territorios Australes Franceses\">Territorios Australes Franceses<\/option><option  value=\"Timor Oriental\">Timor Oriental<\/option><option  value=\"Timor Oriental\">Timor Oriental<\/option><option  value=\"Togo\" data-code=\"TG\">Togo<\/option><option  value=\"Tokelau\" data-code=\"TK\">Tokelau<\/option><option  value=\"Tonga\" data-code=\"TO\">Tonga<\/option><option  value=\"Trinidad y Tobago\">Trinidad y Tobago<\/option><option  value=\"Turkmenist\u00e1n\">Turkmenist\u00e1n<\/option><option  value=\"Turqu\u00eda\">Turqu\u00eda<\/option><option  value=\"Tuvalu\" data-code=\"TV\">Tuvalu<\/option><option  value=\"T\u00fanez\">T\u00fanez<\/option><option  value=\"Ucrania\">Ucrania<\/option><option  value=\"Uganda\" data-code=\"UG\">Uganda<\/option><option  value=\"Uruguay\" data-code=\"UY\">Uruguay<\/option><option  value=\"Uzbekist\u00e1n\">Uzbekist\u00e1n<\/option><option  value=\"Vanuatu\" data-code=\"VU\">Vanuatu<\/option><option  value=\"Venezuela\" data-code=\"VE\">Venezuela<\/option><option  value=\"Vietnam\" data-code=\"VN\">Vietnam<\/option><option  value=\"Wallis y Futuna\">Wallis y Futuna<\/option><option  value=\"Yemen\" data-code=\"YE\">Yemen<\/option><option  value=\"Yibuti\">Yibuti<\/option><option  value=\"Zambia\" data-code=\"ZM\">Zambia<\/option><option  value=\"Zimbabue\">Zimbabue<\/option>\t\t<\/select>\n\t<div class=\"frm_description\">Pa\u00eds<\/div><\/div>\n<div id=\"frm_field_39-state_abbreviation_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_gmwru_state_abbreviation\" class=\"frm_screen_reader frm_hidden\">\n\t\tCentro hospitalario receptor o direcci\u00f3n de destino\t<\/label>\n\t\t<input type=\"hidden\" id=\"field_gmwru_state_abbreviation\" value=\"\" name=\"item_meta[39][state_abbreviation]\"  placeholder=\"\" data-placeholder=\"\" data-sectionid=\"37\"  data-reqmsg=\"Centro hospitalario receptor o direcci\u00f3n de destino es obligatorio.\" aria-required=\"true\" data-invmsg=\"Centro hospitalario receptor o direcci\u00f3n de destino no es v\u00e1lido\" class=\"frm_optional\" aria-invalid=\"false\" data-geoautocomplete=\"1\" data-geofieldid=\"39\" data-geoisaddress=\"1\"   \/>\n\t<\/div>\n<\/div>\n<\/fieldset>\n\r\n\t\r\n\t<input id=\"geo-lat-39\" name=\"geo_lat[39]\" class=\"frm-geo-lat\" type=\"hidden\" value=\"\"><input id=\"geo-lng-39\" name=\"geo_lng[39]\" class=\"frm-geo-lng\" type=\"hidden\" value=\"\">\r\n<\/div>\n<\/div>\n<div id=\"frm_field_41_container\" class=\"frm_form_field  frm_html_container form-field\">\n<hr \/>\n<p>&nbsp;<\/p><\/div>\n<div id=\"frm_field_42_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_d9qka\" id=\"field_d9qka_label\" class=\"frm_primary_label\"><b>Instrucciones especiales o notas importantes<\/b>\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[42]\" id=\"field_d9qka\" rows=\"5\"  data-invmsg=\"&lt;b&gt;Instrucciones especiales o notas importantes&lt;\/b&gt; no es v\u00e1lido\" aria-invalid=\"false\" aria-describedby=\"frm_desc_field_d9qka\"  ><\/textarea>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_d9qka\"><b>Incluya cualquier consideraci\u00f3n cl\u00ednica, necesidad de tiempo, requisitos de ox\u00edgeno, precauciones de aislamiento, inquietudes de movilidad u otros detalles que puedan ayudar con la planificaci\u00f3n.<\/b><\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_43_container\" class=\"frm_form_field  frm_html_container form-field\"><strong>Enviar esta solicitud no crea obligaci\u00f3n de avanzar.<\/strong><\/div>\n<div id=\"frm_field_45_container\" class=\"frm_form_field form-field  frm6 frm_first\">\r\n\t<div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"   formnovalidate=\"formnovalidate\">SOLICITAR COTIZACI\u00d3N<\/button>\r\n\r\n<\/div>\r\n<\/div>\n<input type=\"hidden\" name=\"item_meta[46]\" id=\"field_powns\" value=\"\" data-frmval=\"\"\/>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_133_container\">\n\t\t\t<label for=\"field_ou1ad\" >\n\t\t\t\tSi eres humano, deja este campo en blanco.\t\t\t<\/label>\n\t\t\t<input  id=\"field_ou1ad\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[133]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"VCxgLYP05rl3WOKTVh8xRdDHTexMad\/am7QfXwSCjiUDzCVE5W6XXYmIH3JSHZxn\" \/><\/div>\n<\/fieldset>\n<\/div>\n\n<\/form>\n<\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"et_pb_section_3 et_pb_section et_section_regular et_block_section\">\n<div class=\"et_pb_row_5 et_pb_row et_flex_row\">\n<div class=\"et_pb_column_5 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone\">\n<div class=\"et_pb_text_7 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module\"><div class=\"et_pb_text_inner\"><h2>Qu\u00e9 esperar<\/h2>\n<\/div><\/div>\n\n<div class=\"et_pb_text_8 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module\"><div class=\"et_pb_text_inner\"><p>Las opciones de traslado en avi\u00f3n ambulancia son espec\u00edficas para cada caso y permanecen sujetas a disponibilidad de aeronave, tripulaci\u00f3n de vuelo y personal m\u00e9dico al momento de la reserva, junto con la condici\u00f3n del paciente, el criterio del m\u00e9dico tratante, la ruta, el clima, la documentaci\u00f3n, los aeropuertos adecuados y los requisitos regulatorios aplicables. Los traslados internacionales o intercontinentales tambi\u00e9n pueden depender de aduanas, permisos de aterrizaje, permisos de sobrevuelo y autorizaciones espec\u00edficas de cada pa\u00eds.<\/p>\n<p>Avisar con m\u00e1s anticipaci\u00f3n puede permitir m\u00e1s tiempo para revisar opciones de ruta, documentaci\u00f3n y programaci\u00f3n. Los traslados nacionales m\u00e1s cortos pueden revisarse con mayor rapidez cuando los elementos requeridos se alinean. Los traslados de larga distancia, internacionales o intercontinentales suelen requerir planificaci\u00f3n adicional de ruta, documentaci\u00f3n, aduanas, permisos, autorizaciones, escalas de combustible y requisitos espec\u00edficos de cada pa\u00eds.<\/p>\n<p>Si el traslado se necesita pronto, sugerimos llamar primero para permitir que nuestros Especialistas en Coordinaci\u00f3n de Traslados en Avi\u00f3n Ambulancia revisen detalles sensibles al tiempo antes de completar el formulario.<\/p>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"et_pb_section_4 et_pb_section et_section_regular et_block_section\">\n<div class=\"et_pb_row_6 et_pb_row et_flex_row\">\n<div class=\"et_pb_column_6 et_pb_column et-last-child et_flex_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone\">\n<div class=\"et_pb_text_9 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module\"><div class=\"et_pb_text_inner\"><h2>Despu\u00e9s de enviar la solicitud<\/h2>\n<\/div><\/div>\n\n<div class=\"et_pb_text_10 et_pb_text et_pb_bg_layout_light et_pb_module et_flex_module\"><div class=\"et_pb_text_inner\"><p>Una vez recibida su solicitud, un Especialista en Coordinaci\u00f3n de Traslados en Avi\u00f3n Ambulancia revisa la informaci\u00f3n y da seguimiento con pr\u00f3ximos pasos claros.<\/p>\n<p>Con base en la informaci\u00f3n proporcionada, preparamos opciones escritas de avi\u00f3n ambulancia con precios, consideraciones de ruta y orientaci\u00f3n de planificaci\u00f3n. Si se necesitan detalles cl\u00ednicos o log\u00edsticos adicionales, un Especialista en Coordinaci\u00f3n de Traslados en Avi\u00f3n Ambulancia se lo indicar\u00e1.<\/p>\n<p><strong>Enviar esta solicitud no crea obligaci\u00f3n de avanzar.<\/strong><\/p>\n<p>Las instrucciones de pago por transferencia bancaria se incluyen con cada cotizaci\u00f3n. Complete el pago requerido o la preautorizaci\u00f3n aprobada seg\u00fan los requisitos de reserva. La reserva y los arreglos del traslado avanzan despu\u00e9s de que se completen, acrediten o preautoricen debidamente los pasos requeridos del acuerdo de transporte y pago.<\/p>\n<p>Si ya tiene una cotizaci\u00f3n aprobada y est\u00e1 listo para avanzar: <span style=\"text-decoration: underline;\"><a href=\"https:\/\/airmedical.com\/es\/reservar-avion-ambulancia\/\"><strong>RESERVAR AVI\u00d3N AMBULANCIA<\/strong><\/a><\/span><\/p>\n<p>Las instrucciones de pago por transferencia bancaria se incluyen con cada cotizaci\u00f3n. Si prefiere pagar o completar una autorizaci\u00f3n aprobada de tarjeta de cr\u00e9dito en l\u00ednea, utilice el siguiente enlace: <span style=\"text-decoration: underline;\"><a href=\"https:\/\/airmedical.com\/es\/pago-en-linea\/\"><strong>PAGAR EN L\u00cdNEA<\/strong><\/a><\/span><\/p>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"et_pb_section_5 et_pb_section et_section_regular et_block_section\">\n<div class=\"et_pb_row_7 et_pb_row et_flex_row\">\n<div class=\"et_pb_column_7 et_pb_column et-last-child et_block_column et_pb_css_mix_blend_mode_passthrough et_flex_column_24_24 et_flex_column_24_24_tablet et_flex_column_24_24_phone\">\n<div class=\"et_pb_module et_pb_button_module_wrapper et_pb_button_1_wrapper preset--module--divi-button--d9f5dd98-2ac7-489a-a45e-44397923f485_wrapper\"><a class=\"et_pb_button_1 et_pb_button et_pb_bg_layout_light et_pb_module et_block_module preset--module--divi-button--d9f5dd98-2ac7-489a-a45e-44397923f485\" href=\"https:\/\/airmedical.com\/es\/contacto\/\">COMUN\u00cdQUESE CON AIR MEDICAL TRANSPORT<\/a><\/div>\n\n<div class=\"et_pb_text_11 et_pb_text et_pb_bg_layout_light et_pb_module et_block_module\"><div class=\"et_pb_text_inner\"><div style=\"text-align: center;\"><strong>Si prefiere hablar con un Especialista en Coordinaci\u00f3n de Traslados en Avi\u00f3n Ambulancia, hay asistencia telef\u00f3nica disponible 24\/7.<\/strong><\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1910","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/airmedical.com\/es\/wp-json\/wp\/v2\/pages\/1910","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/airmedical.com\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/airmedical.com\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/airmedical.com\/es\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/airmedical.com\/es\/wp-json\/wp\/v2\/comments?post=1910"}],"version-history":[{"count":5,"href":"https:\/\/airmedical.com\/es\/wp-json\/wp\/v2\/pages\/1910\/revisions"}],"predecessor-version":[{"id":2055,"href":"https:\/\/airmedical.com\/es\/wp-json\/wp\/v2\/pages\/1910\/revisions\/2055"}],"wp:attachment":[{"href":"https:\/\/airmedical.com\/es\/wp-json\/wp\/v2\/media?parent=1910"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}