{"id":1958,"date":"2020-04-04T20:10:56","date_gmt":"2020-04-04T18:10:56","guid":{"rendered":"https:\/\/rrygm.beeweb-green.io\/?page_id=1958"},"modified":"2024-03-27T20:50:44","modified_gmt":"2024-03-27T19:50:44","slug":"formulario-de-admision","status":"publish","type":"page","link":"https:\/\/tre-online.com\/es\/tre-online-learn-how-to\/intake-form\/","title":{"rendered":"Aprender TRE\u00ae: Formulario de admisi\u00f3n\/divulgaci\u00f3n"},"content":{"rendered":"<div class=\"wp-block-media-text alignwide is-stacked-on-mobile\" style=\"grid-template-columns:45% auto\"><figure class=\"wp-block-media-text__media\"><img decoding=\"async\" src=\"https:\/\/tre-online.com\/wp-content\/uploads\/2020\/04\/LogoStress_noExerc3.jpg\" alt=\"\" class=\"wp-image-1971 size-full\"\/><\/figure><div class=\"wp-block-media-text__content\">\n<p class=\"wp-block-paragraph\"><strong>INDEMNIDAD<\/strong><br>TRE\u00ae no pretende diagnosticar, tratar, curar ni prevenir ninguna enfermedad. TRE\u00ae es una t\u00e9cnica de liberaci\u00f3n del estr\u00e9s segura y eficaz para la mayor\u00eda de las personas.<\/p>\n<\/div><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">El proceso TRE\u00ae no debe utilizarse como sustituto de procedimientos de recuperaci\u00f3n de traumas de naturaleza m\u00e9dica o psiqui\u00e1trica\/psicol\u00f3gica. Las personas con afecciones f\u00edsicas o psicol\u00f3gicas que requieran una regulaci\u00f3n estricta, las personas con defensas psicol\u00f3gicas fr\u00e1giles, un historial complejo de traumas o limitaciones f\u00edsicas o m\u00e9dicas restrictivas deben consultar a su profesional m\u00e9dico antes de realizar estos ejercicios. Los resultados pueden variar de una persona a otra. No existen garant\u00edas, ni expresas ni impl\u00edcitas.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>CONFIDENCIALIDAD<\/strong><br>Todo lo que se hable durante el tiempo que dure nuestro trabajo conjunto ser\u00e1 confidencial y no se divulgar\u00e1 a terceros, a excepci\u00f3n del profesional que nos remita. Si se participa en un trabajo de grupo, no se divulgar\u00e1 ning\u00fan material identificativo fuera del grupo.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>LIBERACI\u00d3N<\/strong><br>Yo, reconozco que estoy participando voluntariamente en una sesi\u00f3n privada o de grupo en TRE<strong>\u00ae<\/strong> por mi propia voluntad. Soy consciente de que, al practicar TRE<strong>\u00ae<\/strong>Asumo y acepto el riesgo de cualquier resultado adverso que pudiera producirse. Entiendo que puedo detener mi participaci\u00f3n en cualquier momento que lo desee, y que tengo el control de la intensidad a la que realizo TRE.<strong>\u00ae<\/strong>. Acepto toda la responsabilidad por cualquier efecto secundario o cambio en mi vida que realice TRE<strong>\u00ae<\/strong> puede causar.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Soy consciente de que, aunque Deva Laya Guleng es un TRE certificado<strong>\u00ae<\/strong> Proveedora\/formadora, no es m\u00e9dico titulado y, por lo tanto, no proporciona asesoramiento m\u00e9dico. Reconozco que ella no recomienda que deje de utilizar medicamentos prescritos, tratamientos o asesoramiento de salud mental sin consultar a mi m\u00e9dico o asesor.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Estoy de acuerdo en asumir la plena responsabilidad de mi propia salud f\u00edsica y emocional y eximir a Deva Laya Guleng, y OmniBalance, de cualquier responsabilidad legal, financiera y m\u00e9dica derivada de mi proceso de aprendizaje.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>ENSE\u00d1AR TRE\u00ae A LOS DEM\u00c1S<\/strong><br>Reconozco que no soy un proveedor certificado de TRE<strong>\u00ae<\/strong> despu\u00e9s de asistir a sesiones individuales o en grupo, y por lo tanto no estoy capacitado para ense\u00f1ar a otros c\u00f3mo hacerlo despu\u00e9s de asistir a la sesi\u00f3n (privada\/en grupo). Si ense\u00f1o a TRE<strong>\u00ae<\/strong>Acepto toda la responsabilidad por cualquier reclamaci\u00f3n, demanda o procedimiento iniciado contra m\u00ed por cualquier persona a la que ense\u00f1e, liberando as\u00ed a Deva Laya Guleng, OmniBalance, TRE<strong>\u00ae<\/strong> LLC, y al Dr. David Berceli de cualquier responsabilidad legal, financiera y m\u00e9dica en que pudieran incurrir.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>CONTRAINDICACIONES<\/strong><br>Est\u00e1 contraindicado utilizar TRE\u00ae si padece epilepsia, convulsiones, est\u00e1 actualmente embarazada, en los \u00faltimos 3 meses se ha sometido a una intervenci\u00f3n quir\u00fargica con herida abierta o ha dado a luz. <br><br><strong>ENFERMEDAD<\/strong><br>Tenga en cuenta que si tiene una infecci\u00f3n en el cuerpo el d\u00eda de la sesi\u00f3n de TRE\u00ae con el proveedor de TRE\u00ae, deber\u00e1 informar a su proveedor de TRE\u00ae lo antes posible (preferiblemente el d\u00eda o los d\u00edas anteriores cuando sea v\u00e1lido), para volver a reservar la sesi\u00f3n para otro d\u00eda. <\/p>\n\n\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1990-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"1990\">\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\/1958#wpcf7-f1990-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\" data-trp-original-action=\"\/es\/wp-json\/wp\/v2\/pages\/1958#wpcf7-f1990-o1\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"1990\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1990-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<div class=\"disclosure-form-steps\">\n\t<div class=\"bg\">\n\t<\/div>\n\t<ul>\n\t\t<li class=\"active\">\n\t\t\t<p>Datos personales (1\/6)\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Preguntas\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Preguntas con varias partes\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Enfermedades\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Otros\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Firma\n\t\t\t<\/p>\n\t\t<\/li>\n\t<\/ul>\n<\/div>\n<table class=\"disclosure-form-table\" width=\"100%\">\n\t<tr>\n\t\t<td width=\"50%\">\n\t\t\t<p><label>Nombre <span class=\"disclosure-form-required\">*<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"firstname\"><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=\"firstname\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"50%\" colspan=\"2\">\n\t\t\t<p><label>Apellido <span class=\"disclosure-form-required\">*<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"surname\"><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=\"surname\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td  width=\"50%\">\n\t\t\t<p><label>Fecha de nacimiento <span class=\"disclosure-form-required\">*<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date-of-birth\"><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=\"date-of-birth\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"25%\">\n\t\t\t<p><label>Edad <span class=\"disclosure-form-required\">*<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"age\"><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=\"age\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td  width=\"25%\">\n\t\t\t<p><label>G\u00e9nero <span class=\"disclosure-form-required\">*<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"gender\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"gender\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Male\">Hombre<\/option><option value=\"Female\">Mujer<\/option><option value=\"Other\">Otros<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>M\u00f3vil <span class=\"disclosure-form-required\">*<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"cellphone\"><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=\"cellphone\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td colspan=\"2\">\n\t\t\t<p><label>Ocupaci\u00f3n <span class=\"disclosure-form-required\">*<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"occupation\"><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=\"occupation\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Ciudad <span class=\"disclosure-form-required\">*<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"city\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"city\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td colspan=\"2\">\n\t\t\t<p><label>Pa\u00eds <span class=\"disclosure-form-required\">*<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"country\"><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=\"country\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Correo electr\u00f3nico <span class=\"disclosure-form-required\">*<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><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=\"email\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td colspan=\"2\">\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Familiar m\u00e1s cercano \/ Contacto en caso de emergencia - nombre <span class=\"disclosure-form-required\">*<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"emergency_name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"emergency_name\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td colspan=\"2\">\n\t\t\t<p><label>Familiar m\u00e1s cercano \/ Contacto de emergencia - n\u00famero de tel\u00e9fono <span class=\"disclosure-form-required\">*<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"emergency_phone\"><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=\"emergency_phone\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Familiar m\u00e1s cercano \/ Contacto en caso de emergencia <span class=\"disclosure-form-required\">*<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"emergency_name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"emergency_name\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td colspan=\"2\">\n\t\t<\/td>\n\t<\/tr>\n<\/table>\n\n\n<!-- page 2 -->\n<div class=\"disclosure-form-steps\">\n\t<div class=\"bg\">\n\t<\/div>\n\t<ul>\n\t\t<li>\n\t\t\t<p>Datos personales\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li class=\"active\">\n\t\t\t<p>Preguntas (2\/6)\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Preguntas con varias partes\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Enfermedades\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Otros\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Firma\n\t\t\t<\/p>\n\t\t<\/li>\n\t<\/ul>\n<\/div>\n<table class=\"disclosure-form-table\" width=\"100%\">\n\t<tr>\n\t\t<td colspan=\"4\">\n\t\t\t<p><label>\u00bfHas hecho TRE\u00ae antes? <span class=\"disclosure-form-required\">*<\/span><\/label>\n\t\t\t<\/p>\n\t\t\t<p><small>En caso afirmativo, describa su experiencia con TRE\u00ae: cu\u00e1nto tiempo lleva practicando, d\u00f3nde y cu\u00e1ndo aprendi\u00f3, con qu\u00e9 frecuencia se sacude y cualquier cambio significativo que se haya producido. <\/small>\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"done-tre-before\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"done-tre-before\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"4\">\n\t\t\t<p><label>\u00bfQu\u00e9 espera que cambie como resultado de TRE\u00ae?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tre-expectations\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"tre-expectations\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"4\">\n\t\t\t<p><label>\u00bfPadece actualmente alguna enfermedad? <span class=\"disclosure-form-required\">*<\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"medical-issues\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"medical-issues\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"medical-issues\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/label>\n\t\t\t<\/p>\n\t\t\t<p><small>Por favor, facilite detalles sobre cualquier enfermedad cardiaca, tensi\u00f3n arterial irregular, epilepsia, diabetes o dolor cr\u00f3nico continuo. <\/small>\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"medical-issues-comment\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"medical-issues-comment\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"4\">\n\t\t\t<p><label>\u00bfTiene alguna discapacidad sensorial (como p\u00e9rdida de visi\u00f3n o audici\u00f3n o problemas de equilibrio)? <span class=\"disclosure-form-required\">*<\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sensory-impariment\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"sensory-impariment\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"sensory-impariment\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/label>\n\t\t\t<\/p>\n\t\t\t<p><small>En caso afirmativo, explique cualquier discapacidad sensorial:<\/small>\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"sensory-impariment-comment\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"sensory-impariment-comment\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"4\">\n\t\t\t<p><label>\u00bfRecibe actualmente (o ha recibido) alg\u00fan tipo de atenci\u00f3n psiqui\u00e1trica, terapia o asesoramiento por ansiedad, depresi\u00f3n o cualquier otro problema de salud mental? <span class=\"disclosure-form-required\">*<\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"psychiatric-care\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"psychiatric-care\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"psychiatric-care\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span><\/label>\n\t\t\t<\/p>\n\t\t\t<p><small>Por favor, facilite detalles de cualquier tratamiento que haya recibido en los \u00faltimos 12 meses.<\/small>\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"psychiatric-care-comment\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"psychiatric-care-comment\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"4\">\n\t\t\t<p><label>\u00bfQu\u00e9 medicamentos (con o sin receta), vitaminas, suplementos o remedios naturales toma habitualmente?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"vitamins-supplements-medications\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"vitamins-supplements-medications\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"4\">\n\t\t\t<p><label>\u00bfHa sufrido alg\u00fan trauma en los \u00faltimos 24 meses? <span class=\"disclosure-form-required\">*<\/span><\/label>\n\t\t\t<\/p>\n\t\t\t<p><small>En caso afirmativo, expl\u00edquelo (o responda no a continuaci\u00f3n):<\/small>\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"trauma-last-24-months\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"trauma-last-24-months\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"25%\">\n\t\t\t<p><label>\u00bfEst\u00e1 embarazada?<\/label>\n\t\t\t<\/p>\n\t\t\t<p><small>( S\u00f3lo para mujeres )<\/small>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"25%\">\n\t\t\t<p><label>En caso afirmativo, \u00bfcu\u00e1ntas semanas?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"pregnant-weeks\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"pregnant-weeks\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td colspan=\"2\" width=\"50%\">\n\t\t\t<p>&nbsp;\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n<\/table>\n\n<!-- page 3 -->\n<div class=\"disclosure-form-steps\">\n\t<div class=\"bg\">\n\t<\/div>\n\t<ul>\n\t\t<li>\n\t\t\t<p>Datos personales\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Preguntas\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li class=\"active\">\n\t\t\t<p>Preguntas de varias partes (3\/6)\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Enfermedades\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Otros\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Firma\n\t\t\t<\/p>\n\t\t<\/li>\n\t<\/ul>\n<\/div>\n<table class=\"table-4-choices\">\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\" valign=\"bottom\">\n\t\t\t<p>Casi nunca\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\" valign=\"bottom\">\n\t\t\t<p>Mensualmente\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\" valign=\"bottom\">\n\t\t\t<p>Semanal\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\" valign=\"bottom\">\n\t\t\t<p>Diario\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>Dolores de cabeza o migra\u00f1as\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"headaches_migrations\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"headaches_migrations\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"headaches_migrations\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"headaches_migrations\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>Dolor de espalda, cuello y hombros\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"back_neck_shoulder_pain\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"back_neck_shoulder_pain\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"back_neck_shoulder_pain\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"back_neck_shoulder_pain\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>Dolor p\u00e9lvico\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"pelvic_pain\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"pelvic_pain\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"pelvic_pain\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"pelvic_pain\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>Dolor de rodilla\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"knee_pain\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"knee_pain\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"knee_pain\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"knee_pain\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>Fibromialgia\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"fibromyalgia\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"fibromyalgia\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"fibromyalgia\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"fibromyalgia\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>Alergias\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"allergies\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"allergies\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"allergies\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"allergies\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>Problemas digestivos\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"digestive_issues\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"digestive_issues\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"digestive_issues\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"digestive_issues\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>N\u00e1useas\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"nausea\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"nausea\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"nausea\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"nausea\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>Preoc\u00fapese\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"worry\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"worry\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"worry\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"worry\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>Ira\/c\u00f3lera\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"anger_rage\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"anger_rage\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"anger_rage\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"anger_rage\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>Tristeza\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"sadness\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"sadness\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"sadness\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"sadness\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>Falta de energ\u00eda\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"lack_of_energy\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"lack_of_energy\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"lack_of_energy\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"lack_of_energy\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>Insomnio\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"insomnia\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"insomnia\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"insomnia\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"insomnia\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>Irritabilidad\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"irritability\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"irritability\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"irritability\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"irritability\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>Depresi\u00f3n\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"depression\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"depression\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"depression\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"depression\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>Ansiedad\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"anxiety\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"anxiety\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"anxiety\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"anxiety\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td width=\"80%\">\n\t\t\t<p>Ataques de p\u00e1nico\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"panic_attacks\" value=\"hardly ever\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"panic_attacks\" value=\"monthly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"panic_attacks\" value=\"weekly\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td width=\"5%\" class=\"vertical\">\n\t\t\t<p><input type=\"radio\" name=\"panic_attacks\" value=\"daily\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n<\/table> \n\n <!-- page 4 -->\n<div class=\"disclosure-form-steps\">\n\t<div class=\"bg\">\n\t<\/div>\n\t<ul>\n\t\t<li>\n\t\t\t<p>Datos personales\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Preguntas\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Preguntas con varias partes\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li class=\"active\">\n\t\t\t<p>Enfermedades (4\/6)\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Otros\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Firma\n\t\t\t<\/p>\n\t\t<\/li>\n\t<\/ul>\n<\/div>\n<p><strong>Si padece alguna de las siguientes afecciones, seleccione s\u00ed o no. <\/strong>\n<\/p>\n<table class=\"disclosure-form-table\" width=\"100%\">\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Tensi\u00f3n arterial irregular (alta o baja) <\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"irregular_blood_pressure\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"irregular_blood_pressure\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Hipo o hiperglucemia (medicamentos)<\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"hypo_or_hyperglycaemic\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"hypo_or_hyperglycaemic\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Cirug\u00edas recientes <\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"recent_surgeries\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"recent_surgeries\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Cardiopat\u00edas irregulares (incluyendo cirug\u00eda, marcapasos y arritmia) <\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"irregular_heart_conditions\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"irregular_heart_conditions\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>V\u00e9rtigo\/mareo, especialmente al agacharse <\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"vertigo_dizzyness\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"vertigo_dizzyness\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Afecciones psicol\u00f3gicas (como el TEPT) <\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"psychological_conditions\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"psychological_conditions\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Dolor cr\u00f3nico (fibromialgia \/ esclerosis m\u00faltiple) <\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"chronic_pain\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"chronic_pain\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Fatiga cr\u00f3nica (ME)<\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"chronic_fatigue\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"chronic_fatigue\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>TDAH TDA <\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"ADHA\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"ADHA\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Autismo<\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"Autism\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"Autism\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Adicci\u00f3n<\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"Addiction\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"Addiction\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<p><label>Otros datos o informaci\u00f3n adicional (descr\u00edbalos a continuaci\u00f3n)<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other_condition\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other_condition\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<p><strong>IMPORTANTE: Si padece alguna de las siguientes afecciones, le aconsejamos que s\u00f3lo trabaje con proveedores de TRE\u00ae certificados cuyo \u00e1mbito de pr\u00e1ctica incluya experiencia en el tratamiento de estas afecciones. (Si tiene un terapeuta o un amigo, puede traerlo tambi\u00e9n para que aprenda TRE\u00ae o para que le apoye con TRE\u00ae en su sesi\u00f3n individual). Y no haga sus primeras sesiones de TRE\u00ae en grupo.<\/strong>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Man\u00edaco\/depresivo<\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"manic_depressive\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"manic_depressive\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Afecciones bipolares<\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"bipolar_conditions\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"bipolar_conditions\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Esquizofrenia<\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"schizophrenia\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"schizophrenia\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Depresi\u00f3n grave<\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"severe_depression\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"severe_depression\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Psicosis<\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"psychosis\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"psychosis\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Borderline personality disorder<\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"Borderline_personality_disorder\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"Borderline_personality_disorder\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"No\">No<\/option><option value=\"Yes\">S\u00ed<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n<\/table>\n<tr>\n\t<td colspan=\"2\">\n\t\t<p><label>Descripci\u00f3n detallada a partir de la informaci\u00f3n facilitada anteriormente (descr\u00edbala a continuaci\u00f3n)<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other_condition\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other_condition\"><\/textarea><\/span>\n\t\t<\/p>\n\t<\/td>\n<\/tr>\n\n<!-- page 5 -->\n<div class=\"disclosure-form-steps\">\n\t<div class=\"bg\">\n\t<\/div>\n\t<ul>\n\t\t<li>\n\t\t\t<p>Datos personales\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Preguntas\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Preguntas con varias partes\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Enfermedades\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li class=\"active\">\n\t\t\t<p>Otros (5\/6)\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Firma\n\t\t\t<\/p>\n\t\t<\/li>\n\t<\/ul>\n<\/div>\n<table class=\"disclosure-form-table\" width=\"100%\">\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<p><label>En una escala del uno al diez, siendo diez la intensidad m\u00e1xima, \u00bfc\u00f3mo valorar\u00eda lo siguiente en un d\u00eda normal?<\/label>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>\u00bfNiveles de dolor f\u00edsico?<\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"physical_pain_levels\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"physical_pain_levels\"><option value=\"\"><\/option><option value=\"0\">0<\/option><option value=\"1\">1<\/option><option value=\"2\">2<\/option><option value=\"3\">3<\/option><option value=\"4\">4<\/option><option value=\"5\">5<\/option><option value=\"6\">6<\/option><option value=\"7\">7<\/option><option value=\"8\">8<\/option><option value=\"9\">9<\/option><option value=\"10\">10<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>\u00bfNiveles de dolor emocional?<\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"emotional_pain_levels\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"emotional_pain_levels\"><option value=\"\"><\/option><option value=\"0\">0<\/option><option value=\"1\">1<\/option><option value=\"2\">2<\/option><option value=\"3\">3<\/option><option value=\"4\">4<\/option><option value=\"5\">5<\/option><option value=\"6\">6<\/option><option value=\"7\">7<\/option><option value=\"8\">8<\/option><option value=\"9\">9<\/option><option value=\"10\">10<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>\u00bfNiveles actuales de estr\u00e9s?<\/label><span class=\"disclosure-form-required\">*<\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"current_stress_levels\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"current_stress_levels\"><option value=\"\"><\/option><option value=\"0\">0<\/option><option value=\"1\">1<\/option><option value=\"2\">2<\/option><option value=\"3\">3<\/option><option value=\"4\">4<\/option><option value=\"5\">5<\/option><option value=\"6\">6<\/option><option value=\"7\">7<\/option><option value=\"8\">8<\/option><option value=\"9\">9<\/option><option value=\"10\">10<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<p><label>\u00bfTiene alguna otra preocupaci\u00f3n que le gustar\u00eda compartir antes de asistir a una sesi\u00f3n de TRE\u00ae?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other_concers\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other_concers\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<p><label> \u00bfTiene alguna pregunta sobre TRE? \u00ae antes de nuestra sesi\u00f3n programada?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other_questions\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other_questions\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n<\/table>\n\n\n<!-- page 6 -->\n<div class=\"disclosure-form-steps\">\n\t<div class=\"bg\">\n\t<\/div>\n\t<ul>\n\t\t<li>\n\t\t\t<p>Datos personales\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Preguntas\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Preguntas con varias partes\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Enfermedades\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li>\n\t\t\t<p>Otros\n\t\t\t<\/p>\n\t\t<\/li>\n\t\t<li class=\"active\">\n\t\t\t<p>Firma (6\/6)\n\t\t\t<\/p>\n\t\t<\/li>\n\t<\/ul>\n<\/div>\n\n<!-- signature -->\n<table class=\"disclosure-form-table\" width=\"100%\">\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Escriba su firma <span class=\"disclosure-form-required\">*<\/span><\/label>\n\t\t\t<\/p>\n\t\t\t<p><small>Sugerencia: Utilice el cursor del rat\u00f3n con el bot\u00f3n izquierdo pulsado y escriba su firma en el campo para confirmar los requisitos de divulgaci\u00f3n.<\/small>\n\t\t\t<\/p>\n\t\t\t<p><div class=\"wpcf7-form-control-signature-global-wrap\" data-field-id=\"signature-70\">\n\t\t\t\t<div class=\"wpcf7-form-control-signature-wrap\" style=\"width:300px;height:200px;\">\n\t\t\t\t\t<div class=\"wpcf7-form-control-signature-body\">\n\t\t\t\t\t\t<canvas id=\"wpcf7_signature-70_signature\" class=\"signature-70\"><\/canvas>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"wpcf7-form-control-clear-wrap\">\n\t\t\t\t\t<input id=\"wpcf7_signature-70_clear\" type=\"button\" value=\"Clear\"\/>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<span class=\"wpcf7-form-control-wrap wpcf7-form-control-signature-input-wrap signature-70\">\n\t\t\t\t<input aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"hidden\" name=\"signature-70\" id=\"wpcf7_input_signature-70\"\/><input value=\"value\" type=\"hidden\" name=\"signature-70-attachment\" id=\"wpcf7_input_signature-70_attachment\"\/><input type=\"hidden\" name=\"signature-70-inline\" id=\"wpcf7_input_signature-70_inline\"\/>\n\t\t\t<\/span>\n\t\t\t\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n<\/table>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Enviar\" \/>\n<\/p><input type=\"hidden\" id=\"ct_checkjs_cf7_4e0928de075538c593fbdabb0c5ef2c3\" name=\"ct_checkjs_cf7\" value=\"0\" \/><script >setTimeout(function(){var ct_input_name = \"ct_checkjs_cf7_4e0928de075538c593fbdabb0c5ef2c3\";if (document.getElementById(ct_input_name) !== null) {var ct_input_value = document.getElementById(ct_input_name).value;document.getElementById(ct_input_name).value = document.getElementById(ct_input_name).value.replace(ct_input_value, 'bd194a4ff2a7594a29333f89e35127adfda1452426ed10cfa57bc1f10ddc3c20');}}, 1000);<\/script><input\n                    class=\"apbct_special_field apbct_email_id__wp_contact_form_7\"\n                    name=\"apbct__email_id__wp_contact_form_7\"\n                    aria-label=\"apbct__label_id__wp_contact_form_7\"\n                    type=\"text\" size=\"30\" maxlength=\"200\" autocomplete=\"off\"\n                    value=\"\"\n                \/><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<input type=\"hidden\" name=\"trp-form-language\" value=\"es\"\/><\/form>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>INDEMNITYTRE\u00ae is not intended to diagnose, treat, cure, or prevent any disease. TRE\u00ae is a safe and effective stress release technique for most people. The TRE\u00ae process should not be used as a substitute for trauma recovery procedures of a medical or psychiatric\/psychological nature. Individuals who have physical or psychological conditions that require strict regulation, &hellip; <\/p>","protected":false},"author":2,"featured_media":0,"parent":19,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":"","_members_access_role":[],"_members_access_error":""},"class_list":["post-1958","page","type-page","status-publish","hentry","grid-sizer","latest_post"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Learning TRE\u00ae: Intake\/Disclosure form - TRE\u00ae Tension Releasing Exercises<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/tre-online.com\/es\/tre-en-linea-aprender-a\/formulario-de-admision\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Learning TRE\u00ae: Intake\/Disclosure form - TRE\u00ae Tension Releasing Exercises\" \/>\n<meta property=\"og:description\" content=\"INDEMNITYTRE\u00ae is not intended to diagnose, treat, cure, or prevent any disease. TRE\u00ae is a safe and effective stress release technique for most people. The TRE\u00ae process should not be used as a substitute for trauma recovery procedures of a medical or psychiatric\/psychological nature. Individuals who have physical or psychological conditions that require strict regulation, &hellip;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/tre-online.com\/es\/tre-en-linea-aprender-a\/formulario-de-admision\/\" \/>\n<meta property=\"og:site_name\" content=\"TRE\u00ae Tension Releasing Exercises\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/onlineTRE\" \/>\n<meta property=\"article:modified_time\" content=\"2024-03-27T19:50:44+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/tre-online.com\/wp-content\/uploads\/2020\/04\/LogoStress_noExerc3.jpg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Tiempo de lectura\" \/>\n\t<meta name=\"twitter:data1\" content=\"3 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/tre-online.com\\\/tre-online-learn-how-to\\\/intake-form\\\/\",\"url\":\"https:\\\/\\\/tre-online.com\\\/tre-online-learn-how-to\\\/intake-form\\\/\",\"name\":\"Learning TRE\u00ae: Intake\\\/Disclosure form - TRE\u00ae Tension Releasing Exercises\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/tre-online.com\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/tre-online.com\\\/tre-online-learn-how-to\\\/intake-form\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/tre-online.com\\\/tre-online-learn-how-to\\\/intake-form\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/tre-online.com\\\/wp-content\\\/uploads\\\/2020\\\/04\\\/LogoStress_noExerc3.jpg\",\"datePublished\":\"2020-04-04T18:10:56+00:00\",\"dateModified\":\"2024-03-27T19:50:44+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/tre-online.com\\\/tre-online-learn-how-to\\\/intake-form\\\/#breadcrumb\"},\"inLanguage\":\"es\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/tre-online.com\\\/tre-online-learn-how-to\\\/intake-form\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"es\",\"@id\":\"https:\\\/\\\/tre-online.com\\\/tre-online-learn-how-to\\\/intake-form\\\/#primaryimage\",\"url\":\"https:\\\/\\\/tre-online.com\\\/wp-content\\\/uploads\\\/2020\\\/04\\\/LogoStress_noExerc3.jpg\",\"contentUrl\":\"https:\\\/\\\/tre-online.com\\\/wp-content\\\/uploads\\\/2020\\\/04\\\/LogoStress_noExerc3.jpg\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/tre-online.com\\\/tre-online-learn-how-to\\\/intake-form\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/tre-online.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"TRE\u00ae Online\",\"item\":\"https:\\\/\\\/tre-online.com\\\/tre-online-learn-how-to\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Learning TRE\u00ae: Intake\\\/Disclosure form\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/tre-online.com\\\/#website\",\"url\":\"https:\\\/\\\/tre-online.com\\\/\",\"name\":\"TRE\u00ae Tension Releasing Exercises\",\"description\":\"Release Your Body - Release Your Mind\",\"publisher\":{\"@id\":\"https:\\\/\\\/tre-online.com\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/tre-online.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"es\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/tre-online.com\\\/#organization\",\"name\":\"TRE\u00ae Tension Releasing Exercises\",\"url\":\"https:\\\/\\\/tre-online.com\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"es\",\"@id\":\"https:\\\/\\\/tre-online.com\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/tre-online.com\\\/wp-content\\\/uploads\\\/2021\\\/02\\\/TRE-online-logo-size-optimzed.png\",\"contentUrl\":\"https:\\\/\\\/tre-online.com\\\/wp-content\\\/uploads\\\/2021\\\/02\\\/TRE-online-logo-size-optimzed.png\",\"width\":400,\"height\":397,\"caption\":\"TRE\u00ae Tension Releasing Exercises\"},\"image\":{\"@id\":\"https:\\\/\\\/tre-online.com\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/onlineTRE\",\"https:\\\/\\\/www.instagram.com\\\/online_tre\\\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Aprender TRE\u00ae: Formulario de Admisi\u00f3n\/Divulgaci\u00f3n - TRE\u00ae Ejercicios de Liberaci\u00f3n de Tensi\u00f3n","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/tre-online.com\/es\/tre-en-linea-aprender-a\/formulario-de-admision\/","og_locale":"es_ES","og_type":"article","og_title":"Learning TRE\u00ae: Intake\/Disclosure form - TRE\u00ae Tension Releasing Exercises","og_description":"INDEMNITYTRE\u00ae is not intended to diagnose, treat, cure, or prevent any disease. TRE\u00ae is a safe and effective stress release technique for most people. The TRE\u00ae process should not be used as a substitute for trauma recovery procedures of a medical or psychiatric\/psychological nature. Individuals who have physical or psychological conditions that require strict regulation, &hellip;","og_url":"https:\/\/tre-online.com\/es\/tre-en-linea-aprender-a\/formulario-de-admision\/","og_site_name":"TRE\u00ae Tension Releasing Exercises","article_publisher":"https:\/\/www.facebook.com\/onlineTRE","article_modified_time":"2024-03-27T19:50:44+00:00","og_image":[{"url":"https:\/\/tre-online.com\/wp-content\/uploads\/2020\/04\/LogoStress_noExerc3.jpg","type":"","width":"","height":""}],"twitter_card":"summary_large_image","twitter_misc":{"Tiempo de lectura":"3 minutos"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/tre-online.com\/tre-online-learn-how-to\/intake-form\/","url":"https:\/\/tre-online.com\/tre-online-learn-how-to\/intake-form\/","name":"Aprender TRE\u00ae: Formulario de Admisi\u00f3n\/Divulgaci\u00f3n - TRE\u00ae Ejercicios de Liberaci\u00f3n de Tensi\u00f3n","isPartOf":{"@id":"https:\/\/tre-online.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/tre-online.com\/tre-online-learn-how-to\/intake-form\/#primaryimage"},"image":{"@id":"https:\/\/tre-online.com\/tre-online-learn-how-to\/intake-form\/#primaryimage"},"thumbnailUrl":"https:\/\/tre-online.com\/wp-content\/uploads\/2020\/04\/LogoStress_noExerc3.jpg","datePublished":"2020-04-04T18:10:56+00:00","dateModified":"2024-03-27T19:50:44+00:00","breadcrumb":{"@id":"https:\/\/tre-online.com\/tre-online-learn-how-to\/intake-form\/#breadcrumb"},"inLanguage":"es","potentialAction":[{"@type":"ReadAction","target":["https:\/\/tre-online.com\/tre-online-learn-how-to\/intake-form\/"]}]},{"@type":"ImageObject","inLanguage":"es","@id":"https:\/\/tre-online.com\/tre-online-learn-how-to\/intake-form\/#primaryimage","url":"https:\/\/tre-online.com\/wp-content\/uploads\/2020\/04\/LogoStress_noExerc3.jpg","contentUrl":"https:\/\/tre-online.com\/wp-content\/uploads\/2020\/04\/LogoStress_noExerc3.jpg"},{"@type":"BreadcrumbList","@id":"https:\/\/tre-online.com\/tre-online-learn-how-to\/intake-form\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/tre-online.com\/"},{"@type":"ListItem","position":2,"name":"TRE\u00ae Online","item":"https:\/\/tre-online.com\/tre-online-learn-how-to\/"},{"@type":"ListItem","position":3,"name":"Learning TRE\u00ae: Intake\/Disclosure form"}]},{"@type":"WebSite","@id":"https:\/\/tre-online.com\/#website","url":"https:\/\/tre-online.com\/","name":"TRE\u00ae Ejercicios para liberar la tensi\u00f3n","description":"Libera tu cuerpo - Libera tu mente","publisher":{"@id":"https:\/\/tre-online.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/tre-online.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"es"},{"@type":"Organization","@id":"https:\/\/tre-online.com\/#organization","name":"TRE\u00ae Ejercicios para liberar la tensi\u00f3n","url":"https:\/\/tre-online.com\/","logo":{"@type":"ImageObject","inLanguage":"es","@id":"https:\/\/tre-online.com\/#\/schema\/logo\/image\/","url":"https:\/\/tre-online.com\/wp-content\/uploads\/2021\/02\/TRE-online-logo-size-optimzed.png","contentUrl":"https:\/\/tre-online.com\/wp-content\/uploads\/2021\/02\/TRE-online-logo-size-optimzed.png","width":400,"height":397,"caption":"TRE\u00ae Tension Releasing Exercises"},"image":{"@id":"https:\/\/tre-online.com\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/onlineTRE","https:\/\/www.instagram.com\/online_tre\/"]}]}},"_links":{"self":[{"href":"https:\/\/tre-online.com\/es\/wp-json\/wp\/v2\/pages\/1958","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tre-online.com\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/tre-online.com\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/tre-online.com\/es\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/tre-online.com\/es\/wp-json\/wp\/v2\/comments?post=1958"}],"version-history":[{"count":5,"href":"https:\/\/tre-online.com\/es\/wp-json\/wp\/v2\/pages\/1958\/revisions"}],"predecessor-version":[{"id":6284,"href":"https:\/\/tre-online.com\/es\/wp-json\/wp\/v2\/pages\/1958\/revisions\/6284"}],"up":[{"embeddable":true,"href":"https:\/\/tre-online.com\/es\/wp-json\/wp\/v2\/pages\/19"}],"wp:attachment":[{"href":"https:\/\/tre-online.com\/es\/wp-json\/wp\/v2\/media?parent=1958"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}