{"id":4250,"date":"2021-11-15T14:05:51","date_gmt":"2021-11-15T13:05:51","guid":{"rendered":"https:\/\/www.kiez-hypnose.de\/registro-de-no-fumadores\/"},"modified":"2023-06-02T13:51:44","modified_gmt":"2023-06-02T11:51:44","slug":"registro-de-no-fumadores","status":"publish","type":"page","link":"https:\/\/www.kiez-hypnose.de\/es\/registro-de-no-fumadores\/","title":{"rendered":"Registro de no fumadores"},"content":{"rendered":"<p>[et_pb_section fb_built=\u00bb1&#8243; _builder_version=\u00bb4.16&#8243; _module_preset=\u00bbdefault\u00bb da_disable_devices=\u00bboff|off|off\u00bb global_colors_info=\u00bb{}\u00bb da_is_popup=\u00bboff\u00bb da_exit_intent=\u00bboff\u00bb da_has_close=\u00bbon\u00bb da_alt_close=\u00bboff\u00bb da_dark_close=\u00bboff\u00bb da_not_modal=\u00bbon\u00bb da_is_singular=\u00bboff\u00bb da_with_loader=\u00bboff\u00bb da_has_shadow=\u00bbon\u00bb][et_pb_row _builder_version=\u00bb4.16&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.16&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text admin_label=\u00bbMethoden Aufz\u00e4hlung\u00bb _builder_version=\u00bb4.16&#8243; text_font=\u00bb||||||||\u00bb header_font=\u00bbOpenSans-Light|300|||||||\u00bb header_font_size=\u00bb70px\u00bb header_line_height=\u00bb1.2em\u00bb header_2_font=\u00bb||||||||\u00bb header_2_line_height=\u00bb1.2em\u00bb module_alignment=\u00bbright\u00bb custom_margin=\u00bb5%||0px||false|false\u00bb text_font_size_tablet=\u00bb\u00bb text_font_size_phone=\u00bb15px\u00bb text_font_size_last_edited=\u00bbon|desktop\u00bb header_font_size_tablet=\u00bb40px\u00bb header_font_size_phone=\u00bb25px\u00bb header_font_size_last_edited=\u00bbon|phone\u00bb header_2_font_size_tablet=\u00bb\u00bb header_2_font_size_phone=\u00bb\u00bb header_2_font_size_last_edited=\u00bbon|phone\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n<h2 style=\"text-align: center;\">Formulario de inscripci\u00f3n Hipnosis para no fumadores<\/h2>\n<p>[\/et_pb_text][et_pb_divider color=\u00bb#e95e27&#8243; divider_position=\u00bbcenter\u00bb divider_weight=\u00bb2px\u00bb _builder_version=\u00bb4.16&#8243; _module_preset=\u00bbdefault\u00bb width=\u00bb100px\u00bb module_alignment=\u00bbcenter\u00bb custom_margin=\u00bb0px||20px||false|false\u00bb global_colors_info=\u00bb{}\u00bb][\/et_pb_divider][et_pb_text _builder_version=\u00bb4.16&#8243; _module_preset=\u00bbdefault\u00bb width=\u00bb60%\u00bb width_tablet=\u00bb100%\u00bb width_phone=\u00bb100%\u00bb width_last_edited=\u00bbon|tablet\u00bb module_alignment=\u00bbcenter\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n<p>Estimado cliente,<\/p>\n<p>Su cita de hipnosis est\u00e1 marcada inicialmente, pero a\u00fan no est\u00e1 reservada de forma vinculante. Para la reserva necesito algunos datos importantes de usted.<\/p>\n<p>Sus datos, as\u00ed como el contenido de la sesi\u00f3n, se tratar\u00e1n, por supuesto, de forma confidencial. Rellene todos los campos y haga clic en \u00abenviar\u00bb al final del formulario. Aseg\u00farese de que al final aparezca en la ventana de su navegador \u00abEl mensaje se ha enviado correctamente\u00bb. Es aconsejable preescribir los textos m\u00e1s largos en un programa de tratamiento de textos y luego copiarlos para no perder el contenido en caso de problemas t\u00e9cnicos. Si tiene problemas para enviar los documentos, al final de esta p\u00e1gina hay un documento de Word que puede descargar y enviarme por correo electr\u00f3nico.<\/p>\n<p><strong>Si la informaci\u00f3n es demasiado sensible para enviarla por Internet, tambi\u00e9n puede imprimir el formulario y enviarlo a la direcci\u00f3n de mi consulta o traerlo en persona. El buz\u00f3n de la consulta est\u00e1 situado en la zona de entrada del centro m\u00e9dico y s\u00f3lo es accesible durante el d\u00eda.<\/strong><\/p>\n<p><strong>A continuaci\u00f3n, recibir\u00e1 una confirmaci\u00f3n vinculante de su sesi\u00f3n por correo electr\u00f3nico. Si no recibe un correo electr\u00f3nico en el plazo de dos d\u00edas laborables, ll\u00e1meme.<\/strong><\/p>\n<p>T\u00f3mate un tiempo para rellenar el formulario, \u00a1es parte de tu preparaci\u00f3n!<\/p>\n<p>Espero que se registre.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=\u00bb4.16&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.16&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_code _builder_version=\u00bb4.21.0&#8243; _module_preset=\u00bbdefault\u00bb width=\u00bb60%\u00bb width_tablet=\u00bb100%\u00bb width_phone=\u00bb100%\u00bb width_last_edited=\u00bbon|tablet\u00bb module_alignment=\u00bbcenter\u00bb global_colors_info=\u00bb{}\u00bb]\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f8847-o1\" lang=\"es-ES\" dir=\"ltr\" data-wpcf7-id=\"8847\">\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\/4250#wpcf7-f8847-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formulario de contacto\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"8847\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.7\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"es_ES\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f8847-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<p>Fecha y hora de las citas*.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"datum\"><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=\"datum\" \/><\/span>\n<\/p>\n<p>Nombre y apellidos<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"name-123\"><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=\"name-123\" \/><\/span>\n<\/p>\n<p>e-mail*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email-201\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email-201\" \/><\/span>\n<\/p>\n<p>Tel\u00e9fono M\u00f3vil *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel-298\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"tel-298\" \/><\/span>\n<\/p>\n<p>Calle, casa n\u00ba *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"strasse\"><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=\"strasse\" \/><\/span>\n<\/p>\n<p>C\u00f3digo postal y ciudad *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ort\"><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=\"ort\" \/><\/span>\n<\/p>\n<p>En su caso direcci\u00f3n de la factura diferente<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"rechnungsadresse\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"rechnungsadresse\" \/><\/span>\n<\/p>\n<p>Fecha de nacimiento *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"gebdatum\"><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=\"gebdatum\" \/><\/span>\n<\/p>\n<p>Ocupaci\u00f3n *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"beruf\"><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=\"beruf\" \/><\/span>\n<\/p>\n<p>Embarazo existente*.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-schwangerschaft\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-schwangerschaft\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-schwangerschaft\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Ya he experimentado la hipnosis*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-hypnose\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-hypnose\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-hypnose\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Enfermedades: Epilepsia *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-epilepsie\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-epilepsie\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-epilepsie\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>asma grave *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-asthma\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-asthma\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-asthma\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Otros trastornos convulsivos *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-sonstige\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-sonstige\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-sonstige\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Dolor severo persistente *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-schmerzen\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-schmerzen\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-schmerzen\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Problemas circulatorios considerables *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-kreislauf\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-kreislauf\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-kreislauf\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Enfermedades infecciosas (por ejemplo, hepatitis B\/C) *.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-hepatitis\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-hepatitis\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-hepatitis\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Enfermedades del coraz\u00f3n *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-here\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-here\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-here\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Problemas con los hombros, brazos o manos *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-arme\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-arme\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-arme\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Otra enfermedad f\u00edsica grave *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-sonstige2\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-sonstige2\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-sonstige2\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Discapacidad f\u00edsica o mental *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-behinderung\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-behinderung\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-behinderung\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>En caso afirmativo, qu\u00e9<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"welche-behinderung\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"welche-behinderung\" \/><\/span>\n<\/p>\n<p>En tratamiento con psicoterapeutas *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-psychotherapeuten\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-psychotherapeuten\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-psychotherapeuten\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-psychotherapeuten\" value=\"Anteriormente en tratamiento\" \/><span class=\"wpcf7-list-item-label\">Anteriormente en tratamiento<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Bajo tratamiento por un psiquiatra o neur\u00f3logo *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-psychiater\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-psychiater\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-psychiater\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-psychiater\" value=\"Anteriormente en tratamiento\" \/><span class=\"wpcf7-list-item-label\">Anteriormente en tratamiento<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Diagn\u00f3stico y periodo, si procede<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"diagnose\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"diagnose\" \/><\/span>\n<\/p>\n<p>Actualmente tomo antidepresivos o neurol\u00e9pticos *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-antidepressiva\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-antidepressiva\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-antidepressiva\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Toma regular de los siguientes medicamentos<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"medikamente\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"medikamente\" \/><\/span>\n<\/p>\n<p>Enfermedad mental grave (psicosis) *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-psychose\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-psychose\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-psychose\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>ADD, ADHD o HKS *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-ads\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-ads\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-ads\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Miedos o fobias (si no son motivo de tratamiento)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"phobien\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"phobien\" \/><\/span>\n<\/p>\n<p>Alergias<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"allergien\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"allergien\" \/><\/span>\n<\/p>\n<p>Dependencia de medicamentos *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-medikamentenmissbrauch\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-medikamentenmissbrauch\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-medikamentenmissbrauch\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Dependencia del alcohol *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-alkohol\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-alkohol\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-alkohol\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Drogodependencia (excepto tabaco) *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-drogen2\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-drogen2\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-drogen2\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Consumo de cannabis *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-cannabis\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-cannabis\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-cannabis\" value=\"Raramente\" \/><span class=\"wpcf7-list-item-label\">Raramente<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-cannabis\" value=\"Ocasionalmente\" \/><span class=\"wpcf7-list-item-label\">Ocasionalmente<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-cannabis\" value=\"Frecuentemente\" \/><span class=\"wpcf7-list-item-label\">Frecuentemente<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-cannabis\" value=\"Diariamente\" \/><span class=\"wpcf7-list-item-label\">Diariamente<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Experiencia con drogas psicoactivas, por ejemplo, LSD *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-drogen3\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-drogen3\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-drogen3\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Preparaci\u00f3n de la reuni\u00f3n: Motivo principal de la reuni\u00f3n *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"grund\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"grund\"><\/textarea><\/span>\n<\/p>\n<p>Por favor, describa cu\u00e1l es el cambio m\u00e1s importante que desea conseguir con la hipnosis para no fumadores. Describa este cambio de la forma m\u00e1s clara y completa posible. *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"veraenderung\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"veraenderung\"><\/textarea><\/span>\n<\/p>\n<p>Cigarrillos fumados al d\u00eda (media) *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"zigarettenanzahl\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"zigarettenanzahl\"><\/textarea><\/span>\n<\/p>\n<p>Enumere brevemente y en vi\u00f1etas las situaciones t\u00edpicas en las que fuma (por ejemplo, por la ma\u00f1ana con el caf\u00e9).<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"zigarettensituation\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"zigarettensituation\"><\/textarea><\/span>\n<\/p>\n<p>T\u00f3mese unos minutos y piense en los BENEFICIOS que obtendr\u00e1 en su vida al deS\u00edr de fumar. Por ejemplo, c\u00f3mo afectar\u00e1 este cambio a su trabajo, a su vida personal, a sus relaciones. \u00bfC\u00f3mo le perciben los dem\u00e1s? \u00bfC\u00f3mo se sentir\u00e1 usted? Escriba al menos 7 beneficios. Es una ayuda formular estos beneficios POSITIVAMENTE, as\u00ed que en lugar de \"Ya no tengo necesidad de fumar\": \"Me siento libre\". *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"vorteile\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"vorteile\"><\/textarea><\/span>\n<\/p>\n<p>\u00bfC\u00f3mo se enter\u00f3 de Hipnosis Kiez? *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-herkunft\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-herkunft\" value=\"Recomendaci\u00f3n\" \/><span class=\"wpcf7-list-item-label\">Recomendaci\u00f3n<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-herkunft\" value=\"B\u00fasqueda en Google\" \/><span class=\"wpcf7-list-item-label\">B\u00fasqueda en Google<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-herkunft\" value=\"Anuncio en Google\" \/><span class=\"wpcf7-list-item-label\">Anuncio en Google<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-herkunft\" value=\"Visto en el m\u00e9dico\" \/><span class=\"wpcf7-list-item-label\">Visto en el m\u00e9dico<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-herkunft\" value=\"HypnoBox\" \/><span class=\"wpcf7-list-item-label\">HypnoBox<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-herkunft\" value=\"Workshop\" \/><span class=\"wpcf7-list-item-label\">Workshop<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-herkunft\" value=\"Norbert Preetz Lista de terapeutas\" \/><span class=\"wpcf7-list-item-label\">Norbert Preetz Lista de terapeutas<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-herkunft\" value=\"Facebook\" \/><span class=\"wpcf7-list-item-label\">Facebook<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-herkunft\" value=\"Tarjeta de visita\" \/><span class=\"wpcf7-list-item-label\">Tarjeta de visita<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-herkunft\" value=\"Therapeutenfinder.com\" \/><span class=\"wpcf7-list-item-label\">Therapeutenfinder.com<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-herkunft\" value=\"Therapeuten.de\" \/><span class=\"wpcf7-list-item-label\">Therapeuten.de<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>\u00bfQu\u00e9 t\u00e9 le gustar\u00eda tomar en la sesi\u00f3n? *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-tee\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"checkbox-tee\" value=\"Hierbas\" \/><span class=\"wpcf7-list-item-label\">Hierbas<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-tee\" value=\"Rooibos\" \/><span class=\"wpcf7-list-item-label\">Rooibos<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-tee\" value=\"Frutas\" \/><span class=\"wpcf7-list-item-label\">Frutas<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-tee\" value=\"Hierba lim\u00f3n\" \/><span class=\"wpcf7-list-item-label\">Hierba lim\u00f3n<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-tee\" value=\"Manzanilla\" \/><span class=\"wpcf7-list-item-label\">Manzanilla<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-tee\" value=\"Ortiga\" \/><span class=\"wpcf7-list-item-label\">Ortiga<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"checkbox-tee\" value=\"No importa\" \/><span class=\"wpcf7-list-item-label\">No importa<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"checkbox-tee\" value=\"S\u00f3lo agua\" \/><span class=\"wpcf7-list-item-label\">S\u00f3lo agua<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Condiciones generales de contrataci\u00f3n *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-agb\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"checkbox-agb[]\" value=\"He le\u00eddo y acepto las Condiciones Generales de Contrataci\u00f3n (CGC que figuran a continuaci\u00f3n).\" \/><span class=\"wpcf7-list-item-label\">He le\u00eddo y acepto las Condiciones Generales de Contrataci\u00f3n (CGC que figuran a continuaci\u00f3n).<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Plazo de anulaci\u00f3n*.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-frist\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"checkbox-frist[]\" value=\"Acepto el plazo de cancelaci\u00f3n de 48 horas antes de cada cita. Las cancelaciones deben realizarse con la debida antelaci\u00f3n por tel\u00e9fono (030-91701944) o por correo electr\u00f3nico a info@kiez-hypnose.de.\" \/><span class=\"wpcf7-list-item-label\">Acepto el plazo de cancelaci\u00f3n de 48 horas antes de cada cita. Las cancelaciones deben realizarse con la debida antelaci\u00f3n por tel\u00e9fono (030-91701944) o por correo electr\u00f3nico a info@kiez-hypnose.de.<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Informaci\u00f3n sobre protecci\u00f3n de datos<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-datenschutz\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"checkbox-datenschutz[]\" value=\"Consentimiento en materia de protecci\u00f3n de datos: He tomado nota de la declaraci\u00f3n de protecci\u00f3n de datos. Doy mi consentimiento para que mis datos sean recogidos y almacenados electr\u00f3nicamente con el fin de responder a mi consulta. Puedo revocar mi consentimiento para el futuro en cualquier momento enviando un correo electr\u00f3nico a info@kiez-hypnose.de.\" \/><span class=\"wpcf7-list-item-label\">Consentimiento en materia de protecci\u00f3n de datos: He tomado nota de la declaraci\u00f3n de protecci\u00f3n de datos. Doy mi consentimiento para que mis datos sean recogidos y almacenados electr\u00f3nicamente con el fin de responder a mi consulta. Puedo revocar mi consentimiento para el futuro en cualquier momento enviando un correo electr\u00f3nico a info@kiez-hypnose.de.<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Enviar\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n[\/et_pb_code][et_pb_code _builder_version=\u00bb4.21.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n<style><!-- [et_pb_line_break_holder] -->  span.wpcf7-list-item { <!-- [et_pb_line_break_holder] -->    display: block;<!-- [et_pb_line_break_holder] -->  margin-top: 10px;<!-- [et_pb_line_break_holder] -->  }<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->  input[type=email], input[type=number], input[type=text], textarea {<!-- [et_pb_line_break_holder] -->    padding: 5px 15px;<!-- [et_pb_line_break_holder] -->    width: 70%;<!-- [et_pb_line_break_holder] -->  margin-top:10px;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><\/style>\n<p>[\/et_pb_code][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=\u00bb1_2,1_2&#8243; _builder_version=\u00bb4.16&#8243; _module_preset=\u00bbdefault\u00bb width=\u00bb48%\u00bb width_tablet=\u00bb60%\u00bb width_phone=\u00bb60%\u00bb width_last_edited=\u00bbon|desktop\u00bb module_alignment=\u00bbcenter\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb1_2&#8243; _builder_version=\u00bb4.16&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text _builder_version=\u00bb4.21.0&#8243; _module_preset=\u00bbdefault\u00bb hover_enabled=\u00bb0&#8243; global_colors_info=\u00bb{}\u00bb sticky_enabled=\u00bb0&#8243;]<span style=\"font-size: 100px;\"><i class=\"fas fa-file-pdf\"><\/i> <\/span><\/p>\n<p><strong>AGB Kiez Hipnosis<\/strong><br \/>\nCondiciones generales  <\/p>\n<p><a href=\"https:\/\/www.kiez-hypnose.de\/wp-content\/uploads\/2021\/11\/Allgemeine-Geschaeftsbedingungen-Kiez-Hypnose.pdf\" target=\"_blank\" rel=\"noopener\">Descargar<\/a>[\/et_pb_text][\/et_pb_column][et_pb_column type=\u00bb1_2&#8243; _builder_version=\u00bb4.16&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text _builder_version=\u00bb4.21.0&#8243; _module_preset=\u00bbdefault\u00bb hover_enabled=\u00bb0&#8243; global_colors_info=\u00bb{}\u00bb sticky_enabled=\u00bb0&#8243;]<\/p>\n<p><span style=\"font-size: 100px;\"><i class=\"fas fa-file-word\"><\/i> <\/span><\/p>\n<p><strong>Formulario de inscripci\u00f3n para no fumadores<\/strong><br \/>Formulario de inscripci\u00f3n.docx<br \/><a href=\"https:\/\/www.kiez-hypnose.de\/wp-content\/uploads\/2021\/11\/Anmeldeformular-Nichtraucher.docx\" target=\"_blank\" rel=\"noopener\">Descargar<\/a><\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Formulario de inscripci\u00f3n Hipnosis para no fumadoresEstimado cliente, Su cita de hipnosis est\u00e1 marcada inicialmente, pero a\u00fan no est\u00e1 reservada de forma vinculante. Para la reserva necesito algunos datos importantes de usted. Sus datos, as\u00ed como el contenido de la sesi\u00f3n, se tratar\u00e1n, por supuesto, de forma confidencial. Rellene todos los campos y haga clic [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-4250","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.kiez-hypnose.de\/es\/wp-json\/wp\/v2\/pages\/4250","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.kiez-hypnose.de\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.kiez-hypnose.de\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.kiez-hypnose.de\/es\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.kiez-hypnose.de\/es\/wp-json\/wp\/v2\/comments?post=4250"}],"version-history":[{"count":0,"href":"https:\/\/www.kiez-hypnose.de\/es\/wp-json\/wp\/v2\/pages\/4250\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.kiez-hypnose.de\/es\/wp-json\/wp\/v2\/media?parent=4250"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}