fundacioncm.cl
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Submitted URL: https://www.facm.cl/
Effective URL: https://fundacioncm.cl/
Submission: On May 14 via api from US — Scanned from DE
Effective URL: https://fundacioncm.cl/
Submission: On May 14 via api from US — Scanned from DE
Form analysis 4 forms found in the DOM
<form>
<div>
<div class="nf-before-form-content"><nf-section>
<div class="nf-form-fields-required">Los campos marcados con <span class="ninja-forms-req-symbol">*</span> son obligatorios</div>
</nf-section></div>
<div class="nf-form-content "><nf-rows-wrap>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
<div id="nf-field-17-container" class="nf-field-container listselect-container label-above list-container">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-17-wrap" class="field-wrap listselect-wrap list-wrap list-select-wrap" data-field-id="17">
<div class="nf-field-label">
<label for="nf-field-17" id="nf-label-field-17" class=""> Categoría <span class="ninja-forms-req-symbol">*</span>
</label>
</div>
<div class="nf-field-element">
<select id="nf-field-17" name="nf-field-17" aria-invalid="false" aria-describedby="nf-error-17" class="ninja-forms-field nf-element" aria-labelledby="nf-label-field-17" aria-required="true" required="">
<option value="" selected="selected"></option>
<option value="Consulta">Consulta</option>
<option value="Requerimiento">Requerimiento</option>
<option value="Reclamo">Reclamo</option>
</select>
<div for="nf-field-17"></div>
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-17" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
<div id="nf-field-18-container" class="nf-field-container listselect-container label-above list-container">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-18-wrap" class="field-wrap listselect-wrap list-wrap list-select-wrap" data-field-id="18">
<div class="nf-field-label">
<label for="nf-field-18" id="nf-label-field-18" class=""> Seleccione Tipo de Solicitud <span class="ninja-forms-req-symbol">*</span>
</label>
</div>
<div class="nf-field-element">
<select id="nf-field-18" name="nf-field-18" aria-invalid="false" aria-describedby="nf-error-18" class="ninja-forms-field nf-element" aria-labelledby="nf-label-field-18" aria-required="true" required="">
</select>
<div for="nf-field-18"></div>
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-18" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
<div id="nf-field-21-container" class="nf-field-container firstname-container label-above cont_rut ">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-21-wrap" class="field-wrap firstname-wrap" data-field-id="21">
<div class="nf-field-label">
<label for="nf-field-21" id="nf-label-field-21" class=""> Rut Solicitante en Trámite <span class="ninja-forms-req-symbol">*</span>
</label>
</div>
<div class="nf-field-element">
<input type="text" value="" class="ninja-forms-field rut nf-element" id="nf-field-21" name="fname" autocomplete="given-name" aria-invalid="false" aria-describedby="nf-error-21" aria-labelledby="nf-label-field-21"
aria-required="true" required="">
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-21" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
<div id="nf-field-22-container" class="nf-field-container firstname-container label-above ">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-22-wrap" class="field-wrap firstname-wrap" data-field-id="22">
<div class="nf-field-label">
<label for="nf-field-22" id="nf-label-field-22" class=""> Nombres <span class="ninja-forms-req-symbol">*</span>
</label>
</div>
<div class="nf-field-element">
<input type="text" value="" class="ninja-forms-field nf-element" id="nf-field-22" name="fname" autocomplete="given-name" aria-invalid="false" aria-describedby="nf-error-22" aria-labelledby="nf-label-field-22"
aria-required="true" required="">
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-22" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 50%;">
<nf-fields><nf-field>
<div id="nf-field-23-container" class="nf-field-container lastname-container label-above ">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-23-wrap" class="field-wrap lastname-wrap" data-field-id="23">
<div class="nf-field-label">
<label for="nf-field-23" id="nf-label-field-23" class=""> Apellido Paterno <span class="ninja-forms-req-symbol">*</span>
</label>
</div>
<div class="nf-field-element">
<input type="text" value="" class="ninja-forms-field nf-element" id="nf-field-23" name="lname" autocomplete="family-name" aria-invalid="false" aria-describedby="nf-error-23" aria-labelledby="nf-label-field-23"
aria-required="true" required="">
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-23" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
<div class="nf-cell" style="width: 50%;">
<nf-fields><nf-field>
<div id="nf-field-24-container" class="nf-field-container lastname-container label-above ">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-24-wrap" class="field-wrap lastname-wrap" data-field-id="24">
<div class="nf-field-label">
<label for="nf-field-24" id="nf-label-field-24" class=""> Apellido Materno </label>
</div>
<div class="nf-field-element">
<input type="text" value="" class="ninja-forms-field nf-element" id="nf-field-24" name="lname" autocomplete="family-name" aria-invalid="false" aria-describedby="nf-error-24" aria-labelledby="nf-label-field-24">
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-24" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
<div id="nf-field-25-container" class="nf-field-container number-container label-above ">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-25-wrap" class="field-wrap number-wrap" data-field-id="25">
<div class="nf-field-label">
<label for="nf-field-25" id="nf-label-field-25" class=""> Teléfono <span class="ninja-forms-req-symbol">*</span>
</label>
</div>
<div class="nf-field-element">
<input id="nf-field-25" name="nf-field-25" aria-invalid="false" aria-describedby="nf-error-25" class="ninja-forms-field nf-element" aria-labelledby="nf-label-field-25" aria-required="true" required="" type="number" value=""
min="" max="" step="1">
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-25" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
<div id="nf-field-26-container" class="nf-field-container email-container label-above ">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-26-wrap" class="field-wrap email-wrap" data-field-id="26">
<div class="nf-field-label">
<label for="nf-field-26" id="nf-label-field-26" class=""> Email <span class="ninja-forms-req-symbol">*</span>
</label>
</div>
<div class="nf-field-element">
<input type="email" value="" class="ninja-forms-field nf-element" id="nf-field-26" name="email" autocomplete="email" aria-invalid="false" aria-describedby="nf-error-26" aria-labelledby="nf-label-field-26"
aria-required="true" required="">
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-26" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
<div id="nf-field-28-container" class="nf-field-container listselect-container label-above list-container">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-28-wrap" class="field-wrap listselect-wrap list-wrap list-select-wrap" data-field-id="28">
<div class="nf-field-label">
<label for="nf-field-28" id="nf-label-field-28" class=""> Comisión Médica <span class="ninja-forms-req-symbol">*</span>
</label>
</div>
<div class="nf-field-element">
<select id="nf-field-28" name="nf-field-28" aria-invalid="false" aria-describedby="nf-error-28" class="ninja-forms-field nf-element" aria-labelledby="nf-label-field-28" aria-required="true" required="">
<option value="call-center" selected="selected">Call Center</option>
<option value="cm-central">CM Central</option>
<option value="cmr-arica">CMR Arica</option>
<option value="cmr-iquique">CMR Iquique</option>
<option value="cmr-copiapo">CMR Copiapó</option>
<option value="cmr-antofagasta">CMR Antofagasta</option>
<option value="cmr-la-serena">CMR La Serena</option>
<option value="cmr-los-andes">CMR Los Andes</option>
<option value="cmr-vina-del-mar">CMR Viña del Mar</option>
<option value="crm-casa-matriz">Casa Matriz</option>
<option value="cmr-metropolitana-centro">CMR Metropolitana Centro</option>
<option value="cmr-metropolitana-sur">CMR Metropolitana Sur</option>
<option value="cmr-rancagua">CMR Rancagua</option>
<option value="cmr-talca">CMR Talca</option>
<option value="cmr-chillan">CMR Chillán</option>
<option value="cmr-concepcion">CMR Concepción</option>
<option value="cmr-los-angeles">CMR Los Angeles</option>
<option value="cmr-temuco">CMR Temuco</option>
<option value="cmr-valdivia">CMR Valdivia</option>
<option value="cmr-osorno">CMR Osorno</option>
<option value="cmr-puerto-montt">CMR Puerto Montt</option>
<option value="cmr-chiloe">CMR Chiloé</option>
<option value="cmr-coyhaique">CMR Coyhaique</option>
<option value="cmr-punta-arenas">CMR Punta Arenas</option>
</select>
<div for="nf-field-28"></div>
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-28" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
<div id="nf-field-29-container" class="nf-field-container textarea-container label-above ">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-29-wrap" class="field-wrap textarea-wrap" data-field-id="29">
<div class="nf-field-label">
<label for="nf-field-29" id="nf-label-field-29" class=""> Mensaje <span class="ninja-forms-req-symbol">*</span>
</label>
</div>
<div class="nf-field-element">
<textarea id="nf-field-29" name="nf-field-29" aria-invalid="false" aria-describedby="nf-error-29" class="ninja-forms-field nf-element" aria-labelledby="nf-label-field-29" aria-required="true" required=""></textarea>
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-29" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
<div id="nf-field-30-container" class="nf-field-container file_upload-container label-above textbox-container">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-30-wrap" class="field-wrap file_upload-wrap textbox-wrap" data-field-id="30">
<div class="nf-field-label">
<label for="nf-field-30" id="nf-label-field-30" class=""> Si necesita enviarnos información adicional, puede adjuntar un documento *.pdf, *.docx, *.rar o *.zip de hasta 10MB. </label>
</div>
<div class="nf-field-element">
<button class="btn ninja-forms-field nf-element btn-success nf-fu-fileinput-button" type="button">
<span>Seleccionar</span>
</button>
<button type="reset" class="btn nf-fu-button-cancel" data-field-id="30" data-form-id="3">Cancelar</button>
<input class="nf-element" style="display: block; visibility: hidden; width: 0; height: 0;" type="file" name="files-30" accept=" .docx,.pdf,.rar,.zip">
<input type="hidden" class="nf-upload-nonce" value="3f7281dadf">
<div class="nf-fu-progress">
<div class="nf-fu-progress-bar nf-fu-progress-bar-success"></div>
</div>
<div class="files_uploaded"></div>
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-30" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
<div id="nf-field-31-container" class="nf-field-container submit-container label-above textbox-container">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-31-wrap" class="field-wrap submit-wrap textbox-wrap" data-field-id="31">
<div class="nf-field-label"></div>
<div class="nf-field-element">
<input id="nf-field-31" class="ninja-forms-field btn_proc nf-element " type="submit" value="Enviar">
</div>
<div class="nf-error-wrap"></div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-31" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
</nf-rows-wrap></div>
<div class="nf-after-form-content"><nf-section>
<div id="nf-form-errors-3" class="nf-form-errors" role="alert"><nf-errors></nf-errors></div>
<div class="nf-form-hp"><nf-section>
<label id="nf-label-field-hp-3" for="nf-field-hp-3" aria-hidden="true"> Si eres un ser humano y estás viendo este campo, por favor déjalo vacío. <input id="nf-field-hp-3" name="nf-field-hp" class="nf-element nf-field-hp" type="text"
value="" aria-labelledby="nf-label-field-hp-3">
</label>
</nf-section></div>
</nf-section></div>
</div>
</form><form>
<div>
<div class="nf-before-form-content"><nf-section>
<div class="nf-form-fields-required">Los campos marcados con <span class="ninja-forms-req-symbol">*</span> son obligatorios</div>
</nf-section></div>
<div class="nf-form-content "><nf-rows-wrap>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
<div id="nf-field-32-container" class="nf-field-container listselect-container label-above list-container">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-32-wrap" class="field-wrap listselect-wrap list-wrap list-select-wrap" data-field-id="32">
<div class="nf-field-label">
<label for="nf-field-32" id="nf-label-field-32" class=""> Categoría <span class="ninja-forms-req-symbol">*</span>
</label>
</div>
<div class="nf-field-element">
<select id="nf-field-32" name="nf-field-32" aria-invalid="false" aria-describedby="nf-error-32" class="ninja-forms-field nf-element" aria-labelledby="nf-label-field-32" aria-required="true" required="">
<option value="Denuncia" selected="selected">Denuncia</option>
</select>
<div for="nf-field-32"></div>
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-32" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
<div id="nf-field-37-container" class="nf-field-container firstname-container label-above ">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-37-wrap" class="field-wrap firstname-wrap" data-field-id="37">
<div class="nf-field-label">
<label for="nf-field-37" id="nf-label-field-37" class=""> Nombres <span class="ninja-forms-req-symbol">*</span>
</label>
</div>
<div class="nf-field-element">
<input type="text" value="" class="ninja-forms-field nf-element" id="nf-field-37" name="fname" autocomplete="given-name" aria-invalid="false" aria-describedby="nf-error-37" aria-labelledby="nf-label-field-37"
aria-required="true" required="">
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-37" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 50%;">
<nf-fields><nf-field>
<div id="nf-field-38-container" class="nf-field-container lastname-container label-above ">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-38-wrap" class="field-wrap lastname-wrap" data-field-id="38">
<div class="nf-field-label">
<label for="nf-field-38" id="nf-label-field-38" class=""> Apellido Paterno <span class="ninja-forms-req-symbol">*</span>
</label>
</div>
<div class="nf-field-element">
<input type="text" value="" class="ninja-forms-field nf-element" id="nf-field-38" name="lname" autocomplete="family-name" aria-invalid="false" aria-describedby="nf-error-38" aria-labelledby="nf-label-field-38"
aria-required="true" required="">
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-38" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
<div class="nf-cell" style="width: 50%;">
<nf-fields><nf-field>
<div id="nf-field-39-container" class="nf-field-container lastname-container label-above ">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-39-wrap" class="field-wrap lastname-wrap" data-field-id="39">
<div class="nf-field-label">
<label for="nf-field-39" id="nf-label-field-39" class=""> Apellido Materno </label>
</div>
<div class="nf-field-element">
<input type="text" value="" class="ninja-forms-field nf-element" id="nf-field-39" name="lname" autocomplete="family-name" aria-invalid="false" aria-describedby="nf-error-39" aria-labelledby="nf-label-field-39">
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-39" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
<div id="nf-field-41-container" class="nf-field-container email-container label-above ">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-41-wrap" class="field-wrap email-wrap" data-field-id="41">
<div class="nf-field-label">
<label for="nf-field-41" id="nf-label-field-41" class=""> Email <span class="ninja-forms-req-symbol">*</span>
</label>
</div>
<div class="nf-field-element">
<input type="email" value="" class="ninja-forms-field nf-element" id="nf-field-41" name="email" autocomplete="email" aria-invalid="false" aria-describedby="nf-error-41" aria-labelledby="nf-label-field-41"
aria-required="true" required="">
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-41" class="nf-error-wrap nf-error" role="alert"></div>
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</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
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</div>
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</div>
<div class="nf-row">
<nf-cells>
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<nf-fields><nf-field>
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<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-43-wrap" class="field-wrap listselect-wrap list-wrap list-select-wrap" data-field-id="43">
<div class="nf-field-label">
<label for="nf-field-43" id="nf-label-field-43" class=""> Comisión Médica </label>
</div>
<div class="nf-field-element">
<select id="nf-field-43" name="nf-field-43" aria-invalid="false" aria-describedby="nf-error-43" class="ninja-forms-field nf-element" aria-labelledby="nf-label-field-43">
<option value="call-center" selected="selected"></option>
</select>
<div for="nf-field-43"></div>
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-43" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
<div id="nf-field-44-container" class="nf-field-container textarea-container label-above ">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-44-wrap" class="field-wrap textarea-wrap" data-field-id="44">
<div class="nf-field-label">
<label for="nf-field-44" id="nf-label-field-44" class=""> Mensaje <span class="ninja-forms-req-symbol">*</span>
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</div>
<div class="nf-field-element">
<textarea id="nf-field-44" name="nf-field-44" aria-invalid="false" aria-describedby="nf-error-44" class="ninja-forms-field nf-element" aria-labelledby="nf-label-field-44" aria-required="true" required=""></textarea>
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-44" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
<div id="nf-field-45-container" class="nf-field-container file_upload-container label-above textbox-container">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-45-wrap" class="field-wrap file_upload-wrap textbox-wrap" data-field-id="45">
<div class="nf-field-label">
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</div>
<div class="nf-field-element">
<button class="btn ninja-forms-field nf-element btn-success nf-fu-fileinput-button" type="button">
<span>Seleccionar</span>
</button>
<button type="reset" class="btn nf-fu-button-cancel" data-field-id="45" data-form-id="4">Cancelar</button>
<input class="nf-element" style="display: block; visibility: hidden; width: 0; height: 0;" type="file" name="files-45" accept=" .docx,.pdf,.rar,.zip">
<input type="hidden" class="nf-upload-nonce" value="b9ee31ac46">
<div class="nf-fu-progress">
<div class="nf-fu-progress-bar nf-fu-progress-bar-success"></div>
</div>
<div class="files_uploaded"></div>
</div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-45" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
<div class="nf-row">
<nf-cells>
<div class="nf-cell" style="width: 100%;">
<nf-fields><nf-field>
<div id="nf-field-46-container" class="nf-field-container submit-container label-above textbox-container">
<div class="nf-before-field"><nf-section>
</nf-section></div>
<div class="nf-field">
<div id="nf-field-46-wrap" class="field-wrap submit-wrap textbox-wrap" data-field-id="46">
<div class="nf-field-label"></div>
<div class="nf-field-element">
<input id="nf-field-46" class="ninja-forms-field btn_proc nf-element " type="submit" value="Enviar">
</div>
<div class="nf-error-wrap"></div>
</div>
</div>
<div class="nf-after-field"><nf-section>
<div class="nf-input-limit"></div>
<div id="nf-error-46" class="nf-error-wrap nf-error" role="alert"></div>
</nf-section></div>
</div>
</nf-field></nf-fields>
</div>
</nf-cells>
</div>
</nf-rows-wrap></div>
<div class="nf-after-form-content"><nf-section>
<div id="nf-form-errors-4" class="nf-form-errors" role="alert"><nf-errors></nf-errors></div>
<div class="nf-form-hp"><nf-section>
<label id="nf-label-field-hp-4" for="nf-field-hp-4" aria-hidden="true"> Si eres un ser humano y estás viendo este campo, por favor déjalo vacío. <input id="nf-field-hp-4" name="nf-field-hp" class="nf-element nf-field-hp" type="text"
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</nf-section></div>
</div>
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<button type="submit" value="Buscar" class="ux-search-submit submit-button secondary button icon mb-0" aria-label="Submit">
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