{"id":37299,"date":"2025-11-06T11:33:10","date_gmt":"2025-11-06T10:33:10","guid":{"rendered":"https:\/\/www.grupopoliclinica.es\/?page_id=37299"},"modified":"2026-02-11T08:26:42","modified_gmt":"2026-02-11T07:26:42","slug":"sollicitud-dacces","status":"publish","type":"page","link":"https:\/\/www.grupopoliclinica.es\/ca\/sollicitud-dacces\/","title":{"rendered":"Sol-licitud d\u00b4acc\u00e9s"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"37299\" class=\"elementor elementor-37299 elementor-37037\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-358c7c3 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"358c7c3\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-e40df37\" data-id=\"e40df37\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-be00fa1 elementor-widget-mobile__width-initial elementor-widget elementor-widget-heading\" data-id=\"be00fa1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Sol-licitud d'acc\u00e9s a la Hist\u00f3ria Cl\u00ednica<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-6f2a516 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"6f2a516\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-915c178\" data-id=\"915c178\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7aff670 elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"7aff670\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;step_type&quot;:&quot;none&quot;,&quot;step_icon_shape&quot;:&quot;none&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" id=\"solicitud\" name=\"Solicitud Acceso\" aria-label=\"Solicitud Acceso\" novalidate=\"\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"37299\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"7aff670\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Sol-licitud D\u00b4acc\u00e9s - Grupo Policl\u00ednica\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"37299\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_4da141f elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-widget-container\" style=\"margin: 0px 0px 10px;\">\n\t\t\t\t\t\t\t\t\t<strong>PACIENT <\/strong> \n<\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-dni elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-dni\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDNI\/NIE\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[dni]\" id=\"form-field-dni\" class=\"elementor-field elementor-size-md  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-nombre elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-nombre\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNom\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[nombre]\" id=\"form-field-nombre\" class=\"elementor-field elementor-size-md  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-apellido1 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-apellido1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCognom 1\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[apellido1]\" id=\"form-field-apellido1\" class=\"elementor-field elementor-size-md  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-apellido2 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-apellido2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCognom 2\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[apellido2]\" id=\"form-field-apellido2\" class=\"elementor-field elementor-size-md  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCorreu electr\u00f2nic\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-md  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-telf elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-telf\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tTel\u00e8fon M\u00f2bil\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[telf]\" id=\"form-field-telf\" class=\"elementor-field elementor-size-md  elementor-field-textual\" required=\"required\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_5e049b6 elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-widget-container\" style=\"margin: 50px 0px 10px;\">\n\t\t\t\t\t\t\t\t\t<strong>REPRESENTANT <\/strong>(nom\u00e9s en cas de representaci\u00f3, incapacitat o menors de 14 anys no emancipats):\t\t\t\t\t\t\t\t<\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-representante elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Progenitor\" id=\"form-field-representante-0\" name=\"form_fields[representante]\"> <label for=\"form-field-representante-0\">Progenitor<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Tutor legal\" id=\"form-field-representante-1\" name=\"form_fields[representante]\"> <label for=\"form-field-representante-1\">Tutor legal<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Representant\" id=\"form-field-representante-2\" name=\"form_fields[representante]\"> <label for=\"form-field-representante-2\">Representant<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-dni_representante elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-dni_representante\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDNI\/NIE\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[dni_representante]\" id=\"form-field-dni_representante\" class=\"elementor-field elementor-size-md  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-nombre_representante elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-nombre_representante\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNom\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[nombre_representante]\" id=\"form-field-nombre_representante\" class=\"elementor-field elementor-size-md  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-apellido1_representante elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-apellido1_representante\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCognom 1\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[apellido1_representante]\" id=\"form-field-apellido1_representante\" class=\"elementor-field elementor-size-md  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-apellido2_representante elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-apellido2_representante\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCognom 2\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[apellido2_representante]\" id=\"form-field-apellido2_representante\" class=\"elementor-field elementor-size-md  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email_representante elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email_representante\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCorreu electr\u00f2nic\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email_representante]\" id=\"form-field-email_representante\" class=\"elementor-field elementor-size-md  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-telf_representante elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-telf_representante\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tTel\u00e8fon M\u00f2bil\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[telf_representante]\" id=\"form-field-telf_representante\" class=\"elementor-field elementor-size-md  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_ccfd1b3 elementor-col-100\">\n\t\t\t\t\t<p>El representant legal manifesta sota la seva responsabilitat que, a la data d'aquesta sol\u00b7licitud, no hi ha cap circumst\u00e0ncia que pugui afectar la validesa de la documentaci\u00f3 acreditativa presentada referent a la representaci\u00f3 legal de l'interessat. <\/p>\n<p>Igualment, en cas que l'exercici de dret l'hagi efectuat un dels progenitors del menor, aquest manifesta estar actuant a l'exercici ordinari de la p\u00e0tria potestat sempre amb el coneixement i el consentiment de l'altre progenitor en virtut del que preveu l'article 156 del Codi civil.<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_bac8d92 elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-widget-container\" style=\"margin: 30px 0px 10px;\">\n\t\t\t\t\t\t\t<strong>CANAL PREFERENT DE NOTIFICACIO <\/strong>\t\t\t\t\t\t\t\t<\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-notificacion elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-notificacion\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNotificacio a:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Pacient           \" id=\"form-field-notificacion-0\" name=\"form_fields[notificacion]\" required=\"required\"> <label for=\"form-field-notificacion-0\">Pacient           <\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Persona o entitat representant\" id=\"form-field-notificacion-1\" name=\"form_fields[notificacion]\" required=\"required\"> <label for=\"form-field-notificacion-1\">Persona o entitat representant<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-medio_notificacion elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-medio_notificacion\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMitj\u00e0 de notificaci\u00f3:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Q-Report \u2013 Proves radiol\u00f2giques i informe de proves. (Termini de lliurament 5-7 dies)\" id=\"form-field-medio_notificacion-0\" name=\"form_fields[medio_notificacion]\" required=\"required\"> <label for=\"form-field-medio_notificacion-0\">Q-Report \u2013 Proves radiol\u00f2giques i informe de proves. (Termini de lliurament 5-7 dies)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Correu electr\u00f2nic \u2013 Sol\u00b7licitud informes sense imatges. (Termini de lliurament 5-7 dies)\" id=\"form-field-medio_notificacion-1\" name=\"form_fields[medio_notificacion]\" required=\"required\"> <label for=\"form-field-medio_notificacion-1\">Correu electr\u00f2nic \u2013 Sol\u00b7licitud informes sense imatges. (Termini de lliurament 5-7 dies)<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Recollida a Policl\u00ednica Ntra Sra del Rosario Via Romana (Eivissa) \u2013 Sol\u00b7licituds d&#039;Hist\u00f2ria Cl\u00ednica f\u00edsica (Termini de lliurament 10 dies)\" id=\"form-field-medio_notificacion-2\" name=\"form_fields[medio_notificacion]\" required=\"required\"> <label for=\"form-field-medio_notificacion-2\">Recollida a Policl\u00ednica Ntra Sra del Rosario Via Romana (Eivissa) \u2013 Sol\u00b7licituds d'Hist\u00f2ria Cl\u00ednica f\u00edsica (Termini de lliurament 10 dies)<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_1a8c104 elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-widget-container\" style=\"margin: 50px 0px 10px;\">\n\t\t\t\t\t\t\t\t\t<strong>EXPOSO<\/strong><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_e77831a elementor-col-100\">\n\t\t\t\t\t<p>Que vull exercir el dret d'acc\u00e9s a determinades dades, en virtut de l'article 15 del Reglament (UE) 2016\/679 del Parlament Europeu i del Consell de 27 d'abril de 2016, de l'article 13 de la Llei org\u00e0nica 3\/2018, de 5 desembre, de protecci\u00f3 de dades personals i garantia dels drets digitals 14 de novembre, b\u00e0sica reguladora de l'autonomia del pacient i de drets i obligacions en mat\u00e8ria d'informaci\u00f3 i de documentaci\u00f3 cl\u00ednica.<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_853d754 elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-widget-container\" style=\"margin: 30px 0px 10px;\">\n\t\t\t\t\t\t\t\t\t<strong>SOL\u00b7LICIT<\/strong><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_5d6aa07 elementor-col-100\">\n\t\t\t\t\t<p>Que em faciliteu la informaci\u00f3 relacionada amb el tractament de les dades personals sobre les quals exerceixo el dret d'acc\u00e9s en el termini d'un mes, comptant des de la data del registre d'aquesta sol\u00b7licitud.<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-solicitud elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-solicitud\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDades de la hist\u00f2ria cl\u00ednica del sol\u00b7licitant per les quals se sol\u00b7licita acc\u00e9s:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Hist\u00f2ria cl\u00ednica completa\" id=\"form-field-solicitud-0\" name=\"form_fields[solicitud]\" required=\"required\"> <label for=\"form-field-solicitud-0\">Hist\u00f2ria cl\u00ednica completa<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Informes m\u00e8dics realitzats\" id=\"form-field-solicitud-1\" name=\"form_fields[solicitud]\" required=\"required\"> <label for=\"form-field-solicitud-1\">Informes m\u00e8dics realitzats<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Proves radiol\u00f2giques\" id=\"form-field-solicitud-2\" name=\"form_fields[solicitud]\" required=\"required\"> <label for=\"form-field-solicitud-2\">Proves radiol\u00f2giques<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Resultats de laboratori \" id=\"form-field-solicitud-3\" name=\"form_fields[solicitud]\" required=\"required\"> <label for=\"form-field-solicitud-3\">Resultats de laboratori <\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Altres\" id=\"form-field-solicitud-4\" name=\"form_fields[solicitud]\" required=\"required\"> <label for=\"form-field-solicitud-4\">Altres<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_e4c3781 elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-widget-container\" style=\"margin: 10px 0px 0px;\">Per\u00edode<\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-fecha_inicio elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-fecha_inicio\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDes de:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[fecha_inicio]\" id=\"form-field-fecha_inicio\" class=\"elementor-field elementor-size-md  elementor-field-textual elementor-date-field\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-fecha_fin elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-fecha_fin\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tFins:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[fecha_fin]\" id=\"form-field-fecha_fin\" class=\"elementor-field elementor-size-md  elementor-field-textual elementor-date-field\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-documentacion elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-documentacion\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEspecifiqueu la documentaci\u00f3 sol\u00b7licitada \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-md\" name=\"form_fields[documentacion]\" id=\"form-field-documentacion\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_e7d6406 elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-widget-container\" style=\"margin: 50px 0px 10px;\">\n\t\t\t\t\t\t\t\t\t<strong>DOCUMENTACI\u00d3 QUE S'ADJUNTA<\/strong><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-archivo elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[archivo][]\" id=\"form-field-archivo\" class=\"elementor-field elementor-size-md  elementor-upload-field\" required=\"required\" multiple=\"multiple\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_6ebc055 elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-widget-container\" style=\"margin: 30px 0px 10px;\">\n\t\t\t\t\t\t\t\t\t<strong>INSTRUCCIONES<\/strong><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_43dd3a5 elementor-col-100\">\n\t\t\t\t\t<p>Escriviu preferentment en maj\u00fascules.<\/p>\n<ol>\n \t<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">En cas que la sol\u00b7licitud sigui formalitzada per un representant, s'han de consignar totes les dades del pacient a l'apartat corresponent (\u201cPacient\u201d)..<\/span>\n<ol>\n \t<li style=\"font-weight: 400;\" aria-level=\"2\"><b>Progenitor:<\/b><span style=\"font-weight: 400;\"> persona f\u00edsica que exerceix la p\u00e0tria potestat. Si la sol\u00b7licitud es presenta mitjan\u00e7ant un progenitor, caldr\u00e0 acreditar aquesta condici\u00f3 mitjan\u00e7ant la presentaci\u00f3 del document corresponent. De conformitat amb l'article 156 del Codi civil, respecte de tercers de bona fe, es presumeix que cada un dels progenitors actua a l'exercici ordinari de la p\u00e0tria potestat amb el consentiment de l'altre.<\/span>\n\t\t<br><span style=\"font-weight: 400; font-size: 14px; color: #3156A3;\">*S'ha d'adjuntar una c\u00f2pia de les dues cares del document d'identitat nacional dels pares del pacient, aix\u00ed com la documentaci\u00f3 que demostri aquesta opci\u00f3. Tota la documentaci\u00f3 personal presentada ha de ser v\u00e0lida.<\/span>\n\t<\/li>\n \t<li style=\"font-weight: 400;\" aria-level=\"2\"><b>Tutor legall: <\/b><span style=\"font-weight: 400;\">persona f\u00edsica que exerceix la tutela sobre un menor o una persona incapacitada. Si la sol\u00b7licitud es presenta mitjan\u00e7ant un tutor legal, caldr\u00e0 acreditar aquesta condici\u00f3 i aportar-se el document que ho justifiqui.<\/span>\n\t\t<br><span style=\"font-weight: 400; font-size: 14px; color: #3156A3;\">*S'ha d'adjuntar una c\u00f2pia de les dues cares del document d'identitat nacional dels pares del pacient, aix\u00ed com la documentaci\u00f3 que demostri aquesta opci\u00f3. Tota la documentaci\u00f3 personal presentada ha de ser v\u00e0lida.<\/span>\n\t<\/li>\n \t<li style=\"font-weight: 400;\" aria-level=\"2\"><b>Representant:<\/b><span style=\"font-weight: 400;\"> Qui actu\u00ef com a representant ha d'acreditar la qualitat en qu\u00e8 actua amb qualsevol mitj\u00e0 v\u00e0lid en dret que deixi const\u00e0ncia fidedigna de tal circumst\u00e0ncia.\u00a0<\/span>\n\t\t<br><span style=\"font-weight: 400; font-size: 14px; color: #3156A3;\">*S'ha d'adjuntar una c\u00f2pia de les dues cares del document d'identitat nacional dels pares del pacient, aix\u00ed com la documentaci\u00f3 que demostri aquesta opci\u00f3. Tota la documentaci\u00f3 personal presentada ha de ser v\u00e0lida.<\/span>\n\t<\/li>\n<\/ol>\n<br>\n<\/li>\n \t<li><span style=\"font-weight: 400;\">S'aportar\u00e0 c\u00f2pia del DNI del pacient i, en cas de representant, c\u00f2pia del DNI del progenitor, tutor legal o representant. Tota la documentaci\u00f3 personal que s'aporti s'haur\u00e0 de trobar en vigor.<\/span><\/li>\n<\/ol>\n\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-field_126d99d elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[field_126d99d]\" id=\"form-field-field_126d99d\" class=\"elementor-field elementor-size-md  elementor-acceptance-field\" required=\"required\">\n\t\t\t\t<label for=\"form-field-field_126d99d\">He le\u00eddo y acepto la <a href=\"\/politica-de-privacidad\/\">Pol\u00edtica de Privacidad<\/a><\/label>\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-md\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Enviar<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-43e62f5 elementor-widget elementor-widget-text-editor\" data-id=\"43e62f5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>POLICL\u00cdNICA NTRA. SRA. DEL ROSARIO, S.L.U. es el Responsable del tratamiento de los datos personales del usuario y le informa de que estos datos se tratar\u00e1n de conformidad con lo dispuesto en el Reglamento (UE) 2016\/679, de 27 de abril (GDPR), y la Ley Org\u00e1nica 3\/2018, de 5 de diciembre (LOPDGDD), por lo que se le facilita la siguiente informaci\u00f3n del tratamiento:<br \/><span style=\"text-decoration: underline;\">Fines y legitimaci\u00f3n del tratamiento:<\/span> mantener una relaci\u00f3n comercial (por inter\u00e9s leg\u00edtimo del responsable, art. 6.1.f GDPR) y el env\u00edo de comunicaciones de productos o servicios (por consentimiento del interesado, art. 6.1.a GDPR).<br \/><span style=\"text-decoration: underline;\">Criterios de conservaci\u00f3n de los datos:<\/span> se conservar\u00e1n durante no m\u00e1s tiempo del necesario para mantener el fin del tratamiento o mientras existan prescripciones legales que dictaminen su custodia y cuando ya no sea necesario para ello, se suprimir\u00e1n con medidas de seguridad adecuadas para garantizar la anonimizaci\u00f3n de los datos o la destrucci\u00f3n total de los mismos.<br \/><span style=\"text-decoration: underline;\">Comunicaci\u00f3n de los datos:<\/span> no se comunicar\u00e1n los datos a terceros, salvo obligaci\u00f3n legal. Derechos que asisten al usuario: derecho a retirar el consentimiento en cualquier momento. Derecho de acceso, rectificaci\u00f3n, portabilidad y supresi\u00f3n de sus datos, y de limitaci\u00f3n u oposici\u00f3n a su tratamiento. Derecho a presentar una reclamaci\u00f3n ante la Autoridad de control (www.aepd.es) si considera que el tratamiento no se ajusta a la normativa vigente.<br \/><span style=\"text-decoration: underline;\">Datos de contacto para ejercer sus derechos:<\/span> <a href=\"mailto:lopd@www.grupopoliclinica.es\">lopd@www.grupopoliclinica.es<\/a>.<span style=\"text-decoration: underline;\">Datos de contacto del delegado de protecci\u00f3n de datos:<\/span> <a href=\"mailto:dpd@grupopoliclinica.es\">dpd@grupopoliclinica.es<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Sol-licitud d&#8217;acc\u00e9s a la Hist\u00f3ria Cl\u00ednica POLICL\u00cdNICA NTRA. SRA. DEL ROSARIO, S.L.U. es el Responsable del tratamiento de los datos personales del usuario y le informa de que estos datos se tratar\u00e1n de conformidad con lo dispuesto en el Reglamento (UE) 2016\/679, de 27 de abril (GDPR), y la Ley Org\u00e1nica 3\/2018, de 5 de [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"site-sidebar-layout":"no-sidebar","site-content-layout":"page-builder","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-37299","page","type-page","status-publish","hentry"],"acf":[],"featured_image_urls":{},"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/www.grupopoliclinica.es\/ca\/wp-json\/wp\/v2\/pages\/37299","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.grupopoliclinica.es\/ca\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.grupopoliclinica.es\/ca\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.grupopoliclinica.es\/ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.grupopoliclinica.es\/ca\/wp-json\/wp\/v2\/comments?post=37299"}],"version-history":[{"count":3,"href":"https:\/\/www.grupopoliclinica.es\/ca\/wp-json\/wp\/v2\/pages\/37299\/revisions"}],"predecessor-version":[{"id":38298,"href":"https:\/\/www.grupopoliclinica.es\/ca\/wp-json\/wp\/v2\/pages\/37299\/revisions\/38298"}],"wp:attachment":[{"href":"https:\/\/www.grupopoliclinica.es\/ca\/wp-json\/wp\/v2\/media?parent=37299"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}