CINXE.COM

<!DOCTYPE HTML> <html> <head> <meta name="googlebot" content="noindex, noarchive, nofollow, nosnippet"> <meta name="robots" content="noindex, noarchive, nofollow"> <meta name="slurp" content="noindex, noarchive, nofollow, noodp, noydir"> <meta name="msnbot" content="noindex, noarchive, nofollow, noodp"> <meta http-equiv="Content-Type" content="text/html; charset=UTF-8" /> <meta http-equiv="Cache-Control" content="no-cache"> <meta http-equiv="Pragma" content="no-cache"> <meta http-equiv="expires" content="0"> <meta charset="utf-8"> <meta http-equiv="X-UA-Compatible" content="IE=edge"> <meta name="viewport" content="width=device-width, initial-scale=1"> <title>FORMULARIO DE QUEJAS, SUGERENCIAS, FELICITACIONES Y SOLICITUDES DE INFORMACI脫N (FS_FOR196)</title> <link rel="shortcut icon" href="/redcap/redcap_v13.8.5/Resources/images/favicon.ico"> <link rel="apple-touch-icon-precomposed" href="/redcap/redcap_v13.8.5/Resources/images/apple-touch-icon.png"> <link rel="stylesheet" type="text/css" media="screen,print" href="/redcap/redcap_v13.8.5/Resources/webpack/css/bundle.css?1691400385"/> <link rel="stylesheet" type="text/css" media="screen,print" href="/redcap/redcap_v13.8.5/Resources/webpack/css/bootstrap.min.css?1691400385"/> <link rel="stylesheet" type="text/css" media="screen,print" href="/redcap/redcap_v13.8.5/Resources/webpack/css/datatables/jquery.dataTables.min.css?1691400385"/> <link rel="stylesheet" type="text/css" media="screen,print" href="/redcap/redcap_v13.8.5/Resources/webpack/css/fontawesome/css/all.min.css?1691400385"/> <link rel="stylesheet" type="text/css" media="screen,print" href="/redcap/redcap_v13.8.5/Resources/css/messenger.css?1691400385"/> <link rel="stylesheet" type="text/css" media="screen,print" href="/redcap/redcap_v13.8.5/Resources/css/style.css?1691400385"/> <link rel="stylesheet" type="text/css" media="screen,print" href="/redcap/redcap_v13.8.5/Resources/css/survey.css?1691400385"/> <link rel="stylesheet" type="text/css" media="screen,print" href="/redcap/redcap_v13.8.5/Resources/css/survey_text_large.css?1691400385"/> <script type="text/javascript" src="/redcap/redcap_v13.8.5/Resources/webpack/js/bundle.js?1691400385"></script> <script type="text/javascript" src="/redcap/redcap_v13.8.5/Resources/webpack/js/popper.min.js?1691400385"></script> <script type="text/javascript" src="/redcap/redcap_v13.8.5/Resources/webpack/js/bootstrap.min.js?1691400385"></script> <script type="text/javascript" src="/redcap/redcap_v13.8.5/Resources/js/Libraries/bundle.js?1691400385"></script> <script type="text/javascript" src="/redcap/redcap_v13.8.5/Resources/js/base.js?1691400385"></script> <script type="text/javascript" src="/redcap/redcap_v13.8.5/Resources/js/Libraries/moment.min.js?1691400385"></script> <script type="text/javascript" src="/redcap/redcap_v13.8.5/Resources/js/Libraries/Chart.bundle.min.js?1691400385"></script> <script type="text/javascript" src="/redcap/redcap_v13.8.5/Resources/js/Libraries/patternomaly.min.js?1691400385"></script> <script type="text/javascript" src="/redcap/redcap_v13.8.5/Resources/js/Libraries/Chart.PluginLabels.js?1691400385"></script> <script type="text/javascript" src="/redcap/redcap_v13.8.5/Resources/js/Survey.js?1691400385"></script> <script type="text/javascript" src="/redcap/redcap_v13.8.5/Resources/js/FontSize.js?1691400385"></script> </head> <body> <style type="text/css"> body * { font-family: 'Open Sans',Helvetica,Arial,sans-serif !important; } </style> <style type="text/css"> body { background-image: none; background-color: #0d4c84; } #footer, #footer a { color: #FFFFFF !important; } button, .btn-fileupload {color: #0C74A9 !important; } .btn-fileupload {background-color: #e6e6e6 !important; border-color: #999 !important; } .btn-fileupload:hover {background-color: #ededed !important; border-color: #ccc !important; } #econsent_confirm_instr2, #questiontable td, .floatMtxHdr td { color: #010101; } .matrix_first_col_hdr { color: #010101 !important; } div.enhancedchoice label { color: #010101 !important; border-color: #010101 !important; } div.enhancedchoice label.selectedradio, div.enhancedchoice label.selectedchkbox, div.enhancedchoice label.hover:hover { background-color: #010101; } #return_instructions, #econsent_confirm_instr2, #questiontable>tbody>tr>td, #questiontable td.labelmatrix>table>tbody>tr>td, .floatMtxHdr, .floatMtxHdr td { background-image: none; background-color: #ffffff; } div.enhancedchoice label { background-color: #ffffff; } div.enhancedchoice label.selectedradio, div.enhancedchoice label.selectedchkbox, div.enhancedchoice label.hover:hover { !important; border-color: #ffffff !important; } div.enhancedchoice label.selectedradio, div.enhancedchoice label.selectedradio a, div.enhancedchoice label.selectedchkbox, div.enhancedchoice label.selectedchkbox a, div.enhancedchoice label.hover:hover, div.enhancedchoice label.hover:hover a { color: #ffffff !important; } #econsent_confirm_checkbox_div, .header { color: #FFFFFF !important; } #econsent_confirm_checkbox_div, .header { background-image: none; border: none; background-color: #0b5394 !important; } #surveyinstructions-reveal a, #surveypagenum, #surveytitle, #surveyinstructions, #surveyinstructions p, #surveyinstructions div, #surveyacknowledgment, #surveyacknowledgment p, #surveyacknowledgment div { color: #000000; } #return_corner a, #return_corner span, #return_corner i, #survey_queue_corner a, #dpop .popup-contents, #dpop .popup-contents span, #dpop .popup-contents i { color: #000000 !important; } .mlm-switcher button.btn-outline-secondary { color: #000000 !important; border-color: #000000 !important; } .mlm-switcher button.btn-primary { background-color: #000000 !important; } #pagecontent, #container, #surveytitle, #surveyinstructions, #surveyinstructions p, #surveyinstructions div, #surveyacknowledgment, #surveyacknowledgment p, #surveyacknowledgment div { background-image: none; background-color: #FFFFFF; } #changeFont { color: #000000 !important; } .mlm-switcher button.btn-primary { color: #FFFFFF !important; border-color: #FFFFFF !important; } </style> <script type="text/javascript"> if(typeof lang=='undefined'){var lang={}}; lang.docs_1136='ERROR: The file cannot be uploaded because its file type is not permitted.'; lang.alerts_24='Alerta'; lang.calendar_popup_01='Cerrar'; lang.calendar_widget_choosetime='Seleccionar la hora'; lang.calendar_widget_done='Listo'; lang.calendar_widget_hour='Hora'; lang.calendar_widget_min='Minuto'; lang.calendar_widget_month_jan='Ene'; lang.calendar_widget_month_feb='Feb'; lang.calendar_widget_month_mar='Mar'; lang.calendar_widget_month_apr='Abr'; lang.calendar_widget_month_may='May'; lang.calendar_widget_month_jun='Jun'; lang.calendar_widget_month_jul='Jul'; lang.calendar_widget_month_aug='Ago'; lang.calendar_widget_month_sep='Sep'; lang.calendar_widget_month_oct='Oct'; lang.calendar_widget_month_nov='Nov'; lang.calendar_widget_month_dec='Dic'; lang.calendar_widget_month_day_long_sun='Domingo'; lang.calendar_widget_month_day_long_mon='Lunes'; lang.calendar_widget_month_day_long_tues='Martes'; lang.calendar_widget_month_day_long_wed='Mi茅rcoles'; lang.calendar_widget_month_day_long_thurs='Jueves'; lang.calendar_widget_month_day_long_fri='Viernes'; lang.calendar_widget_month_day_long_sat='S谩bado'; lang.calendar_widget_month_day_short_sun='Do'; lang.calendar_widget_month_day_short_mon='Lu'; lang.calendar_widget_month_day_short_tues='Ma'; lang.calendar_widget_month_day_short_wed='Mi'; lang.calendar_widget_month_day_short_thurs='Ju'; lang.calendar_widget_month_day_short_fri='Vi'; lang.calendar_widget_month_day_short_sat='Sa'; lang.calendar_widget_next='Siguiente'; lang.calendar_widget_prev='Anterior'; lang.dash_72='Habilitar la accesibilidad para personas dalt贸nicas'; lang.dash_73='Deshabilitar la accesibilidad para personas dalt贸nicas'; lang.dashboard_32='Hoy'; lang.design_401='OK'; lang.design_718='V谩lido'; lang.design_839='Funciones especiales'; lang.edit_project_186='Aprenda como usar'; lang.form_renderer_29='Ahora'; lang.global_13='Tiempo'; lang.global_53='Cancelar'; lang.global_146='Variables inteligentes'; lang.global_147='Advertencia de desconexi贸n autom谩tica de REDCap'; lang.global_148='Iniciar sesi贸n'; lang.global_149='Continuar en esta p谩gina'; lang.global_150='Su sesi贸n en REDCap terminar谩 autom谩ticamente en <b>2 MINUTOS</b> debido a inactividad. D茅 clic en el bot贸n abajo para prevenir la desconexi贸n autom谩tica.'; lang.global_151='Su sesi贸n en REDCap terminar谩 autom谩ticamente en <b>30 SEGUNDOS</b> debido a inactividad. D茅 clic en el bot贸n abajo para prevenir la desconexi贸n autom谩tica.'; lang.global_152='<b>Debido a inactividad, su sesi贸n REDCap expir贸.</b> D茅 clic en el bot贸n abajo para iniciar la sesi贸n.'; lang.global_167='Modo vista regular'; lang.global_168='Modo pantalla completa'; lang.global_169='Actualizar y cerrar el editor'; lang.global_170='Editor de l贸gica'; lang.global_171='Error en la sintaxis'; lang.global_172='(La determinaci贸n de la validez podr铆a no ser 100% certera en todos los contextos)'; lang.global_173='Ingrese la nueva l贸gica aqu铆. Use \'and\' para combinar dos variables.'; lang.design_482='Libro de c贸digos'; lang.design_962='or open the'; lang.global_132='Banderas (etiquetas) de acci贸n'; lang.global_208='Use el cuadro de texto a continuaci贸n para componer su l贸gica, c谩lculo, etiquetas de acci贸n, etc. Si necesita m谩s espacio, haga clic en el bot贸n Modo de pantalla completa para ampliar el cuadro de texto. Cuando haya terminado, haga clic en el bot贸n \'Actualizar\' para minimizar la ventana del Editor.'; lang.messaging_118='(d茅 clic para ir al instrumento)'; lang.messaging_119='(instrumento actual)'; lang.messaging_177='AVISO: parece que tiene varias ventanas/cejas del navegador abiertas, lo que puede hacer que algunos aspectos de esta p谩gina no funcionen hasta que la p谩gina se refresque. Se aconseja que termine lo que est茅 haciendo y a continuaci贸n refresque la p谩gina.'; lang.docs_83='Drag and drop files here to upload'; lang.global_272='Upload a file'; lang.docs_81='Upload Error!'; lang.sendit_03='El archivo no pudo ser cargado porque es muy grande'; lang.sendit_04='El archivo debe ser m谩s peque帽o que'; lang.sendit_05=' para cargar'; lang.period='.'; lang.global_266='TIP: Your logic and calculations may contain <b>comments</b>, which are not evaluated but only serve as annotations to help document or explain what the calc/logic is doing. Comments must be on their own lines and start with // (double forward slash) or # (hash sign), optionally preceded by whitespace characters (spaces, tabs). You may not append a comment to a line that is part of the logic or calc expression.'; lang.global_267='View example'; lang.global_272='Upload a file'; lang.global_273='Drop a file or click here<br>to upload an attachment'; lang.global_274='NOTE: Any files uploaded here using the rich text editor will be given a <b>publicly accessible download link</b> that will be placed into the text, in which anyone in possession of that link (including people not logged into REDCap) will be able to download the file at any time. Files containing <b>confidential or sensitive information (e.g., PHI or PII) should *not* be uploaded here</b>. Additionally, all files uploaded here can be later accessed and/or deleted in the File Repository\'s "Miscellaneous File Attachments" folder, whose contents does not count against the total amount of file storage used in the project. '; lang.global_275='Auto-fill form'; lang.docs_81='Upload Error!'; lang.docs_82='File did not upload:'; lang.data_entry_63='Tama帽o m谩ximo del archivo:'; </script> <div id="rc-ace-editor-example" style="display:none;" class="simpleDialog"> <div class="mb-2"><span data-rc-lang="global_271">The code block below illustrates how one might use # and // as comments in your logic and calculations.</span></div> <pre># Text can be put here to explain what the logic/calculation does and why. if ([field1] = '1' and [field2] > 7, // This comment can explain what the next line does. [score] * [factor], // Return '0' if the condition is False. 0 )</pre> </div> <script type="text/javascript"> if(typeof lang=='undefined'){var lang={}}; lang.design_1051='WARNING: The field'; lang.design_1052='is utilized in more than one event and/or is utilized on a repeating instrument or repeating event. Any update to this field on any event or repeating instance will change the value of this field in ALL events and repeating instances.'; </script> <script type="text/javascript"> // Admin privileges var super_user = 0; var super_user_not_impersonator = 0; var admin_rights = '0'; var account_manager = '0'; var access_system_config = '0'; var access_system_upgrade = '0'; var access_external_module_install = '0'; var access_admin_dashboards = '0'; // Project values var missing_data_codes = [""]; var missing_data_codes_check = false; var app_name = 'formulario_sugerencias_quejas_y_felicitaciones'; var pid = 187; var status = 1; var draft_mode = 0; var file_repository_enabled = 1; var table_pk = 'record_id'; var table_pk_label = 'Record ID'; var longitudinal = 0; var auto_inc_set = 1; var project_dashboard_allow_public = 1; var file_upload_vault_enabled = 0; var file_upload_versioning_enabled = 1; var sendgrid_enabled = 0; var data_resolution_enabled = 1; var lock_record = 2; var shared_lib_browse_url = 'https://redcap.vanderbilt.edu/consortium/library/login.php?callback=https%3A%2F%2Fatenea.fisabio.san.gva.es%2Fredcap%2Fredcap_v13.8.5%2FSharedLibrary%2Freceiver.php%3Fpid%3D187&institution=FISABIO&user=081668199de8604e5031fca9519b9d98'; var redcap_colorblind = 0; $(function(){ $('.redcap-chart-colorblind-toggle').removeClass('invisible').find('a').html(window.lang.dash_72).click(function(){ toggleChartColorBlind(); } ); }); // System values var redcap_version = '13.8.5'; var server_name = 'atenea.fisabio.san.gva.es'; var app_path_webroot = '/redcap/redcap_v13.8.5/'; var app_path_webroot_full = 'https://atenea.fisabio.san.gva.es/redcap/'; var app_path_survey_full = 'https://atenea.fisabio.san.gva.es/redcap/surveys/'; var app_path_images = '/redcap/redcap_v13.8.5/Resources/images/'; var page = 'surveys/index.php'; var secondary_pk = ''; var sendit_enabled = 1; var surveys_enabled = 1; var mycap_enabled = 0; var reports_allow_public = '1'; var rich_text_image_embed_enabled = 1; var rich_text_attachment_embed_enabled = 1; var now = '2025-02-17 08:39:46'; var now_mdy = '02-17-2025 08:39:48'; var now_dmy = '17-02-2025 08:39:48'; var today = '2025-02-17'; var today_mdy = '02-17-2025'; var today_dmy = '17-02-2025'; var email_domain_allowlist = new Array(); var user_date_format_jquery = 'dd-mm-yy'; var user_date_format_validation = 'dmy'; var user_date_format_delimiter = '-'; var csv_delimiter = ','; var ALLOWED_TAGS = '<strike><style><code><video><audio><source><caption><canvas><ol><ul><li><label><pre><p><a><br><center><font><b><i><u><h6><h5><h4><h3><h2><h1><hr><table><tbody><tr><th><td><thead><tfoot><img><span><div><em><strong><acronym><sub><sup><map><area>'; var AUTOMATE_ALL = '0'; var restricted_upload_file_types = []; var cookie_samesite = ''; var cookie_secure = true; var datatables_disable = []; var fakeObjectTag = 'objectn001mhnkdnfwwuv1czr5rtevukdsempyanvxwjyzvvnlyws9'; var maxUploadSizeAttachment = 33554432; // bytes function setDatePickerDefaults() { $.datepicker.setDefaults({ closeText: window.lang.calendar_widget_done, prevText: window.lang.calendar_widget_prev, nextText: window.lang.calendar_widget_next, currentText: window.lang.dashboard_32, monthNamesShort:[ window.lang.calendar_widget_month_jan, window.lang.calendar_widget_month_feb, window.lang.calendar_widget_month_mar, window.lang.calendar_widget_month_apr, window.lang.calendar_widget_month_may, window.lang.calendar_widget_month_jun, window.lang.calendar_widget_month_jul, window.lang.calendar_widget_month_aug, window.lang.calendar_widget_month_sep, window.lang.calendar_widget_month_oct, window.lang.calendar_widget_month_nov, window.lang.calendar_widget_month_dec, ], dayNames:[ window.lang.calendar_widget_month_day_long_sun, window.lang.calendar_widget_month_day_long_mon, window.lang.calendar_widget_month_day_long_tues, window.lang.calendar_widget_month_day_long_wed, window.lang.calendar_widget_month_day_long_thurs, window.lang.calendar_widget_month_day_long_fri, window.lang.calendar_widget_month_day_long_sat, ], dayNamesMin:[ window.lang.calendar_widget_month_day_short_sun, window.lang.calendar_widget_month_day_short_mon, window.lang.calendar_widget_month_day_short_tues, window.lang.calendar_widget_month_day_short_wed, window.lang.calendar_widget_month_day_short_thurs, window.lang.calendar_widget_month_day_short_fri, window.lang.calendar_widget_month_day_short_sat, ] }); } $(function(){ setDatePickerDefaults(); }); </script> <div id="working"> <img data-rc-lang-attrs="alt=design_08" alt="Trabajando..." src="/redcap/redcap_v13.8.5/Resources/images/progress_circle.gif"/>  <span data-rc-lang="design_08">Trabajando...</span> </div> <div id="fade"></div>  <div id="slider-0means" class="hidden"><span data-rc-lang="survey_1142">0% significa</span></div> <div id="slider-50means" class="hidden"><span data-rc-lang="survey_1143">50% significa</span></div> <div id="slider-100means" class="hidden"><span data-rc-lang="survey_1144">100% significa</span></div>  <div id="valtext_divs"> <div id="valtext_number"><span data-rc-lang="config_functions_52">El valor proporcionado no es un n煤mero. Por favor, int茅ntelo de nuevo.</span></div> <div id="valtext_integer"><span data-rc-lang="config_functions_53">El valor proporcionado no es un n煤mero entero. Por favor, int茅ntelo de nuevo.</span></div> <div id="valtext_vmrn"><span data-rc-lang="config_functions_54">El valor introducido no es un n煤mero de registro medico v谩lido de Vanderbilt. Int茅ntelo de nuevo.</span></div> <div id="valtext_rangehard"><span data-rc-lang="config_functions_56">El valor que proporcione debe estar dentro del intervalo sugerido.</span></div> <div id="valtext_rangesoft1"><span data-rc-lang="config_functions_57">El valor que proporciona est谩 fuera del intervalo sugerido.</span></div> <div id="valtext_rangesoft2"><span data-rc-lang="config_functions_58">Este valor es admisible, pero es posible que desee comprobar.</span></div> <div id="valtext_time"><span data-rc-lang="config_functions_59">El valor introducido debe ser un valor de tiempo en el siguiente formato HH:MM dentro del intervalo 00:00-23:59 (por ej. 04:32 o 23:19).</span></div> <div id="valtext_zipcode"><span data-rc-lang="config_functions_60">Este campo debe contener los 5 o 9 d铆gitos del c贸digo postal de EE.UU. (como 94043). Vuelva a introducirlo ahora</span></div> <div id="valtext_phone"><span data-rc-lang="config_functions_61">Este campo debe contener los 10 d铆gitos del n煤mero de tel茅fono de EE.UU. (como 415 555 1212). Vuelva a introducirlo ahora</span></div> <div id="valtext_email"><span data-rc-lang="config_functions_62">Este campo debe ser una direcci贸n v谩lida de correo electr贸nico (como alvaro@usuario.com). Por favor, vuelva a introducirlo ahora.</span></div> <div id="valtext_regex"><span data-rc-lang="config_functions_77">El valor proporcionado no se pudo validar debido a que no sigue el formato esperado. Por favor, int茅ntelo de nuevo.</span></div> <div id="valtext_requiredformat"><span data-rc-lang="config_functions_94">Formato requerido:</span></div> </div>  <script> if (typeof window.REDCap == 'undefined') { window.REDCap = {}; } window.REDCap.validations = {}; window.REDCap.validations['postalcode_french'] = {"datatype":"postal_code","regex":"\/^((0?[1-9])|([1-8][0-9])|(9[0-8]))[0-9]{3}$\/"}; window.REDCap.validations['date_dmy'] = {"datatype":"date","regex":"\/^((29([-\\\/])02\\3(\\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1\\d|2[0-8])([-\\\/])(0[1-9]|1[012]))|((29|30)([-\\\/])(0[13-9]|1[012]))|(31([-\\\/])(0[13578]|1[02])))(\\11|\\15|\\18)\\d{4}))$\/"}; window.REDCap.validations['date_mdy'] = {"datatype":"date","regex":"\/^((02([-\\\/])29\\3(\\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1[012])([-\\\/])(0[1-9]|1\\d|2[0-8]))|((0[13-9]|1[012])([-\\\/])(29|30))|((0[13578]|1[02])([-\\\/])31))(\\11|\\15|\\19)\\d{4}))$\/"}; window.REDCap.validations['date_ymd'] = {"datatype":"date","regex":"\/^(((\\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\\\/])02(\\6)29)|(\\d{4}([-\\\/])((0[1-9]|1[012])(\\9)(0[1-9]|1\\d|2[0-8])|((0[13-9]|1[012])(\\9)(29|30))|((0[13578]|1[02])(\\9)31))))$\/"}; window.REDCap.validations['datetime_dmy'] = {"datatype":"datetime","regex":"\/^((29([-\\\/])02\\3(\\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1\\d|2[0-8])([-\\\/])(0[1-9]|1[012]))|((29|30)([-\\\/])(0[13-9]|1[012]))|(31([-\\\/])(0[13578]|1[02])))(\\11|\\15|\\18)\\d{4})) (\\d|[0-1]\\d|[2][0-3]):[0-5]\\d$\/"}; window.REDCap.validations['datetime_mdy'] = {"datatype":"datetime","regex":"\/^((02([-\\\/])29\\3(\\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1[012])([-\\\/])(0[1-9]|1\\d|2[0-8]))|((0[13-9]|1[012])([-\\\/])(29|30))|((0[13578]|1[02])([-\\\/])31))(\\11|\\15|\\19)\\d{4})) (\\d|[0-1]\\d|[2][0-3]):[0-5]\\d$\/"}; window.REDCap.validations['datetime_ymd'] = {"datatype":"datetime","regex":"\/^(((\\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\\\/])02(\\6)29)|(\\d{4}([-\\\/])((0[1-9]|1[012])(\\9)(0[1-9]|1\\d|2[0-8])|((0[13-9]|1[012])(\\9)(29|30))|((0[13578]|1[02])(\\9)31)))) (\\d|[0-1]\\d|[2][0-3]):[0-5]\\d$\/"}; window.REDCap.validations['datetime_seconds_dmy'] = {"datatype":"datetime_seconds","regex":"\/^((29([-\\\/])02\\3(\\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1\\d|2[0-8])([-\\\/])(0[1-9]|1[012]))|((29|30)([-\\\/])(0[13-9]|1[012]))|(31([-\\\/])(0[13578]|1[02])))(\\11|\\15|\\18)\\d{4})) (\\d|[0-1]\\d|[2][0-3])(:[0-5]\\d){2}$\/"}; window.REDCap.validations['datetime_seconds_mdy'] = {"datatype":"datetime_seconds","regex":"\/^((02([-\\\/])29\\3(\\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1[012])([-\\\/])(0[1-9]|1\\d|2[0-8]))|((0[13-9]|1[012])([-\\\/])(29|30))|((0[13578]|1[02])([-\\\/])31))(\\11|\\15|\\19)\\d{4})) (\\d|[0-1]\\d|[2][0-3])(:[0-5]\\d){2}$\/"}; window.REDCap.validations['datetime_seconds_ymd'] = {"datatype":"datetime_seconds","regex":"\/^(((\\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\\\/])02(\\6)29)|(\\d{4}([-\\\/])((0[1-9]|1[012])(\\9)(0[1-9]|1\\d|2[0-8])|((0[13-9]|1[012])(\\9)(29|30))|((0[13578]|1[02])(\\9)31)))) (\\d|[0-1]\\d|[2][0-3])(:[0-5]\\d){2}$\/"}; window.REDCap.validations['email'] = {"datatype":"email","regex":"\/^(?!\\.)((?!.*\\.{2})[a-zA-Z0-9\\u0080-\\u00FF\\u0100-\\u017F\\u0180-\\u024F\\u0250-\\u02AF\\u0300-\\u036F\\u0370-\\u03FF\\u0400-\\u04FF\\u0500-\\u052F\\u0530-\\u058F\\u0590-\\u05FF\\u0600-\\u06FF\\u0700-\\u074F\\u0750-\\u077F\\u0780-\\u07BF\\u07C0-\\u07FF\\u0900-\\u097F\\u0980-\\u09FF\\u0A00-\\u0A7F\\u0A80-\\u0AFF\\u0B00-\\u0B7F\\u0B80-\\u0BFF\\u0C00-\\u0C7F\\u0C80-\\u0CFF\\u0D00-\\u0D7F\\u0D80-\\u0DFF\\u0E00-\\u0E7F\\u0E80-\\u0EFF\\u0F00-\\u0FFF\\u1000-\\u109F\\u10A0-\\u10FF\\u1100-\\u11FF\\u1200-\\u137F\\u1380-\\u139F\\u13A0-\\u13FF\\u1400-\\u167F\\u1680-\\u169F\\u16A0-\\u16FF\\u1700-\\u171F\\u1720-\\u173F\\u1740-\\u175F\\u1760-\\u177F\\u1780-\\u17FF\\u1800-\\u18AF\\u1900-\\u194F\\u1950-\\u197F\\u1980-\\u19DF\\u19E0-\\u19FF\\u1A00-\\u1A1F\\u1B00-\\u1B7F\\u1D00-\\u1D7F\\u1D80-\\u1DBF\\u1DC0-\\u1DFF\\u1E00-\\u1EFF\\u1F00-\\u1FFF\\u20D0-\\u20FF\\u2100-\\u214F\\u2C00-\\u2C5F\\u2C60-\\u2C7F\\u2C80-\\u2CFF\\u2D00-\\u2D2F\\u2D30-\\u2D7F\\u2D80-\\u2DDF\\u2F00-\\u2FDF\\u2FF0-\\u2FFF\\u3040-\\u309F\\u30A0-\\u30FF\\u3100-\\u312F\\u3130-\\u318F\\u3190-\\u319F\\u31C0-\\u31EF\\u31F0-\\u31FF\\u3200-\\u32FF\\u3300-\\u33FF\\u3400-\\u4DBF\\u4DC0-\\u4DFF\\u4E00-\\u9FFF\\uA000-\\uA48F\\uA490-\\uA4CF\\uA700-\\uA71F\\uA800-\\uA82F\\uA840-\\uA87F\\uAC00-\\uD7AF\\uF900-\\uFAFF\\.!#$%&'*+-\/=?^_`{|}~\\-\\d]+)@(?!\\.)([a-zA-Z0-9\\u0080-\\u00FF\\u0100-\\u017F\\u0180-\\u024F\\u0250-\\u02AF\\u0300-\\u036F\\u0370-\\u03FF\\u0400-\\u04FF\\u0500-\\u052F\\u0530-\\u058F\\u0590-\\u05FF\\u0600-\\u06FF\\u0700-\\u074F\\u0750-\\u077F\\u0780-\\u07BF\\u07C0-\\u07FF\\u0900-\\u097F\\u0980-\\u09FF\\u0A00-\\u0A7F\\u0A80-\\u0AFF\\u0B00-\\u0B7F\\u0B80-\\u0BFF\\u0C00-\\u0C7F\\u0C80-\\u0CFF\\u0D00-\\u0D7F\\u0D80-\\u0DFF\\u0E00-\\u0E7F\\u0E80-\\u0EFF\\u0F00-\\u0FFF\\u1000-\\u109F\\u10A0-\\u10FF\\u1100-\\u11FF\\u1200-\\u137F\\u1380-\\u139F\\u13A0-\\u13FF\\u1400-\\u167F\\u1680-\\u169F\\u16A0-\\u16FF\\u1700-\\u171F\\u1720-\\u173F\\u1740-\\u175F\\u1760-\\u177F\\u1780-\\u17FF\\u1800-\\u18AF\\u1900-\\u194F\\u1950-\\u197F\\u1980-\\u19DF\\u19E0-\\u19FF\\u1A00-\\u1A1F\\u1B00-\\u1B7F\\u1D00-\\u1D7F\\u1D80-\\u1DBF\\u1DC0-\\u1DFF\\u1E00-\\u1EFF\\u1F00-\\u1FFF\\u20D0-\\u20FF\\u2100-\\u214F\\u2C00-\\u2C5F\\u2C60-\\u2C7F\\u2C80-\\u2CFF\\u2D00-\\u2D2F\\u2D30-\\u2D7F\\u2D80-\\u2DDF\\u2F00-\\u2FDF\\u2FF0-\\u2FFF\\u3040-\\u309F\\u30A0-\\u30FF\\u3100-\\u312F\\u3130-\\u318F\\u3190-\\u319F\\u31C0-\\u31EF\\u31F0-\\u31FF\\u3200-\\u32FF\\u3300-\\u33FF\\u3400-\\u4DBF\\u4DC0-\\u4DFF\\u4E00-\\u9FFF\\uA000-\\uA48F\\uA490-\\uA4CF\\uA700-\\uA71F\\uA800-\\uA82F\\uA840-\\uA87F\\uAC00-\\uD7AF\\uF900-\\uFAFF\\-\\.\\d]+)((\\.([a-zA-Z\\u0080-\\u00FF\\u0100-\\u017F\\u0180-\\u024F\\u0250-\\u02AF\\u0300-\\u036F\\u0370-\\u03FF\\u0400-\\u04FF\\u0500-\\u052F\\u0530-\\u058F\\u0590-\\u05FF\\u0600-\\u06FF\\u0700-\\u074F\\u0750-\\u077F\\u0780-\\u07BF\\u07C0-\\u07FF\\u0900-\\u097F\\u0980-\\u09FF\\u0A00-\\u0A7F\\u0A80-\\u0AFF\\u0B00-\\u0B7F\\u0B80-\\u0BFF\\u0C00-\\u0C7F\\u0C80-\\u0CFF\\u0D00-\\u0D7F\\u0D80-\\u0DFF\\u0E00-\\u0E7F\\u0E80-\\u0EFF\\u0F00-\\u0FFF\\u1000-\\u109F\\u10A0-\\u10FF\\u1100-\\u11FF\\u1200-\\u137F\\u1380-\\u139F\\u13A0-\\u13FF\\u1400-\\u167F\\u1680-\\u169F\\u16A0-\\u16FF\\u1700-\\u171F\\u1720-\\u173F\\u1740-\\u175F\\u1760-\\u177F\\u1780-\\u17FF\\u1800-\\u18AF\\u1900-\\u194F\\u1950-\\u197F\\u1980-\\u19DF\\u19E0-\\u19FF\\u1A00-\\u1A1F\\u1B00-\\u1B7F\\u1D00-\\u1D7F\\u1D80-\\u1DBF\\u1DC0-\\u1DFF\\u1E00-\\u1EFF\\u1F00-\\u1FFF\\u20D0-\\u20FF\\u2100-\\u214F\\u2C00-\\u2C5F\\u2C60-\\u2C7F\\u2C80-\\u2CFF\\u2D00-\\u2D2F\\u2D30-\\u2D7F\\u2D80-\\u2DDF\\u2F00-\\u2FDF\\u2FF0-\\u2FFF\\u3040-\\u309F\\u30A0-\\u30FF\\u3100-\\u312F\\u3130-\\u318F\\u3190-\\u319F\\u31C0-\\u31EF\\u31F0-\\u31FF\\u3200-\\u32FF\\u3300-\\u33FF\\u3400-\\u4DBF\\u4DC0-\\u4DFF\\u4E00-\\u9FFF\\uA000-\\uA48F\\uA490-\\uA4CF\\uA700-\\uA71F\\uA800-\\uA82F\\uA840-\\uA87F\\uAC00-\\uD7AF\\uF900-\\uFAFF]){2,63})+)$\/i"}; window.REDCap.validations['integer'] = {"datatype":"integer","regex":"\/^[-+]?\\b\\d+\\b$\/"}; window.REDCap.validations['alpha_only'] = {"datatype":"text","regex":"\/^[a-z]+$\/i"}; window.REDCap.validations['mrn_10d'] = {"datatype":"mrn","regex":"\/^\\d{10}$\/"}; window.REDCap.validations['mrn_generic'] = {"datatype":"mrn","regex":"\/^[a-z0-9-_]+$\/i"}; window.REDCap.validations['number'] = {"datatype":"number","regex":"\/^[-+]?[0-9]*\\.?[0-9]+([eE][-+]?[0-9]+)?$\/"}; window.REDCap.validations['number_1dp_comma_decimal'] = {"datatype":"number_comma_decimal","regex":"\/^-?\\d+,\\d$\/"}; window.REDCap.validations['number_1dp'] = {"datatype":"number","regex":"\/^-?\\d+\\.\\d$\/"}; window.REDCap.validations['number_2dp_comma_decimal'] = {"datatype":"number_comma_decimal","regex":"\/^-?\\d+,\\d{2}$\/"}; window.REDCap.validations['number_2dp'] = {"datatype":"number","regex":"\/^-?\\d+\\.\\d{2}$\/"}; window.REDCap.validations['number_3dp_comma_decimal'] = {"datatype":"number_comma_decimal","regex":"\/^-?\\d+,\\d{3}$\/"}; window.REDCap.validations['number_3dp'] = {"datatype":"number","regex":"\/^-?\\d+\\.\\d{3}$\/"}; window.REDCap.validations['number_4dp_comma_decimal'] = {"datatype":"number_comma_decimal","regex":"\/^-?\\d+,\\d{4}$\/"}; window.REDCap.validations['number_4dp'] = {"datatype":"number","regex":"\/^-?\\d+\\.\\d{4}$\/"}; window.REDCap.validations['number_comma_decimal'] = {"datatype":"number_comma_decimal","regex":"\/^[-+]?[0-9]*,?[0-9]+([eE][-+]?[0-9]+)?$\/"}; window.REDCap.validations['phone_australia'] = {"datatype":"phone","regex":"\/^(\$0[2-8]\$|0[2-8])\\s*\\d{4}\\s*\\d{4}$\/"}; window.REDCap.validations['phone'] = {"datatype":"phone","regex":"\/^(?:\$?([2-9]0[1-9]|[2-9]1[02-9]|[2-9][2-9][0-9]|800|811)\$?)\\s*(?:[.-]\\s*)?([0-9]{3})\\s*(?:[.-]\\s*)?([0-9]{4})(?:\\s*(?:#|x\\.?|ext\\.?|extension)\\s*(\\d+))?$\/"}; window.REDCap.validations['phone_uk'] = {"datatype":"phone","regex":"\/^((((\\+44|0044)\\s?\\d{4}|\$?0\\d{4}\$?)\\s?\\d{3}\\s?\\d{3})|(((\\+44|0044)\\s?\\d{3}|\$?0\\d{3}\$?)\\s?\\d{3}\\s?\\d{4})|(((\\+44|0044)\\s?\\d{2}|\$?0\\d{2}\$?)\\s?\\d{4}\\s?\\d{4}))(\\s?\\#(\\d{4}|\\d{3}))?$\/"}; window.REDCap.validations['postalcode_australia'] = {"datatype":"postal_code","regex":"\/^\\d{4}$\/"}; window.REDCap.validations['postalcode_canada'] = {"datatype":"postal_code","regex":"\/^[ABCEGHJKLMNPRSTVXY]{1}\\d{1}[A-Z]{1}\\s*\\d{1}[A-Z]{1}\\d{1}$\/i"}; window.REDCap.validations['postalcode_germany'] = {"datatype":"postal_code","regex":"\/^(0[1-9]|[1-9]\\d)\\d{3}$\/"}; window.REDCap.validations['postalcode_uk'] = {"datatype":"postal_code","regex":"\/^(([A-Z]{1,2}\\d{1,2})|([A-Z]{1,2}\\d[A-Z])) \\d[ABD-HJLNP-Z]{2}$\/"}; window.REDCap.validations['ssn'] = {"datatype":"ssn","regex":"\/^\\d{3}-\\d\\d-\\d{4}$\/"}; window.REDCap.validations['time_hh_mm_ss'] = {"datatype":"time","regex":"\/^(\\d|[01]\\d|(2[0-3]))(:[0-5]\\d){2}$\/"}; window.REDCap.validations['time'] = {"datatype":"time","regex":"\/^([0-9]|[0-1][0-9]|[2][0-3]):([0-5][0-9])$\/"}; window.REDCap.validations['time_mm_ss'] = {"datatype":"time","regex":"\/^[0-5]\\d:[0-5]\\d$\/"}; window.REDCap.validations['vmrn'] = {"datatype":"mrn","regex":"\/^[0-9]{4,9}$\/"}; window.REDCap.validations['zipcode'] = {"datatype":"postal_code","regex":"\/^\\d{5}(-\\d{4})?$\/"}; </script> <div id="valregex_divs"> <div id="valregex-postalcode_french" datatype="postal_code" label="Code Postal 5 caracteres (France)"></div> <div id="valregex-date_dmy" datatype="date" label="Date (D-M-Y)"></div> <div id="valregex-date_mdy" datatype="date" label="Date (M-D-Y)"></div> <div id="valregex-date_ymd" datatype="date" label="Date (Y-M-D)"></div> <div id="valregex-datetime_dmy" datatype="datetime" label="Datetime (D-M-Y H:M)"></div> <div id="valregex-datetime_mdy" datatype="datetime" label="Datetime (M-D-Y H:M)"></div> <div id="valregex-datetime_ymd" datatype="datetime" label="Datetime (Y-M-D H:M)"></div> <div id="valregex-datetime_seconds_dmy" datatype="datetime_seconds" label="Datetime w/ seconds (D-M-Y H:M:S)"></div> <div id="valregex-datetime_seconds_mdy" datatype="datetime_seconds" label="Datetime w/ seconds (M-D-Y H:M:S)"></div> <div id="valregex-datetime_seconds_ymd" datatype="datetime_seconds" label="Datetime w/ seconds (Y-M-D H:M:S)"></div> <div id="valregex-email" datatype="email" label="Email"></div> <div id="valregex-integer" datatype="integer" label="Integer"></div> <div id="valregex-alpha_only" datatype="text" label="Letters only"></div> <div id="valregex-mrn_10d" datatype="mrn" label="MRN (10 digits)"></div> <div id="valregex-mrn_generic" datatype="mrn" label="MRN (generic)"></div> <div id="valregex-number" datatype="number" label="Number"></div> <div id="valregex-number_1dp_comma_decimal" datatype="number_comma_decimal" label="Number (1 decimal place - comma as decimal)"></div> <div id="valregex-number_1dp" datatype="number" label="Number (1 decimal place)"></div> <div id="valregex-number_2dp_comma_decimal" datatype="number_comma_decimal" label="Number (2 decimal places - comma as decimal)"></div> <div id="valregex-number_2dp" datatype="number" label="Number (2 decimal places)"></div> <div id="valregex-number_3dp_comma_decimal" datatype="number_comma_decimal" label="Number (3 decimal places - comma as decimal)"></div> <div id="valregex-number_3dp" datatype="number" label="Number (3 decimal places)"></div> <div id="valregex-number_4dp_comma_decimal" datatype="number_comma_decimal" label="Number (4 decimal places - comma as decimal)"></div> <div id="valregex-number_4dp" datatype="number" label="Number (4 decimal places)"></div> <div id="valregex-number_comma_decimal" datatype="number_comma_decimal" label="Number (comma as decimal)"></div> <div id="valregex-phone_australia" datatype="phone" label="Phone (Australia)"></div> <div id="valregex-phone" datatype="phone" label="Phone (North America)"></div> <div id="valregex-phone_uk" datatype="phone" label="Phone (UK)"></div> <div id="valregex-postalcode_australia" datatype="postal_code" label="Postal Code (Australia)"></div> <div id="valregex-postalcode_canada" datatype="postal_code" label="Postal Code (Canada)"></div> <div id="valregex-postalcode_germany" datatype="postal_code" label="Postal Code (Germany)"></div> <div id="valregex-postalcode_uk" datatype="postal_code" label="Postal Code (UK)"></div> <div id="valregex-ssn" datatype="ssn" label="Social Security Number (U.S.)"></div> <div id="valregex-time_hh_mm_ss" datatype="time" label="Time (HH:MM:SS)"></div> <div id="valregex-time" datatype="time" label="Time (HH:MM)"></div> <div id="valregex-time_mm_ss" datatype="time" label="Time (MM:SS)"></div> <div id="valregex-vmrn" datatype="mrn" label="Vanderbilt MRN"></div> <div id="valregex-zipcode" datatype="postal_code" label="Zipcode (U.S.)"></div> </div> <div id="random_text_hidden_div" style="display:none;">EYwWPSAghvEj8Sj7c2X8Z73MYHuNhi35gdJKAIdRw9yPniDNLWAG</div> <div id="pagecontainer" class="container-fluid" role="main"><div id="container"><div id="pagecontent"> <style> #questiontable td.questionnum, #questiontable td.questionnummatrix { display: none !important; } /* When we clean up the left space, we can extend enhanced choice options to be full width for a better appearance */ div.enhancedchoice label { width: 100% } </style> <style type="text/css">.requiredlabel, .requiredlabelmatrix { display:none; } </style><script type="text/javascript" src="/redcap/redcap_v13.8.5/Resources/js/Libraries/geoPosition.js?1691400385"></script> <script type="text/javascript" src="/redcap/redcap_v13.8.5/Resources/js/Libraries/geoPositionSimulator.js?1691400385"></script> <script type="text/javascript"> if(typeof lang=='undefined'){var lang={}}; lang.dataqueries_160='隆Ocurri贸 un error durante la carga de archivos!'; lang.data_entry_199='驴GUARDAR LOS CAMBIOS?'; lang.data_entry_265='驴Est谩 seguro de que desea cerrar la encuesta? Cualquier respuesta que haya agregado en esta p谩gina se perder谩 si cierra la encuesta ahora. SI NO DESEA ABANDONAR SUS CAMBIOS, d茅 clic en el bot贸n \'Continuar en la p谩gina\' a continuaci贸n y luego d茅 clic en el bot贸n en la parte inferior de la p谩gina para guardar los cambios.'; lang.data_entry_433='El valor de este campo contiene espacios extra al principio o al final. 驴Desea removerlos?'; lang.data_entry_459='Cargar nueva versi贸n'; lang.design_100='S铆'; lang.form_renderer_24='Eliminar el archivo'; lang.form_renderer_25='Compartir'; lang.form_renderer_43='Remove signature'; lang.form_renderer_60='File was successfully uploaded!'; lang.global_53='Cancelar'; lang.survey_1311='Finalizar la encuesta'; lang.survey_1312='Volver y editar la respuesta'; lang.survey_01='驴Finalizar la encuesta?'; </script> <script type="text/javascript"> // Set variables var record_exists = 0; var require_change_reason = 0; var event_id = 420; $(function() { // Check for any reserved parameters in query string checkReservedSurveyParams(new Array('s','hash','page','event_id','pid','pnid','preview','id','sq')); // Enable green row highlight for data entry form table enableDataEntryRowHighlight(); }); </script>  <div id="surveytitlelogo"> <table cellspacing="0" style="width:100%;max-width:100%;"> <tr> <td valign="top"> <div style='padding:10px 0 0;'><img id='survey_logo' onload='try{reloadSpeakIconsForLogo()}catch(e){}' src='/redcap/surveys/index.php?pid=187&doc_id_hash=71d24674ed08917f7e9a0abb639e85d8d6aa0db0&__passthru=DataEntry%2Fimage_view.php&s=EJ3MN74ELWT38MR3&id=16813' alt=' imagen' data-mlm-attrs='alt=survey-logo_alt_text' style='max-width:600px;width:600px;max-width:600px;height:149px;max-height:149px;'></div><h1 id='surveytitle' data-mlm='survey-title'>FORMULARIO DE QUEJAS, SUGERENCIAS, FELICITACIONES Y SOLICITUDES DE INFORMACI脫N (FS_FOR196)</h1> </td>  <td valign="top" id="changeFont" aria-hidden="true" width="1%"> <span class="nowrap font-resize-header"><span style="font-size:150%">A</span> <span style="font-size:125%">A</span> <span style="font-size:100%">A</span> </span> <div class="nowrap"> <button id="mlm-change-lang" class="btn btn-link btn-sm" data-rc-lang-attrs="aria-label=multilang_02 data-bs-original-title=multilang_02" title="Change language" aria-label="Change language" data-toggle="tooltip" style="display:none;"><i class="fas fa-globe"></i> <span class="btn-link-lang-name"></span></button> <button id="enable_text-to-speech" class="btn btn-link btn-sm" data-rc-lang-attrs="data-bs-original-title=survey_997 aria-label=survey_997" title="Activar la voz" aria-label="Activar la voz" data-toggle="tooltip" style="display:none;" onclick="addSpeakIconsToSurveyViaBtnClick(1);"><i class="fas fa-volume-up"></i></button> <button id="disable_text-to-speech" class="btn btn-link btn-sm" data-rc-lang-attrs="data-bs-original-title=survey_998 aria-label=survey_998" title="Desactivar la voz" aria-label="Desactivar la voz" data-toggle="tooltip" style="display:none;" onclick="addSpeakIconsToSurveyViaBtnClick(0);"><i class="fas fa-volume-mute"></i></button> <button class="increaseFont btn btn-link btn-sm" data-rc-lang-attrs="data-bs-original-title=survey_1129 aria-label=survey_1129" title="D茅 clic para aumentar el tama帽o de fuente" aria-label="D茅 clic para aumentar el tama帽o de fuente" data-toggle="tooltip"><i class="far fa-plus-square"></i></button> <button class="decreaseFont btn btn-link btn-sm" data-rc-lang-attrs="data-bs-original-title=survey_1130 aria-label=survey_1130" title="D茅 clic para reducir el tama帽o de fuente" aria-label="D茅 clic para reducir el tama帽o de fuente" data-toggle="tooltip"><i class="far fa-minus-square"></i></button> </div> </td> </tr> </table> </div> <div class='red fs15 p-3' style='max-width:1150px;'> <span data-rc-lang="data_entry_602"> We're sorry, but your current web browser (<b>Internet Explorer</b>) is not compatible with this web page. 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