{"id":9255,"date":"2023-07-13T13:24:49","date_gmt":"2023-07-13T11:24:49","guid":{"rendered":"https:\/\/www.mutuapersonalcaixa.com\/a3-2-alta-smq\/"},"modified":"2025-11-17T13:15:39","modified_gmt":"2025-11-17T12:15:39","slug":"subsidio-medio-quirurgico-alta","status":"publish","type":"page","link":"https:\/\/www.mutuapersonalcaixa.com\/es\/subsidio-medio-quirurgico-alta\/","title":{"rendered":"Subsidio M\u00e9dico Quir\u00fargico-alta"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"9255\" class=\"elementor elementor-9255 elementor-8708\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-987b965 elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"987b965\" 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-8993d55\" data-id=\"8993d55\" 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-1410800 elementor-nav-menu__align-center elementor-nav-menu--dropdown-tablet elementor-nav-menu__text-align-aside elementor-nav-menu--toggle elementor-nav-menu--burger elementor-widget elementor-widget-global elementor-global-161 elementor-widget-nav-menu\" data-id=\"1410800\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;submenu_icon&quot;:{&quot;value&quot;:&quot;fas fa-angle-down&quot;,&quot;library&quot;:&quot;fa-solid&quot;},&quot;layout&quot;:&quot;horizontal&quot;,&quot;toggle&quot;:&quot;burger&quot;}\" data-widget_type=\"nav-menu.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t<nav aria-label=\"Men\u00fa\" class=\"elementor-nav-menu--main elementor-nav-menu__container elementor-nav-menu--layout-horizontal e--pointer-underline e--animation-slide\">\n\t\t\t\t<ul id=\"menu-1-1410800\" class=\"elementor-nav-menu\"><li class=\"simple menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-10029\"><a class=\"elementor-item\">La Mutua<\/a>\n<ul class=\"sub-menu elementor-nav-menu--dropdown\">\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10030\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/la-mutua\/\" class=\"elementor-sub-item\">Qu\u00e9 es la Mutua<\/a><\/li>\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10031\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/contacto\/\" class=\"elementor-sub-item\">Contacto<\/a><\/li>\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10032\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/servicio-datencion-al-mutualista\/\" class=\"elementor-sub-item\">Atenci\u00f3n \/ Defensor mutualista<\/a><\/li>\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10033\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/informacion-corporativa\/\" class=\"elementor-sub-item\">Informaci\u00f3n Corporativa<\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-10034\"><a class=\"elementor-item\">Servicio M\u00e9dico <br \/>Quir\u00fargico<\/a>\n<ul class=\"sub-menu elementor-nav-menu--dropdown\">\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10035\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/subsidio-medico-quirurgico\/\" class=\"elementor-sub-item\">\u00bfQu\u00e9 es?<\/a><\/li>\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10036\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/solicitud\/\" class=\"elementor-sub-item\">Solicitud<\/a><\/li>\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10038\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/subsidio-medio-quirurgico-alta\/\" class=\"elementor-sub-item\">Alta<\/a><\/li>\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10037\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/faqs-subsidio-medio-quirurgico\/\" class=\"elementor-sub-item\">FAQ\u2019s<\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-10039\"><a class=\"elementor-item\">Ayuda Econ\u00f3mica <br \/>a la Orfandad<\/a>\n<ul class=\"sub-menu elementor-nav-menu--dropdown\">\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10040\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/ayuda-economica-orfandad\/\" class=\"elementor-sub-item\">\u00bfQu\u00e9 es?<\/a><\/li>\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10041\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/ayuda-economica-orfandad-faqs\/\" class=\"elementor-sub-item\">FAQ\u2019s<\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-10042\"><a class=\"elementor-item\">Ayuda Econ\u00f3mica <br \/>a la Dependencia<\/a>\n<ul class=\"sub-menu elementor-nav-menu--dropdown\">\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10043\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/ayuda-economica-dependencia\/\" class=\"elementor-sub-item\">\u00bfQu\u00e9 es?<\/a><\/li>\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10044\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/ayuda-economica-dependencia-faqs\/\" class=\"elementor-sub-item\">FAQ\u2019s<\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"simple menu-item menu-item-type-post_type menu-item-object-page current_page_parent menu-item-1587\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/noticias\/\" class=\"elementor-item\">Actualidad y noticias<\/a><\/li>\n<\/ul>\t\t\t<\/nav>\n\t\t\t\t\t<div class=\"elementor-menu-toggle\" role=\"button\" tabindex=\"0\" aria-label=\"Alternar men\u00fa\" aria-expanded=\"false\">\n\t\t\t<i aria-hidden=\"true\" role=\"presentation\" class=\"elementor-menu-toggle__icon--open eicon-menu-bar\"><\/i><i aria-hidden=\"true\" role=\"presentation\" class=\"elementor-menu-toggle__icon--close eicon-close\"><\/i>\t\t<\/div>\n\t\t\t\t\t<nav class=\"elementor-nav-menu--dropdown elementor-nav-menu__container\" aria-hidden=\"true\">\n\t\t\t\t<ul id=\"menu-2-1410800\" class=\"elementor-nav-menu\"><li class=\"simple menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-10029\"><a class=\"elementor-item\" tabindex=\"-1\">La Mutua<\/a>\n<ul class=\"sub-menu elementor-nav-menu--dropdown\">\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10030\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/la-mutua\/\" class=\"elementor-sub-item\" tabindex=\"-1\">Qu\u00e9 es la Mutua<\/a><\/li>\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10031\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/contacto\/\" class=\"elementor-sub-item\" tabindex=\"-1\">Contacto<\/a><\/li>\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10032\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/servicio-datencion-al-mutualista\/\" class=\"elementor-sub-item\" tabindex=\"-1\">Atenci\u00f3n \/ Defensor mutualista<\/a><\/li>\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10033\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/informacion-corporativa\/\" class=\"elementor-sub-item\" tabindex=\"-1\">Informaci\u00f3n Corporativa<\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-10034\"><a class=\"elementor-item\" tabindex=\"-1\">Servicio M\u00e9dico <br \/>Quir\u00fargico<\/a>\n<ul class=\"sub-menu elementor-nav-menu--dropdown\">\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10035\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/subsidio-medico-quirurgico\/\" class=\"elementor-sub-item\" tabindex=\"-1\">\u00bfQu\u00e9 es?<\/a><\/li>\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10036\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/solicitud\/\" class=\"elementor-sub-item\" tabindex=\"-1\">Solicitud<\/a><\/li>\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10038\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/subsidio-medio-quirurgico-alta\/\" class=\"elementor-sub-item\" tabindex=\"-1\">Alta<\/a><\/li>\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10037\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/faqs-subsidio-medio-quirurgico\/\" class=\"elementor-sub-item\" tabindex=\"-1\">FAQ\u2019s<\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-10039\"><a class=\"elementor-item\" tabindex=\"-1\">Ayuda Econ\u00f3mica <br \/>a la Orfandad<\/a>\n<ul class=\"sub-menu elementor-nav-menu--dropdown\">\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10040\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/ayuda-economica-orfandad\/\" class=\"elementor-sub-item\" tabindex=\"-1\">\u00bfQu\u00e9 es?<\/a><\/li>\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10041\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/ayuda-economica-orfandad-faqs\/\" class=\"elementor-sub-item\" tabindex=\"-1\">FAQ\u2019s<\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-10042\"><a class=\"elementor-item\" tabindex=\"-1\">Ayuda Econ\u00f3mica <br \/>a la Dependencia<\/a>\n<ul class=\"sub-menu elementor-nav-menu--dropdown\">\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10043\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/ayuda-economica-dependencia\/\" class=\"elementor-sub-item\" tabindex=\"-1\">\u00bfQu\u00e9 es?<\/a><\/li>\n\t<li class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-10044\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/ayuda-economica-dependencia-faqs\/\" class=\"elementor-sub-item\" tabindex=\"-1\">FAQ\u2019s<\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"simple menu-item menu-item-type-post_type menu-item-object-page current_page_parent menu-item-1587\"><a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/noticias\/\" class=\"elementor-item\" tabindex=\"-1\">Actualidad y noticias<\/a><\/li>\n<\/ul>\t\t\t<\/nav>\n\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<section class=\"elementor-section elementor-top-section elementor-element elementor-element-9df9436 elementor-section-height-min-height elementor-section-boxed elementor-section-height-default elementor-section-items-middle\" data-id=\"9df9436\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;slideshow&quot;,&quot;background_slideshow_gallery&quot;:[],&quot;background_slideshow_loop&quot;:&quot;yes&quot;,&quot;background_slideshow_slide_duration&quot;:5000,&quot;background_slideshow_slide_transition&quot;:&quot;fade&quot;,&quot;background_slideshow_transition_duration&quot;:500}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\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-top-column elementor-element elementor-element-8673218\" data-id=\"8673218\" 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-2e60746 elementor-widget elementor-widget-heading\" data-id=\"2e60746\" 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<h2 class=\"elementor-heading-title elementor-size-default\">Date de alta<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8baa9f5 elementor-widget elementor-widget-heading\" data-id=\"8baa9f5\" 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<h2 class=\"elementor-heading-title elementor-size-default\">Del Servicio M\u00e9dico Quir\u00fargico (SMQ)<\/h2>\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<section class=\"elementor-section elementor-top-section elementor-element elementor-element-84470cc elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"84470cc\" 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-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-db0041c\" data-id=\"db0041c\" 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-56f6ae1 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"56f6ae1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\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<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-83c4ce1\" data-id=\"83c4ce1\" 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-647a156 elementor-widget elementor-widget-heading\" data-id=\"647a156\" 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<h2 class=\"elementor-heading-title elementor-size-default\">FORMULARIO<\/h2>\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<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-852cbcc\" data-id=\"852cbcc\" 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-dd440e7 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"dd440e7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\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<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4f2202c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4f2202c\" 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-top-column elementor-element elementor-element-19d4b15\" data-id=\"19d4b15\" 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-702607f elementor-widget elementor-widget-text-editor\" data-id=\"702607f\" 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\r\n<form id=\"mutua-form\" data-hs-ignore=\"true\" class=\"needs-validation\" novalidate>\r\n    <!-- Honeypot anti-spam -->\r\n    <input type=\"text\" name=\"email_honeypot\" style=\"display:none\">\r\n\r\n    <h2>Alta en el servicio m\u00e9dico quir\u00fargico (SMQ)<\/h2>\r\n\r\n    <h3>Datos personales del mutualista<\/h3>\r\n\r\n    <div class=\"row g-3\">\r\n        <div class=\"col-md-4\">\r\n            <label for=\"nom\" class=\"form-label\">Nombre <span class=\"text-danger\">*<\/span><\/label>\r\n            <input type=\"text\" class=\"form-control\" id=\"nom\" name=\"nom\" required>\r\n        <\/div>\r\n        <div class=\"col-md-4\">\r\n            <label for=\"cognom1\" class=\"form-label\">Primer apellido <span class=\"text-danger\">*<\/span><\/label>\r\n            <input type=\"text\" class=\"form-control\" id=\"cognom1\" name=\"cognom1\" required>\r\n        <\/div>\r\n        <div class=\"col-md-4\">\r\n            <label for=\"cognom2\" class=\"form-label\">Segundo apellido <span class=\"text-danger\">*<\/span><\/label>\r\n            <input type=\"text\" class=\"form-control\" id=\"cognom2\" name=\"cognom2\" required>\r\n        <\/div>\r\n\r\n        <div class=\"col-md-3\">\r\n            <label for=\"idioma\" class=\"form-label\">Idioma <span class=\"text-danger\">*<\/span><\/label>\r\n            <select class=\"form-select\" id=\"idioma\" name=\"idioma\" required>\r\n                <option value=\"ca\">Catal\u00e1n<\/option>\r\n                <option value=\"es\">Castellano<\/option>\r\n            <\/select>\r\n        <\/div>\r\n\r\n        <div class=\"col-md-3\">\r\n            <label for=\"nif\" class=\"form-label\">NIF <span class=\"text-danger\">*<\/span><\/label>\r\n            <input type=\"text\" class=\"form-control\" id=\"nif\" name=\"nif\" required>\r\n        <\/div>\r\n\r\n        <div class=\"col-md-3\">\r\n            <label for=\"sexe\" class=\"form-label\">Sexo<\/label>\r\n            <select class=\"form-select\" id=\"sexe\" name=\"sexe\">\r\n                <option value=\"H\">Hombre<\/option>\r\n                <option value=\"D\">Mujer<\/option>\r\n            <\/select>\r\n        <\/div>\r\n\r\n        <div class=\"col-md-3\">\r\n            <label for=\"data_naix\" class=\"form-label\">Fecha de nacimiento <span class=\"text-danger\">*<\/span><\/label>\r\n            <input type=\"date\" class=\"form-control\" id=\"data_naix\" name=\"data_naix\" required>\r\n        <\/div>\r\n\r\n        <div class=\"col-md-3\">\r\n            <label for=\"email\" class=\"form-label\">Correo electr\u00f3nico <span class=\"text-danger\">*<\/span><\/label>\r\n            <input type=\"email\" class=\"form-control\" id=\"email\" name=\"email\" required>\r\n        <\/div>\r\n\r\n        <div class=\"col-md-3\">\r\n            <label for=\"telefon\" class=\"form-label\">Tel\u00e9fono m\u00f3vil <span class=\"text-danger\">*<\/span><\/label>\r\n            <input type=\"tel\" class=\"form-control\" id=\"telefon\" name=\"telefon\" required>\r\n        <\/div>\r\n\r\n        <div class=\"col-md-3\">\r\n            <label for=\"telefon_fix\" class=\"form-label\">Tel\u00e9fono fijo<\/label>\r\n            <input type=\"tel\" class=\"form-control\" id=\"telefon_fix\" name=\"telefon_fix\">\r\n        <\/div>\r\n\r\n        <div class=\"col-md-3\">\r\n            <label for=\"codi_postal\" class=\"form-label\">C\u00f3digo postal <span class=\"text-danger\">*<\/span><\/label>\r\n            <input type=\"text\" class=\"form-control\" id=\"codi_postal\" name=\"codi_postal\" maxlength=\"5\" required>\r\n        <\/div>\r\n\r\n        <div class=\"col-md-6\">\r\n            <label for=\"domicili\" class=\"form-label\">Domicilio <span class=\"text-danger\">*<\/span><\/label>\r\n            <input type=\"text\" class=\"form-control\" id=\"domicili\" name=\"domicili\" required>\r\n        <\/div>\r\n\r\n        <div class=\"col-md-6\">\r\n            <label for=\"poblacio\" class=\"form-label\">Poblaci\u00f3n <span class=\"text-danger\">*<\/span><\/label>\r\n            <select class=\"form-select\" id=\"poblacio\" name=\"poblacio\"><\/select>\r\n        <\/div>\r\n        <div class=\"col-md-3\">\r\n            <div class=\"form-check\">\r\n                <input class=\"form-check-input\" type=\"checkbox\" id=\"empleat\" name=\"empleat\" value=\"S\u00ed\">\r\n                <label for=\"empleat\" class=\"form-label\">Soy empleado<\/label>\r\n            <\/div>\r\n        <\/div>\r\n\r\n        <div id=\"empleat-fields\" class=\"row\" style=\"display:none;\">\r\n            <div class=\"col-md-2\">\r\n                <label for=\"num_centre\">Centro de trabajo <span class=\"text-danger\">*<\/span><\/label>\r\n                <input type=\"text\" id=\"num_centre\" name=\"num_centre\" class=\"form-control\" maxlength=\"5\">\r\n                <small class=\"form-text text-muted\">\r\n                    Indica el centro de trabajo con cinco d\u00edgitos, a\u00f1adiendo los ceros a la izquierda que sean necesarios.                <\/small>\r\n            <\/div>\r\n            <div class=\"col-md-8\">\r\n                <label for=\"nom_centre\">Nombre del centro de trabajo<\/label>\r\n                <input type=\"text\" id=\"nom_centre\" name=\"nom_centre\" class=\"form-control\">\r\n            <\/div>\r\n            <div class=\"col-md-2\">\r\n                <label for=\"num_empleat\">N\u00famero de empleado <span class=\"text-danger\">*<\/span><\/label>\r\n                <input type=\"text\" id=\"num_empleat\" name=\"num_empleat\" class=\"form-control\">\r\n            <\/div>\r\n        <\/div>\r\n    <\/div>\r\n    <br \/>\r\n    <h3>Datos bancarios<\/h3>\r\n\r\n    <div class=\"row g-3\">\r\n        <div class=\"col-md-6\">\r\n            <div class=\"form-group\">\r\n                <div class=\"form-check\">\r\n                    <input class=\"form-check-input\" type=\"checkbox\" name=\"acceptacio\" id=\"acceptacio\" required>\r\n                    <label class=\"form-check-label\" for=\"acceptacio\">\r\n                        Autorizo los cargos en esta cuenta <span class=\"text-danger\">*<\/span>\r\n                    <\/label>\r\n                <\/div>\r\n                <small class=\"form-text text-muted\">\r\n                    Asimismo, autorizas a la M\u00fatua del Personal de \u201cla Caixa\u201d a enviar instrucciones a tu entidad para cargos en tu cuenta y a la entidad para efectuarlos en tu cuenta siguiendo las instrucciones de la M\u00fatua. Como parte de tus derechos, est\u00e1s legitimado al reembolso por tu entidad seg\u00fan los t\u00e9rminos y condiciones del contrato suscrito con la entidad. La solicitud de reembolso deber\u00e1 efectuarse dentro de las ocho semanas posteriores a la fecha del cargo en cuenta. Puedes obtener informaci\u00f3n adicional sobre tus derechos en tu entidad financiera.                <\/small>\r\n            <\/div>\r\n        <\/div>\r\n\r\n        <div class=\"col-md-6\">\r\n            <label for=\"iban\" class=\"form-label\">Cuenta IBAN <span class=\"text-danger\">*<\/span><\/label>\r\n            <input type=\"text\" class=\"form-control\" id=\"iban\" name=\"iban\" placeholder=\"ESXX-XXXX-XXXX-XXXX-XXXX-XXXX\" required>\r\n        <\/div>\r\n    <\/div>\r\n    <br \/>\r\n    <h3>Familiares<\/h3>\r\n\r\n    <table id=\"familiars-table\" class=\"table\">\r\n        <thead>\r\n        <\/thead>\r\n        <tbody>\r\n        <!-- Les files es generaran din\u00e0micament -->\r\n        <\/tbody>\r\n    <\/table>\r\n    <button type=\"button\" id=\"add-familiar\" class=\"btn btn-sm btn-primary\">A\u00f1adir familiar<\/button>\r\n\r\n    <!--<div class=\"mb-2 mt-5 form-check\">\r\n        <input type=\"checkbox\" class=\"form-check-input\" id=\"pol_ipid\" name=\"pol_ipid\" required>\r\n        <label class=\"form-check-label\" for=\"pol_ipid\">He rebut i compr\u00e8s la informaci\u00f3 sobre el producte (IPID ) i en cas d\u2019haver rebut assessorament personalitzat sobre el producte, confirmo haver compr\u00e8s la recomanaci\u00f3 professional facilitada i quedo informat que els assessors de la m\u00fatua poden percebre incentius variables vinculats a la formalitzaci\u00f3 de l\u2019alta. <span class=\"text-danger\">*<\/span><\/label>\r\n    <\/div>-->\r\n\r\n    <div class=\"mb-2 mt-5 form-check\">\r\n        <input type=\"checkbox\" class=\"form-check-input\" id=\"pol_condgenerals\" name=\"pol_condgenerals\" required>\r\n        <label class=\"form-check-label\" for=\"pol_condgenerals\">He recibido y he comprendido las <a href=\"https:\/\/www.mutuapersonalcaixa.com\/wp-content\/uploads\/2025\/11\/REGLAMENTO-SMQ-1-Abril-2025.pdf\" target=\"_blank\" rel=\"noopener\">Condiciones Generales del seguro<\/a>. <span class=\"text-danger\">*<\/span><\/label>\r\n    <\/div>\r\n\r\n    <div class=\"mb-2 form-check\">\r\n        <input type=\"checkbox\" class=\"form-check-input\" id=\"pol_tractdades\" name=\"pol_tractdades\" required>\r\n        <label class=\"form-check-label\" for=\"pol_tractdades\">Autorizo el tratamiento de mis datos personales de acuerdo con la <a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/aviso-legal\/\" target=\"_blank\" rel=\"noopener\">Pol\u00edtica de Privacidad<\/a>. <span class=\"text-danger\">*<\/span><\/label>\r\n    <\/div>\r\n\r\n    <div class=\"mb-2 form-check\">\r\n        <input type=\"checkbox\" class=\"form-check-input\" id=\"pol_blanqueig\" name=\"pol_blanqueig\" required>\r\n        <label class=\"form-check-label\" for=\"pol_blanqueig\">Autorizo a la aseguradora a la comprobaci\u00f3n de mis datos para el cumplimiento de la normativa de prevenci\u00f3n del <a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/aviso-legal\/\" target=\"_blank\" rel=\"noopener\">blanqueo de capitales y de la financiaci\u00f3n del terrorismo<\/a>. <span class=\"text-danger\">*<\/span><\/label>\r\n    <\/div>\r\n\r\n    <div class=\"mb-2 form-check\">\r\n        <input type=\"checkbox\" class=\"form-check-input\" id=\"pol_desistiment\" name=\"pol_desistiment\" required>\r\n        <label class=\"form-check-label\" for=\"pol_desistiment\">He sido informado\/a de <a href=\"https:\/\/www.mutuapersonalcaixa.com\/es\/aviso-legal\/\" target=\"_blank\" rel=\"noopener\">mi derecho de desistimiento<\/a>. <span class=\"text-danger\">*<\/span><\/label>\r\n    <\/div>\r\n\r\n    <div class=\"mb-5 form-check\">\r\n        <input type=\"checkbox\" class=\"form-check-input\" id=\"pol_comunicacions\" name=\"pol_comunicacions\" required>\r\n        <label class=\"form-check-label\" for=\"pol_comunicacions\">Acepto recibir todas las comunicaciones y documentaci\u00f3n contractual en formato electr\u00f3nico, considerando este medio como soporte duradero, de acuerdo con la Ley 34\/2002 (LSSI). Asimismo, reconozco que la validaci\u00f3n mediante checkbox y el env\u00edo del formulario constituyen mi firma electr\u00f3nica v\u00e1lida, conforme al Reglamento (UE) 910\/2014 (eIDAS). <span class=\"text-danger\">*<\/span><\/label>\r\n    <\/div>\r\n\r\n    <!--<div class=\"mb-4\">\r\n        <p>La Mutua del Personal de \u201cla Caixa\u201d, M.P.S (la Mutua), con NIF G60327798, recoge y trata los datos de car\u00e1cter personal, de acuerdo a la Ley 10\/2003, sobre mutualidades de previsi\u00f3n social, y la Ley 20\/2015, de ordenaci\u00f3n, supervisi\u00f3n y solvencia.<br \/>La Mutua cumple la legislaci\u00f3n respecto a la protecci\u00f3n de datos personales y adopta las medidas de seguridad necesarias, de acuerdo con la normativa aplicable de la Ley y el Reglamento de Protecci\u00f3n de Datos de Car\u00e1cter Personal y Reglamento (UE) 2016\/679 del Parlamento Europeo, como tambi\u00e9n el que se dispone en la Ley de servicios de la sociedad de la informaci\u00f3n y del comercio electr\u00f3nico (Ley 34\/2002, de 11 de julio).<br \/>La Mutua, tratar\u00e1 los datos de los mutualistas y familiares asociados, con la finalidad de establecer la inclusi\u00f3n\/exclusi\u00f3n de prestaciones econ\u00f3micas ofrecidas, permitir el cumplimiento eficaz de los servicios ofrecidos, y la mediaci\u00f3n y gesti\u00f3n de sus reclamaciones.<\/p>\r\n    <\/div>-->\r\n\r\n    <button type=\"button\" id=\"btn-enviar\" class=\"btn btn-success\">Env\u00eda<\/button>\r\n\r\n    <div id=\"loading\" class=\"text-center mt-3\" style=\"display:none;\">\r\n        <div class=\"spinner-border text-primary\" role=\"status\">\r\n            <span class=\"visually-hidden\">Carregant&#8230;<\/span>\r\n        <\/div>\r\n        <p class=\"mt-2\">Enviando datos&#8230;<\/p>\r\n    <\/div>\r\n<\/form>\r\n\n\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<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Date de alta Del Servicio M\u00e9dico Quir\u00fargico (SMQ) FORMULARIO<\/p>\n","protected":false},"author":4,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"content-type":"","footnotes":""},"class_list":["post-9255","page","type-page","status-publish"],"_links":{"self":[{"href":"https:\/\/www.mutuapersonalcaixa.com\/es\/wp-json\/wp\/v2\/pages\/9255","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.mutuapersonalcaixa.com\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.mutuapersonalcaixa.com\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.mutuapersonalcaixa.com\/es\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mutuapersonalcaixa.com\/es\/wp-json\/wp\/v2\/comments?post=9255"}],"version-history":[{"count":0,"href":"https:\/\/www.mutuapersonalcaixa.com\/es\/wp-json\/wp\/v2\/pages\/9255\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.mutuapersonalcaixa.com\/es\/wp-json\/wp\/v2\/media?parent=9255"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}