{"id":2336,"date":"2015-11-18T16:18:45","date_gmt":"2015-11-18T22:18:45","guid":{"rendered":"https:\/\/ideas26.com\/mt\/?page_id=2336"},"modified":"2026-04-04T16:39:50","modified_gmt":"2026-04-04T22:39:50","slug":"cuestionario-de-evaluacion-nutricional","status":"publish","type":"page","link":"https:\/\/ideas26.com\/mt\/formatos-y-descargables\/cuestionario-de-evaluacion-nutricional\/","title":{"rendered":"Cuestionario de Evaluaci\u00f3n Nutricional"},"content":{"rendered":"\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f2335-o1\" lang=\"es-ES\" dir=\"ltr\" data-wpcf7-id=\"2335\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/mt\/wp-json\/wp\/v2\/pages\/2336#wpcf7-f2335-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"2335\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.7\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"es_ES\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f2335-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div class=\"row\">\n\t<h4>Bienvenido, a continuaci\u00f3n te presentamos nuestro cuestionario de evaluaci\u00f3n nutricional, te pedimos leer detenidamente cada una de las preguntas y contestar de forma clara y honesta.\n\t<\/h4>\n\t<h4>Gracias por tu tiempo, para nosotros eres importante.\n\t<\/h4>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-3\" style=\"float:right\">\n\t\t<p>Fecha: <span class=\"wpcf7-form-control-wrap\" data-name=\"fecha\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" id=\"fechaDeRegistro\" aria-invalid=\"false\" placeholder=\"Seleccione la fecha de hoy\" value=\"\" type=\"date\" name=\"fecha\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<h3>I. Informaci\u00f3n General\n\t<\/h3>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-5\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"firstname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Nombre (s)\" value=\"\" type=\"text\" name=\"firstname\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-5\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"lastname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Apellidos\" value=\"\" type=\"text\" name=\"lastname\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-2\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"edad\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"edad\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Edad\" value=\"\" type=\"text\" name=\"edad\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-3\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"emailaddress\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"E-mail\" value=\"\" type=\"email\" name=\"emailaddress\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-3\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Tel\u00e9fono Casa\" value=\"\" type=\"text\" name=\"phone\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-3\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"telefonoCel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Celular\" value=\"\" type=\"text\" name=\"telefonoCel\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-3\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"telefonoOfi\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Tel\u00e9fono Oficina\" value=\"\" type=\"text\" name=\"telefonoOfi\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-4\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"facebook\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Facebook\" value=\"\" type=\"text\" name=\"facebook\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"twitter\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Twitter\" value=\"\" type=\"text\" name=\"twitter\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"instagram\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Instagram\" value=\"\" type=\"text\" name=\"instagram\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-6\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"Ocupacion\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Ocupaci\u00f3n\" value=\"\" type=\"text\" name=\"Ocupacion\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-6\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"Ciudad\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Ciudad donde radica\" value=\"\" type=\"text\" name=\"Ciudad\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-2\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"peso\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Peso\" value=\"\" type=\"text\" name=\"peso\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-2\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"estatura\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Estatura\" value=\"\" type=\"text\" name=\"estatura\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"imc\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"IMC (Indice de masa corporal)*\" value=\"\" type=\"text\" name=\"imc\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<p><small style=\"float:right;\">*Para calcular su IMC: Peso\/(Altura)<sup>2<\/sup><\/small>\n\t<\/p>\n<\/div>\n<hr style=\"margin-top:10px\" \/>\n<div class=\"row\">\n\t<h3>II. Interrogatorio Cl\u00ednico\n\t<\/h3>\n\t<h5>Antecedentes familiares (Padres, hermanos, abuelos)\n\t<\/h5>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-4\" style=\"margin-bottom:10px\">\n\t\t<p>Obesidad:\n\t\t<\/p>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"obesidad\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"obesidad\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"obesidad\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-bottom:10px\">\n\t\t<p>Hipertensi\u00f3n Arterial (HTA):\n\t\t<\/p>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"HTA\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"HTA\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"HTA\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-bottom:10px\">\n\t\t<p>Infartos:\n\t\t<\/p>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"infartos\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"infartos\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"infartos\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-bottom:10px\">\n\t\t<p>Diabetes (DM):\n\t\t<\/p>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"diabetesDM\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"diabetesDM\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"diabetesDM\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-bottom:10px\">\n\t\t<p>Dislipidemias:\n\t\t<\/p>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"dislipidemias\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"dislipidemias\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"dislipidemias\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-bottom:10px\">\n\t\t<p>Tiroides:\n\t\t<\/p>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"tiroides\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"tiroides\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"tiroides\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\" style=\"margin-top:15px\">\n\t<h5>Antecedentes personales (Padres, hermanos, abuelos)\n\t<\/h5>\n\t<h6>Seleccione todas las opciones que apliquen en su caso\n\t<\/h6>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-12\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"antecedentesPersonales\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"antecedentesPersonales[]\" value=\"Diabetes (DM)\" \/><span class=\"wpcf7-list-item-label\">Diabetes (DM)<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"antecedentesPersonales[]\" value=\"HTA (Hipertensi\u00f3n)\" \/><span class=\"wpcf7-list-item-label\">HTA (Hipertensi\u00f3n)<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"antecedentesPersonales[]\" value=\"S\u00edndrome de Ovario Poliqu\u00edstico\" \/><span class=\"wpcf7-list-item-label\">S\u00edndrome de Ovario Poliqu\u00edstico<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"antecedentesPersonales[]\" value=\"Tiroides\" \/><span class=\"wpcf7-list-item-label\">Tiroides<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"antecedentesPersonales[]\" value=\"Depresi\u00f3n\" \/><span class=\"wpcf7-list-item-label\">Depresi\u00f3n<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"antecedentesPersonales[]\" value=\"Ansiedad\" \/><span class=\"wpcf7-list-item-label\">Ansiedad<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"antecedentesPersonales[]\" value=\"Colesterol alto\" \/><span class=\"wpcf7-list-item-label\">Colesterol alto<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"antecedentesPersonales[]\" value=\"Triglic\u00e9ridos altos\" \/><span class=\"wpcf7-list-item-label\">Triglic\u00e9ridos altos<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"antecedentesPersonales[]\" value=\"Obesidad\" \/><span class=\"wpcf7-list-item-label\">Obesidad<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"antecedentesPersonales[]\" value=\"Diarrea\" \/><span class=\"wpcf7-list-item-label\">Diarrea<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"antecedentesPersonales[]\" value=\"Estre\u00f1imiento\" \/><span class=\"wpcf7-list-item-label\">Estre\u00f1imiento<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"antecedentesPersonales[]\" value=\"Gastritis\" \/><span class=\"wpcf7-list-item-label\">Gastritis<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"antecedentesPersonales[]\" value=\"Colitis\" \/><span class=\"wpcf7-list-item-label\">Colitis<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-12\" style=\"margin-bottom:10px\">\n\t\t<p>En tu ni\u00f1ez te consideraban: <span class=\"wpcf7-form-control-wrap\" data-name=\"ninez\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"ninez\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"ninez\" value=\"Delgado\" \/><span class=\"wpcf7-list-item-label\">Delgado<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"ninez\" value=\"Gordo\" \/><span class=\"wpcf7-list-item-label\">Gordo<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"ninez\" value=\"No sabe\" \/><span class=\"wpcf7-list-item-label\">No sabe<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-12\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"mayorPesoAdulto\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"\u00bfCu\u00e1l ha sido su mayor peso en la vida adulta?:\" value=\"\" type=\"text\" name=\"mayorPesoAdulto\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-12\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"menorPesoAdulto\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"\u00bfCu\u00e1l ha sido su menor peso en la vida adulta?:\" value=\"\" type=\"text\" name=\"menorPesoAdulto\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-12\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"PesoDeseado\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"\u00bfCu\u00e1l ser\u00eda su peso deseado?:\" value=\"\" type=\"text\" name=\"PesoDeseado\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-12\" style=\"margin-bottom:10px\">\n\t\t<p>Estado dental: <span class=\"wpcf7-form-control-wrap\" data-name=\"estadoDental\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"estadoDental\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"estadoDental\" value=\"Faltan piezas\" \/><span class=\"wpcf7-list-item-label\">Faltan piezas<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"estadoDental\" value=\"Pr\u00f3tesis dental\" \/><span class=\"wpcf7-list-item-label\">Pr\u00f3tesis dental<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-12\" style=\"margin-bottom:10px\">\n\t\t<p>H\u00e1bito Intestinal: <span class=\"wpcf7-form-control-wrap\" data-name=\"habitoIntestinal\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"habitoIntestinal\" value=\"Regular\" \/><span class=\"wpcf7-list-item-label\">Regular<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"habitoIntestinal\" value=\"Estre\u00f1imiento\" \/><span class=\"wpcf7-list-item-label\">Estre\u00f1imiento<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-12\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"estrenimientoMedicamento\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"\u00bfQu\u00e9 medicamento toma para el estre\u00f1imiento?\" value=\"\" type=\"text\" name=\"estrenimientoMedicamento\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<hr style=\"margin-top:10px\" \/>\n<div class=\"row\">\n\t<h3>III. Estilo de vida\n\t<\/h3>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-10\" style=\"margin-bottom:10px\">\n\t\t<p>\u00bfHace usted alg\u00fan ejercicio o actividad f\u00edsica? <span class=\"wpcf7-form-control-wrap\" data-name=\"actividadFisica\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"actividadFisica\" value=\"Muy ligera\" \/><span class=\"wpcf7-list-item-label\">Muy ligera<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"actividadFisica\" value=\"Ligera\" \/><span class=\"wpcf7-list-item-label\">Ligera<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"actividadFisica\" value=\"Moderada\" \/><span class=\"wpcf7-list-item-label\">Moderada<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"actividadFisica\" value=\"Pesada\" \/><span class=\"wpcf7-list-item-label\">Pesada<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"actividadFisica\" value=\"Excepcional\" \/><span class=\"wpcf7-list-item-label\">Excepcional<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-6\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"tipoActividad\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Tipo de actividad\" value=\"\" type=\"text\" name=\"tipoActividad\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-6\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"FrecuenciaActividadFisica\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Frecuencia\" value=\"\" type=\"text\" name=\"FrecuenciaActividadFisica\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Consumo de Alcohol: <span class=\"wpcf7-form-control-wrap\" data-name=\"alcohol\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"alcohol\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"alcohol\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"tipoAlcohol\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Tipo\" value=\"\" type=\"text\" name=\"tipoAlcohol\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"cantidadAlcohol\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Cantidad\" value=\"\" type=\"text\" name=\"cantidadAlcohol\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<hr style=\"margin-top:10px\" \/>\n<div class=\"row\">\n\t<h3>IV. Interrogatorio diet\u00e9tico\n\t<\/h3>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-4\" style=\"margin-top:10px;margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"comidasPorDia\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"N\u00famero de comidas por d\u00eda\" value=\"\" type=\"text\" name=\"comidasPorDia\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-8\" style=\"margin-bottom:10px\">\n\t\t<p>Selecci\u00f3nalas:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"CommidasPorDia\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"CommidasPorDia[]\" value=\"Desayuno\" \/><span class=\"wpcf7-list-item-label\">Desayuno<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"CommidasPorDia[]\" value=\"Snack de la ma\u00f1ana\" \/><span class=\"wpcf7-list-item-label\">Snack de la ma\u00f1ana<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"CommidasPorDia[]\" value=\"Comida\" \/><span class=\"wpcf7-list-item-label\">Comida<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"CommidasPorDia[]\" value=\"Snack de la tarde\" \/><span class=\"wpcf7-list-item-label\">Snack de la tarde<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"CommidasPorDia[]\" value=\"Cena\" \/><span class=\"wpcf7-list-item-label\">Cena<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-6\" style=\"margin-top:10px;margin-bottom:10px\">\n\t\t<p>\u00bfNormalmente se sirve doble comida? <span class=\"wpcf7-form-control-wrap\" data-name=\"dobleComida\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"dobleComida\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"dobleComida\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-6\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"tiempoComer\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Tiempo que tarda en consumir la comida:\" value=\"\" type=\"text\" name=\"tiempoComer\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-6\" style=\"margin-bottom:10px\">\n\t\t<p>\u00bfHa llevado alg\u00fan r\u00e9gimen diet\u00e9tico? <span class=\"wpcf7-form-control-wrap\" data-name=\"regimenDietetico\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"regimenDietetico\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"regimenDietetico\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-6\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"duracionRegimen\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Duraci\u00f3n del r\u00e9gimen:\" value=\"\" type=\"text\" name=\"duracionRegimen\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-6\" style=\"margin-bottom:10px\">\n\t\t<p>Consist\u00eda en pastillas <span class=\"wpcf7-form-control-wrap\" data-name=\"consistiaPastillas\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"consistiaPastillas\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"consistiaPastillas\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-12\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"DescripcionRegimen\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Descr\u00edbalo\" name=\"DescripcionRegimen\"><\/textarea><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-12\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"motivacionPerderPeso\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"\u00bfCu\u00e1l es su motivaci\u00f3n para perder peso?\" name=\"motivacionPerderPeso\"><\/textarea><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-12\" style=\"margin-bottom:10px\">\n\t\t<p>Considera su apetito: <span class=\"wpcf7-form-control-wrap\" data-name=\"consideraApetito\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"consideraApetito\" value=\"Normal\" \/><span class=\"wpcf7-list-item-label\">Normal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"consideraApetito\" value=\"Aumentado\" \/><span class=\"wpcf7-list-item-label\">Aumentado<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"consideraApetito\" value=\"Disminuido\" \/><span class=\"wpcf7-list-item-label\">Disminuido<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-12\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"horaMasHambre\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"\u00bfA qu\u00e9 hora tiene m\u00e1s hambre?\" value=\"\" type=\"text\" name=\"horaMasHambre\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-4\" style=\"margin-bottom:10px\">\n\t\t<p>\u00bf\"Pellizca\" alimentos? <span class=\"wpcf7-form-control-wrap\" data-name=\"pellizcaAlimentos\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"pellizcaAlimentos\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"pellizcaAlimentos\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-8\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"generalmentePellizca\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"\u00bfGeneralmente qu\u00e9?\" value=\"\" type=\"text\" name=\"generalmentePellizca\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-8\" style=\"margin-bottom:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"diasComerFuera\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"\u00bfCu\u00e1ntos d\u00edas de la semana come fuera de casa?\" value=\"\" type=\"text\" name=\"diasComerFuera\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-6\" style=\"margin-bottom:10px\">\n\t\t<p>\u00bfSu consumo var\u00eda cuando est\u00e1 triste, nervioso o ansioso?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"consumoVariable\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"consumoVariable\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"consumoVariable\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-6\" style=\"margin-bottom:10px\">\n\t\t<p>Preparaci\u00f3n de sus alimentos:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"preparacionAlimentos\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"preparacionAlimentos\" value=\"Vapor\" \/><span class=\"wpcf7-list-item-label\">Vapor<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"preparacionAlimentos\" value=\"A la parrilla\/plancha\" \/><span class=\"wpcf7-list-item-label\">A la parrilla\/plancha<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"preparacionAlimentos\" value=\"Frito\" \/><span class=\"wpcf7-list-item-label\">Frito<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"preparacionAlimentos\" value=\"Empanizado\" \/><span class=\"wpcf7-list-item-label\">Empanizado<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<hr style=\"margin-top:10px\" \/>\n<div class=\"row\">\n\t<h4>Favor de seleccionar la frecuencia con la que se consume cada uno de los alimentos que se presentan a continuaci\u00f3n.\n\t<\/h4>\n\t<h5 style=\"text-align:center; font-weight:bold\">Leche\n\t<\/h5>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Leche Light o yogurt light:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lecheYogurtLight\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"lecheYogurtLight\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"lecheYogurtLight\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"lecheYogurtLight\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"lecheYogurtLight\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"lecheYogurtLight\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"lecheYogurtLight\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Leche deslactosada light:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lecheDeslactosadaLight\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"lecheDeslactosadaLight\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"lecheDeslactosadaLight\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"lecheDeslactosadaLight\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"lecheDeslactosadaLight\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"lecheDeslactosadaLight\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"lecheDeslactosadaLight\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Leche entera o yogurt:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"lecheEnteraYogurt\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"lecheEnteraYogurt\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"lecheEnteraYogurt\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"lecheEnteraYogurt\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"lecheEnteraYogurt\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"lecheEnteraYogurt\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"lecheEnteraYogurt\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<hr style=\"margin-top:10px\" \/>\n<div class=\"row\">\n\t<h5 style=\"text-align:center; font-weight:bold\">Productos de Origen Animal\n\t<\/h5>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Pollo sin piel:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"polloSinPiel\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"polloSinPiel\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"polloSinPiel\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"polloSinPiel\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"polloSinPiel\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"polloSinPiel\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"polloSinPiel\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>At\u00fan en agua:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"atunEnAgua\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"atunEnAgua\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"atunEnAgua\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"atunEnAgua\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"atunEnAgua\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"atunEnAgua\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"atunEnAgua\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Carne de puerco:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"carneDePuerco\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"carneDePuerco\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"carneDePuerco\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"carneDePuerco\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"carneDePuerco\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"carneDePuerco\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"carneDePuerco\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Pescado:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"pescado\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"pescado\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"pescado\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"pescado\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"pescado\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"pescado\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"pescado\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Queso Panela - Oaxaca:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"quesoPanelaOaxaca\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"quesoPanelaOaxaca\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"quesoPanelaOaxaca\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"quesoPanelaOaxaca\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"quesoPanelaOaxaca\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"quesoPanelaOaxaca\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"quesoPanelaOaxaca\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Embutidos de Pavo:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"embutidosDePavo\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"embutidosDePavo\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"embutidosDePavo\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"embutidosDePavo\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"embutidosDePavo\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"embutidosDePavo\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"embutidosDePavo\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Res Magra (cuete, filete, milanesa):<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"resMagra\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"resMagra\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"resMagra\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"resMagra\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"resMagra\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"resMagra\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"resMagra\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Huevo Entero:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"huevoEntero\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"huevoEntero\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"huevoEntero\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"huevoEntero\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"huevoEntero\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"huevoEntero\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"huevoEntero\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Embutidos de cerdo:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"embutidosDeCerdo\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"embutidosDeCerdo\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"embutidosDeCerdo\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"embutidosDeCerdo\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"embutidosDeCerdo\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"embutidosDeCerdo\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"embutidosDeCerdo\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Cortes de carne (arrachera, rib eye):<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"cortesDeCarne\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"cortesDeCarne\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"cortesDeCarne\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"cortesDeCarne\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"cortesDeCarne\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"cortesDeCarne\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"cortesDeCarne\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<hr style=\"margin-top:10px\" \/>\n<div class=\"row\">\n\t<h5 style=\"text-align:center; font-weight:bold\">Cereales y Tub\u00e9rculos\n\t<\/h5>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Cereales para el desayuno:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"cerealesParaDesyuno\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"cerealesParaDesyuno\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"cerealesParaDesyuno\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"cerealesParaDesyuno\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"cerealesParaDesyuno\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"cerealesParaDesyuno\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"cerealesParaDesyuno\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Galletas Mar\u00edas, saladas o habaneras:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"galletasMariasSaladasHabaneras\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"galletasMariasSaladasHabaneras\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"galletasMariasSaladasHabaneras\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"galletasMariasSaladasHabaneras\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"galletasMariasSaladasHabaneras\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"galletasMariasSaladasHabaneras\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"galletasMariasSaladasHabaneras\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Palomitas Naturales:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"palomitasNaturales\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"palomitasNaturales\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"palomitasNaturales\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"palomitasNaturales\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"palomitasNaturales\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"palomitasNaturales\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"palomitasNaturales\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Pan de caja, Integral:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"panDeCajaIntegral\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"panDeCajaIntegral\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"panDeCajaIntegral\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"panDeCajaIntegral\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"panDeCajaIntegral\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"panDeCajaIntegral\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"panDeCajaIntegral\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Pan de caja, Blanco:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"panDeCajaBlanco\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"panDeCajaBlanco\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"panDeCajaBlanco\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"panDeCajaBlanco\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"panDeCajaBlanco\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"panDeCajaBlanco\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"panDeCajaBlanco\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Tortillas de ma\u00edz o tostada horneada:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tortillaTostada\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"tortillaTostada\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"tortillaTostada\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"tortillaTostada\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"tortillaTostada\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"tortillaTostada\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"tortillaTostada\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Tortilla de Harina:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tortillaHarina\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"tortillaHarina\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"tortillaHarina\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"tortillaHarina\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"tortillaHarina\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"tortillaHarina\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"tortillaHarina\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Pan Dulce:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"panDulce\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"panDulce\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"panDulce\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"panDulce\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"panDulce\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"panDulce\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"panDulce\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Frituras:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"frituras\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"frituras\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"frituras\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"frituras\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"frituras\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"frituras\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"frituras\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<hr style=\"margin-top:10px\" \/>\n<div class=\"row\">\n\t<h5 style=\"text-align:center; font-weight:bold\">Verduras\n\t<\/h5>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Crudas, ensaladas, cocidas, precocidas:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"verdurasCrudas\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"verdurasCrudas\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"verdurasCrudas\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"verdurasCrudas\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"verdurasCrudas\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"verdurasCrudas\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"verdurasCrudas\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Verduras enlatadas:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"verdurasEnlatadas\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"verdurasEnlatadas\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"verdurasEnlatadas\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"verdurasEnlatadas\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"verdurasEnlatadas\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"verdurasEnlatadas\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"verdurasEnlatadas\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Jugo de verduras (v8, jugo verde):<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"jugoDeVerduras\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"jugoDeVerduras\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"jugoDeVerduras\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"jugoDeVerduras\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"jugoDeVerduras\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"jugoDeVerduras\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"jugoDeVerduras\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Sopa - crema de verduras:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sopaDeVerduras\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"sopaDeVerduras\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"sopaDeVerduras\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"sopaDeVerduras\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"sopaDeVerduras\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"sopaDeVerduras\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"sopaDeVerduras\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<hr style=\"margin-top:10px\" \/>\n<div class=\"row\">\n\t<h5 style=\"text-align:center; font-weight:bold\">Fruta\n\t<\/h5>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Frutas crudas:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"frutasCrudas\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"frutasCrudas\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"frutasCrudas\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"frutasCrudas\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"frutasCrudas\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"frutasCrudas\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"frutasCrudas\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Frutas Congeladas\/enlatadas:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"frutasCongeladas\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"frutasCongeladas\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"frutasCongeladas\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"frutasCongeladas\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"frutasCongeladas\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"frutasCongeladas\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"frutasCongeladas\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Jugo de frutas natural:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"jugoDeFrutas\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"jugoDeFrutas\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"jugoDeFrutas\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"jugoDeFrutas\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"jugoDeFrutas\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"jugoDeFrutas\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"jugoDeFrutas\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<hr style=\"margin-top:10px\" \/>\n<div class=\"row\">\n\t<h5 style=\"text-align:center; font-weight:bold\">Leguminosas\n\t<\/h5>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Frijol, lenteja, garbanzo, soya, alubias:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"frijolLenteja\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"frijolLenteja\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"frijolLenteja\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"frijolLenteja\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"frijolLenteja\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"frijolLenteja\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"frijolLenteja\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<hr style=\"margin-top:10px\" \/>\n<div class=\"row\">\n\t<h5 style=\"text-align:center; font-weight:bold\">L\u00edpidos\n\t<\/h5>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Mantequilla - manteca:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"mantequilla\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"mantequilla\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"mantequilla\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"mantequilla\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"mantequilla\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"mantequilla\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"mantequilla\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Crema, Mayonesa, aderezos:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"cremaMayonesa\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"cremaMayonesa\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"cremaMayonesa\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"cremaMayonesa\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"cremaMayonesa\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"cremaMayonesa\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"cremaMayonesa\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Chocolates:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"chocolates\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"chocolates\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"chocolates\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"chocolates\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"chocolates\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"chocolates\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"chocolates\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Nueces, pistaches, cacahuates, almendras:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"nueces\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"nueces\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"nueces\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"nueces\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"nueces\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"nueces\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"nueces\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Aguacate:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"aguacate\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"aguacate\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"aguacate\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"aguacate\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"aguacate\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"aguacate\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"aguacate\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<hr style=\"margin-top:10px\" \/>\n<div class=\"row\">\n\t<h5 style=\"text-align:center; font-weight:bold\">Az\u00facares\n\t<\/h5>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Az\u00facar (mermelada, cajeta, refrescos, nieve):<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"azucar\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"azucar\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"azucar\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"azucar\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"azucar\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"azucar\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"azucar\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-4\" style=\"margin-top:10px\">\n\t\t<p>Sustituto de az\u00facar (splenda, stevia):<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"sustitutoAzucar\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"sustitutoAzucar\" value=\"Diario\" \/><span class=\"wpcf7-list-item-label\">Diario<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"sustitutoAzucar\" value=\"Semanal\" \/><span class=\"wpcf7-list-item-label\">Semanal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"sustitutoAzucar\" value=\"Quincenal\" \/><span class=\"wpcf7-list-item-label\">Quincenal<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"sustitutoAzucar\" value=\"Mensual\" \/><span class=\"wpcf7-list-item-label\">Mensual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"sustitutoAzucar\" value=\"Ocasional\" \/><span class=\"wpcf7-list-item-label\">Ocasional<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"sustitutoAzucar\" value=\"Nunca\" \/><span class=\"wpcf7-list-item-label\">Nunca<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<hr style=\"margin-top:10px\" \/>\n<div class=\"row\">\n\t<h4>Favor de describir cada una de las comidas que tienes en un d\u00eda normal, te recordamos que es necesario que contestes con toda honestidad, gracias por tu tiempo.\n\t<\/h4>\n\t<h5 style=\"text-align:center; font-weight:bold\">Dieta Habitual (recordatorio de 24 horas)\n\t<\/h5>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-12\" style=\"margin-top:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"dietaHabitualDesayuno\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Hora y descripci\u00f3n del Desayuno:\" name=\"dietaHabitualDesayuno\"><\/textarea><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-12\" style=\"margin-top:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"dietaHabitualSnackManana\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Hora y descripci\u00f3n del Snack de la ma\u00f1ana\" name=\"dietaHabitualSnackManana\"><\/textarea><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-12\" style=\"margin-top:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"dietaHabitualComida\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Hora y descripci\u00f3n de la comida\" name=\"dietaHabitualComida\"><\/textarea><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-12\" style=\"margin-top:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"dietaHabitualSnackTarde\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Hora y descripci\u00f3n del Snack de la tarde\" name=\"dietaHabitualSnackTarde\"><\/textarea><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-12\" style=\"margin-top:10px\">\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"dietaHabitualCena\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Hora y descripci\u00f3n de la cena\" name=\"dietaHabitualCena\"><\/textarea><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\" style=\"margin:30px 0;float:right\">\n\t<div class=\"col-md-12\">\n\t\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner appointment-submit\" type=\"submit\" value=\"Enviar\" \/>\n\t\t<\/p>\n\t<\/div>\n<\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"Bienvenido, a continuaci\u00f3n te presentamos nuestro cuestionario de evaluaci\u00f3n nutricional, te pedimos leer detenidamente cada una de las preguntas y contestar de forma clara y honesta. Gracias por tu tiempo, para nosotros eres importante. Fecha: I. Informaci\u00f3n General *Para calcular su IMC: Peso\/(Altura)2 II. Interrogatorio Cl\u00ednico Antecedentes familiares (Padres, hermanos, abuelos) Obesidad: S\u00edNo Hipertensi\u00f3n Arterial [...]","protected":false},"author":1,"featured_media":0,"parent":2316,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-2336","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/ideas26.com\/mt\/wp-json\/wp\/v2\/pages\/2336","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ideas26.com\/mt\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/ideas26.com\/mt\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/ideas26.com\/mt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/ideas26.com\/mt\/wp-json\/wp\/v2\/comments?post=2336"}],"version-history":[{"count":0,"href":"https:\/\/ideas26.com\/mt\/wp-json\/wp\/v2\/pages\/2336\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/ideas26.com\/mt\/wp-json\/wp\/v2\/pages\/2316"}],"wp:attachment":[{"href":"https:\/\/ideas26.com\/mt\/wp-json\/wp\/v2\/media?parent=2336"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}