{"id":30256,"date":"2023-08-08T11:11:56","date_gmt":"2023-08-08T16:11:56","guid":{"rendered":"https:\/\/surgeryinperu.com\/?page_id=30256"},"modified":"2026-11-04T14:58:56","modified_gmt":"2026-11-04T19:58:56","slug":"libro-de-reclamaciones","status":"publish","type":"page","link":"https:\/\/surgeryinperu.com\/es\/libro-de-reclamaciones\/","title":{"rendered":"Libro de reclamaciones"},"content":{"rendered":"\n<div class=\"wp-block-uagb-container uagb-block-2de2fb7b alignfull uagb-is-root-container\"><div class=\"uagb-container-inner-blocks-wrap\">\n<div class=\"wp-block-uagb-advanced-heading uagb-block-9e9346b1\"><h2 class=\"uagb-heading-text\">Libro de reclamaciones<\/h2><\/div>\n\n\n\n<div class=\"wp-block-uagb-advanced-heading uagb-block-980052e9\"><h2 class=\"uagb-heading-text\">Conforme a lo establecido en el c\u00f3digo de protecci\u00f3n y defensa del consumidor, esta instituci\u00f3n cuenta con un libro de reclamaciones a su disposici\u00f3n.<\/h2><\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-uagb-container uagb-block-ed224d4e alignfull uagb-is-root-container\"><div class=\"uagb-container-inner-blocks-wrap\"><div class='fluentform ff-default fluentform_wrapper_15  ff_guten_block ff_guten_block-15 ffs_custom_wrap'><form data-form_id=\"15\" id=\"fluentform_15\" class=\"frm-fluent-form fluent_form_15 ff-el-form-top ff_form_instance_15_1 ff-form-loading ffs_custom\" data-form_instance=\"ff_form_instance_15_1\" method=\"POST\" ><fieldset  style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;box-shadow: none!important;outline: none!important; min-inline-size: 100%;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"display: block; margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;overflow:hidden;\">Libro de reclamaciones<\/legend><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"ak_\"><label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"ak_js\" value=\"37\"\/><script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n<\/p><input type='hidden' name='__fluent_form_embded_post_id' value='30256' \/><input type=\"hidden\" id=\"_fluentform_15_fluentformnonce\" name=\"_fluentform_15_fluentformnonce\" value=\"95b6324c01\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/es\/wp-json\/wp\/v2\/pages\/30256\" \/><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_datetime' id='label_ff_15_datetime'>Fecha de reclamo<\/label><\/div><div class='ff-el-input--content'><input  aria-label='Fecha de reclamo Usa las flechas para navegar por las fechas. Pulsa Intro para seleccionar una fecha.'  aria-haspopup='dialog' data-type-datepicker data-format='d\/m\/Y' type=\"text\" name=\"datetime\" id=\"ff_15_datetime\" class=\"ff-el-form-control ff-el-datepicker\" data-name=\"datetime\"  aria-invalid='false' aria-required=true><\/div><\/div><div class='ff-el-group  ff-custom_html' tabindex='-1' data-name=\"custom_html-15_1\" ><h5><strong>1. Identificaci\u00f3n del consumidor reclamante<\/strong><\/h5><\/div><div data-type=\"name-element\" data-name=\"names\" class=\" ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_names_first_name_' id='label_ff_15_names_first_name_'>Nombre<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names[first_name]\" id=\"ff_15_names_first_name_\" class=\"ff-el-form-control\" autocomplete=\"given-name\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_names_last_name_' id='label_ff_15_names_last_name_'>Apellidos<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names[last_name]\" id=\"ff_15_names_last_name_\" class=\"ff-el-form-control\" autocomplete=\"family-name\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_1\"  class='ff-t-container ff-column-container ff_columns_total_2 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_dropdown' id='label_ff_15_dropdown'>Tipo de documento<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown\" id=\"ff_15_dropdown\" class=\"ff-el-form-control\" data-name=\"dropdown\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_15_dropdown\"><option value=\"\">Seleccionar<\/option><option value=\"DNI\"  >DNI<\/option><option value=\"C.E.\"  >C.E.<\/option><option value=\"Pasaporte\"  >Pasaporte<\/option><\/select><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_input_text' id='label_ff_15_input_text'>N\u00famero de documento<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text\" class=\"ff-el-form-control\" data-name=\"input_text\" id=\"ff_15_input_text\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_2\"  class='ff-t-container ff-column-container ff_columns_total_2 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_phone' id='label_ff_15_phone'>Tel\u00e9fono<\/label><\/div><div class='ff-el-input--content'><input name=\"phone\" class=\"ff-el-form-control ff-el-phone ff_el_with_extended_validation\" type=\"tel\" autocomplete=\"tel\" data-name=\"phone\" id=\"ff_15_phone\" inputmode=\"tel\"  aria-invalid='false' aria-required=true><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_email' id='label_ff_15_email'>Email<\/label><\/div><div class='ff-el-input--content'><input autocomplete=\"email\" type=\"email\" name=\"email\" id=\"ff_15_email\" class=\"ff-el-form-control\" data-name=\"email\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><div class=\"ff-name-address-wrapper fluent-address\" data-type=\"address-element\" data-name=\"address_1\" ><div class='ff-el-input--content'><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_address_1_address_line_1_' id='label_ff_15_address_1_address_line_1_'>Direcci\u00f3n<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[address_line_1]\" id=\"ff_15_address_1_address_line_1_\" class=\"ff-el-form-control\" data-key_name=\"address_line_1\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_address_1_city_' id='label_ff_15_address_1_city_'>Ciudad<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[city]\" id=\"ff_15_address_1_city_\" class=\"ff-el-form-control\" data-key_name=\"city\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_address_1_state_' id='label_ff_15_address_1_state_'>Provincia<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[state]\" id=\"ff_15_address_1_state_\" class=\"ff-el-form-control\" data-key_name=\"state\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_address_1_country_' id='label_ff_15_address_1_country_'>Pa\u00eds<\/label><\/div><div class='ff-el-input--content'><select name=\"address_1[country]\" id=\"ff_15_address_1_country_\" class=\"ff-el-form-control\" placeholder=\"Seleccionar pa\u00eds\" data-key_name=\"country\" aria-invalid='false' aria-required=true><option value=''>Seleccionar pa\u00eds<\/option><option value='AF' >Afganist\u00e1n<\/option><option value='AL' >Albania<\/option><option value='DE' >Alemania<\/option><option value='AD' >Andorra<\/option><option value='AO' >Angola<\/option><option value='AI' >Anguilla<\/option><option value='AG' >Antigua y Barbuda<\/option><option value='AQ' >Ant\u00e1rtida<\/option><option value='SA' >Arabia Saudita<\/option><option value='DZ' >Argelia<\/option><option value='AR' >Argentina<\/option><option value='AM' >Armenia<\/option><option value='AW' >Aruba<\/option><option value='AU' >Australia<\/option><option value='AT' >Austria<\/option><option value='AZ' >Azerbaijan<\/option><option value='BS' >Bahamas<\/option><option value='BH' >Bahrain<\/option><option value='BD' >Bangladesh<\/option><option value='BB' >Barbados<\/option><option value='BZ' >Belize<\/option><option value='BJ' >Benin<\/option><option value='BM' >Bermuda<\/option><option value='BT' >Bhutan<\/option><option value='BY' >Bielorrusia<\/option><option value='MM' >Birmania<\/option><option value='BO' >Bolivia<\/option><option value='BQ' >Bonaire, San Eustaquio y Saba<\/option><option value='BA' >Bosnia y Herzegovina<\/option><option value='BW' >Botswana<\/option><option value='BR' >Brasil<\/option><option value='BN' >Brun\u00e9i<\/option><option value='BG' >Bulgaria<\/option><option value='BF' >Burkina Faso<\/option><option value='BI' >Burundi<\/option><option value='BE' >B\u00e9lgica<\/option><option value='CV' >Cabo Verde<\/option><option value='KH' >Camboya<\/option><option value='CM' >Camer\u00fan<\/option><option value='CA' >Canad\u00e1<\/option><option value='TD' >Chad<\/option><option value='CL' >Chile<\/option><option value='CN' >China<\/option><option value='CY' >Chipre<\/option><option value='VA' >Ciudad del Vaticano<\/option><option value='CO' >Colombia<\/option><option value='KM' >Comoras<\/option><option value='KP' >Corea del Norte<\/option><option value='KR' >Corea del Sur<\/option><option value='CR' >Costa Rica<\/option><option value='CI' >Costa de Marfil<\/option><option value='HR' >Croacia<\/option><option value='CU' >Cuba<\/option><option value='CW' >Curazao<\/option><option value='DK' >Dinamarca<\/option><option value='DJ' >Djibouti<\/option><option value='DM' >Dominica<\/option><option value='EC' >Ecuador<\/option><option value='EG' >Egipto<\/option><option value='SV' >El Salvador<\/option><option value='AE' >Emiratos \u00c1rabes Unidos<\/option><option value='ER' >Eritrea<\/option><option value='SK' >Eslovaquia<\/option><option value='SI' >Eslovenia<\/option><option value='ES' >Espa\u00f1a<\/option><option value='VI' >Estados Unidos (EE.UU.) Islas V\u00edrgenes<\/option><option value='US' >Estados Unidos (EEUU)<\/option><option value='EE' >Estonia<\/option><option value='SZ' >Esuatini<\/option><option value='ET' >Etiop\u00eda<\/option><option value='PH' >Filipinas<\/option><option value='FI' >Finlandia<\/option><option value='FJ' >Fiyi<\/option><option value='FR' >Francia<\/option><option value='GA' >Gab\u00f3n<\/option><option value='GM' >Gambia<\/option><option value='GE' >Georgia<\/option><option value='GH' >Ghana<\/option><option value='GI' >Gibraltar<\/option><option value='GD' >Granada<\/option><option value='GR' >Grecia<\/option><option value='GL' >Groenlandia<\/option><option value='GP' >Guadalupe<\/option><option value='GU' >Guam<\/option><option value='GT' >Guatemala<\/option><option value='GF' >Guayana Francesa<\/option><option value='GG' >Guernsey<\/option><option value='GN' >Guinea<\/option><option value='GQ' >Guinea Ecuatorial<\/option><option value='GW' >Guinea-Bis\u00e1u<\/option><option value='GY' >Guyana<\/option><option value='HT' >Hait\u00ed<\/option><option value='HN' >Honduras<\/option><option value='HK' >Hong Kong<\/option><option value='HU' >Hungr\u00eda<\/option><option value='IN' >India<\/option><option value='ID' >Indonesia<\/option><option value='IQ' >Irak<\/option><option value='IE' >Irlanda<\/option><option value='IR' >Ir\u00e1n<\/option><option value='BV' >Isla Bouvet<\/option><option value='NF' >Isla Norfolk<\/option><option value='SH' >Isla Santa Elena<\/option><option value='IM' >Isla de Man<\/option><option value='CX' >Isla de Navidad<\/option><option value='IS' >Islandia<\/option><option value='AX' >Islas Aland<\/option><option value='KY' >Islas Caim\u00e1n<\/option><option value='CC' >Islas Cocos<\/option><option value='CK' >Islas Cook<\/option><option value='FO' >Islas Feroe<\/option><option value='GS' >Islas Georgias y Sandwich del Sur<\/option><option value='HM' >Islas Heard y McDonald<\/option><option value='FK' >Islas Malvinas<\/option><option value='MP' >Islas Marianas del Norte<\/option><option value='MH' >Islas Marshall<\/option><option value='SB' >Islas Salom\u00f3n<\/option><option value='TC' >Islas Turcas y Caicos<\/option><option value='VG' >Islas V\u00edrgenes Brit\u00e1nicas<\/option><option value='UM' >Islas de ultramar menores de Estados Unidos (EEUU)<\/option><option value='IL' >Israel<\/option><option value='IT' >Italia<\/option><option value='JM' >Jamaica<\/option><option value='JP' >Jap\u00f3n<\/option><option value='JE' >Jersey<\/option><option value='JO' >Jordania<\/option><option value='KZ' >Kazajist\u00e1n<\/option><option value='KE' >Kenia<\/option><option value='KG' >Kirguist\u00e1n<\/option><option value='KI' >Kiribati<\/option><option value='XK' >Kosovo<\/option><option value='KW' >Kuwait<\/option><option value='LA' >Laos<\/option><option value='LS' >Lesoto<\/option><option value='LV' >Letonia<\/option><option value='LR' >Liberia<\/option><option value='LY' >Libia<\/option><option value='LI' >Liechtenstein<\/option><option value='LT' >Lituania<\/option><option value='LU' >Luxemburgo<\/option><option value='LB' >L\u00edbano<\/option><option value='MO' >Macao<\/option><option value='MK' >Macedonia del Norte<\/option><option value='MG' >Madagascar<\/option><option value='MY' >Malasia<\/option><option value='MW' >Malaui<\/option><option value='MV' >Maldivas<\/option><option value='MT' >Malta<\/option><option value='ML' >Mal\u00ed<\/option><option value='MA' >Marruecos<\/option><option value='MQ' >Martinica<\/option><option value='MU' >Mauricio<\/option><option value='MR' >Mauritania<\/option><option value='YT' >Mayotte<\/option><option value='FM' >Micronesia<\/option><option value='MD' >Moldavia<\/option><option value='MN' >Mongolia<\/option><option value='ME' >Montenegro<\/option><option value='MS' >Montserrat<\/option><option value='MZ' >Mozambique<\/option><option value='MX' >M\u00e9xico<\/option><option value='MC' >M\u00f3naco<\/option><option value='NA' >Namibia<\/option><option value='NR' >Nauru<\/option><option value='NP' >Nepal<\/option><option value='NI' >Nicaragua<\/option><option value='NG' >Nigeria<\/option><option value='NU' >Niue<\/option><option value='NO' >Noruega<\/option><option value='NC' >Nueva Caledonia<\/option><option value='NZ' >Nueva Zelanda<\/option><option value='NE' >N\u00edger<\/option><option value='OM' >Om\u00e1n<\/option><option value='PK' >Pakist\u00e1n<\/option><option value='PW' >Palaos<\/option><option value='PA' >Panam\u00e1<\/option><option value='PG' >Pap\u00faa Nueva Guinea<\/option><option value='PY' >Paraguay<\/option><option value='NL' >Pa\u00edses Bajos<\/option><option value='PE' selected>Per\u00fa<\/option><option value='PN' >Pitcairn<\/option><option value='PF' >Polinesia Francesa<\/option><option value='PL' >Polonia<\/option><option value='PT' >Portugal<\/option><option value='PR' >Puerto Rico<\/option><option value='QA' >Qatar<\/option><option value='GB' >Reino Unido (UK)<\/option><option value='CF' >Rep\u00fablica Centroafricana<\/option><option value='CZ' >Rep\u00fablica Checa<\/option><option value='CD' >Rep\u00fablica Democr\u00e1tica del Congo (Kinshasa)<\/option><option value='DO' >Rep\u00fablica Dominicana<\/option><option value='CG' >Rep\u00fablica del Congo (Brazzaville)<\/option><option value='RE' >Reuni\u00f3n<\/option><option value='RW' >Ruanda<\/option><option value='RO' >Rumania<\/option><option value='RU' >Rusia<\/option><option value='EH' >Sahara Occidental<\/option><option value='WS' >Samoa<\/option><option value='AS' >Samoa Americana<\/option><option value='BL' >San Bartolom\u00e9<\/option><option value='KN' >San Crist\u00f3bal y Nieves<\/option><option value='SM' >San Marino<\/option><option value='SX' >San Mart\u00edn (Pa\u00edses Bajos)<\/option><option value='MF' >San Mart\u00edn (parte de Francia)<\/option><option value='PM' >San Pedro y Miquel\u00f3n<\/option><option value='VC' >San Vicente y las Granadinas<\/option><option value='LC' >Santa Luc\u00eda<\/option><option value='ST' >Santo Tom\u00e9 y Pr\u00edncipe<\/option><option value='SN' >Senegal<\/option><option value='RS' >Serbia<\/option><option value='SC' >Seychelles<\/option><option value='SL' >Sierra Leona<\/option><option value='SG' >Singapur<\/option><option value='SY' >Siria<\/option><option value='SO' >Somalia<\/option><option value='LK' >Sri Lanka<\/option><option value='ZA' >Sud\u00e1frica<\/option><option value='SD' >Sud\u00e1n<\/option><option value='SS' >Sud\u00e1n del Sur<\/option><option value='SE' >Suecia<\/option><option value='CH' >Suiza<\/option><option value='SR' >Surinam<\/option><option value='SJ' >Svalbard y Jan Mayen<\/option><option value='TH' >Tailandia<\/option><option value='TW' >Taiw\u00e1n<\/option><option value='TZ' >Tanzania<\/option><option value='TJ' >Tayikist\u00e1n<\/option><option value='IO' >Territorio Brit\u00e1nico del Oc\u00e9ano \u00cdndico<\/option><option value='PS' >Territorios Palestinos<\/option><option value='TF' >Territorios australes franceses<\/option><option value='TL' >Timor Oriental<\/option><option value='TG' >Togo<\/option><option value='TK' >Tokelau<\/option><option value='TO' >Tonga<\/option><option value='TT' >Trinidad y Tobago<\/option><option value='TM' >Turkmenist\u00e1n<\/option><option value='TR' >Turqu\u00eda<\/option><option value='TV' >Tuvalu<\/option><option value='TN' >T\u00fanez<\/option><option value='UA' >Ucrania<\/option><option value='UG' >Uganda<\/option><option value='UY' >Uruguay<\/option><option value='UZ' >Uzbekist\u00e1n<\/option><option value='VU' >Vanuatu<\/option><option value='VE' >Venezuela<\/option><option value='VN' >Vietnam<\/option><option value='WF' >Wallis y Futuna<\/option><option value='YE' >Yemen<\/option><option value='ZM' >Zambia<\/option><option value='ZW' >Zimbabue<\/option><\/select><\/div><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  >\u00bfEres menor de edad?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_3527bfbe1f47b61b7fb2a8a44772cde0'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"S\u00ed\"  id='input_radio_3527bfbe1f47b61b7fb2a8a44772cde0' aria-label='S\u00ed' aria-invalid='false' aria-required=true> <span>S\u00ed<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_a66b90c1725f5bf84e3389633513c41b'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"no\"  id='input_radio_a66b90c1725f5bf84e3389633513c41b' aria-label='No' aria-invalid='false' aria-required=true> <span>No<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group  ff-custom_html has-conditions' tabindex='-1' data-name=\"custom_html-15_2\" ><p><strong>Datos del apoderado<\/strong><\/p><\/div><div data-type=\"name-element\" data-name=\"names_1\" class=\"has-conditions  ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_names_1_first_name_' id='label_ff_15_names_1_first_name_'>Nombre<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_1[first_name]\" id=\"ff_15_names_1_first_name_\" class=\"ff-el-form-control\" autocomplete=\"given-name\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_names_1_last_name_' id='label_ff_15_names_1_last_name_'>Apellidos<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_1[last_name]\" id=\"ff_15_names_1_last_name_\" class=\"ff-el-form-control\" autocomplete=\"family-name\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_3\"  class='ff-t-container ff-column-container ff_columns_total_2 has-conditions'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_dropdown_1' id='label_ff_15_dropdown_1'>Tipo de documento del apoderado<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_1\" id=\"ff_15_dropdown_1\" class=\"ff-el-form-control\" data-name=\"dropdown_1\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_15_dropdown_1\"><option value=\"\">Seleccionar<\/option><option value=\"DNI\"  >DNI<\/option><option value=\"C.E.\"  >C.E.<\/option><option value=\"Pasaporte\"  >Pasaporte<\/option><\/select><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_input_text_1' id='label_ff_15_input_text_1'>N\u00famero de documento del apoderado<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_1\" class=\"ff-el-form-control\" data-name=\"input_text_1\" id=\"ff_15_input_text_1\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><div class='ff-el-group  ff-custom_html' tabindex='-1' data-name=\"custom_html-15_3\" ><h5><strong>2. Identificaci\u00f3n del bien contratado<\/strong><\/h5><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  >Tipo de bien contratado<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_1_afe5e6e6de0703857e21d089cb11a7a9'><input  type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Producto\"  id='input_radio_1_afe5e6e6de0703857e21d089cb11a7a9' aria-label='Producto' aria-invalid='false' aria-required=true> <span>Producto<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_1_9b954968bd4712425aab5ef2c146b538'><input  type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Servicio\"  id='input_radio_1_9b954968bd4712425aab5ef2c146b538' aria-label='Servicio' aria-invalid='false' aria-required=true> <span>Servicio<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_15_datetime_1' id='label_ff_15_datetime_1'>Fecha del incidente<\/label><\/div><div class='ff-el-input--content'><input  aria-label='Fecha del incidente Usa las flechas para navegar por las fechas. Pulsa Intro para seleccionar una fecha.'  aria-haspopup='dialog' data-type-datepicker data-format='d\/m\/Y' type=\"text\" name=\"datetime_1\" id=\"ff_15_datetime_1\" class=\"ff-el-form-control ff-el-datepicker\" data-name=\"datetime_1\"  aria-invalid='false' aria-required=false><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_description' id='label_ff_15_description'>Descripci\u00f3n del bien contratado<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"true\" aria-labelledby=\"label_ff_15_description\" name=\"description\" id=\"ff_15_description\" class=\"ff-el-form-control\" cols=\"2\" data-name=\"description\" ><\/textarea><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_15_input_text_2' id='label_ff_15_input_text_2'>Monto del producto o servicio contratado objeto del reclamo<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_2\" class=\"ff-el-form-control\" data-name=\"input_text_2\" id=\"ff_15_input_text_2\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group  ff-custom_html' tabindex='-1' data-name=\"custom_html-15_4\" ><h5><strong>3. Detalle de la reclamaci\u00f3n y pedido del consumidor<\/strong><\/h5><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  >Tipo de reclamo<\/label><div class=\"ff-el-tooltip\" data-content=\"&lt;br&gt;\n&lt;strong&gt;Reclamo:&lt;\/strong&gt; Disconformidad relacionada a los productos o servicios.&lt;br&gt;&lt;br&gt;\n&lt;strong&gt;Queja:&lt;\/strong&gt; Disconformidad no relacionada a los productos o servicios; o malestar, o descontento respecto a la atenci\u00f3n al p\u00fablico.\n&lt;br&gt;&lt;br&gt;\"><svg width=\"16\" height=\"16\" viewbox=\"0 0 25 25\"><path d=\"m329 393l0-46c0-2-1-4-2-6-2-2-4-3-7-3l-27 0 0-146c0-3-1-5-3-7-2-1-4-2-7-2l-91 0c-3 0-5 1-7 2-1 2-2 4-2 7l0 46c0 2 1 5 2 6 2 2 4 3 7 3l27 0 0 91-27 0c-3 0-5 1-7 3-1 2-2 4-2 6l0 46c0 3 1 5 2 7 2 1 4 2 7 2l128 0c3 0 5-1 7-2 1-2 2-4 2-7z m-36-256l0-46c0-2-1-4-3-6-2-2-4-3-7-3l-54 0c-3 0-5 1-7 3-2 2-3 4-3 6l0 46c0 3 1 5 3 7 2 1 4 2 7 2l54 0c3 0 5-1 7-2 2-2 3-4 3-7z m182 119c0 40-9 77-29 110-20 34-46 60-80 80-33 20-70 29-110 29-40 0-77-9-110-29-34-20-60-46-80-80-20-33-29-70-29-110 0-40 9-77 29-110 20-34 46-60 80-80 33-20 70-29 110-29 40 0 77 9 110 29 34 20 60 46 80 80 20 33 29 70 29 110z\" transform=\"scale(0.046875 0.046875)\"><\/path><\/svg><\/div><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_e56d71d3ad1018b8348160fa70f47aa0'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Queja\"  id='input_radio_2_e56d71d3ad1018b8348160fa70f47aa0' aria-label='Queja' aria-invalid='false' aria-required=true> <span>Queja<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_3657fc35d7f6474fd83a56b01eb08714'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Reclamo\"  id='input_radio_2_3657fc35d7f6474fd83a56b01eb08714' aria-label='Reclamo' aria-invalid='false' aria-required=true> <span>Reclamo<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_description_1' id='label_ff_15_description_1'>Detalle de la reclamaci\u00f3n o queja<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"true\" aria-labelledby=\"label_ff_15_description_1\" name=\"description_1\" id=\"ff_15_description_1\" class=\"ff-el-form-control\" cols=\"2\" data-name=\"description_1\" ><\/textarea><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_15_description_2' id='label_ff_15_description_2'>Pedido<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"true\" aria-labelledby=\"label_ff_15_description_2\" name=\"description_2\" id=\"ff_15_description_2\" class=\"ff-el-form-control\" cols=\"2\" data-name=\"description_2\" ><\/textarea><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_15_file-upload_1' id='label_ff_15_file-upload_1'>Adjuntar documentos<\/label><div class=\"ff-el-tooltip\" data-content=\"Tama\u00f1o m\u00e1ximo del archivo 10MB&lt;br&gt;Cantidad de archivos m\u00e1ximos 5&lt;br&gt;Solo archivos en formato PDF, JPG y PNG.\"><svg width=\"16\" height=\"16\" viewbox=\"0 0 25 25\"><path d=\"m329 393l0-46c0-2-1-4-2-6-2-2-4-3-7-3l-27 0 0-146c0-3-1-5-3-7-2-1-4-2-7-2l-91 0c-3 0-5 1-7 2-1 2-2 4-2 7l0 46c0 2 1 5 2 6 2 2 4 3 7 3l27 0 0 91-27 0c-3 0-5 1-7 3-1 2-2 4-2 6l0 46c0 3 1 5 2 7 2 1 4 2 7 2l128 0c3 0 5-1 7-2 1-2 2-4 2-7z m-36-256l0-46c0-2-1-4-3-6-2-2-4-3-7-3l-54 0c-3 0-5 1-7 3-2 2-3 4-3 6l0 46c0 3 1 5 3 7 2 1 4 2 7 2l54 0c3 0 5-1 7-2 2-2 3-4 3-7z m182 119c0 40-9 77-29 110-20 34-46 60-80 80-33 20-70 29-110 29-40 0-77-9-110-29-34-20-60-46-80-80-20-33-29-70-29-110 0-40 9-77 29-110 20-34 46-60 80-80 33-20 70-29 110-29 40 0 77 9 110 29 34 20 60 46 80 80 20 33 29 70 29 110z\" transform=\"scale(0.046875 0.046875)\"><\/path><\/svg><\/div><\/div><div class='ff-el-input--content'><label for='ff_15_file-upload_1' class='ff_file_upload_holder'><span class='ff_upload_btn ff-btn' tabindex='0'>Seleccionar archivo<\/span> <input type=\"file\" name=\"file-upload\" id=\"ff_15_file-upload_1\" class=\"ff-el-form-control  ff-screen-reader-element\" data-name=\"file-upload\" multiple=\"1\"  aria-invalid='false' aria-required=false><\/label><\/div><\/div><div class='ff-el-group  ff-custom_html' tabindex='-1' data-name=\"custom_html-15_5\" ><h5><strong>4. Observaciones y acciones adoptadas por el proveedor<\/strong><\/h5><\/div><div class='ff-el-group  ff-custom_html' tabindex='-1' data-name=\"custom_html-15_6\" ><p>Al ser un reclamo virtual, su caso ser\u00e1 derivado al \u00e1rea de atenci\u00f3n al cliente, a fin de dar respuesta dentro del plazo legalmente establecido.<\/p>\n<p><br \/><em>*La formulaci\u00f3n del reclamo no excluye el recurso a otros medios de resoluci\u00f3n de controversias ni es un requisito previo para presentar una denuncia ante el Indecopi.<\/em><\/p>\n<p><br \/><em>* El proveedor deber\u00e1 dar respuesta al reclamo en un plazo no mayor a (15) quince d\u00edas calendario, pudiendo ampliar el plazo hasta (30) treinta d\u00edas m\u00e1s, previa comunicaci\u00f3n al consumidor.<\/em><\/p><\/div><div class='ff-el-group    ff-el-input--content'><div class='ff-el-form-check ff-el-tc'><label aria-label='Autorizo expresamente que la respuesta a mi reclamo o queja sea notificada al correo electr\u00f3nico que he indicado en este formulario.' class='ff-el-form-check-label ff_tc_label' for='terms-n-condition_f893561ba854abcb59a1dee246fc542f'><span class='ff_tc_checkbox'><input type=\"checkbox\" name=\"terms-n-condition\" class=\"ff-el-form-check-input\" data-name=\"terms-n-condition\" id=\"terms-n-condition_f893561ba854abcb59a1dee246fc542f\"  value='on' aria-invalid='false' aria-required=false><\/span> <div class='ff_t_c'><p>Autorizo expresamente que la respuesta a mi reclamo o queja sea notificada al correo electr\u00f3nico que he indicado en este formulario.<\/p><\/div><\/label><\/div><\/div><div class='ff-el-group    ff-el-input--content'><div class='ff-el-form-check ff-el-tc'><label aria-label='T\u00e9rminos y condiciones: He le\u00eddo y acepto la Pol\u00edtica de Privacidad de Surgery in Per\u00fa. Contiene 1 enlace. Usa la navegaci\u00f3n por pesta\u00f1as para rese\u00f1ar.' class='ff-el-form-check-label ff_tc_label' for='terms-n-condition_1_83a79f68882c39d0b9a87a4e96aac6e7'><span class='ff_tc_checkbox'><input type=\"checkbox\" name=\"terms-n-condition_1\" class=\"ff-el-form-check-input\" data-name=\"terms-n-condition_1\" id=\"terms-n-condition_1_83a79f68882c39d0b9a87a4e96aac6e7\"  value='on' aria-invalid='false' aria-required=false><\/span> <div class='ff_t_c'><p>He le\u00eddo y acepto la <a href=\"https:\/\/surgeryinperu.com\/es\/riesgos-complicaciones-descargo-responsabilidad\/\" target=\"_blank\" rel=\"noopener\">Pol\u00edtica de Privacidad<\/a> de Surgery in Per\u00fa.<\/p><\/div><\/label><\/div><\/div><div class='ff-form-inline-style' hidden><style>form.fluent_form_15 .ff-btn-submit:not(.ff_btn_no_style) { background-color: var(--fluentform-primary); color: #ffffff; }<\/style><\/div><div class='ff-el-group ff-text-left ff_submit_btn_wrapper'><button type=\"submit\" class=\"ff-btn 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