{"id":2463,"date":"2026-05-28T09:12:51","date_gmt":"2026-05-28T09:12:51","guid":{"rendered":"https:\/\/gesmd.es\/?page_id=2463"},"modified":"2026-05-28T10:38:07","modified_gmt":"2026-05-28T10:38:07","slug":"formulario-registro-resmd","status":"publish","type":"page","link":"https:\/\/gesmd.es\/?page_id=2463","title":{"rendered":"FORMULARIO REGISTRO RESMD"},"content":{"rendered":"\n<div class=\"wp-block-uagb-container uagb-block-afed5df2 alignfull uagb-is-root-container\"><div class=\"uagb-container-inner-blocks-wrap\">\n<div class=\"wp-block-uagb-advanced-heading uagb-block-27be517b\"><h2 class=\"uagb-heading-text\">SOLICITUD DE ALTA DE CENTRO<\/h2><\/div>\n\n\n\n<div class=\"wp-block-uagb-advanced-heading uagb-block-fb65187b\"><h2 class=\"uagb-heading-text\">Registro Espa\u00f1ol de S\u00edndromes Mielodispl\u00e1sicos (SMD)<\/h2><\/div>\n\n\n\n<div class=\"wp-block-uagb-container uagb-block-7417267b\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f2464-o1\" lang=\"es-ES\" dir=\"ltr\" data-wpcf7-id=\"2464\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F2463#wpcf7-f2464-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formulario de contacto\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"2464\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"es_ES\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f2464-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\" \/><input type=\"hidden\" name=\"_wpcf7cf_options\" value=\"{&quot;form_id&quot;:2464,&quot;conditions&quot;:[{&quot;then_field&quot;:&quot;-1&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;hematologo&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;No&quot;}]}],&quot;settings&quot;:{&quot;animation&quot;:&quot;yes&quot;,&quot;animation_intime&quot;:200,&quot;animation_outtime&quot;:200,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:false,&quot;repeater_remove_button&quot;:&quot;bottom&quot;}}\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<p style=\"margin-bottom:5px\"><b>1. Centro e investigador<\/b>\n<\/p>\n<p><label> Nombre del centro sanitario: <span>*<\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"centro-sanitario\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"centro-sanitario\" \/><\/span> <\/label>\n<\/p>\n<p><label> Nombre investigador: <span>*<\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"nombre-investigador\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nombre-investigador\" \/><\/span> <\/label>\n<\/p>\n<p><label> Email de contacto: <span>*<\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" autocomplete=\"email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span> <\/label>\n<\/p>\n<p style=\"font-size:14px;color:#101723\">\u00bfEl solicitante es hemat\u00f3logo? <span>*<\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"hematologo\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"hematologo\" value=\"S\u00ed\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"hematologo\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label>Confirmaci\u00f3n de aval del hemat\u00f3logo responsable (si aplica):<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"aval-confirmacion\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"aval-confirmacion[]\" value=\"Confirmo que existe aval del IP responsable del centro\" \/><span class=\"wpcf7-list-item-label\">Confirmo que existe aval del IP responsable del centro<\/span><\/span><\/span><\/span><\/label>\n<\/p>\n<p style=\"font-size:14px;color:#101723\">\u00bfEl solicitante es miembro de GESMD? <span>*<\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"gesmd\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"gesmd\" value=\"S\u00ed\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"gesmd\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p style=\"margin-bottom:5px;margin-top:20px\"><b>2. Confirmo y acepto los criterios de inclusi\u00f3n del registro de datos:<\/b>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"confirmo-criterios\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"confirmo-criterios[]\" value=\"Acepto *\" \/><span class=\"wpcf7-list-item-label\">Acepto *<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p style=\"margin-bottom:5px;margin-top:20px\"><b>3. Confirmo y acepto que mis datos de contacto sean compartidos con otros investigadores con fines de publicaci\u00f3n de resultados del estudio:<\/b>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"confirmo-datos\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"confirmo-datos[]\" value=\"Acepto *\" \/><span class=\"wpcf7-list-item-label\">Acepto *<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p style=\"margin-bottom:5px;margin-top:20px\"><b>4. Firmas<\/b>\n<\/p>\n\n<!-- PRIMERA FIRMA (Investigador) -->\n<p><label> Nombre del investigador principal: <span>*<\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"nombre-firma\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nombre-firma\" \/><\/span> <\/label>\n<\/p>\n<p><label> Firma aqu\u00ed (Investigador): <span>*<\/span> <\/label>\n<\/p>\n<div style=\"border: 1px solid #a4afb7; background: #dddddd; width: 300px; height: 200px; border-radius: 4px; box-shadow: inset 0 1px 2px rgba(0,0,0,0.1);\">\n\t<p><canvas id=\"canvas-investigador\" width=\"300\" height=\"200\" style=\"cursor: crosshair; display: block;\"><\/canvas>\n\t<\/p>\n<\/div>\n<p><button type=\"button\" onclick=\"document.getElementById('canvas-investigador').getContext('2d').clearRect(0,0,300,200); document.getElementById('datos-firma-1').value='';\" style=\"margin-top: 6px; padding: 6px 12px; font-size: 14px; font-family: inherit; background: #f6f7f7; color: #2c3338; border: 1px solid #8c8f94; border-radius: 3px; cursor: pointer; box-shadow: 0 1px 0 #8c8f94; transition: all 0.1s ease-in-out;\">Borrar<\/button>\n<\/p>\n\n<!-- Campo oculto para la firma 1 -->\n<input class=\"wpcf7-form-control wpcf7-hidden\" id=\"datos-firma-1\" value=\"\" type=\"hidden\" name=\"firma-uno\" \/>\n\n\n\n\n\n<!-- SEGUNDA FIRMA (Avalista) -->\n<p><label> Nombre del hemat\u00f3logo avalista (si aplica):<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"nombre-avalista\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nombre-avalista\" \/><\/span> <\/label>\n<\/p>\n<p><label> Firma aqu\u00ed (Avalista): <\/label>\n<\/p>\n<div style=\"border: 1px solid #a4afb7; background: #dddddd; width: 300px; height: 200px; border-radius: 4px; box-shadow: inset 0 1px 2px rgba(0,0,0,0.1);\">\n\t<p><canvas id=\"canvas-avalista\" width=\"300\" height=\"200\" style=\"cursor: crosshair; display: block;\"><\/canvas>\n\t<\/p>\n<\/div>\n<p><button type=\"button\" onclick=\"document.getElementById('canvas-avalista').getContext('2d').clearRect(0,0,300,200); document.getElementById('datos-firma-2').value='';\" style=\"margin-top: 6px; padding: 6px 12px; font-size: 14px; font-family: inherit; background: #f6f7f7; color: #2c3338; border: 1px solid #8c8f94; border-radius: 3px; cursor: pointer; box-shadow: 0 1px 0 #8c8f94; transition: all 0.1s ease-in-out;\">Borrar<\/button>\n<\/p>\n\n<!-- Campo oculto para la firma 2 -->\n<input class=\"wpcf7-form-control wpcf7-hidden\" id=\"datos-firma-2\" value=\"\" type=\"hidden\" name=\"firma-dos\" \/>\n<p><script>\nsetTimeout(function(){\n function activarLienzo(idCanvas, idOculto) {\n var canvas = document.getElementById(idCanvas); if(!canvas) return;\n var oculto = document.getElementById(idOculto); if(!oculto) return;\n var ctx = canvas.getContext('2d'); var dibujando = false;\n \n function o(e) { \n var r = canvas.getBoundingClientRect(); \n return { x: (e.clientX || e.touches[0].clientX) - r.left, y: (e.clientY || e.touches[0].clientY) - r.top }; \n }\n \n function guardarFirma() {\n \/\/ Guarda el trazo autom\u00e1ticamente en el campo oculto\n oculto.value = canvas.toDataURL();\n }\n \n ctx.lineWidth = 2; ctx.strokeStyle = '#000000';\n \n canvas.addEventListener('mousedown', function(e){ dibujando = true; ctx.beginPath(); var p = o(e); ctx.moveTo(p.x, p.y); });\n canvas.addEventListener('mousemove', function(e){ if(!dibujando) return; e.preventDefault(); var p = o(e); ctx.lineTo(p.x, p.y); ctx.stroke(); });\n window.addEventListener('mouseup', function(){ if(dibujando) { dibujando = false; guardarFirma(); } });\n \n canvas.addEventListener('touchstart', function(e){ dibujando = true; ctx.beginPath(); var p = o(e); ctx.moveTo(p.x, p.y); });\n canvas.addEventListener('touchmove', function(e){ if(!dibujando) return; e.preventDefault(); var p = o(e); ctx.lineTo(p.x, p.y); ctx.stroke(); });\n window.addEventListener('touchend', function(){ if(dibujando) { dibujando = false; guardarFirma(); } });\n }\n \n activarLienzo('canvas-investigador', 'datos-firma-1');\n activarLienzo('canvas-avalista', 'datos-firma-2');\n}, 500);\n<\/script>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Enviar\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n<\/div>\n<\/div><\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>SOLICITUD DE ALTA DE CENTRO Registro Espa\u00f1ol de S\u00edndromes Mielodispl\u00e1sicos (SMD)<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-2463","page","type-page","status-publish","hentry"],"uagb_featured_image_src":{"full":false,"thumbnail":false,"medium":false,"medium_large":false,"large":false,"1536x1536":false,"2048x2048":false},"uagb_author_info":{"display_name":"gesmd.jc.alvarez@ene.es","author_link":"https:\/\/gesmd.es\/?author=1"},"uagb_comment_info":0,"uagb_excerpt":"SOLICITUD DE ALTA DE CENTRO Registro Espa\u00f1ol de S\u00edndromes Mielodispl\u00e1sicos (SMD)","_links":{"self":[{"href":"https:\/\/gesmd.es\/index.php?rest_route=\/wp\/v2\/pages\/2463","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/gesmd.es\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/gesmd.es\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/gesmd.es\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/gesmd.es\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2463"}],"version-history":[{"count":14,"href":"https:\/\/gesmd.es\/index.php?rest_route=\/wp\/v2\/pages\/2463\/revisions"}],"predecessor-version":[{"id":2479,"href":"https:\/\/gesmd.es\/index.php?rest_route=\/wp\/v2\/pages\/2463\/revisions\/2479"}],"wp:attachment":[{"href":"https:\/\/gesmd.es\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2463"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}