{"id":1491,"date":"2018-12-26T09:25:55","date_gmt":"2018-12-26T15:25:55","guid":{"rendered":"https:\/\/eyespa.cr\/?p=1491"},"modified":"2019-01-14T09:45:32","modified_gmt":"2019-01-14T15:45:32","slug":"encuesta","status":"publish","type":"post","link":"https:\/\/eyespa.cr\/encuesta\/","title":{"rendered":"Encuesta"},"content":{"rendered":"\n                <div class='gf_browser_chrome gform_wrapper' id='gform_wrapper_3' style='display:none'><a id='gf_3' class='gform_anchor' ><\/a><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_3' id='gform_3'  action='\/wp-json\/wp\/v2\/posts\/1491#gf_3'>\n        <div id='gf_progressbar_wrapper_3' class='gf_progressbar_wrapper'>\n            <h3 class='gf_progressbar_title'>Paso 1 de 4\n        <\/h3>\n            <div class='gf_progressbar'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_25' style='width:25%;'><span>25%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform_body'><div id='gform_page_3_1' class='gform_page' >\n                                    <div class='gform_page_fields'><ul id='gform_fields_3' class='gform_fields top_label form_sublabel_below description_below'><li id='field_3_56'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >Es usted?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_3_56'><li class='gchoice_3_56_0'><input name='input_56' type='radio' value='Paciente Nuevo'  id='choice_3_56_0'   onclick='gf_apply_rules(3,[57,58]);' onkeypress='gf_apply_rules(3,[57,58]);'  \/><label for='choice_3_56_0' id='label_3_56_0'>Paciente Nuevo<\/label><\/li><li class='gchoice_3_56_1'><input name='input_56' type='radio' value='Paciente en Tratamiento'  id='choice_3_56_1'   onclick='gf_apply_rules(3,[57,58]);' onkeypress='gf_apply_rules(3,[57,58]);'  \/><label for='choice_3_56_1' id='label_3_56_1'>Paciente en Tratamiento<\/label><\/li><\/ul><\/div><\/li><li id='field_3_57'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >Paciente en Terapia<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_3_57'><li class='gchoice_3_57_0'><input name='input_57' type='radio' value='1 mes o m\u00e1s'  id='choice_3_57_0'     \/><label for='choice_3_57_0' id='label_3_57_0'>1 mes o m\u00e1s<\/label><\/li><li class='gchoice_3_57_1'><input name='input_57' type='radio' value='6 meses o m\u00e1s'  id='choice_3_57_1'     \/><label for='choice_3_57_1' id='label_3_57_1'>6 meses o m\u00e1s<\/label><\/li><li class='gchoice_3_57_2'><input name='input_57' type='radio' value='12 meses'  id='choice_3_57_2'     \/><label for='choice_3_57_2' id='label_3_57_2'>12 meses<\/label><\/li><\/ul><\/div><\/li><li id='field_3_58'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >Tratamiento<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_3_58'><li class='gchoice_3_58_0'><input name='input_58' type='radio' value='L\u00c1SER (IRPL)'  id='choice_3_58_0'     \/><label for='choice_3_58_0' id='label_3_58_0'>L\u00c1SER (IRPL)<\/label><\/li><li class='gchoice_3_58_1'><input name='input_58' type='radio' value='MANUAL'  id='choice_3_58_1'     \/><label for='choice_3_58_1' id='label_3_58_1'>MANUAL<\/label><\/li><li class='gchoice_3_58_2'><input name='input_58' type='radio' value='MIBOFLO'  id='choice_3_58_2'     \/><label for='choice_3_58_2' id='label_3_58_2'>MiBOFLO<\/label><\/li><li class='gchoice_3_58_3'><input name='input_58' type='radio' value='MiBOLASER'  id='choice_3_58_3'     \/><label for='choice_3_58_3' id='label_3_58_3'>MiBOLASER<\/label><\/li><\/ul><\/div><\/li><li id='field_3_39'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_3_39' >C\u00e9dula de Identidad<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_39' id='input_3_39' type='text' value='' class='medium' maxlength='20'    aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_3_41'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >Sexo<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_3_41'><li class='gchoice_3_41_0'><input name='input_41' type='radio' value='Masculino'  id='choice_3_41_0'     \/><label for='choice_3_41_0' id='label_3_41_0'>Masculino<\/label><\/li><li class='gchoice_3_41_1'><input name='input_41' type='radio' value='Femenino'  id='choice_3_41_1'     \/><label for='choice_3_41_1' id='label_3_41_1'>Femenino<\/label><\/li><\/ul><\/div><\/li><li id='field_3_52'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_3_52' >Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_52' id='input_3_52' type='text' value='' class='medium'      aria-invalid=\"false\"\/>\n                        <\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                         <input type='button' id='gform_next_button_3_47' class='gform_next_button button' value='Siguiente '  onclick='jQuery(\"#gform_target_page_number_3\").val(\"2\");  jQuery(\"#gform_3\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_3\").val(\"2\");  jQuery(\"#gform_3\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_3_2' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_3_2' class='gform_fields top_label form_sublabel_below description_below'><li id='field_3_3'  class='gfield gsection field_sublabel_below field_description_below gfield_visibility_visible' ><h2 class='gsection_title'>\u00bfHa experimentado alguna de las siguientes alteraciones durante la \u00faltima semana?<\/h2><\/li><li id='field_3_2'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible gsurvey-survey-field ' ><label class='gfield_label'  >Sensibilidad a la luz<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_likert'><table class='gsurvey-likert' id='input_3_2'><thead><tr><th scope='col' class='gsurvey-likert-choice-label'>En todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>El 50% del tiempo<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en ningun momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>En ningun momento<\/th><\/tr><\/thead><tbody><tr><td data-label='En todo momento' class='gsurvey-likert-choice'><input name='input_2' type='radio' value='glikertcol2f5b4fa85'  id='choice_3_2_1'   \/><\/td><td data-label='Casi en todo momento' class='gsurvey-likert-choice'><input name='input_2' type='radio' value='glikertcol213cfdb08'  id='choice_3_2_2'   \/><\/td><td data-label='El 50% del tiempo' class='gsurvey-likert-choice'><input name='input_2' type='radio' value='glikertcol24eb2b418'  id='choice_3_2_3'   \/><\/td><td data-label='Casi en ningun momento' class='gsurvey-likert-choice'><input name='input_2' type='radio' value='glikertcol2861e9b69'  id='choice_3_2_4'   \/><\/td><td data-label='En ningun momento' class='gsurvey-likert-choice'><input name='input_2' type='radio' value='glikertcol272d97a9a'  id='choice_3_2_5'   \/><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id='field_3_4'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible gsurvey-survey-field ' ><label class='gfield_label'  >Sensaci\u00f3n de arenilla en los ojos<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_likert'><table class='gsurvey-likert' id='input_3_4'><thead><tr><th scope='col' class='gsurvey-likert-choice-label'>En todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>El 50% del tiempo<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en ningun momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>En ningun momento<\/th><\/tr><\/thead><tbody><tr><td data-label='En todo momento' class='gsurvey-likert-choice'><input name='input_4' type='radio' value='glikertcol2f5b4fa85'  id='choice_3_4_1'   \/><\/td><td data-label='Casi en todo momento' class='gsurvey-likert-choice'><input name='input_4' type='radio' value='glikertcol213cfdb08'  id='choice_3_4_2'   \/><\/td><td data-label='El 50% del tiempo' class='gsurvey-likert-choice'><input name='input_4' type='radio' value='glikertcol24eb2b418'  id='choice_3_4_3'   \/><\/td><td data-label='Casi en ningun momento' class='gsurvey-likert-choice'><input name='input_4' type='radio' value='glikertcol2861e9b69'  id='choice_3_4_4'   \/><\/td><td data-label='En ningun momento' class='gsurvey-likert-choice'><input name='input_4' type='radio' value='glikertcol272d97a9a'  id='choice_3_4_5'   \/><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id='field_3_5'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible gsurvey-survey-field ' ><label class='gfield_label'  >Dolor de ojos<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_likert'><table class='gsurvey-likert' id='input_3_5'><thead><tr><th scope='col' class='gsurvey-likert-choice-label'>En todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>El 50% del tiempo<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en ningun momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>En ningun momento<\/th><\/tr><\/thead><tbody><tr><td data-label='En todo momento' class='gsurvey-likert-choice'><input name='input_5' type='radio' value='glikertcol2f5b4fa85'  id='choice_3_5_1'   \/><\/td><td data-label='Casi en todo momento' class='gsurvey-likert-choice'><input name='input_5' type='radio' value='glikertcol213cfdb08'  id='choice_3_5_2'   \/><\/td><td data-label='El 50% del tiempo' class='gsurvey-likert-choice'><input name='input_5' type='radio' value='glikertcol24eb2b418'  id='choice_3_5_3'   \/><\/td><td data-label='Casi en ningun momento' class='gsurvey-likert-choice'><input name='input_5' type='radio' value='glikertcol2861e9b69'  id='choice_3_5_4'   \/><\/td><td data-label='En ningun momento' class='gsurvey-likert-choice'><input name='input_5' type='radio' value='glikertcol272d97a9a'  id='choice_3_5_5'   \/><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id='field_3_6'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible gsurvey-survey-field ' ><label class='gfield_label'  >Visi\u00f3n borrosa<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_likert'><table class='gsurvey-likert' id='input_3_6'><thead><tr><th scope='col' class='gsurvey-likert-choice-label'>En todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>El 50% del tiempo<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en ningun momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>En ningun momento<\/th><\/tr><\/thead><tbody><tr><td data-label='En todo momento' class='gsurvey-likert-choice'><input name='input_6' type='radio' value='glikertcol2f5b4fa85'  id='choice_3_6_1'   \/><\/td><td data-label='Casi en todo momento' class='gsurvey-likert-choice'><input name='input_6' type='radio' value='glikertcol213cfdb08'  id='choice_3_6_2'   \/><\/td><td data-label='El 50% del tiempo' class='gsurvey-likert-choice'><input name='input_6' type='radio' value='glikertcol24eb2b418'  id='choice_3_6_3'   \/><\/td><td data-label='Casi en ningun momento' class='gsurvey-likert-choice'><input name='input_6' type='radio' value='glikertcol2861e9b69'  id='choice_3_6_4'   \/><\/td><td data-label='En ningun momento' class='gsurvey-likert-choice'><input name='input_6' type='radio' value='glikertcol272d97a9a'  id='choice_3_6_5'   \/><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id='field_3_7'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible gsurvey-survey-field ' ><label class='gfield_label'  >Mala Visi\u00f3n<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_likert'><table class='gsurvey-likert' id='input_3_7'><thead><tr><th scope='col' class='gsurvey-likert-choice-label'>En todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>El 50% del tiempo<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en ningun momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>En ningun momento<\/th><\/tr><\/thead><tbody><tr><td data-label='En todo momento' class='gsurvey-likert-choice'><input name='input_7' type='radio' value='glikertcol2f5b4fa85'  id='choice_3_7_1'   \/><\/td><td data-label='Casi en todo momento' class='gsurvey-likert-choice'><input name='input_7' type='radio' value='glikertcol213cfdb08'  id='choice_3_7_2'   \/><\/td><td data-label='El 50% del tiempo' class='gsurvey-likert-choice'><input name='input_7' type='radio' value='glikertcol24eb2b418'  id='choice_3_7_3'   \/><\/td><td data-label='Casi en ningun momento' class='gsurvey-likert-choice'><input name='input_7' type='radio' value='glikertcol2861e9b69'  id='choice_3_7_4'   \/><\/td><td data-label='En ningun momento' class='gsurvey-likert-choice'><input name='input_7' type='radio' value='glikertcol272d97a9a'  id='choice_3_7_5'   \/><\/td><\/tr><\/tbody><\/table><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                        <input type='button' id='gform_previous_button_3_48' class='gform_previous_button button' value='Anterior'  onclick='jQuery(\"#gform_target_page_number_3\").val(\"1\");  jQuery(\"#gform_3\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_3\").val(\"1\");  jQuery(\"#gform_3\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_3_48' class='gform_next_button button' value='Siguiente '  onclick='jQuery(\"#gform_target_page_number_3\").val(\"3\");  jQuery(\"#gform_3\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_3\").val(\"3\");  jQuery(\"#gform_3\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_3_3' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_3_3' class='gform_fields top_label form_sublabel_below description_below'><li id='field_3_8'  class='gfield gsection field_sublabel_below field_description_below gfield_visibility_visible' ><h2 class='gsection_title'>\u00bfHa tenido problemas en los ojos que le han limitado o impedido realizar alguna de las siguientes acciones?<\/h2><\/li><li id='field_3_9'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible gsurvey-survey-field ' ><label class='gfield_label'  >Leer<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_likert'><table class='gsurvey-likert' id='input_3_9'><thead><tr><th scope='col' class='gsurvey-likert-choice-label'>En todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>El 50% del tiempo<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en ningun momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>En ningun momento<\/th><\/tr><\/thead><tbody><tr><td data-label='En todo momento' class='gsurvey-likert-choice'><input name='input_9' type='radio' value='glikertcol2f5b4fa85'  id='choice_3_9_1'   \/><\/td><td data-label='Casi en todo momento' class='gsurvey-likert-choice'><input name='input_9' type='radio' value='glikertcol213cfdb08'  id='choice_3_9_2'   \/><\/td><td data-label='El 50% del tiempo' class='gsurvey-likert-choice'><input name='input_9' type='radio' value='glikertcol24eb2b418'  id='choice_3_9_3'   \/><\/td><td data-label='Casi en ningun momento' class='gsurvey-likert-choice'><input name='input_9' type='radio' value='glikertcol2861e9b69'  id='choice_3_9_4'   \/><\/td><td data-label='En ningun momento' class='gsurvey-likert-choice'><input name='input_9' type='radio' value='glikertcol272d97a9a'  id='choice_3_9_5'   \/><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id='field_3_10'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible gsurvey-survey-field ' ><label class='gfield_label'  >Conducir de noche<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_likert'><table class='gsurvey-likert' id='input_3_10'><thead><tr><th scope='col' class='gsurvey-likert-choice-label'>En todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>El 50% del tiempo<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en ningun momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>En ningun momento<\/th><\/tr><\/thead><tbody><tr><td data-label='En todo momento' class='gsurvey-likert-choice'><input name='input_10' type='radio' value='glikertcol2f5b4fa85'  id='choice_3_10_1'   \/><\/td><td data-label='Casi en todo momento' class='gsurvey-likert-choice'><input name='input_10' type='radio' value='glikertcol213cfdb08'  id='choice_3_10_2'   \/><\/td><td data-label='El 50% del tiempo' class='gsurvey-likert-choice'><input name='input_10' type='radio' value='glikertcol24eb2b418'  id='choice_3_10_3'   \/><\/td><td data-label='Casi en ningun momento' class='gsurvey-likert-choice'><input name='input_10' type='radio' value='glikertcol2861e9b69'  id='choice_3_10_4'   \/><\/td><td data-label='En ningun momento' class='gsurvey-likert-choice'><input name='input_10' type='radio' value='glikertcol272d97a9a'  id='choice_3_10_5'   \/><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id='field_3_11'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible gsurvey-survey-field ' ><label class='gfield_label'  >Trabajar con un ordenador o utilizar un cajero autom\u00e1tico<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_likert'><table class='gsurvey-likert' id='input_3_11'><thead><tr><th scope='col' class='gsurvey-likert-choice-label'>En todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>El 50% del tiempo<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en ningun momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>En ningun momento<\/th><\/tr><\/thead><tbody><tr><td data-label='En todo momento' class='gsurvey-likert-choice'><input name='input_11' type='radio' value='glikertcol2f5b4fa85'  id='choice_3_11_1'   \/><\/td><td data-label='Casi en todo momento' class='gsurvey-likert-choice'><input name='input_11' type='radio' value='glikertcol213cfdb08'  id='choice_3_11_2'   \/><\/td><td data-label='El 50% del tiempo' class='gsurvey-likert-choice'><input name='input_11' type='radio' value='glikertcol24eb2b418'  id='choice_3_11_3'   \/><\/td><td data-label='Casi en ningun momento' class='gsurvey-likert-choice'><input name='input_11' type='radio' value='glikertcol2861e9b69'  id='choice_3_11_4'   \/><\/td><td data-label='En ningun momento' class='gsurvey-likert-choice'><input name='input_11' type='radio' value='glikertcol272d97a9a'  id='choice_3_11_5'   \/><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id='field_3_12'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible gsurvey-survey-field ' ><label class='gfield_label'  >Ver la televisi\u00f3n<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_likert'><table class='gsurvey-likert' id='input_3_12'><thead><tr><th scope='col' class='gsurvey-likert-choice-label'>En todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en todo momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>El 50% del tiempo<\/th><th scope='col' class='gsurvey-likert-choice-label'>Casi en ningun momento<\/th><th scope='col' class='gsurvey-likert-choice-label'>En ningun momento<\/th><\/tr><\/thead><tbody><tr><td data-label='En todo momento' class='gsurvey-likert-choice'><input name='input_12' type='radio' 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todo momento' class='gsurvey-likert-choice'><input name='input_14' type='radio' value='glikertcol2f5b4fa85'  id='choice_3_14_1'   \/><\/td><td data-label='Casi en todo momento' class='gsurvey-likert-choice'><input name='input_14' type='radio' value='glikertcol213cfdb08'  id='choice_3_14_2'   \/><\/td><td data-label='El 50% del tiempo' class='gsurvey-likert-choice'><input name='input_14' type='radio' value='glikertcol24eb2b418'  id='choice_3_14_3'   \/><\/td><td data-label='Casi en ningun momento' class='gsurvey-likert-choice'><input name='input_14' type='radio' value='glikertcol2861e9b69'  id='choice_3_14_4'   \/><\/td><td data-label='En ningun momento' class='gsurvey-likert-choice'><input name='input_14' type='radio' value='glikertcol272d97a9a'  id='choice_3_14_5'   \/><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id='field_3_15'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible gsurvey-survey-field ' ><label 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