{"id":5734,"date":"2024-08-22T09:05:38","date_gmt":"2024-08-22T07:05:38","guid":{"rendered":"https:\/\/www.kreisklinik-gg.de\/?page_id=5734"},"modified":"2024-09-11T09:08:55","modified_gmt":"2024-09-11T07:08:55","slug":"lob-beschwerde-formular","status":"publish","type":"page","link":"https:\/\/www.kreisklinik-gg.de\/pl\/patienten-besucher\/lob-beschwerde-formular\/","title":{"rendered":"Lob &amp; Formularz skargi"},"content":{"rendered":"<div class=\"wpb-content-wrapper\" id=\"wpb-content-root\"><div data-vc-full-width=\"true\" data-vc-full-width-temp=\"true\" data-vc-full-width-init=\"false\" data-vc-stretch-content=\"true\" class=\"vc_row wpb_row vc_row-fluid vc_row-no-padding vc_row-o-equal-height vc_row-flex\"><div class=\"wpb_column vc_column_container vc_col-sm-6 vc_hidden-sm vc_hidden-xs\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\"><\/div><\/div><\/div><div class=\"wpb_column vc_column_container vc_col-sm-6 vc_hidden-sm vc_hidden-xs\"><div class=\"vc_column-inner vc_custom_1650535550235\"><div class=\"wpb_wrapper\"><div id=\"ultimate-heading-8006ae042105116e\" class=\"uvc-heading ult-adjust-bottom-margin ultimate-heading-8006ae042105116e uvc-5741  uvc-heading-default-font-sizes\" data-hspacer=\"no_spacer\"  data-halign=\"left\" style=\"text-align:left\"><div class=\"uvc-heading-spacer no_spacer\" style=\"top\"><\/div><div class=\"uvc-main-heading ult-responsive\"  data-ultimate-target='.uvc-heading.ultimate-heading-8006ae042105116e h1'  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}' ><h1 style=\"--font-weight:theme;color:#ffffff;margin-top:120px;margin-bottom:0px;\">Lob &amp; Reklamacje - Formularz<\/h1><\/div><\/div><\/div><\/div><\/div><div class=\"wpb_column vc_column_container vc_col-sm-12 vc_hidden-lg vc_hidden-md vc_hidden-xl\"><div class=\"vc_column-inner vc_custom_1650535577017\"><div class=\"wpb_wrapper\"><div id=\"ultimate-heading-37056ae042105141f\" class=\"uvc-heading ult-adjust-bottom-margin ultimate-heading-37056ae042105141f uvc-1632  uvc-heading-default-font-sizes\" data-hspacer=\"no_spacer\"  data-halign=\"center\" style=\"text-align:center\"><div class=\"uvc-heading-spacer no_spacer\" style=\"top\"><\/div><div class=\"uvc-sub-heading ult-responsive\"  data-ultimate-target='.uvc-heading.ultimate-heading-37056ae042105141f .uvc-sub-heading '  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}'  style=\"font-weight:normal;\"><\/p>\n<h2><span style=\"color: #ffffff;\">Pacjent<br \/>\narkusz informacji zwrotnej<\/span><\/h2>\n<p><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"vc_row-full-width vc_clearfix\"><\/div><!-- Row Backgrounds --><div class=\"upb_bg_img\" data-ultimate-bg=\"url(https:\/\/www.kreisklinik-gg.de\/wp-content\/uploads\/2022\/04\/patienten-aerzte-banner.png)\" data-image-id=\"id^3418|url^https:\/\/www.kreisklinik-gg.de\/wp-content\/uploads\/2022\/04\/patienten-aerzte-banner.png|caption^null|alt^null|title^patienten-aerzte-banner|description^null\" data-ultimate-bg-style=\"vcpb-default\" data-bg-img-repeat=\"no-repeat\" data-bg-img-size=\"cover\" data-bg-img-position=\"\" data-parallx_sense=\"30\" data-bg-override=\"ex-full\" data-bg_img_attach=\"scroll\" data-upb-overlay-color=\"\" data-upb-bg-animation=\"\" data-fadeout=\"\" data-bg-animation=\"left-animation\" data-bg-animation-type=\"h\" data-animation-repeat=\"repeat\" data-fadeout-percentage=\"30\" data-parallax-content=\"\" data-parallax-content-sense=\"30\" data-row-effect-mobile-disable=\"true\" data-img-parallax-mobile-disable=\"true\" data-rtl=\"false\"  data-custom-vc-row=\"\"  data-vc=\"9.0.1\"  data-is_old_vc=\"\"  data-theme-support=\"\"   data-overlay=\"false\" data-overlay-color=\"\" data-overlay-pattern=\"\" data-overlay-pattern-opacity=\"\" data-overlay-pattern-size=\"\"    ><\/div><div class=\"vc_row wpb_row vc_row-fluid vc_custom_1639655758535\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\"><div id=\"ultimate-heading-15376ae0421052173\" class=\"uvc-heading ult-adjust-bottom-margin ultimate-heading-15376ae0421052173 uvc-7892  uvc-heading-default-font-sizes\" data-hspacer=\"no_spacer\"  data-halign=\"left\" style=\"text-align:left\"><div class=\"uvc-heading-spacer no_spacer\" style=\"top\"><\/div><div class=\"uvc-main-heading ult-responsive\"  data-ultimate-target='.uvc-heading.ultimate-heading-15376ae0421052173 h2'  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}' ><h2 style=\"--font-weight:theme;margin-bottom:20px;\">Arkusz informacji zwrotnych<\/h2><\/div><\/div>\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f5766-o1\" lang=\"de-DE\" dir=\"ltr\" data-wpcf7-id=\"5766\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/pl\/wp-json\/wp\/v2\/pages\/5734#wpcf7-f5766-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formularz kontaktowy\" novalidate=\"novalidate\" data-status=\"init\" data-etm-original-action=\"\/pl\/wp-json\/wp\/v2\/pages\/5734#wpcf7-f5766-o1\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"5766\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.2.3\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"de_DE\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f5766-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7dtx_version\" value=\"5.0.7\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div class=\"cf7-builder-container-row1 cf7-builder-container-row-inner cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-1645185963118\">\n\t<div class=\"cf7-ctrl\">\n\t\t<div class=\"cf7-move\">\n\t\t<\/div>\n\t\t<div class=\"cf7-colunm\">\n\t\t<\/div>\n\t\t<div class=\"cf7-dub cf7-dub-row\">\n\t\t<\/div>\n\t\t<div class=\"cf7-remove\">\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"cf7-row\">\n\t\t<div class=\"col-md-12\">\n\t\t\t<div class=\"cf7-builder-container-row-inner-drop ui-droppable ui-sortable\">\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-6017563\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p>Drogi cierpliwy, Drogi cierpliwy\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<p>Twoja opinia jest dla nas wa\u017cna. Z tego powodu prosimy o przekazanie nam kr\u00f3tkiej informacji zwrotnej na temat pobytu w szpitalu, aby\u015bmy mogli lepiej dostosowa\u0107 si\u0119 do Twoich \u017cycze\u0144 i potrzeb.\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<p>Dane zawarte w kwestionariuszu s\u0105 gromadzone wy\u0142\u0105cznie do cel\u00f3w statystycznych w kontek\u015bcie zapewniania jako\u015bci. Gwarantujemy, \u017ce dane osobowe nie b\u0119d\u0105 przekazywane osobom trzecim ani nie b\u0119d\u0105 mog\u0142y by\u0107 przegl\u0105dane przez osoby trzecie.\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"cf7-builder-container-row1 cf7-builder-container-row-inner cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-6731484\">\n\t<div class=\"cf7-ctrl\">\n\t\t<div class=\"cf7-move\">\n\t\t<\/div>\n\t\t<div class=\"cf7-colunm\">\n\t\t<\/div>\n\t\t<div class=\"cf7-dub cf7-dub-row\">\n\t\t<\/div>\n\t\t<div class=\"cf7-remove\">\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"cf7-row\">\n\t\t<div class=\"col-md-12\">\n\t\t\t<div class=\"cf7-builder-container-row-inner-drop ui-droppable ui-sortable\">\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-helper ui-sortable-handle\" id=\"cf7-container-builder-5981507\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p>Dane osobowe\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"cf7-builder-container-row1 cf7-builder-container-row-inner cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-5727087\">\n\t<div class=\"cf7-ctrl\">\n\t\t<div class=\"cf7-move\">\n\t\t<\/div>\n\t\t<div class=\"cf7-colunm\">\n\t\t<\/div>\n\t\t<div class=\"cf7-dub cf7-dub-row\">\n\t\t<\/div>\n\t\t<div class=\"cf7-remove\">\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"cf7-row\">\n\t\t<div class=\"col-md-6\">\n\t\t\t<div class=\"cf7-builder-container-row-inner-drop ui-droppable ui-sortable\">\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-helper ui-sortable-handle\" id=\"cf7-container-builder-8858725\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Imi\u0119 i nazwisko\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"Name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"\" value=\"\" type=\"text\" name=\"Name\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6\">\n\t\t\t<div class=\"cf7-builder-container-row-inner-drop ui-droppable ui-sortable\">\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-helper ui-sortable-handle\" id=\"cf7-container-builder-1645185739517\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Tw\u00f3j adres e-mail*\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"email-adress\"><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=\"@\" value=\"\" type=\"email\" name=\"email-adress\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"cf7-builder-container-row1 cf7-builder-container-row-inner cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-1511678423660\">\n\t<div class=\"cf7-ctrl\">\n\t\t<div class=\"cf7-move\">\n\t\t<\/div>\n\t\t<div class=\"cf7-colunm\">\n\t\t<\/div>\n\t\t<div class=\"cf7-dub cf7-dub-row\">\n\t\t<\/div>\n\t\t<div class=\"cf7-remove\">\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"cf7-row\">\n\t\t<div class=\"col-md-6\">\n\t\t\t<div class=\"cf7-builder-container-row-inner-drop ui-droppable ui-sortable\">\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-1645185539626\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Wiek*\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"Alter\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"\" value=\"\" type=\"text\" name=\"Alter\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6\">\n\t\t\t<div class=\"cf7-builder-container-row-inner-drop ui-droppable ui-sortable\">\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-1645185562040\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>P\u0142e\u0107*\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"Geschlecht\"><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=\"Geschlecht\" value=\"m\" \/><span class=\"wpcf7-list-item-label\">m<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"Geschlecht\" value=\"w\" \/><span class=\"wpcf7-list-item-label\">w<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"Geschlecht\" value=\"d\" \/><span class=\"wpcf7-list-item-label\">d<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"cf7-builder-container-row1 cf7-builder-container-row-inner cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-1645185512055\">\n\t<div class=\"cf7-ctrl\">\n\t\t<div class=\"cf7-move\">\n\t\t<\/div>\n\t\t<div class=\"cf7-colunm\">\n\t\t<\/div>\n\t\t<div class=\"cf7-dub cf7-dub-row\">\n\t\t<\/div>\n\t\t<div class=\"cf7-remove\">\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"cf7-row\">\n\t\t<div class=\"col-md-12\">\n\t\t\t<div class=\"cf7-builder-container-row-inner-drop ui-droppable ui-sortable\">\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-helper ui-sortable-handle\" id=\"cf7-container-builder-261507\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p>hospitalizacji\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"cf7-builder-container-row1 cf7-builder-container-row-inner cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-5022536\">\n\t<div class=\"cf7-ctrl\">\n\t\t<div class=\"cf7-move\">\n\t\t<\/div>\n\t\t<div class=\"cf7-colunm\">\n\t\t<\/div>\n\t\t<div class=\"cf7-dub cf7-dub-row\">\n\t\t<\/div>\n\t\t<div class=\"cf7-remove\">\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"cf7-row\">\n\t\t<div class=\"col-md-6\">\n\t\t\t<div class=\"cf7-builder-container-row-inner-drop ui-droppable ui-sortable\">\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-8074660\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Data\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"datum-von\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"datum-von\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6\">\n\t\t\t<div class=\"cf7-builder-container-row-inner-drop ui-droppable ui-sortable\">\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-helper ui-sortable-handle\" id=\"cf7-container-builder-1645185641867\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Data do\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"datum-bis\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"datum-bis\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"cf7-builder-container-row1 cf7-builder-container-row-inner cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-4535309\">\n\t<div class=\"cf7-ctrl\">\n\t\t<div class=\"cf7-move\">\n\t\t<\/div>\n\t\t<div class=\"cf7-colunm\">\n\t\t<\/div>\n\t\t<div class=\"cf7-dub cf7-dub-row\">\n\t\t<\/div>\n\t\t<div class=\"cf7-remove\">\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"cf7-row\">\n\t\t<div class=\"col-md-6\">\n\t\t\t<div class=\"cf7-builder-container-row-inner-drop ui-droppable ui-sortable\">\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-helper ui-sortable-handle\" id=\"cf7-container-builder-685689\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Na jakiej stacji si\u0119 Pa\u0144stwo znajdowali?*\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"abteilung\"><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=\"abteilung\" value=\"Innere\" \/><span class=\"wpcf7-list-item-label\">Wn\u0119trze<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"abteilung\" value=\"Chirurgie\" \/><span class=\"wpcf7-list-item-label\">chirurgia<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-md-6\">\n\t\t\t<div class=\"cf7-builder-container-row-inner-drop ui-droppable ui-sortable\">\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-helper ui-sortable-handle\" id=\"cf7-container-builder-8521275\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Kt\u00f3ra stacja by\u0142a za Ciebie odpowiedzialna?*\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"station\"><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=\"station\" value=\"2A\/B\" \/><span class=\"wpcf7-list-item-label\">2A\/B<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"station\" value=\"3A\/B\" \/><span class=\"wpcf7-list-item-label\">3A\/B<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"station\" value=\"Intensiv\" \/><span class=\"wpcf7-list-item-label\">Intensywny<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"station\" value=\"4A\" \/><span class=\"wpcf7-list-item-label\">4A<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"cf7-builder-container-row1 cf7-builder-container-row-inner cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-1645185776513\">\n\t<div class=\"cf7-ctrl\">\n\t\t<div class=\"cf7-move\">\n\t\t<\/div>\n\t\t<div class=\"cf7-colunm\">\n\t\t<\/div>\n\t\t<div class=\"cf7-dub cf7-dub-row\">\n\t\t<\/div>\n\t\t<div class=\"cf7-remove\">\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"cf7-row\">\n\t\t<div class=\"col-md-12\">\n\t\t\t<div class=\"cf7-builder-container-row-inner-drop ui-droppable ui-sortable\">\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-1645185813008\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Czy by\u0142e\u015b mile widziany w informacji?\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check1\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check1\" value=\"ja\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">tak<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check1\" value=\"nein\" \/><span class=\"wpcf7-list-item-label\">nie<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"ui-sortable-placeholder cf7-text cf7-main-builder dropped ui-sortable-handle\" >\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"ui-sortable-placeholder cf7-text cf7-main-builder dropped ui-sortable-handle\" >\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"ui-sortable-placeholder cf7-text cf7-main-builder dropped ui-sortable-handle\" >\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-8808094\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Recepcja w recepcji pacjenta by\u0142a przyjazna?\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check2\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check2\" value=\"ja\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">tak<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check2\" value=\"nein\" \/><span class=\"wpcf7-list-item-label\">nie<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-8398371\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Czy zostali Pa\u0144stwo poinformowani o mo\u017cliwo\u015bci wykonania fakultatywnego?\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check3\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check3\" value=\"ja\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">tak<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check3\" value=\"nein\" \/><span class=\"wpcf7-list-item-label\">nie<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-2415589\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Czy szpital zrobi\u0142 czyste wra\u017cenie?\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check4\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check4\" value=\"ja\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">tak<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check4\" value=\"nein\" \/><span class=\"wpcf7-list-item-label\">nie<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"cf7-builder-container-row1 cf7-builder-container-row-inner cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-9363533\">\n\t<div class=\"cf7-ctrl\">\n\t\t<div class=\"cf7-move\">\n\t\t<\/div>\n\t\t<div class=\"cf7-colunm\">\n\t\t<\/div>\n\t\t<div class=\"cf7-dub cf7-dub-row\">\n\t\t<\/div>\n\t\t<div class=\"cf7-remove\">\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"cf7-row\">\n\t\t<div class=\"col-md-12\">\n\t\t\t<div class=\"cf7-builder-container-row-inner-drop ui-droppable ui-sortable\">\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-6253927\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p>Prosz\u0119 oceni\u0107:\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"cf7-builder-container-row1 cf7-builder-container-row-inner cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-6450327\">\n\t<div class=\"cf7-ctrl\">\n\t\t<div class=\"cf7-move\">\n\t\t<\/div>\n\t\t<div class=\"cf7-colunm\">\n\t\t<\/div>\n\t\t<div class=\"cf7-dub cf7-dub-row\">\n\t\t<\/div>\n\t\t<div class=\"cf7-remove\">\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"cf7-row\">\n\t\t<div class=\"col-md-12\">\n\t\t\t<div class=\"cf7-builder-container-row-inner-drop ui-droppable ui-sortable\">\n\t\t\t\t<div class=\"ui-sortable-placeholder cf7-text cf7-main-builder dropped ui-sortable-handle\" >\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"ui-sortable-placeholder cf7-text cf7-main-builder dropped ui-sortable-handle\" >\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"ui-sortable-placeholder cf7-text cf7-main-builder dropped ui-sortable-handle\" >\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-3880190\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>opieka medyczna\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check5\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check5\" value=\"vorbildlich\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">wzorowe<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check5\" value=\"gut\" \/><span class=\"wpcf7-list-item-label\">dobre<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check5\" value=\"verbesserungsf\u00e4hig\" \/><span class=\"wpcf7-list-item-label\">Mo\u017cna ulepszy\u0107<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check5\" value=\"ungen\u00fcgend\" \/><span class=\"wpcf7-list-item-label\">niewystarczaj\u0105cy<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-92464\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>opieka piel\u0119gniarska\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check6\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check6\" value=\"vorbildlich\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">wzorowe<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check6\" value=\"gut\" \/><span class=\"wpcf7-list-item-label\">dobre<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check6\" value=\"verbesserungsf\u00e4hig\" \/><span class=\"wpcf7-list-item-label\">Mo\u017cna ulepszy\u0107<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check6\" value=\"ungen\u00fcgend\" \/><span class=\"wpcf7-list-item-label\">niewystarczaj\u0105cy<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-7564763\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>karetka\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check7\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check7\" value=\"vorbildlich\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">wzorowe<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check7\" value=\"gut\" \/><span class=\"wpcf7-list-item-label\">dobre<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check7\" value=\"verbesserungsf\u00e4hig\" \/><span class=\"wpcf7-list-item-label\">Mo\u017cna ulepszy\u0107<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check7\" value=\"ungen\u00fcgend\" \/><span class=\"wpcf7-list-item-label\">niewystarczaj\u0105cy<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-6651047\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>EKG\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check8\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check8\" value=\"vorbildlich\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">wzorowe<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check8\" value=\"gut\" \/><span class=\"wpcf7-list-item-label\">dobre<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check8\" value=\"verbesserungsf\u00e4hig\" \/><span class=\"wpcf7-list-item-label\">Mo\u017cna ulepszy\u0107<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check8\" value=\"ungen\u00fcgend\" \/><span class=\"wpcf7-list-item-label\">niewystarczaj\u0105cy<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-9110136\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>endoskopia\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check9\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check9\" value=\"vorbildlich\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">wzorowe<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check9\" value=\"gut\" \/><span class=\"wpcf7-list-item-label\">dobre<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check9\" value=\"verbesserungsf\u00e4hig\" \/><span class=\"wpcf7-list-item-label\">Mo\u017cna ulepszy\u0107<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check9\" value=\"ungen\u00fcgend\" \/><span class=\"wpcf7-list-item-label\">niewystarczaj\u0105cy<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-5348936\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>fizjoterapia\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check10\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check10\" value=\"vorbildlich\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">wzorowe<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check10\" value=\"gut\" \/><span class=\"wpcf7-list-item-label\">dobre<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check10\" value=\"verbesserungsf\u00e4hig\" \/><span class=\"wpcf7-list-item-label\">Mo\u017cna ulepszy\u0107<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check10\" value=\"ungen\u00fcgend\" \/><span class=\"wpcf7-list-item-label\">niewystarczaj\u0105cy<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-465004\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Dzia\u0142 rentgenowski\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check11\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check11\" value=\"vorbildlich\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">wzorowe<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check11\" value=\"gut\" \/><span class=\"wpcf7-list-item-label\">dobre<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check11\" value=\"verbesserungsf\u00e4hig\" \/><span class=\"wpcf7-list-item-label\">Mo\u017cna ulepszy\u0107<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check11\" value=\"ungen\u00fcgend\" \/><span class=\"wpcf7-list-item-label\">niewystarczaj\u0105cy<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-8794560\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Serwis Soziel\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check12\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check12\" value=\"vorbildlich\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">wzorowe<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check12\" value=\"gut\" \/><span class=\"wpcf7-list-item-label\">dobre<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check12\" value=\"verbesserungsf\u00e4hig\" \/><span class=\"wpcf7-list-item-label\">Mo\u017cna ulepszy\u0107<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check12\" value=\"ungen\u00fcgend\" \/><span class=\"wpcf7-list-item-label\">niewystarczaj\u0105cy<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-4415518\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Centralny PO\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check13\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check13\" value=\"vorbildlich\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">wzorowe<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check13\" value=\"gut\" \/><span class=\"wpcf7-list-item-label\">dobre<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check13\" value=\"verbesserungsf\u00e4hig\" \/><span class=\"wpcf7-list-item-label\">Mo\u017cna ulepszy\u0107<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check13\" value=\"ungen\u00fcgend\" \/><span class=\"wpcf7-list-item-label\">niewystarczaj\u0105cy<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-6126812\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>kr\u0105g pomocnik\u00f3w\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check14\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check14\" value=\"vorbildlich\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">wzorowe<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check14\" value=\"gut\" \/><span class=\"wpcf7-list-item-label\">dobre<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check14\" value=\"verbesserungsf\u00e4hig\" \/><span class=\"wpcf7-list-item-label\">Mo\u017cna ulepszy\u0107<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check14\" value=\"ungen\u00fcgend\" \/><span class=\"wpcf7-list-item-label\">niewystarczaj\u0105cy<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"cf7-builder-container-row1 cf7-builder-container-row-inner cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-1645187319309\">\n\t<div class=\"cf7-ctrl\">\n\t\t<div class=\"cf7-move\">\n\t\t<\/div>\n\t\t<div class=\"cf7-colunm\">\n\t\t<\/div>\n\t\t<div class=\"cf7-dub cf7-dub-row\">\n\t\t<\/div>\n\t\t<div class=\"cf7-remove\">\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"cf7-row\">\n\t\t<div class=\"col-md-12\">\n\t\t\t<div class=\"cf7-builder-container-row-inner-drop ui-droppable ui-sortable\">\n\t\t\t\t<div class=\"ui-sortable-placeholder cf7-text cf7-main-builder dropped ui-sortable-handle\" >\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-1645187322717\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p>Wspieraj\u0105 nas w naszych wysi\u0142kach, aby zapewni\u0107 Tobie i wszystkim innym pacjentom najlepsz\u0105 mo\u017cliw\u0105 opiek\u0119.\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"ui-sortable-placeholder cf7-text cf7-main-builder dropped ui-sortable-handle\" >\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-2577771\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Co Wam si\u0119 szczeg\u00f3lnie podoba\u0142o lub w og\u00f3le nie podoba\u0142o?\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check15\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"\" value=\"\" type=\"text\" name=\"check15\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-3734027\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Jakie sugestie dotycz\u0105ce ulepsze\u0144 mo\u017cesz nam przedstawi\u0107?\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check16\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"\" value=\"\" type=\"text\" name=\"check16\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-265969\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p>Prosz\u0119 oceni\u0107 nasze jedzenie:\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-helper ui-sortable-handle\" id=\"cf7-container-builder-882373\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>smak\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check17\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check17\" value=\"vorbildlich\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">wzorowe<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check17\" value=\"gut\" \/><span class=\"wpcf7-list-item-label\">dobre<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check17\" value=\"verbesserungsf\u00e4hig\" \/><span class=\"wpcf7-list-item-label\">Mo\u017cna ulepszy\u0107<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check17\" value=\"ungen\u00fcgend\" \/><span class=\"wpcf7-list-item-label\">niewystarczaj\u0105cy<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-550085\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Wielko\u015b\u0107 porcji\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check18\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check18\" value=\"vorbildlich\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">wzorowe<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check18\" value=\"gut\" \/><span class=\"wpcf7-list-item-label\">dobre<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check18\" value=\"verbesserungsf\u00e4hig\" \/><span class=\"wpcf7-list-item-label\">Mo\u017cna ulepszy\u0107<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check18\" value=\"ungen\u00fcgend\" \/><span class=\"wpcf7-list-item-label\">niewystarczaj\u0105cy<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-4918775\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>odmiana\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check19\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check19\" value=\"vorbildlich\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">wzorowe<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check19\" value=\"gut\" \/><span class=\"wpcf7-list-item-label\">dobre<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check19\" value=\"verbesserungsf\u00e4hig\" \/><span class=\"wpcf7-list-item-label\">Mo\u017cna ulepszy\u0107<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check19\" value=\"ungen\u00fcgend\" \/><span class=\"wpcf7-list-item-label\">niewystarczaj\u0105cy<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"cf7-builder-container-row1 cf7-builder-container-row-inner cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-813069\">\n\t<div class=\"cf7-ctrl\">\n\t\t<div class=\"cf7-move\">\n\t\t<\/div>\n\t\t<div class=\"cf7-colunm\">\n\t\t<\/div>\n\t\t<div class=\"cf7-dub cf7-dub-row\">\n\t\t<\/div>\n\t\t<div class=\"cf7-remove\">\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"cf7-row\">\n\t\t<div class=\"col-md-12\">\n\t\t\t<div class=\"cf7-builder-container-row-inner-drop ui-droppable ui-sortable\">\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-1416167\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Jak dowiedzia\u0142e\u015b si\u0119 o nas lub o klinice powiatowej?\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check20\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"check20\" value=\"bereits Patient gewesen\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">By\u0142e\u015b ju\u017c pacjentem<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check20\" value=\"anderes Krankenhaus\" \/><span class=\"wpcf7-list-item-label\">Inne szpitale<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check20\" value=\"durch Empfehlung des Haus- bzw. Facharztes\" \/><span class=\"wpcf7-list-item-label\">na podstawie zalecenia lekarza og\u00f3lnego lub specjalisty<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"check20\" value=\"durch Empfehlung von Freunden\/Bekannten\/Nachbarn\" \/><span class=\"wpcf7-list-item-label\">przez rekomendacj\u0119 przyjaci\u00f3\u0142\/znajomych\/s\u0105siad\u00f3w<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"check20\" value=\"durch Internet\/Prospekt\/Presse\/TV\" \/><span class=\"wpcf7-list-item-label\">Internet\/Prospekt emisyjny\/Prasa\/Telewizja<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-6619944\" >\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"check25\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"inne\" value=\"\" type=\"text\" name=\"check25\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-3550193\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_label\">\n\t\t\t\t\t\t<p>Czy poleci\u0142by\u015b nasz\u0105 klinik\u0119 powiatow\u0105?\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"weiterempfehlung\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"weiterempfehlung\" value=\"Ja\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Tak<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"weiterempfehlung\" value=\"Nein\" \/><span class=\"wpcf7-list-item-label\">Nie<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-helper ui-sortable-handle\" id=\"cf7-container-builder-8508650\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p>Dzi\u0119kujemy za opini\u0119, prosz\u0119 pobra\u0107 Google reCAPTCHA przed wys\u0142aniem formularza\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"ui-sortable-placeholder cf7-text cf7-main-builder dropped ui-sortable-handle\" >\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"cf7-text cf7-main-builder dropped ui-sortable-handle\" id=\"cf7-container-builder-6329488\">\n\t\t\t\t\t<div class=\"cf7-ctrl cf7-ctrl-inner\">\n\t\t\t\t\t\t<div class=\"cf7-move\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-edit\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-dub cf7-dub-text\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"cf7-remove\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_font\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"cf7_text_shortcode\">\n\t\t\t\t\t\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"KWESTIONARIUSZ WY\u015aLIJ\" \/>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div><input type=\"text\" class=\"wpcf7_hp_field\" name=\"wpcf7_hp_field\" value=\"\" tabindex=\"-1\" autocomplete=\"off\" \/><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<input type=\"hidden\" name=\"etm-form-language\" value=\"pl\"\/><\/form>\n<\/div>\n\n\t<div class=\"wpb_text_column wpb_content_element\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<p>[borlabs-cookie id=\u2019recaptcha\u2019 type=\u2019content-blocker\u2019]Za\u0142adowano Google reCAPTCHA.[\/borlabs-cookie]<\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div><!-- Row Backgrounds --><div class=\"upb_color\" data-bg-override=\"full\" data-bg-color=\"#f1f1f1\" data-fadeout=\"\" data-fadeout-percentage=\"30\" data-parallax-content=\"\" data-parallax-content-sense=\"30\" data-row-effect-mobile-disable=\"true\" data-img-parallax-mobile-disable=\"true\" data-rtl=\"false\"  data-custom-vc-row=\"\"  data-vc=\"9.0.1\"  data-is_old_vc=\"\"  data-theme-support=\"\"   data-overlay=\"false\" data-overlay-color=\"\" data-overlay-pattern=\"\" data-overlay-pattern-opacity=\"\" data-overlay-pattern-size=\"\"    ><\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Lob &amp; Reklamacje - Formularz pacjenta - informacja zwrotna Drogi pacjencie Twoja opinia jest dla nas wa\u017cna. Z tego powodu prosimy o przekazanie nam kr\u00f3tkiej informacji zwrotnej na temat pobytu w szpitalu, aby\u015bmy mogli lepiej dostosowa\u0107 si\u0119 do Twoich \u017cycze\u0144 i potrzeb. Dane zawarte w kwestionariuszu b\u0119d\u0105 wykorzystywane wy\u0142\u0105cznie do cel\u00f3w statystycznych w ramach...<\/p>","protected":false},"author":5,"featured_media":0,"parent":1331,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-5734","page","type-page","status-publish","hentry","description-off"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.kreisklinik-gg.de\/pl\/wp-json\/wp\/v2\/pages\/5734","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.kreisklinik-gg.de\/pl\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.kreisklinik-gg.de\/pl\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.kreisklinik-gg.de\/pl\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/www.kreisklinik-gg.de\/pl\/wp-json\/wp\/v2\/comments?post=5734"}],"version-history":[{"count":5,"href":"https:\/\/www.kreisklinik-gg.de\/pl\/wp-json\/wp\/v2\/pages\/5734\/revisions"}],"predecessor-version":[{"id":5767,"href":"https:\/\/www.kreisklinik-gg.de\/pl\/wp-json\/wp\/v2\/pages\/5734\/revisions\/5767"}],"up":[{"embeddable":true,"href":"https:\/\/www.kreisklinik-gg.de\/pl\/wp-json\/wp\/v2\/pages\/1331"}],"wp:attachment":[{"href":"https:\/\/www.kreisklinik-gg.de\/pl\/wp-json\/wp\/v2\/media?parent=5734"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}