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Submitted URL: https://www.contactenos.bussie.com.co/
Effective URL: https://es.research.net/r/7HSMRFV
Submission: On September 13 via automatic, source certstream-suspicious — Scanned from DE
Effective URL: https://es.research.net/r/7HSMRFV
Submission: On September 13 via automatic, source certstream-suspicious — Scanned from DE
Form analysis 1 forms found in the DOM
Name: surveyForm — POST
<form name="surveyForm" action="" method="post" enctype="multipart/form-data" novalidate="novalidate" data-survey-page-form="">
<div class="questions clearfix">
<div class="question-click-shield" tabindex="-1"></div>
<div class="question-row clearfix overlay
" tabindex="-1">
<div data-question-type="open_ended_single" data-rq-question-type="open_ended" class="question-container
">
<div id="question-field-275894162" data-qnumber="1" data-qdispnumber="1" data-question-id="275894162" class=" question-open-ended-single qn question single question-required">
<h3 class="screenreader-only">Question Title</h3>
<div class=" question-fieldset question-legend">
<h4 id="question-title-275894162" class=" question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 1<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Nombre</span>
</h4>
<div class="question-body clearfix notranslate ">
<div id="open-ended-single_275894162" data-question-id="275894162" data-response="" data-sm-open-single="" data-ng="true" data-required="true" data-size="50" data-labeledby="question-title-275894162">
<div class="question-body open-ended-single"><input aria-labelledby="question-title-275894162" id="275894162" aria-required="true" data-sm-open-single="true" class="wds-input wds-input--lg qt-input_text text" name="275894162"
size="50" value=""></div>
</div>
</div>
</div>
</div>
</div>
<button id="275894162-ok" class="new-button ok-button user-generated notranslate hide" type="submit"> Aceptar </button>
</div>
<div class="question-click-shield" tabindex="-1"></div>
<div class="question-row clearfix overlay
" tabindex="-1">
<div data-question-type="open_ended_single" data-rq-question-type="open_ended" class="question-container
">
<div id="question-field-275894885" data-qnumber="2" data-qdispnumber="2" data-question-id="275894885" class=" question-open-ended-single qn question single question-required">
<h3 class="screenreader-only">Question Title</h3>
<div class=" question-fieldset question-legend">
<h4 id="question-title-275894885" class=" question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 2<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Telefono</span>
</h4>
<div class="question-body clearfix notranslate ">
<div id="open-ended-single_275894885" data-question-id="275894885" data-response="" data-sm-open-single="" data-ng="true" data-required="true" data-size="50" data-labeledby="question-title-275894885">
<div class="question-body open-ended-single"><input aria-labelledby="question-title-275894885" id="275894885" aria-required="true" data-sm-open-single="true" class="wds-input wds-input--lg qt-input_text text" name="275894885"
size="50" value=""></div>
</div>
</div>
</div>
</div>
</div>
<button id="275894885-ok" class="new-button ok-button user-generated notranslate hide" type="submit"> Aceptar </button>
</div>
<div class="question-click-shield" tabindex="-1"></div>
<div class="question-row clearfix overlay
" tabindex="-1">
<div data-question-type="open_ended_single" data-rq-question-type="open_ended" class="question-container
">
<div id="question-field-275894401" data-qnumber="3" data-qdispnumber="3" data-question-id="275894401" class=" question-open-ended-single qn question single question-required">
<h3 class="screenreader-only">Question Title</h3>
<div class=" question-fieldset question-legend">
<h4 id="question-title-275894401" class=" question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 3<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Correo</span>
</h4>
<div class="question-body clearfix notranslate ">
<div id="open-ended-single_275894401" data-question-id="275894401" data-response="" data-sm-open-single="" data-ng="true" data-required="true" data-size="50" data-labeledby="question-title-275894401">
<div class="question-body open-ended-single"><input aria-labelledby="question-title-275894401" id="275894401" aria-required="true" data-sm-open-single="true" class="wds-input wds-input--lg qt-input_text text" name="275894401"
size="50" value=""></div>
</div>
</div>
</div>
</div>
</div>
<button id="275894401-ok" class="new-button ok-button user-generated notranslate hide" type="submit"> Aceptar </button>
</div>
<div class="question-click-shield" tabindex="-1"></div>
<div class="question-row clearfix overlay
" tabindex="-1">
<div data-question-type="open_ended_single" data-rq-question-type="open_ended" class="question-container
">
<div id="question-field-275894598" data-qnumber="4" data-qdispnumber="4" data-question-id="275894598" class=" question-open-ended-single qn question single question-required">
<h3 class="screenreader-only">Question Title</h3>
<div class=" question-fieldset question-legend">
<h4 id="question-title-275894598" class=" question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 4<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Dirección</span>
</h4>
<div class="question-body clearfix notranslate ">
<div id="open-ended-single_275894598" data-question-id="275894598" data-response="" data-sm-open-single="" data-ng="true" data-required="true" data-size="50" data-labeledby="question-title-275894598">
<div class="question-body open-ended-single"><input aria-labelledby="question-title-275894598" id="275894598" aria-required="true" data-sm-open-single="true" class="wds-input wds-input--lg qt-input_text text" name="275894598"
size="50" value=""></div>
</div>
</div>
</div>
</div>
</div>
<button id="275894598-ok" class="new-button ok-button user-generated notranslate hide" type="submit"> Aceptar </button>
</div>
<div class="question-click-shield" tabindex="-1"></div>
<div class="question-row clearfix overlay
" tabindex="-1">
<div data-question-type="open_ended_single" data-rq-question-type="open_ended" class="question-container
">
<div id="question-field-275894695" data-qnumber="5" data-qdispnumber="5" data-question-id="275894695" class=" question-open-ended-single qn question single question-required">
<h3 class="screenreader-only">Question Title</h3>
<div class=" question-fieldset question-legend">
<h4 id="question-title-275894695" class=" question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 5<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Ciudad</span>
</h4>
<div class="question-body clearfix notranslate ">
<div id="open-ended-single_275894695" data-question-id="275894695" data-response="" data-sm-open-single="" data-ng="true" data-required="true" data-size="50" data-labeledby="question-title-275894695">
<div class="question-body open-ended-single"><input aria-labelledby="question-title-275894695" id="275894695" aria-required="true" data-sm-open-single="true" class="wds-input wds-input--lg qt-input_text text" name="275894695"
size="50" value=""></div>
</div>
</div>
</div>
</div>
</div>
<button id="275894695-ok" class="new-button ok-button user-generated notranslate hide" type="submit"> Aceptar </button>
</div>
<div class="question-click-shield" tabindex="-1"></div>
<div class="question-row clearfix overlay
" tabindex="-1">
<div data-question-type="open_ended_single" data-rq-question-type="open_ended" class="question-container
">
<div id="question-field-275894756" data-qnumber="6" data-qdispnumber="6" data-question-id="275894756" class=" question-open-ended-single qn question single question-required">
<h3 class="screenreader-only">Question Title</h3>
<div class=" question-fieldset question-legend">
<h4 id="question-title-275894756" class=" question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 6<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Departamento</span>
</h4>
<div class="question-body clearfix notranslate ">
<div id="open-ended-single_275894756" data-question-id="275894756" data-response="" data-sm-open-single="" data-ng="true" data-required="true" data-size="50" data-labeledby="question-title-275894756">
<div class="question-body open-ended-single"><input aria-labelledby="question-title-275894756" id="275894756" aria-required="true" data-sm-open-single="true" class="wds-input wds-input--lg qt-input_text text" name="275894756"
size="50" value=""></div>
</div>
</div>
</div>
</div>
</div>
<button id="275894756-ok" class="new-button ok-button user-generated notranslate hide" type="submit"> Aceptar </button>
</div>
<div class="question-click-shield" tabindex="-1"></div>
<div class="question-row clearfix overlay
" tabindex="-1">
<div data-question-type="datetime_date_only" data-rq-question-type="datetime" class="question-container
">
<div id="question-field-275895084" data-qnumber="7" data-qdispnumber="7" data-question-id="275895084" class=" question-datetime qn question date_only question-required">
<h3 class="screenreader-only">Question Title</h3>
<div class=" question-fieldset question-legend">
<h4 id="question-title-275895084" class=" question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 7<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Fecha de Nacimiento</span>
</h4>
<div class="question-body clearfix notranslate ">
<div class="question-datetime-row row-0 clearfix">
<!-- translate to-do -->
<label id="275895084_1858069256_DMY_label" class="question-datetime-row-text question-body-font-theme row-0 user-generated"> Fecha </label>
<div class="question-datetime-fields">
<div class="question-datetime-date">
<div class="question-datetime_hint"> Fecha </div>
<div class="input-group date">
<input id="275895084_1858069256_DMY" name="275895084_1858069256_DMY" type="text" class="form-control text date--picker date-validation" data-date-question-id="275895084_1858069256" placeholder="DD/MM/AAAA" maxlength="10"
autocomplete="off" data-date-picker="" data-date-format="dd/mm/yyyy" data-date-language="es" data-format-message="* Indica la fecha en formato dd/mm/aaaa." data-year-message="* Indica el año de 1900 a 9999."
aria-label="Para escoger o modificar la fecha, presiona las teclas shift + flecha abajo o flecha arriba para mover el mes, y las teclas ctrl + shift + flecha abajo o flecha arriba para mover el año.">
<label class="input-group-addon btn" for="275895084_1858069256_DMY">
<span class="glyphicon glyphicon-calendar" aria-hidden="true"></span>
</label>
</div>
</div>
</div>
<div class="datetime_validations">
<label for="275895084_1858069256_DMY" generated="true" class="error" role="alert"></label>
<label for="275895084_1858069256_H" generated="true" class="error" role="alert"></label>
<label for="275895084_1858069256_M" generated="true" class="error" role="alert"></label>
<label for="275895084_1858069256_AM" generated="true" class="error" role="alert"></label>
</div>
</div>
</div>
</div>
</div>
</div>
<button id="275895084-ok" class="new-button ok-button user-generated notranslate hide" type="submit"> Aceptar </button>
</div>
<div class="question-click-shield" tabindex="-1"></div>
<div class="question-row clearfix overlay
" tabindex="-1">
<div data-question-type="single_choice_vertical" data-rq-question-type="single_choice_vertical" class="question-container
">
<div id="question-field-275895309" data-qnumber="8" data-qdispnumber="8" data-question-id="275895309" class=" question-single-choice-radio qn question vertical question-required">
<h3 class="screenreader-only">Question Title</h3>
<fieldset class=" question-fieldset" data-radio-button-group="">
<legend class="question-legend">
<h4 id="question-title-275895309" class="
question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 8<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Género</span>
</h4>
</legend>
<div class="question-body clearfix notranslate ">
<div class="">
<div class="answer-option-cell">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-275895309">
<input id="275895309_1858070557" aria-labelledby="275895309_1858070557_label" name="275895309" type="radio" role="radio" class="radio-button-input " value="1858070557" aria-checked="false">
<label data-sm-radio-button-label="" id="275895309_1858070557_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="275895309_1858070557">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Masculino </span>
</label>
</div>
</div>
<div class="answer-option-cell">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-275895309">
<input id="275895309_1858070558" aria-labelledby="275895309_1858070558_label" name="275895309" type="radio" role="radio" class="radio-button-input " value="1858070558" aria-checked="false">
<label data-sm-radio-button-label="" id="275895309_1858070558_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="275895309_1858070558">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Femenino </span>
</label>
</div>
</div>
<div class="answer-option-cell">
<div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-275895309">
<input id="275895309_1858070559" aria-labelledby="275895309_1858070559_label" name="275895309" type="radio" role="radio" class="radio-button-input " value="1858070559" aria-checked="false">
<label data-sm-radio-button-label="" id="275895309_1858070559_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="275895309_1858070559">
<span class="radio-button-display ">
</span>
<span class="radio-button-label-text question-body-font-theme user-generated "> Otro </span>
</label>
</div>
</div>
</div>
</div>
</fieldset>
</div>
</div>
<button id="275895309-ok" class="new-button ok-button user-generated notranslate hide" type="submit"> Aceptar </button>
</div>
<div class="question-click-shield" tabindex="-1"></div>
<div class="question-row clearfix overlay
" tabindex="-1">
<div data-question-type="open_ended_single" data-rq-question-type="open_ended" class="question-container
">
<div id="question-field-275895833" data-qnumber="9" data-qdispnumber="9" data-question-id="275895833" class=" question-open-ended-single qn question single question-required">
<h3 class="screenreader-only">Question Title</h3>
<div class=" question-fieldset question-legend">
<h4 id="question-title-275895833" class=" question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 9<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Profesión</span>
</h4>
<div class="question-body clearfix notranslate ">
<div id="open-ended-single_275895833" data-question-id="275895833" data-response="" data-sm-open-single="" data-ng="true" data-required="true" data-size="50" data-labeledby="question-title-275895833">
<div class="question-body open-ended-single"><input aria-labelledby="question-title-275895833" id="275895833" aria-required="true" data-sm-open-single="true" class="wds-input wds-input--lg qt-input_text text" name="275895833"
size="50" value=""></div>
</div>
</div>
</div>
</div>
</div>
<button id="275895833-ok" class="new-button ok-button user-generated notranslate hide" type="submit"> Aceptar </button>
</div>
<div class="question-click-shield" tabindex="-1"></div>
<div class="question-row clearfix overlay
" tabindex="-1">
<div data-question-type="open_ended_essay" data-rq-question-type="open_ended" class="question-container
">
<div id="question-field-275895353" data-qnumber="10" data-qdispnumber="10" data-question-id="275895353" class=" question-essay qn question essay question-required">
<h3 class="screenreader-only">Question Title</h3>
<div class=" question-fieldset question-legend">
<h4 id="question-title-275895353" class=" question-title-container ">
<span class="required-asterisk notranslate"> * </span>
<span class="question-number notranslate"> 10<span class="question-dot">.</span>
</span>
<span class="user-generated notranslate
"> Observaciones</span>
</h4>
<div class="question-body clearfix notranslate ">
<div class="textarea-container">
<textarea aria-labelledby="question-title-275895353" id="275895353" aria-required="true" name="275895353" class="textarea" spellcheck="true" rows="3" cols="50" data-sm-textarea=""></textarea>
</div>
</div>
</div>
</div>
</div>
<button id="275895353-ok" class="new-button ok-button user-generated notranslate hide" type="submit"> Aceptar </button>
</div>
</div>
<div class="survey-submit-actions center-text clearfix">
<button type="submit" data-submit-page-button="" class="btn small done-button survey-page-button user-generated notranslate"> LISTO </button>
</div>
<input type="hidden" id="survey_data" name="survey_data"
value="4FoTYerhlqpl9PSGmuD5IcxF2vfKzcLzXL5NcM9UYWaHsl_2FkXMwLTuRf_2FaEo4ykcke87cgeK3Rig5vkxV_2FrVwRzTfM5s44RMpx1jjP6rGpQjJ_2B4vPWsvxwNlv_2BaDSEYnVuyH_2BwvnyZPKcZiT8wTdaiwmNU5WTrgnoFo15LOd6TZ1huZ5lDIyaFxOdAiq0qhto2Mf3_2FJJSE04ZQ4FEskB_2Bbdr1a2XSKQeF_2Bd53xidccdJQrC5nSy_2BGVw8S0G0gzTzvAwrnNebEZ4AfVIHyjClOG66D3NBDb2zT7hUUwRyQD4UelEoXY_2FRRRFX_2Fy2LNMoGc8jQjvY_2FvnmqCmHpluvmfzT3MFfNCfNpzxA_2BQ3ZimU_2B61v74Si8HZNvJwPcgB4MDWaP6E5IO6IVHtYi2q0nWANZH1bvZrFzf3kRAEC6_2B6fdnBIzl3T_2Bf7egxygeW4Vymv9vYVN3dRxxMFNALchKvtiJVf3i0_2FhDp_2FXhvDQT_2BNGHM6pmwoVdZv63mzZClwiYUjXF4U05yLZpwsWjE2WFP0qKmF_2BtyOqA_2Bcv_2F3QIawwnVQoomvbITv1HTpryob8rPu">
<input type="hidden" data-response-quality="" id="response_quality_data" name="response_quality_data" value="{}">
<input type="hidden" id="is_previous" name="is_previous" value="false">
<input type="hidden" id="disable_survey_buttons_on_submit" name="disable_survey_buttons_on_submit" value="">
</form>Text Content
CONTACTENOS SERVICIO AL CLIENTE QUESTION TITLE * 1. NOMBRE Aceptar QUESTION TITLE * 2. TELEFONO Aceptar QUESTION TITLE * 3. CORREO Aceptar QUESTION TITLE * 4. DIRECCIÓN Aceptar QUESTION TITLE * 5. CIUDAD Aceptar QUESTION TITLE * 6. DEPARTAMENTO Aceptar QUESTION TITLE * 7. FECHA DE NACIMIENTO Fecha Fecha Aceptar QUESTION TITLE * 8. GÉNERO Masculino Femenino Otro Aceptar QUESTION TITLE * 9. PROFESIÓN Aceptar QUESTION TITLE * 10. OBSERVACIONES Aceptar LISTO ( Privacy & Cookie Notice 0 de 10 respondidas Javascript is required for this site to function, please enable.