{"id":3098,"date":"2025-09-14T18:30:04","date_gmt":"2025-09-14T18:30:04","guid":{"rendered":"https:\/\/fieldready.org.tr\/?page_id=3098"},"modified":"2025-09-14T19:06:57","modified_gmt":"2025-09-14T19:06:57","slug":"improving-access-to-healthcare-services-in-kilis","status":"publish","type":"page","link":"https:\/\/fieldready.org.tr\/index.php\/improving-access-to-healthcare-services-in-kilis\/","title":{"rendered":"Improving Access to Healthcare Services in Kilis"},"content":{"rendered":"\n<div class=\"forminator-guttenberg\"><div class=\"forminator-ui forminator-custom-form forminator-custom-form-3104 forminator-design--default  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-3104\" data-uid=\"6a69249b980e5\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-3104\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-3104 forminator-design--default  forminator_ajax\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"3104\"\n\t\t\t\tenctype=\"multipart\/form-data\" data-color-option=\"default\" data-design=\"default\" data-grid=\"open\" style=\"display: none;\"\n\t\t\t\tdata-uid=\"6a69249b980e5\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"section-1\" class=\"forminator-field-section forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h2 class=\"forminator-title\">Language \/ Dil<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-1\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-1-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-1-6a69249b980e5-label\" class=\"forminator-label\">Choose Language \/ Dil Se\u00e7iniz <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-1-label-1\" for=\"forminator-field-radio-1-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"English\"><input type=\"radio\" name=\"radio-1\" value=\"EN\" id=\"forminator-field-radio-1-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-1-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">English<\/span><\/label><label id=\"forminator-field-radio-1-label-2\" for=\"forminator-field-radio-1-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"T\u00fcrk\u00e7e\"><input type=\"radio\" name=\"radio-1\" value=\"TR\" id=\"forminator-field-radio-1-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-1-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">T\u00fcrk\u00e7e<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-100\" class=\"forminator-field-section forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h2 class=\"forminator-title\">Part 1: Facility Profile (To be filled out once per health facility)<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-101\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-101_6a69249b980e5\" id=\"forminator-field-text-101_6a69249b980e5-label\" class=\"forminator-label\">Facility Name: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-101\" value=\"\" placeholder=\"\" id=\"forminator-field-text-101_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-102\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-3104__field--select-102_6a69249b980e5\" id=\"forminator-form-3104__field--select-102_6a69249b980e5-label\" class=\"forminator-label\">Province: <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-3104__field--select-102_6a69249b980e5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-102\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Please select an option\" data-search=\"false\" data-search-placeholder=\"Please select an option\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-3104__field--select-102_6a69249b980e5-label\"><option value=\"\"  >Please select an option<\/option><option value=\"Kilis\"  data-calculation=\"0\">Kilis<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-103\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-3104__field--select-103_6a69249b980e5\" id=\"forminator-form-3104__field--select-103_6a69249b980e5-label\" class=\"forminator-label\">District: (Select one) <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-3104__field--select-103_6a69249b980e5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-103\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Please select an option\" data-search=\"false\" data-search-placeholder=\"Please select an option\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-3104__field--select-103_6a69249b980e5-label\"><option value=\"\"  >Please select an option<\/option><option value=\"Center (Merkez)\"  data-calculation=\"0\">Center (Merkez)<\/option><option value=\"Elbeyli\"  data-calculation=\"0\">Elbeyli<\/option><option value=\"Musabeyli\"  data-calculation=\"0\">Musabeyli<\/option><option value=\"Polateli\"  data-calculation=\"0\">Polateli<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-104\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-3104__field--select-104_6a69249b980e5\" id=\"forminator-form-3104__field--select-104_6a69249b980e5-label\" class=\"forminator-label\">Neighborhood: (Select one from the list) <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-3104__field--select-104_6a69249b980e5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-104\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Please select an option\" data-search=\"false\" data-search-placeholder=\"Please select an option\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-3104__field--select-104_6a69249b980e5-label\"><option value=\"\"  >Please select an option<\/option><option value=\"Other\"  data-calculation=\"0\">Other<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-105\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-105_6a69249b980e5\" id=\"forminator-field-text-105_6a69249b980e5-label\" class=\"forminator-label\">(If &quot;Other&quot; is selected) Please Specify Neighborhood: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-105\" value=\"\" placeholder=\"\" id=\"forminator-field-text-105_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-106\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-106_6a69249b980e5\" id=\"forminator-field-text-106_6a69249b980e5-label\" class=\"forminator-label\">Street Address (Street, Building Name\/Number): <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-106\" value=\"\" placeholder=\"\" id=\"forminator-field-text-106_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-107\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-107_6a69249b980e5\" id=\"forminator-field-text-107_6a69249b980e5-label\" class=\"forminator-label\">Focal Point Information \u2013 Name: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-107\" value=\"\" placeholder=\"\" id=\"forminator-field-text-107_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-108\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-108_6a69249b980e5\" id=\"forminator-field-text-108_6a69249b980e5-label\" class=\"forminator-label\">Focal Point Information \u2013 Position\/Title: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-108\" value=\"\" placeholder=\"\" id=\"forminator-field-text-108_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-109\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-109_6a69249b980e5\" id=\"forminator-field-text-109_6a69249b980e5-label\" class=\"forminator-label\">Focal Point Information \u2013 Contact Info: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-109\" value=\"\" placeholder=\"\" id=\"forminator-field-text-109_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-110\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-110_6a69249b980e5\" id=\"forminator-field-text-110_6a69249b980e5-label\" class=\"forminator-label\">Average number of patients served per month (approximate): <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-110\" value=\"\" placeholder=\"\" id=\"forminator-field-text-110_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-111\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-111-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-111-6a69249b980e5-label\" class=\"forminator-label\">Approximate percentage of patients who are refugees: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-111-label-1\" for=\"forminator-field-radio-111-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Less than 25%\"><input type=\"radio\" name=\"radio-111\" value=\"&lt;25\" id=\"forminator-field-radio-111-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-111-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Less than 25%<\/span><\/label><label id=\"forminator-field-radio-111-label-2\" for=\"forminator-field-radio-111-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"25\u201350%\"><input type=\"radio\" name=\"radio-111\" value=\"25-50\" id=\"forminator-field-radio-111-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-111-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">25\u201350%<\/span><\/label><label id=\"forminator-field-radio-111-label-3\" for=\"forminator-field-radio-111-3-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"50\u201375%\"><input type=\"radio\" name=\"radio-111\" value=\"50-75\" id=\"forminator-field-radio-111-3-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-111-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">50\u201375%<\/span><\/label><label id=\"forminator-field-radio-111-label-4\" for=\"forminator-field-radio-111-4-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"More than 75%\"><input type=\"radio\" name=\"radio-111\" value=\"75+\" id=\"forminator-field-radio-111-4-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-111-label-4\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">More than 75%<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-112\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-112-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-112-6a69249b980e5-label\" class=\"forminator-label\">Does your hospital have an in-house biomedical\/maintenance department? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-112-label-1\" for=\"forminator-field-radio-112-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-112\" value=\"Yes\" id=\"forminator-field-radio-112-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-112-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-112-label-2\" for=\"forminator-field-radio-112-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-112\" value=\"No\" id=\"forminator-field-radio-112-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-112-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-113\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-113_6a69249b980e5\" id=\"forminator-field-text-113_6a69249b980e5-label\" class=\"forminator-label\">(If &quot;Yes&quot; is selected) Please Specify Details (like department\/personal\/services provider contact information, etc.) <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"text-113\" placeholder=\"\" id=\"forminator-field-text-113_6a69249b980e5\" class=\"forminator-textarea\" aria-required=\"true\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-114\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-114_6a69249b980e5\" id=\"forminator-field-text-114_6a69249b980e5-label\" class=\"forminator-label\">GPS Coordinates (Optional) \u2013 Latitude<\/label><input type=\"text\" name=\"text-114\" value=\"\" placeholder=\"\" id=\"forminator-field-text-114_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-115\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-115_6a69249b980e5\" id=\"forminator-field-text-115_6a69249b980e5-label\" class=\"forminator-label\">GPS Coordinates (Optional) \u2013 Longitude<\/label><input type=\"text\" name=\"text-115\" value=\"\" placeholder=\"\" id=\"forminator-field-text-115_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-119\" class=\"forminator-field-html forminator-col forminator-col-12 \"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-119\"><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-120\" class=\"forminator-field-group forminator-col forminator-col-12 \"><label class=\"forminator-label forminator-repeater-label\">Part 2 &amp; 3: Individual Device Assessment (Repeatable Group)<\/label><div class=\"forminator-all-group-copies forminator-repeater-field\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:true,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Add Another Device \\\/ Ba\\u015fka Bir Cihaz Ekle&quot;,&quot;remove_text&quot;:&quot;Remove&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"text-121\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-121_6a69249b980e5\" id=\"forminator-field-text-121_6a69249b980e5-label\" class=\"forminator-label\">Device ID: [Internal Use: Kilis-00X]<\/label><input type=\"text\" name=\"text-121\" value=\"\" placeholder=\"\" id=\"forminator-field-text-121_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-122\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-122_6a69249b980e5\" id=\"forminator-field-text-122_6a69249b980e5-label\" class=\"forminator-label\">Device Name: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-122\" value=\"\" placeholder=\"\" id=\"forminator-field-text-122_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-123\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-123_6a69249b980e5\" id=\"forminator-field-text-123_6a69249b980e5-label\" class=\"forminator-label\">Brand \/ Manufacturer: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-123\" value=\"\" placeholder=\"\" id=\"forminator-field-text-123_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-124\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-124_6a69249b980e5\" id=\"forminator-field-text-124_6a69249b980e5-label\" class=\"forminator-label\">Year of Manufacture (approximate):<\/label><input type=\"text\" name=\"text-124\" value=\"\" placeholder=\"\" id=\"forminator-field-text-124_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-125\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-3104__field--select-125_6a69249b980e5\" id=\"forminator-form-3104__field--select-125_6a69249b980e5-label\" class=\"forminator-label\">Department \/ Unit where the device is located (Select one): <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-3104__field--select-125_6a69249b980e5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-125\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Please select an option\" data-search=\"false\" data-search-placeholder=\"Please select an option\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-3104__field--select-125_6a69249b980e5-label\"><option value=\"\"  >Please select an option<\/option><option value=\"Imaging - Radiology\"  data-calculation=\"0\">Imaging - Radiology<\/option><option value=\"Laboratory\"  data-calculation=\"0\">Laboratory<\/option><option value=\"Operating Room\"  data-calculation=\"0\">Operating Room<\/option><option value=\"Intensive Care Unit (ICU)\"  data-calculation=\"0\">Intensive Care Unit (ICU)<\/option><option value=\"Maternity &amp; Neonatal Care\"  data-calculation=\"0\">Maternity &amp; Neonatal Care<\/option><option value=\"Sterilization Unit\"  data-calculation=\"0\">Sterilization Unit<\/option><option value=\"Dental Clinic\"  data-calculation=\"0\">Dental Clinic<\/option><option value=\"Physiotherapy &amp; Rehabilitation\"  data-calculation=\"0\">Physiotherapy &amp; Rehabilitation<\/option><option value=\"Dialysis Unit\"  data-calculation=\"0\">Dialysis Unit<\/option><option value=\"Emergency Department\"  data-calculation=\"0\">Emergency Department<\/option><option value=\"General Wards - Inpatient Services\"  data-calculation=\"0\">General Wards - Inpatient Services<\/option><option value=\"Other\"  data-calculation=\"0\">Other<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-126\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-126_6a69249b980e5\" id=\"forminator-field-text-126_6a69249b980e5-label\" class=\"forminator-label\">(If &quot;Other&quot; is selected) Please Specify Department: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-126\" value=\"\" placeholder=\"\" id=\"forminator-field-text-126_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-127\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-127-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-127-6a69249b980e5-label\" class=\"forminator-label\">Device Condition: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-127-label-1\" for=\"forminator-field-radio-127-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Not working\"><input type=\"radio\" name=\"radio-127\" value=\"Not working\" id=\"forminator-field-radio-127-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-127-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Not working<\/span><\/label><label id=\"forminator-field-radio-127-label-2\" for=\"forminator-field-radio-127-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Partially working\"><input type=\"radio\" name=\"radio-127\" value=\"Partially working\" id=\"forminator-field-radio-127-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-127-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Partially working<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-128\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-128_6a69249b980e5\" id=\"forminator-field-text-128_6a69249b980e5-label\" class=\"forminator-label\">Description of Malfunction: <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"text-128\" placeholder=\"\" id=\"forminator-field-text-128_6a69249b980e5\" class=\"forminator-textarea\" aria-required=\"true\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-129\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-129-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-129-6a69249b980e5-label\" class=\"forminator-label\">Is there an alternative device available at the facility to perform this function? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-129-label-1\" for=\"forminator-field-radio-129-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-129\" value=\"Yes\" id=\"forminator-field-radio-129-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-129-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-129-label-2\" for=\"forminator-field-radio-129-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-129\" value=\"No\" id=\"forminator-field-radio-129-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-129-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-130\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-130-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-130-6a69249b980e5-label\" class=\"forminator-label\">Repair Priority (According to facility staff): <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-130-label-1\" for=\"forminator-field-radio-130-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Highest Priority\"><input type=\"radio\" name=\"radio-130\" value=\"Highest\" id=\"forminator-field-radio-130-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-130-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Highest Priority<\/span><\/label><label id=\"forminator-field-radio-130-label-2\" for=\"forminator-field-radio-130-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Medium Priority\"><input type=\"radio\" name=\"radio-130\" value=\"Medium\" id=\"forminator-field-radio-130-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-130-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Medium Priority<\/span><\/label><label id=\"forminator-field-radio-130-label-3\" for=\"forminator-field-radio-130-3-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Low Priority\"><input type=\"radio\" name=\"radio-130\" value=\"Low\" id=\"forminator-field-radio-130-3-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-130-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Low Priority<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-131\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-131_6a69249b980e5\" id=\"forminator-field-text-131_6a69249b980e5-label\" class=\"forminator-label\">Estimated Number of Patients Served by this Device (per week, when functional): <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-131\" value=\"\" placeholder=\"\" id=\"forminator-field-text-131_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-132\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-132-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-132-6a69249b980e5-label\" class=\"forminator-label\">Type of Maintenance Needed: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-132-label-1\" for=\"forminator-field-radio-132-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"One-time emergency repair\"><input type=\"radio\" name=\"radio-132\" value=\"One-time emergency repair\" id=\"forminator-field-radio-132-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-132-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">One-time emergency repair<\/span><\/label><label id=\"forminator-field-radio-132-label-2\" for=\"forminator-field-radio-132-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Preventive\/Regular maintenance\"><input type=\"radio\" name=\"radio-132\" value=\"Preventive\/Regular maintenance\" id=\"forminator-field-radio-132-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-132-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Preventive\/Regular maintenance<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-133\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-133-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-133-6a69249b980e5-label\" class=\"forminator-label\">Previous Repair Attempts: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-133-label-1\" for=\"forminator-field-radio-133-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-133\" value=\"Yes\" id=\"forminator-field-radio-133-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-133-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-133-label-2\" for=\"forminator-field-radio-133-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-133\" value=\"No\" id=\"forminator-field-radio-133-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-133-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-134\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-134_6a69249b980e5\" id=\"forminator-field-text-134_6a69249b980e5-label\" class=\"forminator-label\">If yes, please describe: <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"text-134\" placeholder=\"\" id=\"forminator-field-text-134_6a69249b980e5\" class=\"forminator-textarea\" aria-required=\"true\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-135\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-135_6a69249b980e5\" id=\"forminator-field-text-135_6a69249b980e5-label\" class=\"forminator-label\">Visual Inspection Notes:<\/label><textarea name=\"text-135\" placeholder=\"\" id=\"forminator-field-text-135_6a69249b980e5\" class=\"forminator-textarea\" aria-required=\"false\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-136\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-136_6a69249b980e5\" id=\"forminator-field-text-136_6a69249b980e5-label\" class=\"forminator-label\">Suspected Cause of Failure:<\/label><textarea name=\"text-136\" placeholder=\"\" id=\"forminator-field-text-136_6a69249b980e5\" class=\"forminator-textarea\" aria-required=\"false\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-137\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-137_6a69249b980e5\" id=\"forminator-field-text-137_6a69249b980e5-label\" class=\"forminator-label\">Required Spare Parts (if known):<\/label><textarea name=\"text-137\" placeholder=\"\" id=\"forminator-field-text-137_6a69249b980e5\" class=\"forminator-textarea\" aria-required=\"false\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-138\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-138-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-138-6a69249b980e5-label\" class=\"forminator-label\">Estimated Cost of Repair\/Maintenance (USD):<\/span><label id=\"forminator-field-radio-138-label-1\" for=\"forminator-field-radio-138-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"&lt; $100\"><input type=\"radio\" name=\"radio-138\" value=\"&lt;100\" id=\"forminator-field-radio-138-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-138-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">&lt; $100<\/span><\/label><label id=\"forminator-field-radio-138-label-2\" for=\"forminator-field-radio-138-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"$100 - $300\"><input type=\"radio\" name=\"radio-138\" value=\"100-300\" id=\"forminator-field-radio-138-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-138-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">$100 - $300<\/span><\/label><label id=\"forminator-field-radio-138-label-3\" for=\"forminator-field-radio-138-3-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"$300 - $500\"><input type=\"radio\" name=\"radio-138\" value=\"300-500\" id=\"forminator-field-radio-138-3-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-138-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">$300 - $500<\/span><\/label><label id=\"forminator-field-radio-138-label-4\" for=\"forminator-field-radio-138-4-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"&gt; $500\"><input type=\"radio\" name=\"radio-138\" value=\"&gt;500\" id=\"forminator-field-radio-138-4-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-138-label-4\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">&gt; $500<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-139\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-139-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-139-6a69249b980e5-label\" class=\"forminator-label\">Repair Feasibility:<\/span><label id=\"forminator-field-radio-139-label-1\" for=\"forminator-field-radio-139-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"High: Can likely be repaired locally\"><input type=\"radio\" name=\"radio-139\" value=\"High\" id=\"forminator-field-radio-139-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-139-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">High: Can likely be repaired locally<\/span><\/label><label id=\"forminator-field-radio-139-label-2\" for=\"forminator-field-radio-139-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Medium: May require specialized parts\"><input type=\"radio\" name=\"radio-139\" value=\"Medium\" id=\"forminator-field-radio-139-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-139-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Medium: May require specialized parts<\/span><\/label><label id=\"forminator-field-radio-139-label-3\" for=\"forminator-field-radio-139-3-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Low: Difficult to repair\"><input type=\"radio\" name=\"radio-139\" value=\"Low\" id=\"forminator-field-radio-139-3-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-139-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Low: Difficult to repair<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-140\" class=\"forminator-field-upload forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-upload-140_6a69249b980e5\" id=\"forminator-field-upload-140_6a69249b980e5-label\" class=\"forminator-label\">Photo of the Device (Optional):<\/label><div class=\"forminator-file-upload \" data-element=\"upload-140_6a69249b980e5\"><input type=\"file\" name=\"upload-140\" id=\"forminator-field-upload-140_6a69249b980e5\" class=\"forminator-input-file\" tabindex=\"-1\"><button id=\"forminator-field-upload-140_6a69249b980e5_button\" class=\"forminator-button forminator-button-upload\" data-id=\"forminator-field-upload-140_6a69249b980e5\">Choose File<\/button><span data-empty-text=\"No file chosen\">No file chosen<\/span><button class=\"forminator-button-delete\" style=\"display: none;\"><i class=\"forminator-icon-close\" aria-hidden=\"true\"><\/i><span class=\"forminator-screen-reader-only\">Delete uploaded file<\/span><\/button><\/div><\/div><\/div><\/div><div class=\"forminator-row forminator-action-buttons\"><div class=\"forminator-col forminator-col-12\"><input type=\"button\" value=\"Add Another Device \/ Ba\u015fka Bir Cihaz Ekle\" class=\"forminator-repeater-action-button forminator-repeater-add\" \/><input type=\"button\" value=\"Remove\" class=\"forminator-repeater-action-button forminator-repeater-remove\" \/><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-200\" class=\"forminator-field-section forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h2 class=\"forminator-title\">B\u00f6l\u00fcm 1: Tesis Profili (Her sa\u011fl\u0131k tesisi i\u00e7in bir kez doldurulacakt\u0131r)<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-201\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-201_6a69249b980e5\" id=\"forminator-field-text-201_6a69249b980e5-label\" class=\"forminator-label\">Tesis Ad\u0131: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-201\" value=\"\" placeholder=\"\" id=\"forminator-field-text-201_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-202\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-3104__field--select-202_6a69249b980e5\" id=\"forminator-form-3104__field--select-202_6a69249b980e5-label\" class=\"forminator-label\">\u0130l: <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-3104__field--select-202_6a69249b980e5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-202\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Please select an option\" data-search=\"false\" data-search-placeholder=\"Please select an option\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-3104__field--select-202_6a69249b980e5-label\"><option value=\"\"  >Please select an option<\/option><option value=\"Kilis\"  data-calculation=\"0\">Kilis<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-203\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-3104__field--select-203_6a69249b980e5\" id=\"forminator-form-3104__field--select-203_6a69249b980e5-label\" class=\"forminator-label\">\u0130l\u00e7e: (Birini se\u00e7iniz) <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-3104__field--select-203_6a69249b980e5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-203\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Please select an option\" data-search=\"false\" data-search-placeholder=\"Please select an option\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-3104__field--select-203_6a69249b980e5-label\"><option value=\"\"  >Please select an option<\/option><option value=\"Merkez\"  data-calculation=\"0\">Merkez<\/option><option value=\"Elbeyli\"  data-calculation=\"0\">Elbeyli<\/option><option value=\"Musabeyli\"  data-calculation=\"0\">Musabeyli<\/option><option value=\"Polateli\"  data-calculation=\"0\">Polateli<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-204\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-3104__field--select-204_6a69249b980e5\" id=\"forminator-form-3104__field--select-204_6a69249b980e5-label\" class=\"forminator-label\">Mahalle: (Listeden birini se\u00e7iniz) <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-3104__field--select-204_6a69249b980e5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-204\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Please select an option\" data-search=\"false\" data-search-placeholder=\"Please select an option\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-3104__field--select-204_6a69249b980e5-label\"><option value=\"\"  >Please select an option<\/option><option value=\"Di\u011fer\"  data-calculation=\"0\">Di\u011fer<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-205\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-205_6a69249b980e5\" id=\"forminator-field-text-205_6a69249b980e5-label\" class=\"forminator-label\">(E\u011fer &quot;Di\u011fer&quot; se\u00e7ilirse) L\u00fctfen Mahalleyi Belirtiniz: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-205\" value=\"\" placeholder=\"\" id=\"forminator-field-text-205_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-206\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-206_6a69249b980e5\" id=\"forminator-field-text-206_6a69249b980e5-label\" class=\"forminator-label\">A\u00e7\u0131k Adres (Sokak, Bina Ad\u0131\/No): <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-206\" value=\"\" placeholder=\"\" id=\"forminator-field-text-206_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-207\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-207_6a69249b980e5\" id=\"forminator-field-text-207_6a69249b980e5-label\" class=\"forminator-label\">\u0130rtibat Ki\u015fisi Bilgileri \u2013 Ad\u0131: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-207\" value=\"\" placeholder=\"\" id=\"forminator-field-text-207_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-208\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-208_6a69249b980e5\" id=\"forminator-field-text-208_6a69249b980e5-label\" class=\"forminator-label\">\u0130rtibat Ki\u015fisi Bilgileri \u2013 G\u00f6rev\/Unvan: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-208\" value=\"\" placeholder=\"\" id=\"forminator-field-text-208_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-209\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-209_6a69249b980e5\" id=\"forminator-field-text-209_6a69249b980e5-label\" class=\"forminator-label\">\u0130rtibat Ki\u015fisi Bilgileri \u2013 \u0130leti\u015fim Bilgileri: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-209\" value=\"\" placeholder=\"\" id=\"forminator-field-text-209_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-210\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-210_6a69249b980e5\" id=\"forminator-field-text-210_6a69249b980e5-label\" class=\"forminator-label\">Ayl\u0131k ortalama hasta say\u0131s\u0131 (tahmini): <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-210\" value=\"\" placeholder=\"\" id=\"forminator-field-text-210_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-211\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-211-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-211-6a69249b980e5-label\" class=\"forminator-label\">Yabanc\u0131 (Suriyeli) hastalar\u0131n oran\u0131 (tahmini): <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-211-label-1\" for=\"forminator-field-radio-211-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"%25\u2019ten az\"><input type=\"radio\" name=\"radio-211\" value=\"&lt;25\" id=\"forminator-field-radio-211-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-211-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">%25\u2019ten az<\/span><\/label><label id=\"forminator-field-radio-211-label-2\" for=\"forminator-field-radio-211-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"25\u201350%\"><input type=\"radio\" name=\"radio-211\" value=\"25-50\" id=\"forminator-field-radio-211-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-211-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">25\u201350%<\/span><\/label><label id=\"forminator-field-radio-211-label-3\" for=\"forminator-field-radio-211-3-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"50\u201375%\"><input type=\"radio\" name=\"radio-211\" value=\"50-75\" id=\"forminator-field-radio-211-3-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-211-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">50\u201375%<\/span><\/label><label id=\"forminator-field-radio-211-label-4\" for=\"forminator-field-radio-211-4-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"%75\u2019ten fazla\"><input type=\"radio\" name=\"radio-211\" value=\"75+\" id=\"forminator-field-radio-211-4-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-211-label-4\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">%75\u2019ten fazla<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-212\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-212-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-212-6a69249b980e5-label\" class=\"forminator-label\">Hastanenizde biyomedikal\/bak\u0131m departman\u0131 var m\u0131? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-212-label-1\" for=\"forminator-field-radio-212-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Evet\"><input type=\"radio\" name=\"radio-212\" value=\"Yes\" id=\"forminator-field-radio-212-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-212-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Evet<\/span><\/label><label id=\"forminator-field-radio-212-label-2\" for=\"forminator-field-radio-212-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Hay\u0131r\"><input type=\"radio\" name=\"radio-212\" value=\"No\" id=\"forminator-field-radio-212-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-212-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Hay\u0131r<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-213\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-213_6a69249b980e5\" id=\"forminator-field-text-213_6a69249b980e5-label\" class=\"forminator-label\">(E\u011fer &quot;Evet&quot; se\u00e7ilirse) L\u00fctfen Ayr\u0131nt\u0131lar\u0131 Belirtin (departman\/ki\u015fi\/hizmet sa\u011flay\u0131c\u0131 ileti\u015fim bilgileri vb.) <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"text-213\" placeholder=\"\" id=\"forminator-field-text-213_6a69249b980e5\" class=\"forminator-textarea\" aria-required=\"true\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-214\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-214_6a69249b980e5\" id=\"forminator-field-text-214_6a69249b980e5-label\" class=\"forminator-label\">GPS Koordinatlar\u0131 (\u0130ste\u011fe Ba\u011fl\u0131) \u2013 Enlem<\/label><input type=\"text\" name=\"text-214\" value=\"\" placeholder=\"\" id=\"forminator-field-text-214_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-215\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-215_6a69249b980e5\" id=\"forminator-field-text-215_6a69249b980e5-label\" class=\"forminator-label\">GPS Koordinatlar\u0131 (\u0130ste\u011fe Ba\u011fl\u0131) \u2013 Boylam<\/label><input type=\"text\" name=\"text-215\" value=\"\" placeholder=\"\" id=\"forminator-field-text-215_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-219\" class=\"forminator-field-html forminator-col forminator-col-12 \"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-219\"><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-220\" class=\"forminator-field-group forminator-col forminator-col-12 \"><label class=\"forminator-label forminator-repeater-label\">B\u00f6l\u00fcm 2 &amp; 3: Bireysel Cihaz De\u011ferlendirmesi (Tekrarlanabilir Grup)<\/label><div class=\"forminator-all-group-copies forminator-repeater-field\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:true,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Ba\\u015fka Bir Cihaz Ekle&quot;,&quot;remove_text&quot;:&quot;Kald\\u0131r&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"text-221\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-221_6a69249b980e5\" id=\"forminator-field-text-221_6a69249b980e5-label\" class=\"forminator-label\">Cihaz Kimli\u011fi: [Dahili Kullan\u0131m: Kilis-00X]<\/label><input type=\"text\" name=\"text-221\" value=\"\" placeholder=\"\" id=\"forminator-field-text-221_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-222\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-222_6a69249b980e5\" id=\"forminator-field-text-222_6a69249b980e5-label\" class=\"forminator-label\">Cihaz\u0131n Ad\u0131: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-222\" value=\"\" placeholder=\"\" id=\"forminator-field-text-222_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-223\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-223_6a69249b980e5\" id=\"forminator-field-text-223_6a69249b980e5-label\" class=\"forminator-label\">Marka \/ \u00dcretici: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-223\" value=\"\" placeholder=\"\" id=\"forminator-field-text-223_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-224\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-224_6a69249b980e5\" id=\"forminator-field-text-224_6a69249b980e5-label\" class=\"forminator-label\">\u00dcretim Tarihi (tahmini):<\/label><input type=\"text\" name=\"text-224\" value=\"\" placeholder=\"\" id=\"forminator-field-text-224_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-225\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-3104__field--select-225_6a69249b980e5\" id=\"forminator-form-3104__field--select-225_6a69249b980e5-label\" class=\"forminator-label\">Cihaz\u0131n Kullan\u0131ld\u0131\u011f\u0131 B\u00f6l\u00fcm (birini se\u00e7iniz): <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-3104__field--select-225_6a69249b980e5\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-225\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Please select an option\" data-search=\"false\" data-search-placeholder=\"Please select an option\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-3104__field--select-225_6a69249b980e5-label\"><option value=\"\"  >Please select an option<\/option><option value=\"G\u00f6r\u00fcnt\u00fcleme - Radyoloji\"  data-calculation=\"0\">G\u00f6r\u00fcnt\u00fcleme - Radyoloji<\/option><option value=\"Laboratuvar\"  data-calculation=\"0\">Laboratuvar<\/option><option value=\"Ameliyathane\"  data-calculation=\"0\">Ameliyathane<\/option><option value=\"Yo\u011fun Bak\u0131m \u00dcnitesi\"  data-calculation=\"0\">Yo\u011fun Bak\u0131m \u00dcnitesi<\/option><option value=\"Do\u011fum ve Yenido\u011fan Bak\u0131m\u0131\"  data-calculation=\"0\">Do\u011fum ve Yenido\u011fan Bak\u0131m\u0131<\/option><option value=\"Sterilizasyon \u00dcnitesi\"  data-calculation=\"0\">Sterilizasyon \u00dcnitesi<\/option><option value=\"Di\u015f Klini\u011fi\"  data-calculation=\"0\">Di\u015f Klini\u011fi<\/option><option value=\"Fizik Tedavi ve Rehabilitasyon\"  data-calculation=\"0\">Fizik Tedavi ve Rehabilitasyon<\/option><option value=\"Diyaliz \u00dcnitesi\"  data-calculation=\"0\">Diyaliz \u00dcnitesi<\/option><option value=\"Acil Servis\"  data-calculation=\"0\">Acil Servis<\/option><option value=\"Genel Servisler - Yatan Hasta Servisleri\"  data-calculation=\"0\">Genel Servisler - Yatan Hasta Servisleri<\/option><option value=\"Di\u011fer\"  data-calculation=\"0\">Di\u011fer<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-226\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-226_6a69249b980e5\" id=\"forminator-field-text-226_6a69249b980e5-label\" class=\"forminator-label\">(E\u011fer &quot;Di\u011fer&quot; se\u00e7ilirse) L\u00fctfen B\u00f6l\u00fcm\u00fc Belirtiniz: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-226\" value=\"\" placeholder=\"\" id=\"forminator-field-text-226_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-227\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-227-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-227-6a69249b980e5-label\" class=\"forminator-label\">Cihaz\u0131n Durumu: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-227-label-1\" for=\"forminator-field-radio-227-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"\u00c7al\u0131\u015fm\u0131yor\"><input type=\"radio\" name=\"radio-227\" value=\"Not working\" id=\"forminator-field-radio-227-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-227-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">\u00c7al\u0131\u015fm\u0131yor<\/span><\/label><label id=\"forminator-field-radio-227-label-2\" for=\"forminator-field-radio-227-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"K\u0131smen \u00c7al\u0131\u015f\u0131yor\"><input type=\"radio\" name=\"radio-227\" value=\"Partially working\" id=\"forminator-field-radio-227-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-227-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">K\u0131smen \u00c7al\u0131\u015f\u0131yor<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-228\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-228_6a69249b980e5\" id=\"forminator-field-text-228_6a69249b980e5-label\" class=\"forminator-label\">Ar\u0131za Tan\u0131m\u0131: <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"text-228\" placeholder=\"\" id=\"forminator-field-text-228_6a69249b980e5\" class=\"forminator-textarea\" aria-required=\"true\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-229\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-229-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-229-6a69249b980e5-label\" class=\"forminator-label\">Cihaz i\u00e7in \u015fu anda alternatif mevcut mu? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-229-label-1\" for=\"forminator-field-radio-229-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Evet\"><input type=\"radio\" name=\"radio-229\" value=\"Yes\" id=\"forminator-field-radio-229-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-229-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Evet<\/span><\/label><label id=\"forminator-field-radio-229-label-2\" for=\"forminator-field-radio-229-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Hay\u0131r\"><input type=\"radio\" name=\"radio-229\" value=\"No\" id=\"forminator-field-radio-229-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-229-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Hay\u0131r<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-230\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-230-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-230-6a69249b980e5-label\" class=\"forminator-label\">Onar\u0131m \u00d6nceli\u011fi (tesis personeline g\u00f6re): <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-230-label-1\" for=\"forminator-field-radio-230-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"En Y\u00fcksek \u00d6ncelik\"><input type=\"radio\" name=\"radio-230\" value=\"Highest\" id=\"forminator-field-radio-230-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-230-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">En Y\u00fcksek \u00d6ncelik<\/span><\/label><label id=\"forminator-field-radio-230-label-2\" for=\"forminator-field-radio-230-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Orta \u00d6ncelik\"><input type=\"radio\" name=\"radio-230\" value=\"Medium\" id=\"forminator-field-radio-230-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-230-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Orta \u00d6ncelik<\/span><\/label><label id=\"forminator-field-radio-230-label-3\" for=\"forminator-field-radio-230-3-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"D\u00fc\u015f\u00fck \u00d6ncelik\"><input type=\"radio\" name=\"radio-230\" value=\"Low\" id=\"forminator-field-radio-230-3-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-230-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">D\u00fc\u015f\u00fck \u00d6ncelik<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-231\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-231_6a69249b980e5\" id=\"forminator-field-text-231_6a69249b980e5-label\" class=\"forminator-label\">Cihaz\u0131n Hizmet Verdi\u011fi Tahmini Hasta Say\u0131s\u0131 (haftal\u0131k, \u00e7al\u0131\u015f\u0131r durumdayken): <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-231\" value=\"\" placeholder=\"\" id=\"forminator-field-text-231_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-232\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-232-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-232-6a69249b980e5-label\" class=\"forminator-label\">Gerekli Bak\u0131m T\u00fcr\u00fc: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-232-label-1\" for=\"forminator-field-radio-232-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Tek seferlik acil onar\u0131m\"><input type=\"radio\" name=\"radio-232\" value=\"One-time emergency repair\" id=\"forminator-field-radio-232-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-232-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Tek seferlik acil onar\u0131m<\/span><\/label><label id=\"forminator-field-radio-232-label-2\" for=\"forminator-field-radio-232-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"\u00d6nleyici\/D\u00fczenli bak\u0131m\"><input type=\"radio\" name=\"radio-232\" value=\"Preventive\/Regular maintenance\" id=\"forminator-field-radio-232-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-232-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">\u00d6nleyici\/D\u00fczenli bak\u0131m<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-233\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-233-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-233-6a69249b980e5-label\" class=\"forminator-label\">\u00d6nceki Onar\u0131m Denemeleri: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-233-label-1\" for=\"forminator-field-radio-233-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Evet\"><input type=\"radio\" name=\"radio-233\" value=\"Yes\" id=\"forminator-field-radio-233-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-233-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Evet<\/span><\/label><label id=\"forminator-field-radio-233-label-2\" for=\"forminator-field-radio-233-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Hay\u0131r\"><input type=\"radio\" name=\"radio-233\" value=\"No\" id=\"forminator-field-radio-233-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-233-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Hay\u0131r<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-234\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-234_6a69249b980e5\" id=\"forminator-field-text-234_6a69249b980e5-label\" class=\"forminator-label\">E\u011fer evet ise, l\u00fctfen a\u00e7\u0131klay\u0131n\u0131z: <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"text-234\" placeholder=\"\" id=\"forminator-field-text-234_6a69249b980e5\" class=\"forminator-textarea\" aria-required=\"true\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-235\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-235_6a69249b980e5\" id=\"forminator-field-text-235_6a69249b980e5-label\" class=\"forminator-label\">G\u00f6rsel \u0130nceleme Notlar\u0131:<\/label><textarea name=\"text-235\" placeholder=\"\" id=\"forminator-field-text-235_6a69249b980e5\" class=\"forminator-textarea\" aria-required=\"false\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-236\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-236_6a69249b980e5\" id=\"forminator-field-text-236_6a69249b980e5-label\" class=\"forminator-label\">\u015e\u00fcphelenilen Ar\u0131za Nedeni:<\/label><textarea name=\"text-236\" placeholder=\"\" id=\"forminator-field-text-236_6a69249b980e5\" class=\"forminator-textarea\" aria-required=\"false\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-237\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-237_6a69249b980e5\" id=\"forminator-field-text-237_6a69249b980e5-label\" class=\"forminator-label\">Gerekli Yedek Par\u00e7alar (biliniyorsa):<\/label><textarea name=\"text-237\" placeholder=\"\" id=\"forminator-field-text-237_6a69249b980e5\" class=\"forminator-textarea\" aria-required=\"false\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-238\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-238-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-238-6a69249b980e5-label\" class=\"forminator-label\">Tahmini Onar\u0131m\/Bak\u0131m Maliyeti (USD):<\/span><label id=\"forminator-field-radio-238-label-1\" for=\"forminator-field-radio-238-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"&lt; $100\"><input type=\"radio\" name=\"radio-238\" value=\"&lt;100\" id=\"forminator-field-radio-238-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-238-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">&lt; $100<\/span><\/label><label id=\"forminator-field-radio-238-label-2\" for=\"forminator-field-radio-238-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"$100 - $300\"><input type=\"radio\" name=\"radio-238\" value=\"100-300\" id=\"forminator-field-radio-238-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-238-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">$100 - $300<\/span><\/label><label id=\"forminator-field-radio-238-label-3\" for=\"forminator-field-radio-238-3-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"$300 - $500\"><input type=\"radio\" name=\"radio-238\" value=\"300-500\" id=\"forminator-field-radio-238-3-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-238-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">$300 - $500<\/span><\/label><label id=\"forminator-field-radio-238-label-4\" for=\"forminator-field-radio-238-4-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"&gt; $500\"><input type=\"radio\" name=\"radio-238\" value=\"&gt;500\" id=\"forminator-field-radio-238-4-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-238-label-4\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">&gt; $500<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-239\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-239-6a69249b980e5-label\"><span id=\"forminator-radiogroup-radio-239-6a69249b980e5-label\" class=\"forminator-label\">Onar\u0131m Uygulanabilirli\u011fi:<\/span><label id=\"forminator-field-radio-239-label-1\" for=\"forminator-field-radio-239-1-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Y\u00fcksek: Yerel olarak onar\u0131labilir\"><input type=\"radio\" name=\"radio-239\" value=\"High\" id=\"forminator-field-radio-239-1-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-239-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Y\u00fcksek: Yerel olarak onar\u0131labilir<\/span><\/label><label id=\"forminator-field-radio-239-label-2\" for=\"forminator-field-radio-239-2-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"Orta: \u00d6zel par\u00e7a gerektirebilir\"><input type=\"radio\" name=\"radio-239\" value=\"Medium\" id=\"forminator-field-radio-239-2-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-239-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Orta: \u00d6zel par\u00e7a gerektirebilir<\/span><\/label><label id=\"forminator-field-radio-239-label-3\" for=\"forminator-field-radio-239-3-6a69249b980e5\" class=\"forminator-radio forminator-radio-inline\" title=\"D\u00fc\u015f\u00fck: Onar\u0131m\u0131 zor\"><input type=\"radio\" name=\"radio-239\" value=\"Low\" id=\"forminator-field-radio-239-3-6a69249b980e5\" aria-labelledby=\"forminator-field-radio-239-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">D\u00fc\u015f\u00fck: Onar\u0131m\u0131 zor<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-240\" class=\"forminator-field-upload forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-upload-240_6a69249b980e5\" id=\"forminator-field-upload-240_6a69249b980e5-label\" class=\"forminator-label\">Cihaz Foto\u011fraf\u0131 (\u0130ste\u011fe Ba\u011fl\u0131):<\/label><div class=\"forminator-file-upload \" data-element=\"upload-240_6a69249b980e5\"><input type=\"file\" name=\"upload-240\" id=\"forminator-field-upload-240_6a69249b980e5\" class=\"forminator-input-file\" tabindex=\"-1\"><button id=\"forminator-field-upload-240_6a69249b980e5_button\" class=\"forminator-button forminator-button-upload\" data-id=\"forminator-field-upload-240_6a69249b980e5\">Choose File<\/button><span data-empty-text=\"No file chosen\">No file chosen<\/span><button class=\"forminator-button-delete\" style=\"display: none;\"><i class=\"forminator-icon-close\" aria-hidden=\"true\"><\/i><span class=\"forminator-screen-reader-only\">Delete uploaded file<\/span><\/button><\/div><\/div><\/div><\/div><div class=\"forminator-row forminator-action-buttons\"><div class=\"forminator-col forminator-col-12\"><input type=\"button\" value=\"Ba\u015fka Bir Cihaz Ekle\" class=\"forminator-repeater-action-button forminator-repeater-add\" \/><input type=\"button\" value=\"Kald\u0131r\" class=\"forminator-repeater-action-button forminator-repeater-remove\" \/><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-250\" class=\"forminator-field-section forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h2 class=\"forminator-title\">B\u00f6l\u00fcm 5: Genel Zorluklar ve Kapan\u0131\u015f<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-251\" class=\"forminator-field-checkbox forminator-col forminator-col-12 \"><div role=\"group\" class=\"forminator-field required\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-251-6a69249b980e5-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-251-6a69249b980e5-label\" class=\"forminator-label\">Sizce tesisinizin t\u0131bbi cihazlar\u0131 \u00e7al\u0131\u015f\u0131r durumda tutmada kar\u015f\u0131la\u015ft\u0131\u011f\u0131 ba\u015fl\u0131ca zorluklar nelerdir? (En fazla \u00dc\u00c7 tane se\u00e7in) <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-checkbox-251-1-6a69249b980e5-label\" for=\"forminator-field-checkbox-251-1-6a69249b980e5\" class=\"forminator-checkbox\" title=\"E\u011fitimli teknik personel eksikli\u011fi\"><input type=\"checkbox\" name=\"checkbox-251[]\" value=\"E\u011fitimli teknik personel eksikli\u011fi\" id=\"forminator-field-checkbox-251-1-6a69249b980e5\" aria-labelledby=\"forminator-field-checkbox-251-1-6a69249b980e5-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">E\u011fitimli teknik personel eksikli\u011fi<\/span><\/label><label id=\"forminator-field-checkbox-251-2-6a69249b980e5-label\" for=\"forminator-field-checkbox-251-2-6a69249b980e5\" class=\"forminator-checkbox\" title=\"Bak\u0131m i\u00e7in s\u0131n\u0131rl\u0131 b\u00fct\u00e7e\"><input type=\"checkbox\" name=\"checkbox-251[]\" value=\"Bak\u0131m i\u00e7in s\u0131n\u0131rl\u0131 b\u00fct\u00e7e\" id=\"forminator-field-checkbox-251-2-6a69249b980e5\" aria-labelledby=\"forminator-field-checkbox-251-2-6a69249b980e5-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Bak\u0131m i\u00e7in s\u0131n\u0131rl\u0131 b\u00fct\u00e7e<\/span><\/label><label id=\"forminator-field-checkbox-251-3-6a69249b980e5-label\" for=\"forminator-field-checkbox-251-3-6a69249b980e5\" class=\"forminator-checkbox\" title=\"Yedek par\u00e7a bulma\/eri\u015fim zorlu\u011fu\"><input type=\"checkbox\" name=\"checkbox-251[]\" value=\"Yedek par\u00e7a bulma\/eri\u015fim zorlu\u011fu\" id=\"forminator-field-checkbox-251-3-6a69249b980e5\" aria-labelledby=\"forminator-field-checkbox-251-3-6a69249b980e5-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Yedek par\u00e7a bulma\/eri\u015fim zorlu\u011fu<\/span><\/label><label id=\"forminator-field-checkbox-251-4-6a69249b980e5-label\" for=\"forminator-field-checkbox-251-4-6a69249b980e5\" class=\"forminator-checkbox\" title=\"D\u0131\u015f onar\u0131m hizmetlerinde uzun gecikmeler\"><input type=\"checkbox\" name=\"checkbox-251[]\" value=\"D\u0131\u015f onar\u0131m hizmetlerinde uzun gecikmeler\" id=\"forminator-field-checkbox-251-4-6a69249b980e5\" aria-labelledby=\"forminator-field-checkbox-251-4-6a69249b980e5-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">D\u0131\u015f onar\u0131m hizmetlerinde uzun gecikmeler<\/span><\/label><label id=\"forminator-field-checkbox-251-5-6a69249b980e5-label\" for=\"forminator-field-checkbox-251-5-6a69249b980e5\" class=\"forminator-checkbox\" title=\"D\u00fczenli \u00f6nleyici bak\u0131m eksikli\u011fi\"><input type=\"checkbox\" name=\"checkbox-251[]\" value=\"D\u00fczenli \u00f6nleyici bak\u0131m eksikli\u011fi\" id=\"forminator-field-checkbox-251-5-6a69249b980e5\" aria-labelledby=\"forminator-field-checkbox-251-5-6a69249b980e5-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">D\u00fczenli \u00f6nleyici bak\u0131m eksikli\u011fi<\/span><\/label><label id=\"forminator-field-checkbox-251-6-6a69249b980e5-label\" for=\"forminator-field-checkbox-251-6-6a69249b980e5\" class=\"forminator-checkbox\" title=\"Klinik personelin do\u011fru cihaz kullan\u0131m\u0131 konusunda e\u011fitim eksikli\u011fi\"><input type=\"checkbox\" name=\"checkbox-251[]\" value=\"Klinik personelin do\u011fru cihaz kullan\u0131m\u0131 konusunda e\u011fitim eksikli\u011fi\" id=\"forminator-field-checkbox-251-6-6a69249b980e5\" aria-labelledby=\"forminator-field-checkbox-251-6-6a69249b980e5-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Klinik personelin do\u011fru cihaz kullan\u0131m\u0131 konusunda e\u011fitim eksikli\u011fi<\/span><\/label><label id=\"forminator-field-checkbox-251-7-6a69249b980e5-label\" for=\"forminator-field-checkbox-251-7-6a69249b980e5\" class=\"forminator-checkbox\" title=\"Di\u011fer\"><input type=\"checkbox\" name=\"checkbox-251[]\" value=\"Di\u011fer\" id=\"forminator-field-checkbox-251-7-6a69249b980e5\" aria-labelledby=\"forminator-field-checkbox-251-7-6a69249b980e5-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Di\u011fer<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-252\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-252_6a69249b980e5\" id=\"forminator-field-text-252_6a69249b980e5-label\" class=\"forminator-label\">(E\u011fer &quot;Di\u011fer&quot; se\u00e7ilirse) L\u00fctfen Zorlu\u011fu Belirtiniz: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-252\" value=\"\" placeholder=\"\" id=\"forminator-field-text-252_6a69249b980e5\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-253\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-253_6a69249b980e5\" id=\"forminator-field-text-253_6a69249b980e5-label\" class=\"forminator-label\">Di\u011fer Notlar veya Yorumlar:<\/label><textarea name=\"text-253\" placeholder=\"\" id=\"forminator-field-text-253_6a69249b980e5\" class=\"forminator-textarea\" aria-required=\"false\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-254\" class=\"forminator-field-upload forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-upload-254_6a69249b980e5\" id=\"forminator-field-upload-254_6a69249b980e5-label\" class=\"forminator-label\">Ekip Foto\u011fraf\u0131 (\u0130ste\u011fe Ba\u011fl\u0131):<\/label><div class=\"forminator-file-upload \" data-element=\"upload-254_6a69249b980e5\"><input type=\"file\" name=\"upload-254\" id=\"forminator-field-upload-254_6a69249b980e5\" class=\"forminator-input-file\" tabindex=\"-1\"><button id=\"forminator-field-upload-254_6a69249b980e5_button\" class=\"forminator-button forminator-button-upload\" data-id=\"forminator-field-upload-254_6a69249b980e5\">Choose File<\/button><span data-empty-text=\"No file chosen\">No file chosen<\/span><button class=\"forminator-button-delete\" style=\"display: none;\"><i class=\"forminator-icon-close\" aria-hidden=\"true\"><\/i><span class=\"forminator-screen-reader-only\">Delete uploaded file<\/span><\/button><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-255\" class=\"forminator-field-html forminator-col forminator-col-12 \"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-255\"><\/div><\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div class=\"forminator-row forminator-row-last\"><div class=\"forminator-col\"><div class=\"forminator-field\"><button class=\"forminator-button forminator-button-submit\">Submit \/ G&ouml;nder<\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"7d0977071c\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php\/wp-json\/wp\/v2\/pages\/3098\" \/><input type=\"hidden\" name=\"form_id\" value=\"3104\"><input type=\"hidden\" name=\"page_id\" value=\"3098\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/fieldready.org.tr\/index.php\/improving-access-to-healthcare-services-in-kilis\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><\/form><\/div>\n","protected":false},"excerpt":{"rendered":"Language \/ DilChoose Language \/ Dil Se\u00e7iniz *EnglishT\u00fcrk\u00e7ePart 1: Facility Profile (To be filled out once per health facility)Facility Name: *Province: *Please select an optionKilisDistrict: (Select one) *Please select an optionCenter (Merkez)ElbeyliMusabeyliPolateliNeighborhood: (Select one from the list) *Please select an optionOther(If &quot;Other&quot; is selected) Please...","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-3098","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Improving Access to Healthcare Services in Kilis - Sahaya Hazir \u0130novasyon Derne\u011fi<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/fieldready.org.tr\/index.php\/improving-access-to-healthcare-services-in-kilis\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Improving Access to Healthcare Services in Kilis - Sahaya Hazir \u0130novasyon Derne\u011fi\" \/>\n<meta property=\"og:url\" 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