{"id":19215,"date":"2020-06-18T16:31:09","date_gmt":"2020-06-18T16:31:09","guid":{"rendered":"https:\/\/www.ub.edu\/ossma\/?page_id=19215"},"modified":"2026-08-04T07:41:10","modified_gmt":"2026-08-04T07:41:10","slug":"questionari-vulnerabilitat-covid19","status":"publish","type":"page","link":"https:\/\/www.ub.edu\/ossma\/procediments-tramits\/questionari-vulnerabilitat-covid19","title":{"rendered":"Q\u00fcestionari vulnerabilitat UB-COVID19"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Detecci\u00f3 de personal especialment vulnerable a SARS-CoV-2 i d\u2019altres possibles situacions d\u2019especial sensibilitat.<\/p>\n\n\n\n<p class=\"atencio wp-block-paragraph\"><strong>MOLT IMPORTANT: Aquest q\u00fcestionari nom\u00e9s l\u2019has d\u2019emplenar si et trobes inclosa o incl\u00f2s en alguna de les situacions de vulnerabilitat indicades en l\u2019apartat Factors de risc que s\u2019indiquen a continuaci\u00f3, i no has estat valorada o valorat anteriorment o b\u00e9 et cal actualitzaci\u00f3.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">M\u00e9s informaci\u00f3: <a rel=\"noreferrer noopener\" href=\"https:\/\/www.ub.edu\/ossma\/wp-content\/uploads\/2021\/08\/20210727-gestio-medica-personal-vulnerable-juliol-ub.pdf\" target=\"_blank\">Gesti\u00f3 m\u00e8dica de la vulnerabilitat front Covid-19 a la UB<\/a>.<\/p>\n\n\n\n<hr class=\"wp-block-separator alignfull has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">Q\u00fcestionari<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f19218-o1\" lang=\"ca\" dir=\"ltr\" data-wpcf7-id=\"19218\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/ossma\/wp-json\/wp\/v2\/pages\/19215#wpcf7-f19218-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formulari de contacte\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"19218\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.2.3\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"ca\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f19218-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\" \/><input type=\"hidden\" name=\"_wpcf7cf_options\" value=\"{&quot;form_id&quot;:19218,&quot;conditions&quot;:[{&quot;then_field&quot;:&quot;malalties-mes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;malalties&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;S\\u00ed&quot;}]},{&quot;then_field&quot;:&quot;discapacitats-mes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;discapacitats&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;S\\u00ed&quot;}]},{&quot;then_field&quot;:&quot;altre-lloc-treball&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;altre-lloc&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;S\\u00ed&quot;}]},{&quot;then_field&quot;:&quot;comunicar-mes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;comunicar&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;S\\u00ed&quot;}]},{&quot;then_field&quot;:&quot;contacte-mes&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;contacte-estret&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;S\\u00ed&quot;}]},{&quot;then_field&quot;:&quot;group-malalties&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;risc&quot;,&quot;operator&quot;:&quot;not equals&quot;,&quot;if_value&quot;:&quot;Cap d\\u2019aquests factors de risc&quot;}]},{&quot;then_field&quot;:&quot;group-edat&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;risc&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Ets m\\u00e9s gran de 60 anys&quot;},{&quot;if_field&quot;:&quot;-1&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;S\\u00ed&quot;}]}],&quot;settings&quot;:{&quot;animation&quot;:&quot;yes&quot;,&quot;animation_intime&quot;:200,&quot;animation_outtime&quot;:200,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:false,&quot;repeater_remove_button&quot;:&quot;bottom&quot;}}\" \/>\n<\/fieldset>\n<div class=\"formulari-destacat\">\n\t<p>Si per qualsevol causa prefereixes no respondre al q\u00fcestionari, no ho facis, contacta amb el servei m\u00e8dic a <a href=\"mailto:medicinadeltreball.ossma@ub.edu\">medicinadeltreball.ossma@ub.edu<\/a> per informar-ne\n\t<\/p>\n<\/div>\n<p><span class=\"small\">Els camps amb asterisc (*) s\u00f3n obligatoris<\/span>\n<\/p>\n<div class=\"form-two-columns\">\n\t<fieldset>\n\t\t<legend>Dades personals\n\t\t<\/legend>\n\t\t<p><label for=\"nom\">Cognoms, Nom*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"nom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"nom\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nom\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"naixement\">Data de naixement*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"naixement\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"naixement\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"naixement\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"nif\">NIF*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"nif\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"nif\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nif\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"relacio-ub\">Relaci\u00f3 amb la UB*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"relacio-ub\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\" id=\"relacio-ub\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"relacio-ub[]\" value=\"PAS\" \/><span class=\"wpcf7-list-item-label\">PAS<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"relacio-ub[]\" value=\"PDI\" \/><span class=\"wpcf7-list-item-label\">PDI<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"facultat\"> Facultat\/centre*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"facultat\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" id=\"facultat\" aria-required=\"true\" aria-invalid=\"false\" multiple=\"multiple\" name=\"facultat[]\"><option value=\"\u00c0rea de Formaci\u00f3 Complement\u00e0ria (Casa Jeroni Granell)\">\u00c0rea de Formaci\u00f3 Complement\u00e0ria (Casa Jeroni Granell)<\/option><option value=\"\u00c0rea de Formaci\u00f3 Complement\u00e0ria (Edifici El Carme)\">\u00c0rea de Formaci\u00f3 Complement\u00e0ria (Edifici El Carme)<\/option><option value=\"\u00c0rea de Formaci\u00f3 Complement\u00e0ria (Torre de la Creu)\">\u00c0rea de Formaci\u00f3 Complement\u00e0ria (Torre de la Creu)<\/option><option value=\"Aulari Josep Carner\">Aulari Josep Carner<\/option><option value=\"Centre de Recerca d\u2019Alta Muntanya\">Centre de Recerca d\u2019Alta Muntanya<\/option><option value=\"Edifici Baldiri Reixac 2\">Edifici Baldiri Reixac 2<\/option><option value=\"Edifici Hist\u00f2ric\">Edifici Hist\u00f2ric<\/option><option value=\"Edifici Sol\u00e9 i Sabar\u00eds (CCiTUB)\">Edifici Sol\u00e9 i Sabar\u00eds (CCiTUB)<\/option><option value=\"Dip\u00f2sit CRAI (Cervera)\">Dip\u00f2sit CRAI (Cervera)<\/option><option value=\"Facultat de Belles Arts\">Facultat de Belles Arts<\/option><option value=\"Facultat d\u2019Informaci\u00f3 i Mitjans Audiovisuals (UB Sants)\">Facultat d\u2019Informaci\u00f3 i Mitjans Audiovisuals (UB Sants)<\/option><option value=\"Facultat de Biologia\">Facultat de Biologia<\/option><option value=\"Facultat de Ci\u00e8ncies de la Terra\">Facultat de Ci\u00e8ncies de la Terra<\/option><option value=\"Facultat de Dret\">Facultat de Dret<\/option><option value=\"Facultat d\u2019Economia i Empresa\">Facultat d\u2019Economia i Empresa<\/option><option value=\"Facultat d\u2019Educaci\u00f3\">Facultat d\u2019Educaci\u00f3<\/option><option value=\"Facultat de Farm\u00e0cia i Ci\u00e8ncies de l\u2019Alimentaci\u00f3 (Campus de Torribera)\">Facultat de Farm\u00e0cia i Ci\u00e8ncies de l\u2019Alimentaci\u00f3 (Campus de Torribera)<\/option><option value=\"Facultat de Farm\u00e0cia i Ci\u00e8ncies de l\u2019Alimentaci\u00f3 (Diagonal Sud)\">Facultat de Farm\u00e0cia i Ci\u00e8ncies de l\u2019Alimentaci\u00f3 (Diagonal Sud)<\/option><option value=\"Facultat de Filosofia i Facultat de Geografia i Hist\u00f2ria\">Facultat de Filosofia i Facultat de Geografia i Hist\u00f2ria<\/option><option value=\"Facultat de F\u00edsica i Facultat de Qu\u00edmica\">Facultat de F\u00edsica i Facultat de Qu\u00edmica<\/option><option value=\"Facultat de Medicina i Ci\u00e8ncies de la Salut (Campus Cl\u00ednic)\">Facultat de Medicina i Ci\u00e8ncies de la Salut (Campus Cl\u00ednic)<\/option><option value=\"Facultat de Medicina i Ci\u00e8ncies de la Salut (Campus de Bellvitge)\">Facultat de Medicina i Ci\u00e8ncies de la Salut (Campus de Bellvitge)<\/option><option value=\"Facultat de Psicologia\">Facultat de Psicologia<\/option><option value=\"Finca Pere Pons\">Finca Pere Pons<\/option><option value=\"Parc de les Humanitats i les Ci\u00e8ncies Socials (Edifici Can Jaumandreu)\">Parc de les Humanitats i les Ci\u00e8ncies Socials (Edifici Can Jaumandreu)<\/option><option value=\"Pavell\u00f3 Rosa\">Pavell\u00f3 Rosa<\/option><option value=\"Servei d\u2019Esports\">Servei d\u2019Esports<\/option><option value=\"Altres espais de la UB\">Altres espais de la UB<\/option><option value=\"Altres espais fora de la UB\">Altres espais fora de la UB<\/option><\/select><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"departament\">Departament\/servei\/unitat*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"departament\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"departament\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"departament\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"edifici\">Edifici\/s<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"edifici\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"edifici\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"edifici\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"correu\">Correu electr\u00f2nic*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"correu\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" id=\"correu\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"correu\" \/><\/span>\n\t\t<\/p>\n\t<\/fieldset>\n\t<fieldset>\n\t\t<legend>Factors de risc\n\t\t<\/legend>\n\t\t<p><label for=\"risc\">Tens algun dels factors de risc que s\u2019exposen a continuaci\u00f3?<br \/>\n<span class=\"small\">(Amb la tecla Crtl. pots seleccionar m\u00e9s d'una opci\u00f3)<\/span><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"risc\"><select class=\"wpcf7-form-control wpcf7-select\" id=\"risc\" aria-invalid=\"false\" multiple=\"multiple\" name=\"risc[]\"><option value=\"Cap d\u2019aquests factors de risc\">Cap d\u2019aquests factors de risc<\/option><option value=\"Malaltia cardiovascular, inclosa hipertensi\u00f3\">Malaltia cardiovascular, inclosa hipertensi\u00f3<\/option><option value=\"Malaltia pulmonar cr\u00f2nica\">Malaltia pulmonar cr\u00f2nica<\/option><option value=\"Diabetis\">Diabetis<\/option><option value=\"Insufici\u00e8ncia renal cr\u00f2nica\">Insufici\u00e8ncia renal cr\u00f2nica<\/option><option value=\"Immunodepressi\u00f3\">Immunodepressi\u00f3<\/option><option value=\"C\u00e0ncer en fase de tractament actiu\">C\u00e0ncer en fase de tractament actiu<\/option><option value=\"Malaltia hep\u00e0tica cr\u00f2nica severa\">Malaltia hep\u00e0tica cr\u00f2nica severa<\/option><option value=\"Obesitat m\u00f2rbida (IMC&gt;40)\">Obesitat m\u00f2rbida (IMC&gt;40)<\/option><option value=\"Embar\u00e0s\">Embar\u00e0s<\/option><option value=\"Ets m\u00e9s gran de 60 anys\">Ets m\u00e9s gran de 60 anys<\/option><\/select><\/span>\n\t\t<\/p>\n\t\t<div data-id=\"group-edat\" data-orig_data_id=\"group-edat\" data-clear_on_hide class=\"\" data-class=\"wpcf7cf_group\">\n\t\t\t<p><label for=\"edat\">Edat<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"edat\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"edat\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"edat\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div data-id=\"group-malalties\" data-orig_data_id=\"group-malalties\" data-clear_on_hide class=\"\" data-class=\"wpcf7cf_group\">\n\t\t\t<p>En cas que hagis marcat alguna de les caselles anteriors, a excepci\u00f3 de situaci\u00f3 d\u2019embar\u00e0s o ser major de 60 anys, explica si us plau:\n\t\t\t<\/p>\n\t\t\t<p><label for=\"risc-desde\">Des de quan el pateixes?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"risc-desde\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"risc-desde\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"risc-desde\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"diagnostic\">Quin el diagn\u00f2stic m\u00e8dic per a aquest factor de risc?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"diagnostic\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"diagnostic\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"diagnostic\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"risc-tractament\">Quin \u00e9s el tractament m\u00e8dic que tens pautat actualment?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"risc-tractament\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"risc-tractament\" aria-invalid=\"false\" name=\"risc-tractament\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"risc-controlada\">Consideres que est\u00e0 controlada la teva patologia?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"risc-controlada\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"risc-controlada\" aria-invalid=\"false\" name=\"risc-controlada\"><\/textarea><\/span><br \/>\n<label for=\"inform-medic\">Si ho consideres necessari, pots adjuntar informaci\u00f3 m\u00e8dica actualitzada<br \/>\n<span class=\"small\">(Mida m\u00e0xima del fitxer: 20Mb)<\/span><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"inform-medic\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" id=\"inform-medic\" accept=\"audio\/*,video\/*,image\/*\" aria-invalid=\"false\" type=\"file\" name=\"inform-medic\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/fieldset>\n\t<fieldset>\n\t\t<legend>Altres malalties\n\t\t<\/legend>\n\t\t<p><label for=\"malalties\">Tens alguna altra malaltia que no estigui a la llista per la qual et calgui tractament i que consideres que podria ser incompatible amb les condicions de treball en el moment actual de la pand\u00e8mia?* <\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"malalties\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"malalties\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"malalties\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"malalties\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t\t<div data-id=\"malalties-mes\" data-orig_data_id=\"malalties-mes\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t\t<p><label for=\"malalties-explica\">Si \u00e9s que s\u00ed, si us plau, digues quin \u00e9s el diagn\u00f2stic, tractament i el teu estat de salut actual i ho valorarem<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"malalties-explica\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"malalties-explica\" aria-invalid=\"false\" name=\"malalties-explica\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/fieldset>\n\t<fieldset>\n\t\t<legend>Discapacitats\n\t\t<\/legend>\n\t\t<p><label for=\"discapacitats\">Tens alguna discapacitat que consideris que \u00e9s incompatible amb les condicions de treball que tens a la UB?*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"discapacitats\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"discapacitats\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"discapacitats\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"discapacitats\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t\t<div data-id=\"discapacitats-mes\" data-orig_data_id=\"discapacitats-mes\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t\t<p><label for=\"discapacitats-explica\">Si \u00e9s que s\u00ed, si us plau explica\u2019ns la teva situaci\u00f3 personal i la valorarem<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"discapacitats-explica\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"discapacitats-explica\" aria-invalid=\"false\" name=\"discapacitats-explica\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/fieldset>\n\t<fieldset>\n\t\t<legend> Dades sobre la teva activitat presencial a la UB actualment\n\t\t<\/legend>\n\t\t<p><label for=\"transport\">Quin mitj\u00e0 de despla\u00e7ament utilitzes per arribar al teu lloc de treball?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"transport\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"transport\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"transport\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"temps\">Quan de temps trigues en arribar al teu lloc de treball?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"temps\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"temps\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"temps\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"transport-abans\">En quin mitj\u00e0 de transport venies abans de la situaci\u00f3 de pand\u00e8mia?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"transport-abans\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"transport-abans\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"transport-abans\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"lloc\">Quin \u00e9s el teu lloc de treball habitual?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"lloc\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"lloc\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"lloc\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"habituals\">Les teves tasques en aquest moment son diferents de les habituals i per tant al teu criteri, l\u2019activitat presenta algun risc afegit (ali\u00e8 al SARS-CoV2)<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"habituals\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"habituals\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"habituals\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"horari\">Horari <b>habitual<\/b> del teu lloc de treball <\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"horari\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"horari\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"horari\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"horari-previst\">Horari <b>previst<\/b> i dies de pres\u00e8ncia\/de treball presencial actualment <\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"horari-previst\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"horari-previst\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"horari-previst\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"horari-docencia\">En cas de ser PDI, hores setmanals de doc\u00e8ncia presencial previstes, tant te\u00f2rica com pr\u00e0ctica<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"horari-docencia\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"horari-docencia\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"horari-docencia\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"altre-lloc\">Has d\u2019accedir a algun altre lloc de treball diferent de l\u2019habitual durant la teva pres\u00e8ncia a la UB?*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"altre-lloc\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"altre-lloc\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"altre-lloc\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"altre-lloc\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t\t<div data-id=\"altre-lloc-treball\" data-orig_data_id=\"altre-lloc-treball\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t\t<p><label for=\"altre-lloc-perque\">On? Per qu\u00e8?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"altre-lloc-perque\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"altre-lloc-perque\" aria-invalid=\"false\" name=\"altre-lloc-perque\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<p><label for=\"eina\">Utilitzes alguna eina, mobiliari, material que tamb\u00e9 utilitzen altres companys o treballadors aliens i pugui representar perill de contaminaci\u00f3? <\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"eina\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"eina\" aria-invalid=\"false\" name=\"eina\"><\/textarea><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"neteja\">Hi ha servei de neteja del mobiliari i instal\u00b7lacions que utilitzeu?*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"neteja\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"neteja\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"neteja\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"neteja\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"productes\">En cas que feu una neteja addicional del mobiliari o materials que utilitzeu, disposeu dels productes i dels elements de protecci\u00f3 adients? Quins son aquests? <\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"productes\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"productes\" aria-invalid=\"false\" name=\"productes\"><\/textarea><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"comunicar\">Si est\u00e0s sol, tens contacte peri\u00f2dic (Telef\u00f2nic? Presencial?) amb alg\u00fa durant el temps de perman\u00e8ncia al teu lloc de treball per si haguessis de comunicar una situaci\u00f3 d\u2019emerg\u00e8ncia?*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"comunicar\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"comunicar\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"comunicar\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"comunicar\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t\t<div data-id=\"comunicar-mes\" data-orig_data_id=\"comunicar-mes\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t\t<p><label for=\"comunicar-qui\">Amb qui?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"comunicar-qui\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"comunicar-qui\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"comunicar-qui\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/fieldset>\n\t<fieldset>\n\t\t<legend>Interacci\u00f3 amb d'altres persones\n\t\t<\/legend>\n\t\t<p><label for=\"contacte-estret\">Consideres que el teu treball requereix en algun moment tenir un contacte estret* en el teu lloc de treball?* <span class=\"small\">(*Contacte estret = qualsevol persona que hagi estat en el mateix lloc que cas un a una dist\u00e0ncia menor de 2 metres durant almenys 15 minuts sense protecci\u00f3 adequada)<br \/>\n<\/span><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"contacte-estret\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"contacte-estret\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"contacte-estret\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"contacte-estret\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t\t<div data-id=\"contacte-mes\" data-orig_data_id=\"contacte-mes\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t\t<p><label for=\"contacte-estret-explica\">Explica la situaci\u00f3<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"contacte-estret-explica\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"contacte-estret-explica\" aria-invalid=\"false\" name=\"contacte-estret-explica\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/fieldset>\n\t<fieldset>\n\t\t<legend>Tasques\n\t\t<\/legend>\n\t\t<p><label for=\"tasques\">Indica molt breument quines s\u00f3n les tasques que realitzar\u00e0s al teu lloc de treball habitual (presencial i de treball a dist\u00e0ncia) i que t'han portat a pensar que, sent vulnerable, representen un risc per a la teva salut <\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"tasques\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"tasques\" aria-invalid=\"false\" name=\"tasques\"><\/textarea><\/span>\n\t\t<\/p>\n\t<\/fieldset>\n\t<fieldset>\n\t\t<legend>Signatura\n\t\t<\/legend>\n\t\t<p>Declaro que*:\n\t\t<\/p>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"aceptacio-certes\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"aceptacio-certes\" value=\"1\" id=\"aceptacio-certes\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">les informacions que he facilitat en aquest q\u00fcestionari s\u00f3n certes<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"aceptacio-canvis\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"aceptacio-canvis\" value=\"1\" id=\"aceptacio-canvis\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">informar\u00e9 a l\u2019OSSMA en cas de qualsevol modificaci\u00f3 de la meva situaci\u00f3<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"signatura\">Signatura del treballador*<br \/>\n<small>(Dibuixa la teva signatura al requadre)<\/small><\/label>\n\t\t<\/p>\n\t\t<div class=\"formulari-dreta\">\n\t\t\t<p><div class=\"dscf7_signature\">\n\t\t\t<div class=\"dscf7_signature_inner\">\n\t\t\t\t<canvas id=\"digital_signature-pad_signatura\" name=\"signatura\" class=\"digital_signature-pad\" color=\"#000000\" backcolor=\"#dddddd\" width=\"300\" height=\"200\"><\/canvas>\n\t\t\t\t<input class=\"clearButton\" type=\"button\" value=\"+\">\n\t\t\t<\/div>\n\t\t\t<span class=\"wpcf7-form-control-wrap signatura\" data-name=\"signatura\">\n\t\t\t\t<input class=\"wpcf7-form-control wpcf7-signature wpcf7-validates-as-required wpcf7-validates-as-signature dscf7-signature\" id=\"signatura\" value=\"\" type=\"hidden\" name=\"signatura\"\/>\n\t\t\t\t<input type=\"hidden\" name=\"signatura-attachment\" class=\"wpcf7_input_signatura_attachment\"\/>\n\t\t\t\t<input type=\"hidden\" name=\"signatura-inline\" class=\"wpcf7_input_signatura_inline\"\/>\n\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/fieldset>\n\t<div class=\"ressaltat\">\n\t\t<p>IMPORTANT:\n\t\t<\/p>\n\t<\/div>\n\t<p>At\u00e8s que el q\u00fcestionari cont\u00e9 informaci\u00f3 m\u00e8dica, s\u2019enviar\u00e0 directament i nom\u00e9s al personal sanitari a l\u2019adre\u00e7a medicinadeltreball.ossma@ub.edu. Des d\u2019aquesta adre\u00e7a, es derivar\u00e0 als t\u00e8cnics de prevenci\u00f3 \u00fanicament la informaci\u00f3 t\u00e8cnica. En virtut de les respostes al q\u00fcestionari, es far\u00e0 una valoraci\u00f3 m\u00e8dica i t\u00e8cnica, per determinar si hi ha alguna condici\u00f3 espec\u00edfica a considerar.\n\t<\/p>\n\t<p><b>Dret d\u2019informaci\u00f3 relatiu al tractament de dades personals<\/b>\n\t<\/p>\n\t<p>(1) El responsable del tractament de les vostres dades \u00e9s la Secretaria General de la Universitat de Barcelona. (2) La finalitat del tractament \u00e9s gestionar la vigil\u00e0ncia peri\u00f2dica de l\u2019estat de salut dels treballadors. (3) Teniu dret a accedir a les vostres dades, rectificar-les, suprimir-les, oposar-vos al seu tractament, sol\u00b7licitar-ne la portabilitat i la limitaci\u00f3 dels tractaments, en determinades circumst\u00e0ncies. (4) Podeu consultar la <a href=\"https:\/\/www.ub.edu\/ossma\/dret-informacio-addicional\/dret-dinformacio-tractament-dades-personals-examen-salut\" target=\"_blank\">informaci\u00f3 detallada dels tractaments esmentats<\/a>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"acceptacio\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptacio\" value=\"1\" id=\"acceptacio\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Declaro que he llegit el dret d\u2019informaci\u00f3 i consento el tractament de les meves dades personals en els termes indicats.<\/span><\/label><\/span><\/span><\/span>\n\t<\/p>\n<\/div>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Enviar\" \/>\n<\/p>\n<p>(El formulari pot trigar uns segons a confirmar l'enviament. Si us plau, no el reenvieu ni recarregueu la p\u00e0gina.)\n<\/p><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"37\"\/><script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Detecci\u00f3 de personal especialment vulnerable a SARS-CoV-2 i d\u2019altres possibles situacions d\u2019especial sensibilitat. MOLT IMPORTANT: Aquest q\u00fcestionari nom\u00e9s l\u2019has d\u2019emplenar si et trobes inclosa o incl\u00f2s en alguna de les situacions de vulnerabilitat indicades en l\u2019apartat Factors de risc que s\u2019indiquen a continuaci\u00f3, i no has estat valorada o valorat anteriorment o b\u00e9 et cal &#8230; <a title=\"Q\u00fcestionari vulnerabilitat UB-COVID19\" class=\"read-more\" href=\"https:\/\/www.ub.edu\/ossma\/procediments-tramits\/questionari-vulnerabilitat-covid19\" aria-label=\"M\u00e9s informaci\u00f3 sobre Q\u00fcestionari vulnerabilitat UB-COVID19\">Llegiu m\u00e9s<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":771,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"advgb_blocks_editor_width":"","advgb_blocks_columns_visual_guide":"","footnotes":""},"class_list":["post-19215","page","type-page","status-publish"],"coauthors":[],"author_meta":{"author_link":"https:\/\/www.ub.edu\/ossma\/author\/ossmau1","display_name":"OSSMA"},"relative_dates":{"created":"Posted 6 anys ago","modified":"Updated 3 mesos ago"},"absolute_dates":{"created":"Posted on 18\/06\/2020","modified":"Updated on 04\/08\/2026"},"absolute_dates_time":{"created":"Posted on 18\/06\/2020 16:31","modified":"Updated on 04\/08\/2026 7:41"},"featured_img_caption":"","featured_img":false,"series_order":"","_links":{"self":[{"href":"https:\/\/www.ub.edu\/ossma\/wp-json\/wp\/v2\/pages\/19215","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ub.edu\/ossma\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.ub.edu\/ossma\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.ub.edu\/ossma\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ub.edu\/ossma\/wp-json\/wp\/v2\/comments?post=19215"}],"version-history":[{"count":13,"href":"https:\/\/www.ub.edu\/ossma\/wp-json\/wp\/v2\/pages\/19215\/revisions"}],"predecessor-version":[{"id":100853,"href":"https:\/\/www.ub.edu\/ossma\/wp-json\/wp\/v2\/pages\/19215\/revisions\/100853"}],"up":[{"embeddable":true,"href":"https:\/\/www.ub.edu\/ossma\/wp-json\/wp\/v2\/pages\/771"}],"wp:attachment":[{"href":"https:\/\/www.ub.edu\/ossma\/wp-json\/wp\/v2\/media?parent=19215"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}