{"id":1984,"date":"2020-02-19T17:24:14","date_gmt":"2020-02-19T08:24:14","guid":{"rendered":"http:\/\/nagano-medical.test\/?page_id=1984"},"modified":"2026-05-11T10:01:31","modified_gmt":"2026-05-11T01:01:31","slug":"oc-form","status":"publish","type":"page","link":"https:\/\/nagano-iryoueisei.ac.jp\/medical\/contact\/oc-form","title":{"rendered":"\u30aa\u30fc\u30d7\u30f3\u30ad\u30e3\u30f3\u30d1\u30b9\u7533\u3057\u8fbc\u307f"},"content":{"rendered":"\n<div class=\"wp-block-group\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<p class=\"c-container u-mt-medium u-mb-medium wp-block-paragraph\">\u53d6\u5f97\u3057\u305f\u500b\u4eba\u60c5\u5831\u306f\u3001\u5165\u5b66\u6848\u5185\u3084\u52df\u96c6\u8981\u9805\u306e\u9001\u4ed8\u3001\u624b\u7d19\u3084\u96fb\u8a71\u30fb\u30e1\u30fc\u30eb\u7b49\u5404\u7a2e\u30b3\u30df\u30e5\u30cb\u30b1\u30fc\u30b7\u30e7\u30f3\u30c4\u30fc\u30eb\u3092\u5229\u7528\u3057\u305f\u9032\u8def\u60c5\u5831\u306e\u63d0\u4f9b\u3001\u9ad8\u7b49\u5b66\u6821\u3078\u306e\u9023\u7d61\u306b\u5229\u7528\u3055\u308c\u3001\u672c\u4eba\u306e\u540c\u610f\u3092\u5f97\u308b\u3053\u3068\u306a\u304f\u500b\u4eba\u60c5\u5831\u3092\u7b2c\u4e09\u8005\u306b\u63d0\u4f9b\u3001\u958b\u793a\u306f\u4e00\u5207\u3044\u305f\u3057\u307e\u305b\u3093\u3002<\/p>\n\n\n\n<p class=\"c-container u-mt-medium u-mb-medium wp-block-paragraph\">\u500b\u4eba\u60c5\u5831\u4fdd\u8b77\u306b\u95a2\u3059\u308b\u8a73\u3057\u3044\u60c5\u5831\u306f\u3001<a href=\"\/privacy-policy\" data-type=\"URL\" data-id=\"\/privacy-policy\">\u3053\u3061\u3089<\/a>\u3092\u3054\u89a7\u304f\u3060\u3055\u3044\u3002<\/p>\n\n\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1076-o1\" lang=\"ja\" dir=\"ltr\" data-wpcf7-id=\"1076\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/medical\/wp-json\/wp\/v2\/pages\/1984#wpcf7-f1076-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"\u30b3\u30f3\u30bf\u30af\u30c8\u30d5\u30a9\u30fc\u30e0\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"1076\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"ja\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1076-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div class=\"p-flexform h-adr\">\n\t<p><span class=\"p-country-name\">Japan<\/span>\n\t<\/p>\n\t<div class=\"p-flexform__wrapper\">\n\t\t<div class=\"p-flexform__item p-flexform__required\">\n\t\t\t<div class=\"p-flexform__headding\">\n\t\t\t\t<p>\u30a4\u30d9\u30f3\u30c8\u9078\u629e\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"p-flexform__content\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"event\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"event\"><option value=\"5\u670817\u65e5(\u65e5) \u6b6f\u79d1\u885b\u751f\u58eb\u5b66\u79d1\uff1a\u6b6f\u77f3\u53d6\u308a\u4f53\u9a13\uff0b\u30d0\u30ad\u30e5\u30fc\u30e0\u4f53\u9a13(\u8d85\u97f3\u6ce2\u30b9\u30b1\u30fc\u30e9\u30fc)\">5\u670817\u65e5(\u65e5) \u6b6f\u79d1\u885b\u751f\u58eb\u5b66\u79d1\uff1a\u6b6f\u77f3\u53d6\u308a\u4f53\u9a13\uff0b\u30d0\u30ad\u30e5\u30fc\u30e0\u4f53\u9a13(\u8d85\u97f3\u6ce2\u30b9\u30b1\u30fc\u30e9\u30fc)<\/option><option value=\"5\u670817\u65e5(\u65e5) \u8a00\u8a9e\u8074\u899a\u58eb\u5b66\u79d1\uff1a\u8a00\u8a9e\u8074\u899a\u58eb\u306e\u4ed5\u4e8b\u3092\u77e5\u308d\u3046\">5\u670817\u65e5(\u65e5) \u8a00\u8a9e\u8074\u899a\u58eb\u5b66\u79d1\uff1a\u8a00\u8a9e\u8074\u899a\u58eb\u306e\u4ed5\u4e8b\u3092\u77e5\u308d\u3046<\/option><option value=\"5\u670817\u65e5(\u65e5) \u97f3\u697d\u7642\u6cd5\u58eb\u5b66\u79d1\uff1a\u97f3\u697d\u7642\u6cd5\u30ef\u30fc\u30af\u30b7\u30e7\u30c3\u30d7\uff5e\u590f\u306e\u97f3\u697d\uff5e\">5\u670817\u65e5(\u65e5) \u97f3\u697d\u7642\u6cd5\u58eb\u5b66\u79d1\uff1a\u97f3\u697d\u7642\u6cd5\u30ef\u30fc\u30af\u30b7\u30e7\u30c3\u30d7\uff5e\u590f\u306e\u97f3\u697d\uff5e<\/option><option value=\"6\u670813\u65e5(\u571f) \u6b6f\u79d1\u885b\u751f\u58eb\u5b66\u79d1\uff1a\u6b6f\u79d1\u6750\u6599\u3067\u30b3\u30a4\u30f3\u78e8\u304d(\u6b6f\u9762\u7814\u78e8)\">6\u670813\u65e5(\u571f) \u6b6f\u79d1\u885b\u751f\u58eb\u5b66\u79d1\uff1a\u6b6f\u79d1\u6750\u6599\u3067\u30b3\u30a4\u30f3\u78e8\u304d(\u6b6f\u9762\u7814\u78e8)<\/option><option value=\"6\u670813\u65e5(\u571f) \u8a00\u8a9e\u8074\u899a\u58eb\u5b66\u79d1\uff1a\u8a00\u8a9e\u8074\u899a\u58eb\u306e\u4ed5\u4e8b\u3092\u77e5\u308d\u3046\">6\u670813\u65e5(\u571f) \u8a00\u8a9e\u8074\u899a\u58eb\u5b66\u79d1\uff1a\u8a00\u8a9e\u8074\u899a\u58eb\u306e\u4ed5\u4e8b\u3092\u77e5\u308d\u3046<\/option><option value=\"6\u670813\u65e5(\u571f) \u97f3\u697d\u7642\u6cd5\u58eb\u5b66\u79d1\uff1a\u97f3\u697d\u7642\u6cd5\u30ef\u30fc\u30af\u30b7\u30e7\u30c3\u30d7\uff5e\u590f\u306e\u97f3\u697d\uff5e\">6\u670813\u65e5(\u571f) \u97f3\u697d\u7642\u6cd5\u58eb\u5b66\u79d1\uff1a\u97f3\u697d\u7642\u6cd5\u30ef\u30fc\u30af\u30b7\u30e7\u30c3\u30d7\uff5e\u590f\u306e\u97f3\u697d\uff5e<\/option><option value=\"7\u670825\u65e5(\u571f) \u6b6f\u79d1\u885b\u751f\u58eb\u5b66\u79d1\uff1a\u6b6f\u79d1\u6750\u6599\u306b\u89e6\u308c\u3066\u307f\u3088\u3046(\u30a2\u30eb\u30b8\u30cd\u30fc\u30c8\u5370\u8c61)\">7\u670825\u65e5(\u571f) \u6b6f\u79d1\u885b\u751f\u58eb\u5b66\u79d1\uff1a\u6b6f\u79d1\u6750\u6599\u306b\u89e6\u308c\u3066\u307f\u3088\u3046(\u30a2\u30eb\u30b8\u30cd\u30fc\u30c8\u5370\u8c61)<\/option><option value=\"7\u670825\u65e5(\u571f) \u8a00\u8a9e\u8074\u899a\u58eb\u5b66\u79d1\uff1a\u8a00\u8a9e\u8074\u899a\u58eb\u306e\u4ed5\u4e8b\u3092\u77e5\u308d\u3046\">7\u670825\u65e5(\u571f) \u8a00\u8a9e\u8074\u899a\u58eb\u5b66\u79d1\uff1a\u8a00\u8a9e\u8074\u899a\u58eb\u306e\u4ed5\u4e8b\u3092\u77e5\u308d\u3046<\/option><option value=\"7\u670825\u65e5(\u571f) \u97f3\u697d\u7642\u6cd5\u58eb\u5b66\u79d1\uff1a\u97f3\u697d\u7642\u6cd5\u30ef\u30fc\u30af\u30b7\u30e7\u30c3\u30d7\uff5e\u30c8\u30fc\u30f3\u30c1\u30e3\u30a4\u30e0\u4f53\u9a13\uff5e\">7\u670825\u65e5(\u571f) \u97f3\u697d\u7642\u6cd5\u58eb\u5b66\u79d1\uff1a\u97f3\u697d\u7642\u6cd5\u30ef\u30fc\u30af\u30b7\u30e7\u30c3\u30d7\uff5e\u30c8\u30fc\u30f3\u30c1\u30e3\u30a4\u30e0\u4f53\u9a13\uff5e<\/option><option value=\"8\u670810\u65e5(\u65e5) \u6b6f\u79d1\u885b\u751f\u58eb\u5b66\u79d1\uff1a\u6b6f\u79d1\u6750\u6599\u306b\u89e6\u308c\u3066\u307f\u3088\u3046(\u30a2\u30eb\u30b8\u30cd\u30fc\u30c8\u5370\u8c61)\">8\u670810\u65e5(\u65e5) \u6b6f\u79d1\u885b\u751f\u58eb\u5b66\u79d1\uff1a\u6b6f\u79d1\u6750\u6599\u306b\u89e6\u308c\u3066\u307f\u3088\u3046(\u30a2\u30eb\u30b8\u30cd\u30fc\u30c8\u5370\u8c61)<\/option><option value=\"8\u670810\u65e5(\u65e5) \u8a00\u8a9e\u8074\u899a\u58eb\u5b66\u79d1\uff1a\u8a00\u8a9e\u8074\u899a\u58eb\u306e\u4ed5\u4e8b\u3092\u77e5\u308d\u3046(\u5352\u696d\u751f\u30c8\u30fc\u30af)\">8\u670810\u65e5(\u65e5) \u8a00\u8a9e\u8074\u899a\u58eb\u5b66\u79d1\uff1a\u8a00\u8a9e\u8074\u899a\u58eb\u306e\u4ed5\u4e8b\u3092\u77e5\u308d\u3046(\u5352\u696d\u751f\u30c8\u30fc\u30af)<\/option><option value=\"8\u670810\u65e5(\u65e5) \u97f3\u697d\u7642\u6cd5\u58eb\u5b66\u79d1\uff1a\u97f3\u697d\u7642\u6cd5\u30ef\u30fc\u30af\u30b7\u30e7\u30c3\u30d7\uff5e\u6253\u697d\u5668\u4f53\u9a13\uff5e\">8\u670810\u65e5(\u65e5) \u97f3\u697d\u7642\u6cd5\u58eb\u5b66\u79d1\uff1a\u97f3\u697d\u7642\u6cd5\u30ef\u30fc\u30af\u30b7\u30e7\u30c3\u30d7\uff5e\u6253\u697d\u5668\u4f53\u9a13\uff5e<\/option><option value=\"9\u67085\u65e5(\u571f) \u6b6f\u79d1\u885b\u751f\u58eb\u5b66\u79d1\uff1a\u6b6f\u79d1\u6750\u6599\u3067\u30b3\u30a4\u30f3\u78e8\u304d(\u6b6f\u9762\u7814\u78e8)\">9\u67085\u65e5(\u571f) \u6b6f\u79d1\u885b\u751f\u58eb\u5b66\u79d1\uff1a\u6b6f\u79d1\u6750\u6599\u3067\u30b3\u30a4\u30f3\u78e8\u304d(\u6b6f\u9762\u7814\u78e8)<\/option><option value=\"9\u67085\u65e5(\u571f) \u8a00\u8a9e\u8074\u899a\u58eb\u5b66\u79d1\uff1a\u8a00\u8a9e\u8074\u899a\u58eb\u306e\u4ed5\u4e8b\u3092\u77e5\u308d\u3046(\u6620\u753b\u4e0a\u6620\u300c\u8a00\u8449\u306e\u304d\u305a\u306a\u300d)\">9\u67085\u65e5(\u571f) \u8a00\u8a9e\u8074\u899a\u58eb\u5b66\u79d1\uff1a\u8a00\u8a9e\u8074\u899a\u58eb\u306e\u4ed5\u4e8b\u3092\u77e5\u308d\u3046(\u6620\u753b\u4e0a\u6620\u300c\u8a00\u8449\u306e\u304d\u305a\u306a\u300d)<\/option><option value=\"9\u67085\u65e5(\u571f) \u97f3\u697d\u7642\u6cd5\u58eb\u5b66\u79d1\uff1a\u97f3\u697d\u7642\u6cd5\u30ef\u30fc\u30af\u30b7\u30e7\u30c3\u30d7\uff5e\u79cb\u306e\u97f3\u697d\uff5e\">9\u67085\u65e5(\u571f) \u97f3\u697d\u7642\u6cd5\u58eb\u5b66\u79d1\uff1a\u97f3\u697d\u7642\u6cd5\u30ef\u30fc\u30af\u30b7\u30e7\u30c3\u30d7\uff5e\u79cb\u306e\u97f3\u697d\uff5e<\/option><option value=\"12\u670812\u65e5(\u571f) \u6b6f\u79d1\u885b\u751f\u58eb\u5b66\u79d1\uff1a\u6b6f\u77f3\u53d6\u308a\u4f53\u9a13\uff0b\u30d0\u30ad\u30e5\u30fc\u30e0\u4f53\u9a13(\u8d85\u97f3\u6ce2\u30b9\u30b1\u30fc\u30e9\u30fc)\">12\u670812\u65e5(\u571f) \u6b6f\u79d1\u885b\u751f\u58eb\u5b66\u79d1\uff1a\u6b6f\u77f3\u53d6\u308a\u4f53\u9a13\uff0b\u30d0\u30ad\u30e5\u30fc\u30e0\u4f53\u9a13(\u8d85\u97f3\u6ce2\u30b9\u30b1\u30fc\u30e9\u30fc)<\/option><option value=\"12\u670812\u65e5(\u571f) \u8a00\u8a9e\u8074\u899a\u58eb\u5b66\u79d1\uff1a\u8a00\u8a9e\u8074\u899a\u58eb\u306e\u4ed5\u4e8b\u3092\u77e5\u308d\u3046\">12\u670812\u65e5(\u571f) \u8a00\u8a9e\u8074\u899a\u58eb\u5b66\u79d1\uff1a\u8a00\u8a9e\u8074\u899a\u58eb\u306e\u4ed5\u4e8b\u3092\u77e5\u308d\u3046<\/option><option value=\"12\u670812\u65e5(\u571f) \u97f3\u697d\u7642\u6cd5\u58eb\u5b66\u79d1\uff1a\u97f3\u697d\u7642\u6cd5\u30ef\u30fc\u30af\u30b7\u30e7\u30c3\u30d7\uff5e\u51ac\u306e\u97f3\u697d\uff5e\">12\u670812\u65e5(\u571f) \u97f3\u697d\u7642\u6cd5\u58eb\u5b66\u79d1\uff1a\u97f3\u697d\u7642\u6cd5\u30ef\u30fc\u30af\u30b7\u30e7\u30c3\u30d7\uff5e\u51ac\u306e\u97f3\u697d\uff5e<\/option><option value=\"3\u670820\u65e5(\u571f\u30fb\u795d) \u6b6f\u79d1\u885b\u751f\u58eb\u5b66\u79d1\uff1a\u6b6f\u79d1\u6750\u6599\u306b\u89e6\u308c\u3066\u307f\u3088\u3046(\u30a2\u30eb\u30b8\u30cd\u30fc\u30c8\u5370\u8c61)\">3\u670820\u65e5(\u571f\u30fb\u795d) \u6b6f\u79d1\u885b\u751f\u58eb\u5b66\u79d1\uff1a\u6b6f\u79d1\u6750\u6599\u306b\u89e6\u308c\u3066\u307f\u3088\u3046(\u30a2\u30eb\u30b8\u30cd\u30fc\u30c8\u5370\u8c61)<\/option><option value=\"3\u670820\u65e5(\u571f\u30fb\u795d) \u8a00\u8a9e\u8074\u899a\u58eb\u5b66\u79d1\uff1a\u8a00\u8a9e\u8074\u899a\u58eb\u306e\u4ed5\u4e8b\u3092\u77e5\u308d\u3046\">3\u670820\u65e5(\u571f\u30fb\u795d) \u8a00\u8a9e\u8074\u899a\u58eb\u5b66\u79d1\uff1a\u8a00\u8a9e\u8074\u899a\u58eb\u306e\u4ed5\u4e8b\u3092\u77e5\u308d\u3046<\/option><option value=\"3\u670820\u65e5(\u571f\u30fb\u795d) \u97f3\u697d\u7642\u6cd5\u58eb\u5b66\u79d1\uff1a\u97f3\u697d\u7642\u6cd5\u30ef\u30fc\u30af\u30b7\u30e7\u30c3\u30d7\uff5e\u6625\u306e\u97f3\u697d\uff5e\">3\u670820\u65e5(\u571f\u30fb\u795d) \u97f3\u697d\u7642\u6cd5\u58eb\u5b66\u79d1\uff1a\u97f3\u697d\u7642\u6cd5\u30ef\u30fc\u30af\u30b7\u30e7\u30c3\u30d7\uff5e\u6625\u306e\u97f3\u697d\uff5e<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"p-flexform__item p-flexform__required\">\n\t\t\t<div class=\"p-flexform__headding\">\n\t\t\t\t<p>\u5165\u5b66\u8a66\u9a13\u30fb\u5968\u5b66\u91d1\u8aac\u660e<br \/>\n\u30fb\u500b\u5225\u76f8\u8ac7\u4f1a\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"p-flexform__content\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"join\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"join\" value=\"\u53c2\u52a0\u3059\u308b\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">\u53c2\u52a0\u3059\u308b<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"join\" value=\"\u53c2\u52a0\u3057\u306a\u3044\" \/><span class=\"wpcf7-list-item-label\">\u53c2\u52a0\u3057\u306a\u3044<\/span><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"p-flexform__item p-flexform__required\">\n\t\t\t<div class=\"p-flexform__headding\">\n\t\t\t\t<p>\u304a\u540d\u524d\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"p-flexform__content p-flexform__content_double\">\n\t\t\t\t<p><label><span class=\"wpcf7-form-control-wrap\" data-name=\"your-family-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"\u4f8b) \u7530\u4e2d\" value=\"\" type=\"text\" name=\"your-family-name\" \/><\/span><\/label><br \/>\n<label><span class=\"wpcf7-form-control-wrap\" data-name=\"your-first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"\u4f8b) \u592a\u90ce\" value=\"\" type=\"text\" name=\"your-first-name\" \/><\/span><\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"p-flexform__item p-flexform__required\">\n\t\t\t<div class=\"p-flexform__headding\">\n\t\t\t\t<p>\u30d5\u30ea\u30ac\u30ca\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"p-flexform__content p-flexform__content_double\">\n\t\t\t\t<p><label><span class=\"wpcf7-form-control-wrap\" data-name=\"read-your-family-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"\u4f8b) \u30bf\u30ca\u30ab\" value=\"\" type=\"text\" name=\"read-your-family-name\" \/><\/span><\/label><br \/>\n<label><span class=\"wpcf7-form-control-wrap\" data-name=\"read-your-first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"\u4f8b) \u30bf\u30ed\u30a6\" value=\"\" type=\"text\" name=\"read-your-first-name\" \/><\/span><\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"p-flexform__item p-flexform__required\">\n\t\t\t<div class=\"p-flexform__headding\">\n\t\t\t\t<p>\u6027\u5225\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"p-flexform__content\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"gender\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"gender\" value=\"\u7537\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">\u7537<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"gender\" value=\"\u5973\" \/><span class=\"wpcf7-list-item-label\">\u5973<\/span><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"p-flexform__item p-flexform__required\">\n\t\t\t<div class=\"p-flexform__headding\">\n\t\t\t\t<p>\u3054\u4f4f\u6240\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"p-flexform__content\">\n\t\t\t\t<p><span class=\"p-flexform__zipcode\">\u3012<label><span class=\"wpcf7-form-control-wrap\" data-name=\"your-zip\"><input size=\"40\" maxlength=\"400\" minlength=\"7\" class=\"wpcf7-form-control wpcf7-text p-postal-code\" aria-invalid=\"false\" placeholder=\"\u4f8b)\n                        390-0000\" value=\"\" type=\"text\" name=\"your-zip\" \/><\/span><\/label><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"prefecture\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"prefecture\"><option value=\"\u9577\u91ce\u770c\">\u9577\u91ce\u770c<\/option><option value=\"\u65b0\u6f5f\u770c\">\u65b0\u6f5f\u770c<\/option><option value=\"-----------------\">-----------------<\/option><option value=\"\u5317\u6d77\u9053\">\u5317\u6d77\u9053<\/option><option value=\"\u9752\u68ee\u770c\">\u9752\u68ee\u770c<\/option><option value=\"\u5ca9\u624b\u770c\">\u5ca9\u624b\u770c<\/option><option value=\"\u5bae\u57ce\u770c\">\u5bae\u57ce\u770c<\/option><option value=\"\u79cb\u7530\u770c\">\u79cb\u7530\u770c<\/option><option value=\"\u5c71\u5f62\u770c\">\u5c71\u5f62\u770c<\/option><option value=\"\u798f\u5cf6\u770c\">\u798f\u5cf6\u770c<\/option><option value=\"\u8328\u57ce\u770c\">\u8328\u57ce\u770c<\/option><option value=\"\u6803\u6728\u770c\">\u6803\u6728\u770c<\/option><option value=\"\u7fa4\u99ac\u770c\">\u7fa4\u99ac\u770c<\/option><option value=\"\u57fc\u7389\u770c\">\u57fc\u7389\u770c<\/option><option value=\"\u5343\u8449\u770c\">\u5343\u8449\u770c<\/option><option value=\"\u6771\u4eac\u90fd\">\u6771\u4eac\u90fd<\/option><option value=\"\u795e\u5948\u5ddd\u770c\">\u795e\u5948\u5ddd\u770c<\/option><option value=\"\u5bcc\u5c71\u770c\">\u5bcc\u5c71\u770c<\/option><option value=\"\u77f3\u5ddd\u770c\">\u77f3\u5ddd\u770c<\/option><option value=\"\u798f\u4e95\u770c\">\u798f\u4e95\u770c<\/option><option value=\"\u5c71\u68a8\u770c\">\u5c71\u68a8\u770c<\/option><option value=\"\u5c90\u961c\u770c\">\u5c90\u961c\u770c<\/option><option value=\"\u9759\u5ca1\u770c\">\u9759\u5ca1\u770c<\/option><option value=\"\u611b\u77e5\u770c\">\u611b\u77e5\u770c<\/option><option value=\"\u4e09\u91cd\u770c\">\u4e09\u91cd\u770c<\/option><option value=\"\u6ecb\u8cc0\u770c\">\u6ecb\u8cc0\u770c<\/option><option value=\"\u4eac\u90fd\u5e9c\">\u4eac\u90fd\u5e9c<\/option><option value=\"\u5927\u962a\u5e9c\">\u5927\u962a\u5e9c<\/option><option value=\"\u5175\u5eab\u770c\">\u5175\u5eab\u770c<\/option><option value=\"\u5948\u826f\u770c\">\u5948\u826f\u770c<\/option><option value=\"\u548c\u6b4c\u5c71\u770c\">\u548c\u6b4c\u5c71\u770c<\/option><option value=\"\u9ce5\u53d6\u770c\">\u9ce5\u53d6\u770c<\/option><option value=\"\u5cf6\u6839\u770c\">\u5cf6\u6839\u770c<\/option><option value=\"\u5ca1\u5c71\u770c\">\u5ca1\u5c71\u770c<\/option><option value=\"\u5e83\u5cf6\u770c\">\u5e83\u5cf6\u770c<\/option><option value=\"\u5c71\u53e3\u770c\">\u5c71\u53e3\u770c<\/option><option value=\"\u5fb3\u5cf6\u770c\">\u5fb3\u5cf6\u770c<\/option><option value=\"\u9999\u5ddd\u770c\">\u9999\u5ddd\u770c<\/option><option value=\"\u611b\u5a9b\u770c\">\u611b\u5a9b\u770c<\/option><option value=\"\u9ad8\u77e5\u770c\">\u9ad8\u77e5\u770c<\/option><option value=\"\u798f\u5ca1\u770c\">\u798f\u5ca1\u770c<\/option><option value=\"\u4f50\u8cc0\u770c\">\u4f50\u8cc0\u770c<\/option><option value=\"\u9577\u5d0e\u770c\">\u9577\u5d0e\u770c<\/option><option value=\"\u718a\u672c\u770c\">\u718a\u672c\u770c<\/option><option value=\"\u5927\u5206\u770c\">\u5927\u5206\u770c<\/option><option value=\"\u5bae\u5d0e\u770c\">\u5bae\u5d0e\u770c<\/option><option value=\"\u9e7f\u5150\u5cf6\u770c\">\u9e7f\u5150\u5cf6\u770c<\/option><option value=\"\u6c96\u7e04\u770c\">\u6c96\u7e04\u770c<\/option><\/select><\/span><label><span class=\"wpcf7-form-control-wrap\" data-name=\"your-address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required p-region p-locality p-street-address p-extended-address\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"\u5e02\u533a\u753a\u6751\u30fb\u756a\u5730\u30fb\u5efa\u7269\" value=\"\" type=\"text\" name=\"your-address\" \/><\/span><\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"p-flexform__item p-flexform__required\">\n\t\t\t<div class=\"p-flexform__headding\">\n\t\t\t\t<p>\u5b66\u5e74\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"p-flexform__content\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"schoolyear\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"schoolyear\"><option value=\"\u9ad8\u68213\u5e74\u751f\">\u9ad8\u68213\u5e74\u751f<\/option><option value=\"\u9ad8\u68212\u5e74\u751f\">\u9ad8\u68212\u5e74\u751f<\/option><option value=\"\u9ad8\u68211\u5e74\u751f\">\u9ad8\u68211\u5e74\u751f<\/option><option value=\"\u4e88\u5099\u6821\u751f\">\u4e88\u5099\u6821\u751f<\/option><option value=\"\u9ad8\u5352\u8a8d\u5b9a\u751f(\u65e7\u5927\u691c\u751f)\">\u9ad8\u5352\u8a8d\u5b9a\u751f(\u65e7\u5927\u691c\u751f)<\/option><option value=\"\u4fdd\u8b77\u8005\">\u4fdd\u8b77\u8005<\/option><option value=\"\u5927\u5b66\u9662\u751f\">\u5927\u5b66\u9662\u751f<\/option><option value=\"\u5927\u5b66\u751f\">\u5927\u5b66\u751f<\/option><option value=\"\u77ed\u5927\u751f\">\u77ed\u5927\u751f<\/option><option value=\"\u9ad8\u5c08\u751f\">\u9ad8\u5c08\u751f<\/option><option value=\"\u5c02\u9580\u5b66\u6821\u751f\">\u5c02\u9580\u5b66\u6821\u751f<\/option><option value=\"\u4e2d\u5b66\u751f\">\u4e2d\u5b66\u751f<\/option><option value=\"\u305d\u306e\u4ed6\u306e\u5b66\u751f\">\u305d\u306e\u4ed6\u306e\u5b66\u751f<\/option><option value=\"\u4e00\u822c\u793e\u4f1a\u4eba\">\u4e00\u822c\u793e\u4f1a\u4eba<\/option><option value=\"\u9ad8\u6821\u306e\u6559\u8077\u54e1\">\u9ad8\u6821\u306e\u6559\u8077\u54e1<\/option><option value=\"\u9ad8\u6821\u4ee5\u5916\u306e\u6559\u8077\u54e1\">\u9ad8\u6821\u4ee5\u5916\u306e\u6559\u8077\u54e1<\/option><option value=\"\u305d\u306e\u4ed6\">\u305d\u306e\u4ed6<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"p-flexform__item p-flexform__required\">\n\t\t\t<div class=\"p-flexform__headding\">\n\t\t\t\t<p>\u5352\u696d\u4e88\u5b9a\u5e74\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"p-flexform__content\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"g-year\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"g-year\"><option value=\"2027\">2027<\/option><option value=\"2028\">2028<\/option><option value=\"2029\">2029<\/option><option value=\"\u305d\u306e\u4ed6\">\u305d\u306e\u4ed6<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"p-flexform__item p-flexform__required\">\n\t\t\t<div class=\"p-flexform__headding\">\n\t\t\t\t<p>\u9ad8\u6821\u540d\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"p-flexform__content\">\n\t\t\t\t<p><label><span class=\"wpcf7-form-control-wrap\" data-name=\"your-school\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"\" value=\"\" type=\"text\" name=\"your-school\" \/><\/span><\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"p-flexform__item p-flexform__required\">\n\t\t\t<div class=\"p-flexform__headding\">\n\t\t\t\t<p>\u96fb\u8a71\u756a\u53f7\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"p-flexform__content\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-tel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"\u4f8b) 080-0000-0000\" value=\"\" type=\"tel\" name=\"your-tel\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"p-flexform__item p-flexform__required\">\n\t\t\t<div class=\"p-flexform__headding\">\n\t\t\t\t<p>\u5e0c\u671b\u5b66\u79d1\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"p-flexform__content\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"subject\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"subject\" value=\"\u6b6f\u79d1\u885b\u751f\u58eb\u5b66\u79d1\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">\u6b6f\u79d1\u885b\u751f\u58eb\u5b66\u79d1<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"subject\" value=\"\u8a00\u8a9e\u8074\u899a\u58eb\u5b66\u79d1\" \/><span class=\"wpcf7-list-item-label\">\u8a00\u8a9e\u8074\u899a\u58eb\u5b66\u79d1<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"subject\" value=\"\u97f3\u697d\u7642\u6cd5\u58eb\u5b66\u79d1\" \/><span class=\"wpcf7-list-item-label\">\u97f3\u697d\u7642\u6cd5\u58eb\u5b66\u79d1<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"p-flexform__item p-flexform__required\">\n\t\t\t<div class=\"p-flexform__headding\">\n\t\t\t\t<p>\u30e1\u30fc\u30eb\u30a2\u30c9\u30ec\u30b9\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"p-flexform__content\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"\u4f8b) example@mail.com\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"p-flexform__item\">\n\t\t\t<div class=\"p-flexform__headding\">\n\t\t\t\t<p>\u540c\u884c\u8005\uff08\u4fdd\u8b77\u8005\uff09\u306e\u4eba\u6570\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"p-flexform__content\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"number-of-people\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"number-of-people\"><option value=\"\u306a\u3057\">\u306a\u3057<\/option><option value=\"1\u4eba\">1\u4eba<\/option><option value=\"2\u4eba\">2\u4eba<\/option><option value=\"3\u4eba\">3\u4eba<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"p-flexform__item\">\n\t\t\t<div class=\"p-flexform__headding\">\n\t\t\t\t<p>\u5f53\u65e5\u805e\u304d\u305f\u3044\u3053\u3068<br \/>\n\uff08\u5165\u8a66\u30fb\u6388\u696d\u5185\u5bb9\u30fb\u5b9f\u7fd2<br \/>\n\u30fb\u5c31\u8077\u5148\u306b\u3064\u3044\u3066\u7b49\uff09\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"p-flexform__content\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"your-message\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner c-btn\" type=\"submit\" value=\"\u9001\u4fe1\" \/>\n\t<\/p>\n<\/div>\n<p style=\"text-align: center;\"><small>\u3053\u306e\u30b5\u30a4\u30c8\u306freCAPTCHA\u306b\u3088\u3063\u3066\u4fdd\u8b77\u3055\u308c\u3066\u304a\u308a\u3001Google\u306e<a href=\"https:\/\/policies.google.com\/privacy\" target=\"_blank\">\u30d7\u30e9\u30a4\u30d0\u30b7\u30fc\u30dd\u30ea\u30b7\u30fc<\/a>\u3068<a href=\"https:\/\/policies.google.com\/terms\" target=\"_blank\">\u5229\u7528\u898f\u7d04<\/a>\u304c\u9069\u7528\u3055\u308c\u307e\u3059\u3002<\/small>\n<\/p>\n<p><script>\ndocument.addEventListener('wpcf7mailsent', function(event) {\n location = 'http:\/\/nagano-iryoueisei.ac.jp\/medical\/thanks-application';\n}, false);\n<\/script>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n<\/div><\/div>\n\n\n\n<p class=\"u-text-bold u-text-center u-text-hot u-text-medium wp-block-paragraph\">\u9001\u4fe1\u30dc\u30bf\u30f3\u306f\u4e00\u5ea6\u3060\u3051\u62bc\u3057\u3066\u304f\u3060\u3055\u3044\u3002<\/p>\n\n\n\n<p class=\"has-text-align-left wp-block-paragraph\">\u30bb\u30ad\u30e5\u30ea\u30c6\u30a3\u78ba\u8a8d\u3084\u30c7\u30fc\u30bf\u9001\u4fe1\u306e\u305f\u3081\u3001\u51e6\u7406\u306b\u6642\u9593\u304c\u304b\u304b\u308b\u30b1\u30fc\u30b9\u304c\u3054\u3056\u3044\u307e\u3059\u3002<br><strong>\u753b\u9762\u304c\u5207\u308a\u66ff\u308f\u308b\u524d\u306b\u30dc\u30bf\u30f3\u3092\u4f55\u5ea6\u3082\u62bc\u3059\u3068\u3001\u30a8\u30e9\u30fc\u304c\u767a\u751f\u3059\u308b\u6050\u308c\u304c\u3042\u308a\u307e\u3059\u3002<\/strong><br>\u305d\u306e\u307e\u307e\u3057\u3070\u3089\u304f\u304a\u5f85\u3061\u304f\u3060\u3055\u3044\u3002<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u9001\u4fe1\u30dc\u30bf\u30f3\u306f\u4e00\u5ea6\u3060\u3051\u62bc\u3057\u3066\u304f\u3060\u3055\u3044\u3002 \u30bb\u30ad\u30e5\u30ea\u30c6\u30a3\u78ba\u8a8d\u3084\u30c7\u30fc\u30bf\u9001\u4fe1\u306e\u305f\u3081\u3001\u51e6\u7406\u306b\u6642\u9593\u304c\u304b\u304b\u308b\u30b1\u30fc\u30b9\u304c\u3054\u3056\u3044\u307e\u3059\u3002\u753b\u9762\u304c\u5207\u308a\u66ff\u308f\u308b\u524d\u306b\u30dc\u30bf\u30f3\u3092\u4f55\u5ea6\u3082\u62bc\u3059\u3068\u3001\u30a8\u30e9\u30fc\u304c\u767a\u751f\u3059\u308b\u6050\u308c\u304c\u3042\u308a\u307e\u3059\u3002\u305d\u306e\u307e\u307e\u3057\u3070\u3089\u304f\u304a\u5f85\u3061\u304f\u3060\u3055\u3044\u3002<\/p>\n","protected":false},"author":7,"featured_media":11238,"parent":65,"menu_order":3,"comment_status":"closed","ping_status":"closed","template":"template_has-submenu.php","meta":{"footnotes":""},"class_list":["post-1984","page","type-page","status-publish","has-post-thumbnail","hentry"],"publishpress_future_action":{"enabled":false,"date":"2026-08-10 01:06:04","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"acf":[],"_links":{"self":[{"href":"https:\/\/nagano-iryoueisei.ac.jp\/medical\/wp-json\/wp\/v2\/pages\/1984","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nagano-iryoueisei.ac.jp\/medical\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/nagano-iryoueisei.ac.jp\/medical\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/nagano-iryoueisei.ac.jp\/medical\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/nagano-iryoueisei.ac.jp\/medical\/wp-json\/wp\/v2\/comments?post=1984"}],"version-history":[{"count":24,"href":"https:\/\/nagano-iryoueisei.ac.jp\/medical\/wp-json\/wp\/v2\/pages\/1984\/revisions"}],"predecessor-version":[{"id":20531,"href":"https:\/\/nagano-iryoueisei.ac.jp\/medical\/wp-json\/wp\/v2\/pages\/1984\/revisions\/20531"}],"up":[{"embeddable":true,"href":"https:\/\/nagano-iryoueisei.ac.jp\/medical\/wp-json\/wp\/v2\/pages\/65"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/nagano-iryoueisei.ac.jp\/medical\/wp-json\/wp\/v2\/media\/11238"}],"wp:attachment":[{"href":"https:\/\/nagano-iryoueisei.ac.jp\/medical\/wp-json\/wp\/v2\/media?parent=1984"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}