{"id":15322,"date":"2024-08-30T13:37:41","date_gmt":"2024-08-30T20:37:41","guid":{"rendered":"https:\/\/e-safecare.com\/?page_id=15322"},"modified":"2024-08-31T11:18:35","modified_gmt":"2024-08-31T18:18:35","slug":"formulaire","status":"publish","type":"page","link":"https:\/\/e-safecare.com\/fr\/formulaire\/","title":{"rendered":"Formulaire"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"15322\" class=\"elementor elementor-15322\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-bbbea5a elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"bbbea5a\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2b62e72\" data-id=\"2b62e72\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d4c06c1 elementor-widget elementor-widget-spacer\" data-id=\"d4c06c1\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-78fadc6 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"78fadc6\" data-element_type=\"section\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-329baaa\" data-id=\"329baaa\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element-custom_font_size elementor-element-custom_font_family elementor-element-custom_font_weight elementor-element-custom_color elementor-element elementor-element-7056c34 elementor-widget elementor-widget-text-editor\" data-id=\"7056c34\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span>FORMULAIRE<br \/><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element-custom_font_size elementor-element-custom_line_height elementor-element-custom_font_family elementor-element-custom_font_weight elementor-element-custom_color elementor-element elementor-element-1a62803 elementor-widget elementor-widget-text-editor\" data-id=\"1a62803\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span><a href=\"http:\/\/www.e-safecare.com\">www.e-safecare.com<\/a><\/span><\/p><p>Updated on\u00a0: 01\/01\/2024<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-549828a elementor-widget elementor-widget-spacer\" data-id=\"549828a\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c7e34d3 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c7e34d3\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-aff63e0\" data-id=\"aff63e0\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-dff1dd1 elementor-widget__width-initial elementor-widget-mobile__width-initial elementor-widget elementor-widget-shortcode\" data-id=\"dff1dd1\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f15337-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"15337\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/fr\/wp-json\/wp\/v2\/pages\/15322#wpcf7-f15337-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\" data-trp-original-action=\"\/fr\/wp-json\/wp\/v2\/pages\/15322#wpcf7-f15337-o1\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"15337\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.4\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f15337-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<p>Information<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Votre nom*\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"destination\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Destination\/Expatriation*\" value=\"\" type=\"text\" name=\"destination\" \/><\/span>\n<\/p>\n<p>Date de naissance<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"dob\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" min=\"1920-01-28\" aria-required=\"true\" aria-invalid=\"false\" value=\"DOB\" type=\"date\" name=\"dob\" \/><\/span><br \/>\nDate de naissance du partenaire\/conjoint<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"partner\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" min=\"1920-01-28\" aria-invalid=\"false\" value=\"Partner\" type=\"date\" name=\"partner\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"kids\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" min=\"0\" max=\"15\" aria-invalid=\"false\" placeholder=\"Nombre d&#039;enfants*\" value=\"\" type=\"number\" name=\"kids\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"nationality\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Nationalit\u00e9*\" value=\"\" type=\"text\" name=\"nationality\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"T\u00e9l\u00e9phone\" value=\"\" type=\"text\" name=\"tel\" \/><\/span><br \/>\n<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=\"Email*\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n<\/p>\n<p>Besoin d'assurance<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Insuranceneed\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"Insuranceneed[]\" value=\"Voyage\" \/><span class=\"wpcf7-list-item-label\">Voyage<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"Insuranceneed[]\" value=\"\u00c9tudiant\" \/><span class=\"wpcf7-list-item-label\">\u00c9tudiant<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"Insuranceneed[]\" value=\"Mission professionnelle\" \/><span class=\"wpcf7-list-item-label\">Mission professionnelle<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"Insuranceneed[]\" value=\"M\u00e9dical\" \/><span class=\"wpcf7-list-item-label\">M\u00e9dical<\/span><\/label><\/span><\/span><\/span><br \/>\nEn envoyant ce formulaire, j'accepte les CGU\/Politiques relatives aux donn\u00e9es\/Cookies d'E-Safecare\u2019s\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Envoyer\" \/>\n<\/p>\n<p>Envoyer pour obtenir un devis et prendre rendez-vous\n<\/p><input type=\"hidden\" id=\"hostbox_recaptcha_nonce\" name=\"hostbox_recaptcha_nonce\" value=\"3e86caf053\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/fr\/wp-json\/wp\/v2\/pages\/15322\" \/><input type=\"hidden\" name=\"recaptcha_response\" class=\"recaptcha-v3-response\" value=\"\"><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<input type=\"hidden\" name=\"trp-form-language\" value=\"fr\"\/><\/form>\n<\/div>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-53b6950 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"53b6950\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6df6a84\" data-id=\"6df6a84\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-51389e0 elementor-widget elementor-widget-spacer\" data-id=\"51389e0\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>FORMULAIRE www.e-safecare.com Updated on\u00a0: 01\/01\/2024<\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-15322","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/e-safecare.com\/fr\/wp-json\/wp\/v2\/pages\/15322","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/e-safecare.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/e-safecare.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/e-safecare.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/e-safecare.com\/fr\/wp-json\/wp\/v2\/comments?post=15322"}],"version-history":[{"count":3,"href":"https:\/\/e-safecare.com\/fr\/wp-json\/wp\/v2\/pages\/15322\/revisions"}],"predecessor-version":[{"id":15356,"href":"https:\/\/e-safecare.com\/fr\/wp-json\/wp\/v2\/pages\/15322\/revisions\/15356"}],"wp:attachment":[{"href":"https:\/\/e-safecare.com\/fr\/wp-json\/wp\/v2\/media?parent=15322"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}