{"id":40396,"date":"2022-11-28T18:18:44","date_gmt":"2022-11-28T23:18:44","guid":{"rendered":"https:\/\/amisun.biz\/cient\/vitalaxion\/fr\/?page_id=40396"},"modified":"2025-12-30T06:52:39","modified_gmt":"2025-12-30T11:52:39","slug":"inscrire-mes-coordonnees","status":"publish","type":"page","link":"https:\/\/vitalaxion.com\/fr\/localisateur-de-session\/inscrire-mes-coordonnees\/","title":{"rendered":"Formulaire pour offrir des s\u00e9ances"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"40396\" class=\"elementor elementor-40396\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"wd-negative-gap elementor-element elementor-element-55c373d title-sec e-flex e-con-boxed e-con e-parent\" data-id=\"55c373d\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1ff2943 premium-floating-effects-yes color-5 elementor-widget elementor-widget-heading\" data-id=\"1ff2943\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;premium_fe_translate_switcher&quot;:&quot;yes&quot;,&quot;premium_fe_Xtranslate&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:{&quot;from&quot;:-4,&quot;to&quot;:-4}},&quot;premium_fe_Ytranslate&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:{&quot;from&quot;:-19,&quot;to&quot;:16}},&quot;premium_fe_direction&quot;:&quot;normal&quot;,&quot;premium_fe_loop&quot;:&quot;number&quot;,&quot;premium_fe_loop_number&quot;:1,&quot;premium_fe_trigger&quot;:&quot;load&quot;,&quot;premium_fe_trans_duration&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:1000,&quot;sizes&quot;:[]},&quot;premium_fe_trans_delay&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;premium_fe_easing&quot;:&quot;easeInOutSine&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\"><strong>FORMULAIRE POUR OFFRIR DES S\u00c9ANCES<\/strong><\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b99edc6 elementor-widget elementor-widget-image\" data-id=\"b99edc6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"1375\" height=\"529\" src=\"https:\/\/vitalaxion.com\/fr\/wp-content\/uploads\/2025\/12\/VitalAxion_Banniere_Inscrire-Coordo.jpg\" class=\"attachment-full size-full wp-image-61156\" alt=\"\" srcset=\"https:\/\/vitalaxion.com\/fr\/wp-content\/uploads\/2025\/12\/VitalAxion_Banniere_Inscrire-Coordo.jpg 1375w, https:\/\/vitalaxion.com\/fr\/wp-content\/uploads\/2025\/12\/VitalAxion_Banniere_Inscrire-Coordo-150x58.jpg 150w, https:\/\/vitalaxion.com\/fr\/wp-content\/uploads\/2025\/12\/VitalAxion_Banniere_Inscrire-Coordo-600x231.jpg 600w, https:\/\/vitalaxion.com\/fr\/wp-content\/uploads\/2025\/12\/VitalAxion_Banniere_Inscrire-Coordo-300x115.jpg 300w, https:\/\/vitalaxion.com\/fr\/wp-content\/uploads\/2025\/12\/VitalAxion_Banniere_Inscrire-Coordo-1024x394.jpg 1024w, https:\/\/vitalaxion.com\/fr\/wp-content\/uploads\/2025\/12\/VitalAxion_Banniere_Inscrire-Coordo-768x295.jpg 768w\" sizes=\"(max-width: 1375px) 100vw, 1375px\" title=\"\">\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"wd-negative-gap elementor-element elementor-element-51d6803 custom-feedback e-flex e-con-boxed e-con e-parent\" data-id=\"51d6803\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-53f45c1 div-ider elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"53f45c1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d40481a wd-width-100 elementor-widget elementor-widget-wd_title\" data-id=\"d40481a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wd_title.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"title-wrapper wd-set-mb reset-last-child wd-title-color-default wd-title-style-default wd-title-size-default text-center\">\n\n\t\t\t\n\t\t\t<div class=\"liner-continer\">\n\t\t\t\t<h4 class=\"woodmart-title-container title wd-fontsize-l\"><\/h4> \n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t<div class=\"title-after_title reset-last-child wd-fontsize-xs\">\n\t\t\t\t\t<p><strong>Remplissez ce formulaire si vous poss\u00e9dez un de nos appareils et si vous d\u00e9sirez afficher vos services.<\/strong><\/p><p>Nous offrons cette visibilit\u00e9 gratuitement \u00e0 tous nos usagers. N\u2019oubliez pas de nous avertir de tout changement futur afin de maintenir cette banque de donn\u00e9es \u00e0 jour et valide. Vous pouvez retirer votre inscription \u00e0 tout moment.<\/p>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9633022 div-ider elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"9633022\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\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\t\t<\/div>\n\t\t<div class=\"wd-negative-gap elementor-element elementor-element-d7537d9 e-flex e-con-boxed e-con e-parent\" data-id=\"d7537d9\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7879c8b testimonial-form elementor-widget elementor-widget-shortcode\" data-id=\"7879c8b\" data-element_type=\"widget\" data-e-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-f40398-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"40398\">\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\/40396#wpcf7-f40398-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"40398\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f40398-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=\"row\">\n\t<div class=\"col-md-6\">\n\t\t<p><strong>Votre pr\u00e9nom\/nom ou nom de l'entreprise (requis)<\/strong><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\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-6\">\n\t\t<p><strong>Votre email (requis)<\/strong><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"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\" value=\"\" type=\"email\" name=\"email\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-6\">\n\t\t<p><strong>T\u00e9l\u00e9phone (requis)<\/strong><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"YOURTELEP\"><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\" value=\"\" type=\"tel\" name=\"YOURTELEP\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-6\">\n\t\t<p><strong>Date d'achat de votre technologie VitalBody 3 en 1 ? (requis)<\/strong><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"DATEACHAT\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"DATEACHAT\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"marg-p-0\">\n\t<p><span id=\"wpcf7-6a45c2c617113-wrapper\" class=\"wpcf7-form-control-wrap honeypot-725-wrap\" data-cf7apps-honeypot=\"honeypot-725\" style=\"display: block;\n\t\t    width: 0px;\n\t\t    height: 0px;\n\t\t    padding: 0px;\n\t\t    border: 1px solid transparent;\n\t\t    display: block;\n\t\t    overflow: hidden;\n\t\t    \"><input type=\"hidden\" name=\"honeypot-725-random-hash\" value=\"30052099\"><input\n\t    id=\"wpcf7-6a45c2c617113-field\"\n\t    \n\t    class=\"wpcf7-form-control wpcf7-text\"\n\t    type=\"text\"\n\t    name=\"epp51lm180eu\"\n\t    value=\"\"\n\t    size=\"40\"\n\t    autocomplete=\"new-password\"\n\t    tabindex=\"1000\"\n    \/><\/span>\n\t<\/p>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-6\">\n\t\t<p><strong>Si vous avez un site Web, quelle est l'adresse ?<\/strong><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"YOURWEBSI\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"YOURWEBSI\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-6\">\n\t\t<p><strong>Votre adresse compl\u00e8te <small>(Ex. : #, rue, ville, province, pays, code postal)<\/small><\/strong><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ADRESSE\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"ADRESSE\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"col-md-6\">\n\t\t<p><strong>Vous \u00eates une entreprise ou un particulier ? (requis)<\/strong><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ENTORPARTI\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"ENTORPARTI\" value=\"Entreprise avec locaux\" \/><span class=\"wpcf7-list-item-label\">Entreprise avec locaux<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"ENTORPARTI\" value=\"Particulier \u00e0 domicile\" \/><span class=\"wpcf7-list-item-label\">Particulier \u00e0 domicile<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"col-md-6\">\n\t\t<p><strong>Langue dans laquelle vous offrez le service ? (requis)<\/strong><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"LANGUE\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"LANGUE\" value=\"Fran\u00e7ais\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Fran\u00e7ais<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"LANGUE\" value=\"Anglais\" \/><span class=\"wpcf7-list-item-label\">Anglais<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"LANGUE\" value=\"Bilingue\" \/><span class=\"wpcf7-list-item-label\">Bilingue<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<p style=\"padding-top:30px\"><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Envoyer\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/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\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>FORMULAIRE POUR OFFRIR DES S\u00c9ANCES Remplissez ce formulaire si vous poss\u00e9dez un de nos appareils et si vous d\u00e9sirez afficher<\/p>\n","protected":false},"author":64,"featured_media":0,"parent":6011,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-40396","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/vitalaxion.com\/fr\/wp-json\/wp\/v2\/pages\/40396","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vitalaxion.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/vitalaxion.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/vitalaxion.com\/fr\/wp-json\/wp\/v2\/users\/64"}],"replies":[{"embeddable":true,"href":"https:\/\/vitalaxion.com\/fr\/wp-json\/wp\/v2\/comments?post=40396"}],"version-history":[{"count":0,"href":"https:\/\/vitalaxion.com\/fr\/wp-json\/wp\/v2\/pages\/40396\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/vitalaxion.com\/fr\/wp-json\/wp\/v2\/pages\/6011"}],"wp:attachment":[{"href":"https:\/\/vitalaxion.com\/fr\/wp-json\/wp\/v2\/media?parent=40396"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}<!-- This website is optimized by Airlift. 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