{"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":"2026-07-06T03:09:29","modified_gmt":"2026-07-06T07:09:29","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=\"inscrire mes coordonn\u00e9es\" 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>Utilisez ce formulaire pour inscrire mes coordonn\u00e9es et rejoindre le r\u00e9seau VitalAxion.<\/p><p><span style=\"font-size: 17px\">We offer this visibility free of charge to all our users. Please remember to notify us of any future changes so we can keep this database up-to-date and valid. You can unsubscribe at any time.<\/span><\/p><p>\u00a0<\/p><p>\u00a0<\/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=\"wpcf7-6a6172170529b-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=\"63051849\"><input\n\t    id=\"wpcf7-6a6172170529b-field\"\n\t    \n\t    class=\"wpcf7-form-control wpcf7-text\"\n\t    type=\"text\"\n\t    name=\"gkeumyp6hcab\"\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 Utilisez ce formulaire pour inscrire mes coordonn\u00e9es et rejoindre le r\u00e9seau VitalAxion. We offer this<\/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":12,"href":"https:\/\/vitalaxion.com\/fr\/wp-json\/wp\/v2\/pages\/40396\/revisions"}],"predecessor-version":[{"id":62487,"href":"https:\/\/vitalaxion.com\/fr\/wp-json\/wp\/v2\/pages\/40396\/revisions\/62487"}],"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. Learn more: https://airlift.net. Template:. Learn more: https://airlift.net. Template: 6a5bdb4619063611bf42c88a. Config Timestamp: 2026-07-18 20:00:05 UTC, Cached Timestamp: 2026-07-23 01:44:55 UTC, Optimization Time: 6.97ms -->