{"id":514,"date":"2023-04-22T11:05:16","date_gmt":"2023-04-22T09:05:16","guid":{"rendered":"https:\/\/cardiosurvivor.ch\/anmeldung\/"},"modified":"2023-04-25T12:26:25","modified_gmt":"2023-04-25T10:26:25","slug":"inscription","status":"publish","type":"page","link":"https:\/\/cardiosurvivor.ch\/fr\/inscription\/","title":{"rendered":"Inscription"},"content":{"rendered":"<div  class=\"page-section style-lavender\">\n\t<div class=\"section-grid grid-layout\"><div  style=\"--grid-layout-index: 1; --col-xs: 2; --col-sm: 2; --col-md: 2; --col-lg: 2; --col-xl: 2\" class=\"section-item\"><div class=\"cell style-default\"><h1>Inscription<\/h1>\n\n<div class=\"wpforms-container \" id=\"wpforms-585\"><form id=\"wpforms-form-585\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"585\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/fr\/wp-json\/wp\/v2\/pages\/514\" data-token=\"1a3e84d83d7d5a47cad9990e6f012ac6\" data-token-time=\"1776508096\"><noscript class=\"wpforms-error-noscript\">Veuillez activer JavaScript dans votre navigateur pour remplir ce formulaire.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-585-field_7-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"7\"><div class=\"wpforms-field-layout-columns wpforms-field-layout-preset-50-50\"><div class=\"wpforms-layout-column wpforms-layout-column-50\" ><div id=\"wpforms-585-field_2-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-585-field_2\">Nom, pr\u00e9nom <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-585-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\" ><div id=\"wpforms-585-field_18-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-585-field_18\">Date de naissance <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-585-field_18\" class=\"wpforms-field-medium wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"99.99.9999\" name=\"wpforms[fields][18]\" required><\/div><\/div><\/div><\/div><div id=\"wpforms-585-field_8-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"8\"><div class=\"wpforms-field-layout-columns wpforms-field-layout-preset-50-50\"><div class=\"wpforms-layout-column wpforms-layout-column-50\" ><div id=\"wpforms-585-field_9-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-585-field_9\">Rue et num\u00e9ro <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-585-field_9\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][9]\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\" ><div id=\"wpforms-585-field_10-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"10\"><label class=\"wpforms-field-label\" for=\"wpforms-585-field_10\">Code postal et ville <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-585-field_10\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][10]\" required><\/div><\/div><\/div><\/div><div id=\"wpforms-585-field_11-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"11\"><div class=\"wpforms-field-layout-columns wpforms-field-layout-preset-50-50\"><div class=\"wpforms-layout-column wpforms-layout-column-50\" ><div id=\"wpforms-585-field_14-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-585-field_14\">T\u00e9l\u00e9phone <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-585-field_14\" class=\"wpforms-field-medium wpforms-field-required wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][14]\" aria-label=\"T\u00e9l\u00e9phone\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\" ><div id=\"wpforms-585-field_4-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-585-field_4\">Adresse de courriel <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-585-field_4\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][4]\" spellcheck=\"false\" required><\/div><\/div><\/div><\/div><div id=\"wpforms-585-field_19-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"19\"><div class=\"wpforms-field-layout-columns wpforms-field-layout-preset-50-50\"><div class=\"wpforms-layout-column wpforms-layout-column-50\" ><div id=\"wpforms-585-field_21-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"21\"><ul id=\"wpforms-585-field_21\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-585-field_21_1\" name=\"wpforms[fields][21][]\" value=\"Je souhaite obtenir un rendez-vous \u00e0 la \u00abConsultation post-cardiaque\u00bb.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-585-field_21_1\">Je souhaite obtenir un rendez-vous \u00e0 la \u00abConsultation post-cardiaque\u00bb.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-585-field_21_2\" name=\"wpforms[fields][21][]\" value=\"J&#039;ai d\u00e9j\u00e0 eu un examen cardiaque au cours des cinq derni\u00e8res ann\u00e9es.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-585-field_21_2\">J&#8217;ai d\u00e9j\u00e0 eu un examen cardiaque au cours des cinq derni\u00e8res ann\u00e9es.<\/label><\/li><\/ul><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\" ><div id=\"wpforms-585-field_24-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"24\"><div id=\"wpforms-585-field_24\" class=\"wpforms-field-medium wpforms-field-row\"><p>Volontaire :<\/p>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-585-field_25-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"25\"><label class=\"wpforms-field-label\" for=\"wpforms-585-field_25\">Nom du sp\u00e9cialiste cardiaque<\/label><input type=\"text\" id=\"wpforms-585-field_25\" class=\"wpforms-field-medium\" name=\"wpforms[fields][25]\" ><\/div><div id=\"wpforms-585-field_26-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"26\"><label class=\"wpforms-field-label\" for=\"wpforms-585-field_26\">Lieu (adresse du cabinet ou h\u00f4pital)<\/label><input type=\"text\" id=\"wpforms-585-field_26\" class=\"wpforms-field-medium\" name=\"wpforms[fields][26]\" ><\/div><div id=\"wpforms-585-field_27-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"27\"><label class=\"wpforms-field-label\" for=\"wpforms-585-field_27\">Date approximative du dernier examen (ann\u00e9e)<\/label><input type=\"text\" id=\"wpforms-585-field_27\" class=\"wpforms-field-medium\" name=\"wpforms[fields][27]\" ><\/div><div id=\"wpforms-585-field_28-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"28\"><ul id=\"wpforms-585-field_28\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-585-field_28_1\" name=\"wpforms[fields][28][]\" value=\"L&#039;\u00e9quipe de l&#039;\u00e9tude peut demander mes documents au cardiologue mentionn\u00e9 \u00e0 des fins d&#039;\u00e9tude.\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-585-field_28_1\">L&#8217;\u00e9quipe de l&#8217;\u00e9tude peut demander mes documents au cardiologue mentionn\u00e9 \u00e0 des fins d&#8217;\u00e9tude.<\/label><\/li><\/ul><\/div><\/div><\/div><\/div><div id=\"wpforms-585-field_5-container\" class=\"wpforms-field wpforms-field-captcha\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-585-field_5\">Protection contre le spam <span class=\"wpforms-required-label\">*<\/span><\/label>\t\t\t<div class=\"wpforms-captcha-math\">\n\t\t\t\t<span id=\"wpforms-585-field_5-question\" class=\"wpforms-captcha-equation\">\n\t\t\t\t\t<span class=\"n1\">1<\/span>\n\t\t\t\t\t\t\t<span class=\"cal\">+<\/span>\n\t\t\t\t\t\t\t<span class=\"n2\">7<\/span>\t\t\t\t\t<span class=\"e\">=<\/span>\n\t\t\t\t<\/span>\n\t\t\t\t<input type=\"text\" id=\"wpforms-585-field_5\" class=\"wpforms-field-medium wpforms-field-required a\" data-rule-wpf-captcha=\"math\" data-is-wrapped-field=\"1\" name=\"wpforms[fields][5][a]\" aria-describedby=\"wpforms-585-field_5-question\" required>\t\t\t\t<input type=\"hidden\" name=\"wpforms[fields][5][cal]\" class=\"cal\">\n\t\t\t\t<input type=\"hidden\" name=\"wpforms[fields][5][n2]\" class=\"n2\">\n\t\t\t\t<input type=\"hidden\" name=\"wpforms[fields][5][n1]\" class=\"n1\">\n\t\t\t<\/div>\n\t\t\t<div class=\"wpforms-field-description\">Veuillez r\u00e9soudre le probl\u00e8me suivant pour prouver que vous \u00eates un \u00eatre humain.<\/div><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"585\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/cardiosurvivor.ch\/fr\/wp-json\/wp\/v2\/pages\/514\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-585\" class=\"wpforms-submit\" data-alt-text=\"En cours d&#039;envoi...\" data-submit-text=\"Envoyer\" aria-live=\"assertive\" value=\"wpforms-submit\">Envoyer<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/cardiosurvivor.ch\/wp-content\/plugins\/wpforms\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Chargement en cours\"><\/div><\/form><\/div>  <!-- .wpforms-container --><\/div><\/div><\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Inscription Veuillez activer JavaScript dans votre navigateur pour remplir ce formulaire.Nom, pr\u00e9nom *Date de naissance *Rue et num\u00e9ro *Code postal et ville *T\u00e9l\u00e9phone *Adresse de courriel *Je souhaite obtenir un rendez-vous \u00e0 la \u00abConsultation post-cardiaque\u00bb.J&#8217;ai d\u00e9j\u00e0 eu un examen cardiaque au cours des cinq derni\u00e8res ann\u00e9es.Volontaire : Nom du sp\u00e9cialiste cardiaqueLieu (adresse du cabinet ou [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-514","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/cardiosurvivor.ch\/fr\/wp-json\/wp\/v2\/pages\/514","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiosurvivor.ch\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cardiosurvivor.ch\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cardiosurvivor.ch\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiosurvivor.ch\/fr\/wp-json\/wp\/v2\/comments?post=514"}],"version-history":[{"count":3,"href":"https:\/\/cardiosurvivor.ch\/fr\/wp-json\/wp\/v2\/pages\/514\/revisions"}],"predecessor-version":[{"id":590,"href":"https:\/\/cardiosurvivor.ch\/fr\/wp-json\/wp\/v2\/pages\/514\/revisions\/590"}],"wp:attachment":[{"href":"https:\/\/cardiosurvivor.ch\/fr\/wp-json\/wp\/v2\/media?parent=514"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}