{"id":1637,"date":"2022-06-13T11:31:39","date_gmt":"2022-06-13T09:31:39","guid":{"rendered":"https:\/\/www.theramex.com\/fr-be\/?page_id=1637"},"modified":"2022-06-14T12:43:18","modified_gmt":"2022-06-14T10:43:18","slug":"contact-fr","status":"publish","type":"page","link":"https:\/\/www.theramex.com\/fr-be\/contact-fr\/","title":{"rendered":"Contact KAM"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_2' >\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Contact<\/h2>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_custom\">(requis)<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_2'  action='\/fr-be\/wp-json\/wp\/v2\/pages\/1637' data-formid='2' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_2_9\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_9'><span class='gform-field-label__text'>Facebook<\/span><\/label><div class='ginput_container'><input name='input_9' id='input_2_9' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_2_9'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_2_2\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Cher Docteur,\n\nVeuillez remplir les informations ci-dessous afin que nous puissions vous mettre en contact avec le Key Account Manager de votre r\u00e9gion :\n<\/div><div id=\"field_2_1\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_1'><span class='gform-field-label__text'>Nom<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_2_1' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_3\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_3'><span class='gform-field-label__text'>Pr\u00e9nom<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_2_3' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_4\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_4'><span class='gform-field-label__text'>R\u00e9gion<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_4' id='input_2_4' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='R\u00e9gion Bruxelles, Brabant-Wallon, Hainaut' >R\u00e9gion Bruxelles, Brabant-Wallon, Hainaut<\/option><option value='R\u00e9gion Namur, Li\u00e8ge, Luxembourg' >R\u00e9gion Namur, Li\u00e8ge, Luxembourg<\/option><\/select><\/div><\/div><div id=\"field_2_5\" class=\"gfield gfield--type-phone gfield--phone-format-international gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_5'><span class='gform-field-label__text'>T\u00e9l\u00e9phone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_5' id='input_2_5' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/div><fieldset id=\"field_2_6\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Comment pr\u00e9f\u00e9rez-vous \u00eates contact\u00e9(e) ?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_6'>\n\t\t\t<div class='gchoice gchoice_2_6_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='Email'  id='choice_2_6_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_6_0' id='label_2_6_0' class='gform-field-label gform-field-label--type-inline'>Email<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_6_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='T\u00e9l\u00e9phone'  id='choice_2_6_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_6_1' id='label_2_6_1' class='gform-field-label gform-field-label--type-inline'>T\u00e9l\u00e9phone<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_7\" class=\"gfield gfield--type-captcha gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_2_7'><span class='gform-field-label__text'><\/span><\/label><div id='input_2_7' class='ginput_container ginput_recaptcha' data-sitekey='6Le7pD8gAAAAAHzlMTtWCjn4rwzCTIci76JSoyTw'  data-theme='light' data-tabindex='0'  data-badge=''><\/div><\/div><fieldset id=\"field_2_8\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Politique de confidentialit\u00e9<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_custom\">(requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_8.1' id='input_2_8_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_2_8\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_2_8_1' ><span class='gform-field-label__text'>J&rsquo;ai lu et j&rsquo;accepte la charte de confidentialit\u00e9.<\/span><\/label><input type='hidden' name='input_8.2' value='J&#039;ai lu et j&#039;accepte la charte de confidentialit\u00e9.' class='gform_hidden' \/><input type='hidden' name='input_8.3' value='2' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_2_8'><div class='gfield_consent_description_text' tabindex='0'>Vous pouvez trouver la politique de confidentialit\u00e9 ici :<br \/>\nhttps:\/\/www.theramex.com\/fr-be\/politique-de-confidentialite-et-d-usage-de-cookies\/<\/div><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_2' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Envoyer<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_2' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_2' id='gform_theme_2' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_2' id='gform_style_settings_2' value='[]' \/>\n            <input type='hidden' class='gform_hidden' 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