{"id":2592,"date":"2023-10-17T09:54:34","date_gmt":"2023-10-17T07:54:34","guid":{"rendered":"https:\/\/www.espace-sante-bersim.fr\/?page_id=2592"},"modified":"2023-10-17T09:54:34","modified_gmt":"2023-10-17T07:54:34","slug":"liste-dattente-mme-margueritte","status":"publish","type":"page","link":"https:\/\/www.espace-sante-bersim.fr\/index.php\/liste-dattente-mme-margueritte\/","title":{"rendered":"Liste d&#8217;attente Mme MARGUERITTE"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">Inscription sur liste d&#8217;attente de Mme MARGUERITTE, Ergoth\u00e9rapeute.<\/h2>\n\n\n\n<div class=\"wp-block-contact-form-7-contact-form-selector\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f2553-o1\" lang=\"fr-FR\" dir=\"ltr\" data-wpcf7-id=\"2553\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/2592#wpcf7-f2553-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formulaire de contact\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"2553\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"fr_FR\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f2553-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<p>* Champs obligatoire\n<\/p>\n<p>Date de demande* <span class=\"wpcf7-form-control-wrap\" data-name=\"date-demande\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-demande\" \/><\/span><label> NOM*(de l'enfant si inscription pour un enfant)<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> <\/label><label>Pr\u00e9nom*(de l'enfant si inscription pour un enfant)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-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=\"last-name\" \/><\/span> <\/label><br \/>\n<label>Date de naissance*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date-naissance\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"\" value=\"\" type=\"date\" name=\"date-naissance\" \/><\/span> <\/label>\n<\/p>\n<p>Classe : <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-classe\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-classe\"><option value=\"\">&#8212;Veuillez choisir une option&#8212;<\/option><option value=\"petite section\">petite section<\/option><option value=\"Moyenne section\">Moyenne section<\/option><option value=\"Grande Section\">Grande Section<\/option><option value=\"CP\">CP<\/option><option value=\"CE1\">CE1<\/option><option value=\"CE2\">CE2<\/option><option value=\"CM1\">CM1<\/option><option value=\"CM2\">CM2<\/option><option value=\"6\u00e8me\">6\u00e8me<\/option><option value=\"5\u00e8me\">5\u00e8me<\/option><option value=\"4\u00e8me\">4\u00e8me<\/option><option value=\"3\u00e8me\">3\u00e8me<\/option><option value=\"Second\">Second<\/option><option value=\"1\u00e8re\">1\u00e8re<\/option><option value=\"Terminale\">Terminale<\/option><\/select><\/span>\n<\/p>\n<p>Pour les enfants de quelle \u00e9cole : <span class=\"wpcf7-form-control-wrap\" data-name=\"text-ecole-de\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Ecole de ....\" value=\"\" type=\"text\" name=\"text-ecole-de\" \/><\/span>\n<\/p>\n<p><label>Coordonn\u00e9es des parents ou responsables l\u00e9gaux (pour un enfant inscrit)<br \/>\n<\/label><label> Adresse* : <span class=\"wpcf7-form-control-wrap\" data-name=\"Adres1\"><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=\"Adres1\" \/><\/span> <\/label><label> Compl\u00e9ment adresse : <span class=\"wpcf7-form-control-wrap\" data-name=\"adres2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"adres2\" \/><\/span> <\/label><br \/>\n<label> Lieu-dit : <span class=\"wpcf7-form-control-wrap\" data-name=\"lieudit\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"lieudit\" \/><\/span> <\/label><br \/>\n<label> CP* : <span class=\"wpcf7-form-control-wrap\" data-name=\"cp\"><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=\"cp\" \/><\/span> <\/label><label> Ville* : <span class=\"wpcf7-form-control-wrap\" data-name=\"ville\"><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=\"ville\" \/><\/span> <\/label><br \/>\nT\u00e9l\u00e9phone* : <span class=\"wpcf7-form-control-wrap\" data-name=\"tel-131\"><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=\"tel-131\" \/><\/span><br \/>\n<label> Votre adresse de messagerie*<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\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span> <\/label>\n<\/p>\n<p>Type de demande*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"firstdemande\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"firstdemande[]\" value=\"1\u00e8re demande\" \/><span class=\"wpcf7-list-item-label\">1\u00e8re demande<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"firstdemande[]\" value=\"Renouvellement\" \/><span class=\"wpcf7-list-item-label\">Renouvellement<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>Demande de*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-motif\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><span class=\"wpcf7-list-item-label\">bilan<\/span><input type=\"checkbox\" name=\"checkbox-motif\" value=\"bilan\" \/><\/span><span class=\"wpcf7-list-item last\"><span class=\"wpcf7-list-item-label\">suivi<\/span><input type=\"checkbox\" name=\"checkbox-motif\" value=\"suivi\" \/><\/span><\/span><\/span>\n<\/p>\n<p><label> Motif de la demande*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"your-message\"><\/textarea><\/span> <\/label>\n<\/p>\n<p>demande \u00e9manant de :<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"radio-provenance\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><span class=\"wpcf7-list-item-label\">parents<\/span><input type=\"radio\" name=\"radio-provenance\" value=\"parents\" checked=\"checked\" \/><\/span><span class=\"wpcf7-list-item\"><span class=\"wpcf7-list-item-label\">m\u00e9decin traitant<\/span><input type=\"radio\" name=\"radio-provenance\" value=\"m\u00e9decin traitant\" \/><\/span><span class=\"wpcf7-list-item\"><span class=\"wpcf7-list-item-label\">m\u00e9decine scolaire<\/span><input type=\"radio\" name=\"radio-provenance\" value=\"m\u00e9decine scolaire\" \/><\/span><span class=\"wpcf7-list-item\"><span class=\"wpcf7-list-item-label\">PMI<\/span><input type=\"radio\" name=\"radio-provenance\" value=\"PMI\" \/><\/span><span class=\"wpcf7-list-item\"><span class=\"wpcf7-list-item-label\">enseignant<\/span><input type=\"radio\" name=\"radio-provenance\" value=\"enseignant\" \/><\/span><span class=\"wpcf7-list-item last\"><span class=\"wpcf7-list-item-label\">autres<\/span><input type=\"radio\" name=\"radio-provenance\" value=\"autres\" \/><\/span><\/span><\/span>\n<\/p>\n<p>Ordonnance du :<span class=\"wpcf7-form-control-wrap\" data-name=\"date-ordonnance\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-ordonnance\" \/><\/span><br \/>\nM\u00e9decin pr\u00e9scripteur :<span class=\"wpcf7-form-control-wrap\" data-name=\"text-medecin-prescript\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-medecin-prescript\" \/><\/span><br \/>\nAutres suivis en cours : <span class=\"wpcf7-form-control-wrap\" data-name=\"text-autres-suivis\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-autres-suivis\" \/><\/span><br \/>\nNotes compl\u00e9mentaires : <span class=\"wpcf7-form-control-wrap\" data-name=\"text-complement\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-complement\" \/><\/span><br \/>\nJoindre un document (2Mo max - JPG ou PDF) : <span class=\"wpcf7-form-control-wrap\" data-name=\"file-569\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\".jpg,.pdf\" aria-invalid=\"false\" type=\"file\" name=\"file-569\" \/><\/span><br \/>\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Envoyer\" \/>\n<\/p><input type='hidden' class='wpcf7-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Inscription sur liste d&#8217;attente de Mme MARGUERITTE, Ergoth\u00e9rapeute.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-2592","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.espace-sante-bersim.fr\/index.php\/wp-json\/wp\/v2\/pages\/2592","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.espace-sante-bersim.fr\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.espace-sante-bersim.fr\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.espace-sante-bersim.fr\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.espace-sante-bersim.fr\/index.php\/wp-json\/wp\/v2\/comments?post=2592"}],"version-history":[{"count":1,"href":"https:\/\/www.espace-sante-bersim.fr\/index.php\/wp-json\/wp\/v2\/pages\/2592\/revisions"}],"predecessor-version":[{"id":2593,"href":"https:\/\/www.espace-sante-bersim.fr\/index.php\/wp-json\/wp\/v2\/pages\/2592\/revisions\/2593"}],"wp:attachment":[{"href":"https:\/\/www.espace-sante-bersim.fr\/index.php\/wp-json\/wp\/v2\/media?parent=2592"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}