{"id":7117,"date":"2021-06-29T11:27:03","date_gmt":"2021-06-29T09:27:03","guid":{"rendered":"https:\/\/www.chanasassurances.com\/appointment-form\/"},"modified":"2022-09-20T10:38:27","modified_gmt":"2022-09-20T08:38:27","slug":"appointment-form","status":"publish","type":"page","link":"https:\/\/www.chanasassurances.com\/en\/appointment-form\/","title":{"rendered":"Appointment form"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:2%;--awb-padding-bottom:2%;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-content-wrap\" style=\"max-width:1185.6px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_2_3 2_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:66.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:2.88%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form fusion-form-builder fusion-form-form-wrapper fusion-form-15081\" style=\"--awb-tooltip-text-color:#ffffff;--awb-tooltip-background-color:#333333;\" data-form-id=\"15081\" data-config=\"{&quot;form_id&quot;:15081,&quot;form_post_id&quot;:15081,&quot;post_id&quot;:7117,&quot;form_type&quot;:&quot;ajax&quot;,&quot;confirmation_type&quot;:&quot;message&quot;,&quot;redirect_url&quot;:&quot;&quot;,&quot;redirect_timeout&quot;:&quot;0&quot;,&quot;field_labels&quot;:{&quot;Vous \\u00eates&quot;:&quot;Vous \\u00eates:&quot;,&quot;nom&quot;:&quot;Nom &quot;,&quot;Pr\\u00e9nom&quot;:&quot;Pr\\u00e9nom&quot;,&quot;telephone&quot;:&quot;T\\u00e9l\\u00e9phone&quot;,&quot;email&quot;:&quot;Email&quot;,&quot;definir_la_date_de_rendez-vous&quot;:&quot;D\\u00e9finir la date de rendez-vous&quot;,&quot;choisir_une_tranche_horaire&quot;:&quot;Choisir une tranche horaire&quot;,&quot;confirmation_de_rendez-vous&quot;:&quot;Confirmation de rendez-vous&quot;,&quot;veillez_fournir_des_informations_complementaires_detaillees&quot;:&quot;Veillez fournir des informations compl\\u00e9mentaires d\\u00e9taill\\u00e9es&quot;},&quot;field_logics&quot;:{&quot;Vous \\u00eates&quot;:&quot;[]&quot;,&quot;nom&quot;:&quot;[]&quot;,&quot;Pr\\u00e9nom&quot;:&quot;[]&quot;,&quot;telephone&quot;:&quot;&quot;,&quot;email&quot;:&quot;&quot;,&quot;definir_la_date_de_rendez-vous&quot;:&quot;&quot;,&quot;choisir_une_tranche_horaire&quot;:&quot;&quot;,&quot;confirmation_de_rendez-vous&quot;:&quot;&quot;,&quot;veillez_fournir_des_informations_complementaires_detaillees&quot;:&quot;&quot;,&quot;notice_1&quot;:&quot;&quot;,&quot;submit_1&quot;:&quot;&quot;},&quot;field_types&quot;:{&quot;Vous \\u00eates&quot;:&quot;select&quot;,&quot;nom&quot;:&quot;text&quot;,&quot;Pr\\u00e9nom&quot;:&quot;text&quot;,&quot;telephone&quot;:&quot;phone_number&quot;,&quot;email&quot;:&quot;email&quot;,&quot;definir_la_date_de_rendez-vous&quot;:&quot;date&quot;,&quot;choisir_une_tranche_horaire&quot;:&quot;radio&quot;,&quot;confirmation_de_rendez-vous&quot;:&quot;radio&quot;,&quot;veillez_fournir_des_informations_complementaires_detaillees&quot;:&quot;textarea&quot;,&quot;notice_1&quot;:&quot;notice&quot;,&quot;submit_1&quot;:&quot;submit&quot;},&quot;nonce_method&quot;:&quot;ajax&quot;,&quot;form_views&quot;:&quot;ajax&quot;,&quot;form_views_counting&quot;:&quot;all&quot;}\"><form action=\"https:\/\/www.chanasassurances.com\/en\/appointment-form\/\" method=\"post\" class=\"fusion-form fusion-form-15081\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:0;--awb-flex-shrink-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:0;--awb-flex-shrink-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1 awb-text-cols fusion-text-columns-2\" style=\"--awb-columns:2;--awb-column-spacing:2em;--awb-column-min-width:100px;--awb-rule-style:2px solid #e0dede;\"><h3>Prendre un rendez-vous<\/h3>\n<p>Pour obtenir un rendez-vous, vous pouvez nous t\u00e9l\u00e9phoner au <strong>+237\u00a0 699 302 713 | 676 803 983<\/strong> ou remplir le formulaire en ligne ci-dessous.<\/p>\n<p>Prise de rendez-vous en ligne.<\/p>\n<ul>\n<li>D\u00e9terminez le jour et la plage horaire qui vous conviennent.<\/li>\n<li>Laissez-nous vos coordonn\u00e9es compl\u00e8tes.<\/li>\n<li>Vous recevrez en moins de 24 heures, soit par t\u00e9l\u00e9phone ou par courriel, une confirmation de votre rendez-vous ou une proposition pour une nouvelle plage horaire.<\/li>\n<\/ul>\n<\/div>\n<\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:0;--awb-flex-shrink-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:0;--awb-flex-shrink-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-select-field fusion-form-label-above\" style=\"\" data-form-id=\"15081\"><label for=\"Vous \u00eates\">Vous \u00eates: <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><div class=\"fusion-select-wrapper\"><select autocomplete=\"off\" tabindex=\"\" id=\"Vous \u00eates\" name=\"Vous \u00eates\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"><option value=\"Une entreprise\" >Une entreprise<\/option><option value=\"Un particulier\" >Un particulier<\/option><\/select><div class=\"select-arrow\"><svg width=\"12\" height=\"8\" viewBox=\"0 0 12 8\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"> <path d=\"M1.5 1.75L6 6.25L10.5 1.75\" stroke=\"#6D6D6D\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/> <\/svg><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:0;--awb-flex-shrink-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:0;--awb-flex-shrink-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"15081\"><div class=\"fusion-form-label-wrapper\"><label for=\"nom\">Nom  <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"nom\" id=\"nom\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" placeholder=\"Votre nom *\" data-holds-private-data=\"false\" minlength=\"0\" maxlength=\"104\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:0;--awb-flex-shrink-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:0;--awb-flex-shrink-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"15081\"><div class=\"fusion-form-label-wrapper\"><label for=\"Pr\u00e9nom\">Pr\u00e9nom <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"Pr\u00e9nom\" id=\"Pr\u00e9nom\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" placeholder=\"Votre nom *\" data-holds-private-data=\"false\" minlength=\"0\" maxlength=\"104\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_3_4 3_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:75%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:2.56%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.56%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:0;--awb-flex-shrink-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:0;--awb-flex-shrink-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-phone-number-field fusion-form-label-above\" style=\"\" data-form-id=\"15081\"><div class=\"fusion-form-label-wrapper\"><label for=\"telephone\">T\u00e9l\u00e9phone <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><div class=\"fusion-form-input-with-icon\"><i class=\"awb-form-icon fa-phone-square-alt fas\"><\/i><input type=\"tel\" autocomplete=\"off\" name=\"telephone\" id=\"telephone\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" placeholder=\"Num\u00e9ro de t\u00e9l\u00e9phone *\" data-holds-private-data=\"false\"\/><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_3_4 3_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:75%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:2.56%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.56%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:0;--awb-flex-shrink-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:0;--awb-flex-shrink-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-email-field fusion-form-label-above\" style=\"\" data-form-id=\"15081\"><div class=\"fusion-form-label-wrapper\"><label for=\"email\">Email <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"email\" autocomplete=\"off\" name=\"email\" id=\"email\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" placeholder=\"Votre email *\" data-holds-private-data=\"false\"\/><\/div><div class=\"fusion-form-field fusion-form-date-field fusion-form-label-above\" style=\"\" data-form-id=\"15081\"><label for=\"definir_la_date_de_rendez-vous\">D\u00e9finir la date de rendez-vous <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><input autocomplete=\"off\" type=\"date\" data-first-day=\"1\"  data-format=\"\" tabindex=\"\" id=\"definir_la_date_de_rendez-vous\" name=\"definir_la_date_de_rendez-vous\" data-type=\"custom\" value=\"\" data-holds-private-data=\"false\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\"autocomplete=\"no\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-7 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:0;--awb-flex-shrink-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:0;--awb-flex-shrink-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above\" style=\"\" data-form-id=\"15081\"><fieldset><legend class=\"fusion-form-label-wrapper\"><span class=\"label\">Choisir une tranche horaire <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/span><\/legend><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-choisir_une_tranche_horaire-1-0\" type=\"radio\" value=\"[8H - 9H]\" name=\"choisir_une_tranche_horaire\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-choisir_une_tranche_horaire-1-0\">[8H - 9H]<\/label><\/div><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-choisir_une_tranche_horaire-1-1\" type=\"radio\" value=\"[9H30 - 11H]\" name=\"choisir_une_tranche_horaire\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-choisir_une_tranche_horaire-1-1\">[9H30 - 11H]<\/label><\/div><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-choisir_une_tranche_horaire-1-2\" type=\"radio\" value=\"[11H - 12H]\" name=\"choisir_une_tranche_horaire\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-choisir_une_tranche_horaire-1-2\">[11H - 12H]<\/label><\/div><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-choisir_une_tranche_horaire-1-3\" type=\"radio\" value=\"[13H30 - 15H]\" name=\"choisir_une_tranche_horaire\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-choisir_une_tranche_horaire-1-3\">[13H30 - 15H]<\/label><\/div><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-choisir_une_tranche_horaire-1-4\" type=\"radio\" value=\"[15H - 16H30]\" name=\"choisir_une_tranche_horaire\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-choisir_une_tranche_horaire-1-4\">[15H - 16H30]<\/label><\/div><\/fieldset><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-8 fusion_builder_column_3_4 3_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:75%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:2.56%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.56%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:0;--awb-flex-shrink-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:0;--awb-flex-shrink-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above\" style=\"\" data-form-id=\"15081\"><fieldset><legend class=\"fusion-form-label-wrapper\"><span class=\"label\">Confirmation de rendez-vous <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/span><div class=\"fusion-form-tooltip\"><i class=\"awb-icon-question-circle\"><\/i><span class=\"fusion-form-tooltip-content\">Comment souhaiteriez-vous que Chanas Assurances S.A confirme votre rendez-vous?<\/span><\/div><\/legend><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-confirmation_de_rendez-vous-2-0\" type=\"radio\" value=\"Par couriel\" name=\"confirmation_de_rendez-vous\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-confirmation_de_rendez-vous-2-0\">Par couriel<\/label><\/div><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-confirmation_de_rendez-vous-2-1\" type=\"radio\" value=\"Par t\u00e9l\u00e9phone\" name=\"confirmation_de_rendez-vous\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-confirmation_de_rendez-vous-2-1\">Par t\u00e9l\u00e9phone<\/label><\/div><\/fieldset><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-9 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:0;--awb-flex-shrink-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:0;--awb-flex-shrink-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-textarea-field fusion-form-label-above\" style=\"\" data-form-id=\"15081\"><label for=\"veillez_fournir_des_informations_complementaires_detaillees\">Veillez fournir des informations compl\u00e9mentaires d\u00e9taill\u00e9es<\/label><textarea cols=\"40\" autocomplete=\"off\"  minlength=\"0\"  rows=\"5\" tabindex=\"\" id=\"veillez_fournir_des_informations_complementaires_detaillees\" name=\"veillez_fournir_des_informations_complementaires_detaillees\" class=\"fusion-form-input\" data-holds-private-data=\"false\"><\/textarea><\/div><div class=\"form-submission-notices data-notice_1\" id=\"fusion-notices-1\" data-instance=\"1\"><div class=\"fusion-alert alert success alert-success fusion-alert-center fusion-form-response fusion-form-response-success fusion-alert-capitalize awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"alert-icon\"><i class=\"awb-icon-check-circle\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-alert-content\">Votre demande de rendez-vous a \u00e9t\u00e9 envoy\u00e9.<\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">&times;<\/button><\/div><div class=\"fusion-alert alert error alert-danger fusion-alert-center fusion-form-response fusion-form-response-error fusion-alert-capitalize awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"alert-icon\"><i class=\"awb-icon-exclamation-triangle\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-alert-content\">Une erreur s'est produite lors de la tentative d'envoi de votre demande de prise de rendez-vous. Veuillez r\u00e9essayer plus tard.<\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">&times;<\/button><\/div><\/div><div class=\"fusion-form-field fusion-form-submit-field fusion-form-label-above\" style=\"\" data-form-id=\"15081\"><div ><button type=\"submit\" class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-1 fusion-button-default-span  button-default form-form-submit\" style=\"--button_accent_color:#ffffff;--button_accent_hover_color:#ffffff;--button_border_hover_color:#f3f3f3;--button_gradient_top_color:#0052a1;--button_gradient_bottom_color:#0052a1;--button_gradient_top_color_hover:#333333;--button_gradient_bottom_color_hover:#333333;\" data-form-number=\"15081\" tabindex=\"\"><span class=\"fusion-button-text awb-button__text awb-button__text--default\">ENVOYER<\/span><\/button><\/div><\/div><\/div><\/div><\/div><\/div><input type=\"hidden\" name=\"fusion_privacy_store_ip_ua\" value=\"true\"><\/form><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-10 fusion_builder_column_1_3 1_3 fusion-flex-column\" style=\"--awb-padding-top:5%;--awb-padding-bottom:2%;--awb-bg-color:#f6f6f6;--awb-bg-color-hover:#f6f6f6;--awb-bg-size:cover;--awb-box-shadow:2px 3px 5px 0px ;;--awb-border-color:#ececec;--awb-border-top:2px;--awb-border-right:2px;--awb-border-bottom:2px;--awb-border-left:2px;--awb-border-style:solid;--awb-width-large:33.333333333333%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:5.76%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:0;--awb-flex-shrink-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:0;--awb-flex-shrink-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1-2 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-11 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:0;--awb-flex-shrink-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:0;--awb-flex-shrink-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-widget-area awb-widget-area-element fusion-widget-area-1 fusion-content-widget-area\" style=\"--awb-title-color:#0033a0;--awb-padding:0px 0px 0px 0px;\"><div id=\"search-7\" class=\"widget widget_search\" style=\"border-style: solid;border-color:transparent;border-width:0px;\"><div class=\"heading\"><h4 class=\"widget-title\">Search<\/h4><\/div>\t\t<form role=\"search\" class=\"searchform fusion-search-form  fusion-search-form-classic\" method=\"get\" action=\"https:\/\/www.chanasassurances.com\/en\/\">\n\t\t\t<div class=\"fusion-search-form-content\">\n\n\t\t\t\t\n\t\t\t\t<div class=\"fusion-search-field search-field\">\n\t\t\t\t\t<label><span class=\"screen-reader-text\">Search for:<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"search\" value=\"\" name=\"s\" class=\"s\" placeholder=\"Search...\" required aria-required=\"true\" aria-label=\"Search...\"\/>\n\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"fusion-search-button search-button\">\n\t\t\t\t\t<input type=\"submit\" class=\"fusion-search-submit searchsubmit\" aria-label=\"Search\" value=\"&#xf002;\" \/>\n\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\n\t\t\t<\/div>\n\n\n\t\t\t\n\t\t<\/form>\n\t\t<\/div><div id=\"custom_html-25\" class=\"widget_text widget widget_custom_html\" style=\"border-style: solid;border-color:transparent;border-width:0px;\"><div class=\"textwidget custom-html-widget\"><h4 style=\"text-align: center; color: #ffffff; background-color: #0e3594\"><strong><br>Liens utiles<br><\/strong><br><\/h4><\/div><\/div><div id=\"nav_menu-4\" class=\"widget widget_nav_menu\" style=\"margin: 10%;border-style: solid;border-color:transparent;border-width:0px;\"><div class=\"menu-chanas-assurances-footer-liens-utiles-menu-anglais-container\"><ul id=\"menu-chanas-assurances-footer-liens-utiles-menu-anglais\" class=\"menu\"><li id=\"menu-item-7695\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-7695\"><a href=\"https:\/\/www.chanasassurances.com\/devenir-agent-general-ou-collaborateur-commercial-dagence\/\">Apporteur Libre d\u2019affaire<\/a><\/li>\n<li id=\"menu-item-7693\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-7693\"><a href=\"https:\/\/www.chanasassurances.com\/en\/my-customer-area\/\">My customer area<\/a><\/li>\n<li id=\"menu-item-7694\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-7694\"><a href=\"https:\/\/www.chanasassurances.com\/en\/join-us\/\">Join us<\/a><\/li>\n<li id=\"menu-item-7696\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-7696\"><a href=\"https:\/\/www.chanasassurances.com\/en\/approved-garages\/\">Approved garages<\/a><\/li>\n<li id=\"menu-item-7698\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-7698\"><a href=\"https:\/\/www.chanasassurances.com\/en\/lexicon\/\">Lexicon<\/a><\/li>\n<\/ul><\/div><\/div><div class=\"fusion-additional-widget-content\"><\/div><\/div><\/div><\/div><\/div><\/div>\n<\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-7117","page","type-page","status-publish","hentry"],"acf":[],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.chanasassurances.com\/en\/wp-json\/wp\/v2\/pages\/7117","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.chanasassurances.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.chanasassurances.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.chanasassurances.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.chanasassurances.com\/en\/wp-json\/wp\/v2\/comments?post=7117"}],"version-history":[{"count":3,"href":"https:\/\/www.chanasassurances.com\/en\/wp-json\/wp\/v2\/pages\/7117\/revisions"}],"predecessor-version":[{"id":7656,"href":"https:\/\/www.chanasassurances.com\/en\/wp-json\/wp\/v2\/pages\/7117\/revisions\/7656"}],"wp:attachment":[{"href":"https:\/\/www.chanasassurances.com\/en\/wp-json\/wp\/v2\/media?parent=7117"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}