{"id":2617,"date":"2020-12-21T15:45:13","date_gmt":"2020-12-21T14:45:13","guid":{"rendered":"https:\/\/aca-pl.com\/?page_id=2617"},"modified":"2020-12-21T15:53:43","modified_gmt":"2020-12-21T14:53:43","slug":"questionnaire-chiens-chats","status":"publish","type":"page","link":"https:\/\/aca-pl.com\/?page_id=2617","title":{"rendered":"QUESTIONNAIRE CHIENS\/CHATS"},"content":{"rendered":"\n<p class=\"has-background\" style=\"background-color:#f1e830\">L\u2019objectif de ce questionnaire est d\u2019obtenir les informations destin\u00e9es \u00e0 votre \u00e9tude personnalis\u00e9e. Ces informations ne seront en aucun cas transmis \u00e0 des tiers, hormis les assureurs interrog\u00e9s. Merci de s\u00e9lectionner les propositions ou bien de remplir les informations demand\u00e9es. Si certaines r\u00e9ponses propos\u00e9es, ne correspondent pas, indiquez-le-nous dans votre message d\u2019envoi.<\/p>\n\n\n\n<div class=\"forminator-guttenberg\"><div class=\"forminator-ui forminator-custom-form forminator-custom-form-2589 forminator-design--default  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-2589\" data-uid=\"69fde49614860\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-2589\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-2589 forminator-design--default  forminator_ajax\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"2589\"\n\t\t\t\t\n\t\t\t\tdata-design=\"default\"\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\tdata-grid=\"open\"\n\t\t\t\t\n\t\t\t\t\n\t\t\t\tstyle=\"display: none;\"\n\t\t\t\t\n\t\t\t\tdata-uid=\"69fde49614860\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"html-6\" class=\"forminator-field-html forminator-col forminator-col-12 \"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-6\"><label class=\"forminator-label\">Questionnaire compl\u00e9mentaire sant\u00e9 CHIENS et CHATS<\/label><p>Afin de pouvoir vous adresser un projet personnalis\u00e9, merci de compl\u00e9ter le questionnaire ci-dessous.<\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-12 \"><div class=\"forminator-row forminator-no-margin\" data-multiple=\"true\"><div class=\"forminator-col forminator-col-md-6\"><div class=\"forminator-field\"><label for=\"forminator-form-2589__field--name-1_69fde49614860\" id=\"forminator-form-2589__field--name-1_69fde49614860-label\" class=\"forminator-label\">Pr\u00e9fixe<\/label><select name=\"name-1-prefix\" id=\"forminator-form-2589__field--name-1_69fde49614860\" class=\"forminator-select2\" data-multi=\"1\" aria-labelledby=\"forminator-form-2589__field--name-1_69fde49614860-label\" data-default-value=\"\"><option value=\"Mr\" >M.<\/option><option value=\"Mrs\" >Mme<\/option><option value=\"Ms\" >Mme<\/option><option value=\"Mx\" >Mx<\/option><option value=\"Miss\" >Mlle<\/option><option value=\"Dr\" >Dr.<\/option><option value=\"Prof\" >Prof.<\/option><\/select><\/div><\/div><div class=\"forminator-col forminator-col-md-6\"><div class=\"forminator-field\"><label for=\"forminator-field-first-name-1_69fde49614860\" class=\"forminator-label\" id=\"forminator-field-first-name-1_69fde49614860-label\">Nom <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1-first-name\" placeholder=\"\" id=\"forminator-field-first-name-1_69fde49614860\" class=\"forminator-input\" aria-required=\"true\" data-multi=\"1\" value=\"\" \/><\/div><\/div><div class=\"forminator-col forminator-col-md-6\"><div class=\"forminator-field\"><label for=\"forminator-field-last-name-1_69fde49614860\" class=\"forminator-label\" id=\"forminator-field-last-name-1_69fde49614860-label\">Pr\u00e9nom <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1-last-name\" placeholder=\"\" id=\"forminator-field-last-name-1_69fde49614860\" class=\"forminator-input\" aria-required=\"true\" data-multi=\"1\" value=\"\" \/><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"address-1\" class=\"forminator-field-address forminator-col forminator-col-12 \"><div class=\"forminator-row\"><div id=\"address-1-street_address\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-street_address_69fde49614860\" class=\"forminator-label\" id=\"forminator-field-address-1-street_address_69fde49614860-label\">Rue<\/label><input type=\"text\" name=\"address-1-street_address\" placeholder=\"\" id=\"forminator-field-address-1-street_address_69fde49614860\" class=\"forminator-input\" data-required=\"\" aria-required=\"false\" value=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"address-1-address_line\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-address_line_69fde49614860\" class=\"forminator-label\" id=\"forminator-field-address-1-address_line_69fde49614860-label\">Appartement, suite, etc.<\/label><input type=\"text\" name=\"address-1-address_line\" placeholder=\"\" id=\"forminator-field-address-1-address_line_69fde49614860\" class=\"forminator-input\" data-required=\"\" aria-required=\"false\" value=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\" data-multiple=\"false\"><div id=\"address-1-city\" class=\"forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-city_69fde49614860\" class=\"forminator-label\" id=\"forminator-field-address-1-city_69fde49614860-label\">Ville<\/label><input type=\"text\" name=\"address-1-city\" placeholder=\"\" id=\"forminator-field-address-1-city_69fde49614860\" class=\"forminator-input\" data-required=\"\" aria-required=\"false\" value=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\" data-multiple=\"false\"><div id=\"address-1-zip\" class=\"forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-zip_69fde49614860\" class=\"forminator-label\" id=\"forminator-field-address-1-zip_69fde49614860-label\">Code postal<\/label><input type=\"text\" name=\"address-1-zip\" placeholder=\"\" id=\"forminator-field-address-1-zip_69fde49614860\" class=\"forminator-input\" value=\"\" \/><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_69fde49614860\" class=\"forminator-label\" id=\"forminator-field-phone-1_69fde49614860-label\">Num\u00e9ro de t\u00e9l\u00e9phone <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"Par exemple\u00a0: +1 3004005000\" id=\"forminator-field-phone-1_69fde49614860\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" data-validation=\"1\" \/><\/div><\/div><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_69fde49614860\" class=\"forminator-label\" id=\"forminator-field-email-1_69fde49614860-label\">Adresse de messagerie <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"jacques@martin.com\" id=\"forminator-field-email-1_69fde49614860\" class=\"forminator-input forminator-email--field\" data-required=\"true\" aria-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-3\" class=\"forminator-field-section forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h2 class=\"forminator-title\">Animal \u00e0 Garantir:<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-1\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-1_69fde49614860\" class=\"forminator-label\" id=\"forminator-field-text-1_69fde49614860-label\">Quel est son nom ?<\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"\" id=\"forminator-field-text-1_69fde49614860\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"date-1\" class=\"forminator-field-date forminator-col forminator-col-6 \"><label for=\"forminator-field-date-1\" class=\"forminator-label\">Quelle est sa date de naissance ?<\/label><div class=\"forminator-date-input\"><div class=\"forminator-row\" data-multiple=\"true\"><div id=\"date-1-month\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-date-1-month_69fde49614860\" class=\"forminator-label\" id=\"forminator-field-date-1-month_69fde49614860-label\">Mois<\/label><input type=\"number\" min=\"1\" max=\"12\" name=\"date-1-month\" value=\"\" placeholder=\"\" id=\"forminator-field-date-1-month_69fde49614860\" class=\"forminator-input\" data-field=\"month\" data-format=\"mm\/dd\/yy\" data-parent=\"date-1\" aria-describedby=\"forminator-field-date-1_69fde49614860-description\" \/><\/div><\/div><div id=\"date-1-day\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-date-1-day_69fde49614860\" class=\"forminator-label\" id=\"forminator-field-date-1-day_69fde49614860-label\">Jour<\/label><input type=\"number\" min=\"1\" max=\"31\" name=\"date-1-day\" value=\"\" placeholder=\"\" id=\"forminator-field-date-1-day_69fde49614860\" class=\"forminator-input\" data-field=\"day\" data-format=\"mm\/dd\/yy\" data-parent=\"date-1\" aria-describedby=\"forminator-field-date-1_69fde49614860-description\" \/><\/div><\/div><div id=\"date-1-year\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-date-1-year_69fde49614860\" class=\"forminator-label\" id=\"forminator-field-date-1-year_69fde49614860-label\">Ann\u00e9e<\/label><input type=\"number\" min=\"1\" name=\"date-1-year\" placeholder=\"\" id=\"forminator-field-date-1-year_69fde49614860\" class=\"forminator-input\" data-field=\"year\" value=\"\" data-format=\"mm\/dd\/yy\" data-parent=\"date-1\" aria-describedby=\"forminator-field-date-1_69fde49614860-description\" \/><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-12\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-2589__field--select-12_69fde49614860\" id=\"forminator-form-2589__field--select-12_69fde49614860-label\" class=\"forminator-label\">S&#039;agit il d&#039;un chat ou d&#039;un chien ?<\/label><select id=\"forminator-form-2589__field--select-12_69fde49614860\" class=\"forminator-select--field forminator-select2\" data-required=\"\" name=\"select-12\" data-default-value=\"\" data-placeholder=\"\" data-search=\"false\" aria-labelledby=\"forminator-form-2589__field--select-12_69fde49614860-label\" aria-describedby=\"forminator-form-2589__field--select-12_69fde49614860-description\"><option value=\"chien\"  data-calculation=\"0\">Chien<\/option><option value=\"chat\"  data-calculation=\"0\">Chat<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-11\" class=\"forminator-field-select forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-form-2589__field--select-11_69fde49614860\" id=\"forminator-form-2589__field--select-11_69fde49614860-label\" class=\"forminator-label\">Sexe<\/label><select id=\"forminator-form-2589__field--select-11_69fde49614860\" class=\"forminator-select--field forminator-select2\" data-required=\"\" name=\"select-11\" data-default-value=\"\" data-placeholder=\"\" data-search=\"false\" aria-labelledby=\"forminator-form-2589__field--select-11_69fde49614860-label\" aria-describedby=\"forminator-form-2589__field--select-11_69fde49614860-description\"><option value=\"masculin\"  data-calculation=\"0\">Masculin<\/option><option value=\"F\u00e9minin\"  data-calculation=\"0\">F\u00e9minin<\/option><\/select><\/div><\/div><div id=\"textarea-4\" class=\"forminator-field-textarea forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-4_69fde49614860\" id=\"forminator-field-textarea-4_69fde49614860-label\" class=\"forminator-label\">Quelle est la race de votre animal ?<\/label><textarea name=\"textarea-4\" placeholder=\"Si crois\u00e9 le pr\u00e9ciser\" id=\"forminator-field-textarea-4_69fde49614860\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-15\" class=\"forminator-field-select forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-form-2589__field--select-15_69fde49614860\" id=\"forminator-form-2589__field--select-15_69fde49614860-label\" class=\"forminator-label\">Votre chien est-il class\u00e9 en1\u00e8re ou 2\u00e8me cat\u00e9gorie ?<\/label><select id=\"forminator-form-2589__field--select-15_69fde49614860\" class=\"forminator-select--field forminator-select2\" data-required=\"\" name=\"select-15\" data-default-value=\"\" data-placeholder=\"\" data-search=\"false\" aria-labelledby=\"forminator-form-2589__field--select-15_69fde49614860-label\" aria-describedby=\"forminator-form-2589__field--select-15_69fde49614860-description\"><option value=\"oui\"  data-calculation=\"0\">OUI<\/option><option value=\"non\"  data-calculation=\"0\">NON<\/option><\/select><\/div><\/div><div id=\"select-14\" class=\"forminator-field-select forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-form-2589__field--select-14_69fde49614860\" id=\"forminator-form-2589__field--select-14_69fde49614860-label\" class=\"forminator-label\">Votre chat est-il un chat d&#039;int\u00e9rieur ? (il ne sort pas autrement que sur un balcon)<\/label><select id=\"forminator-form-2589__field--select-14_69fde49614860\" class=\"forminator-select--field forminator-select2\" data-required=\"\" name=\"select-14\" data-default-value=\"\" data-placeholder=\"\" data-search=\"false\" aria-labelledby=\"forminator-form-2589__field--select-14_69fde49614860-label\" aria-describedby=\"forminator-form-2589__field--select-14_69fde49614860-description\"><option value=\"oui\"  data-calculation=\"0\">OUI<\/option><option value=\"non\"  data-calculation=\"0\">NON<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-4\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-2589__field--select-4_69fde49614860\" id=\"forminator-form-2589__field--select-4_69fde49614860-label\" class=\"forminator-label\">Votre animal est-il st\u00e9rilis\u00e9 ou castr\u00e9 ?<\/label><select id=\"forminator-form-2589__field--select-4_69fde49614860\" class=\"forminator-select--field forminator-select2\" data-required=\"\" name=\"select-4\" data-default-value=\"\" data-placeholder=\"\" data-search=\"false\" aria-labelledby=\"forminator-form-2589__field--select-4_69fde49614860-label\" aria-describedby=\"forminator-form-2589__field--select-4_69fde49614860-description\"><option value=\"oui\"  data-calculation=\"0\">OUI<\/option><option value=\"non\"  data-calculation=\"0\">NON<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-6\" class=\"forminator-field-select forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-form-2589__field--select-6_69fde49614860\" id=\"forminator-form-2589__field--select-6_69fde49614860-label\" class=\"forminator-label\">Votre animal est-il puc\u00e9 ou tatou\u00e9 ?<\/label><select id=\"forminator-form-2589__field--select-6_69fde49614860\" class=\"forminator-select--field forminator-select2\" data-required=\"\" name=\"select-6\" data-default-value=\"\" data-placeholder=\"\" data-search=\"false\" aria-labelledby=\"forminator-form-2589__field--select-6_69fde49614860-label\" aria-describedby=\"forminator-form-2589__field--select-6_69fde49614860-description\"><option value=\"oui\"  data-calculation=\"0\">OUI<\/option><option value=\"non\"  data-calculation=\"0\">NON<\/option><\/select><\/div><\/div><div id=\"textarea-3\" class=\"forminator-field-textarea forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-3_69fde49614860\" id=\"forminator-field-textarea-3_69fde49614860-label\" class=\"forminator-label\">Pr\u00e9ciser les r\u00e9f\u00e9rences de la puce ou du tatouage<\/label><textarea name=\"textarea-3\" placeholder=\"\" id=\"forminator-field-textarea-3_69fde49614860\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-24\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-2589__field--select-24_69fde49614860\" id=\"forminator-form-2589__field--select-24_69fde49614860-label\" class=\"forminator-label\">Avez-vous eu un contrat sant\u00e9 r\u00e9sili\u00e9 par un autre assureur ?<\/label><select id=\"forminator-form-2589__field--select-24_69fde49614860\" class=\"forminator-select--field forminator-select2\" data-required=\"\" name=\"select-24\" data-default-value=\"\" data-placeholder=\"\" data-search=\"false\" aria-labelledby=\"forminator-form-2589__field--select-24_69fde49614860-label\" aria-describedby=\"forminator-form-2589__field--select-24_69fde49614860-description\"><option value=\"oui\"  data-calculation=\"0\">OUI<\/option><option value=\"non\"  data-calculation=\"0\">NON<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-16\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-2589__field--select-16_69fde49614860\" id=\"forminator-form-2589__field--select-16_69fde49614860-label\" class=\"forminator-label\">Votre animal est-il utilis\u00e9 \u00e0 des fins professionnelles ?<\/label><select id=\"forminator-form-2589__field--select-16_69fde49614860\" class=\"forminator-select--field forminator-select2\" data-required=\"\" name=\"select-16\" data-default-value=\"\" data-placeholder=\"\" data-search=\"false\" aria-labelledby=\"forminator-form-2589__field--select-16_69fde49614860-label\" aria-describedby=\"forminator-form-2589__field--select-16_69fde49614860-description\"><option value=\"oui\"  data-calculation=\"0\">OUI<\/option><option value=\"non\"  data-calculation=\"0\">NON<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-23\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-2589__field--select-23_69fde49614860\" id=\"forminator-form-2589__field--select-23_69fde49614860-label\" class=\"forminator-label\">Votre animal habite-t-il \u00e0 l&#039;adresse ci-dessus ?<\/label><select id=\"forminator-form-2589__field--select-23_69fde49614860\" class=\"forminator-select--field forminator-select2\" data-required=\"\" name=\"select-23\" data-default-value=\"\" data-placeholder=\"\" data-search=\"false\" aria-labelledby=\"forminator-form-2589__field--select-23_69fde49614860-label\" aria-describedby=\"forminator-form-2589__field--select-23_69fde49614860-description\"><option value=\"oui\"  data-calculation=\"0\">OUI<\/option><option value=\"non\"  data-calculation=\"0\">NON<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"address-2\" class=\"forminator-field-address forminator-col forminator-col-12 \"><div class=\"forminator-row\"><div id=\"address-2-street_address\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-address-2-street_address_69fde49614860\" class=\"forminator-label\" id=\"forminator-field-address-2-street_address_69fde49614860-label\">Quelle est son adresse ?<\/label><input type=\"text\" name=\"address-2-street_address\" placeholder=\"\" id=\"forminator-field-address-2-street_address_69fde49614860\" class=\"forminator-input\" data-required=\"\" aria-required=\"false\" value=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\" data-multiple=\"false\"><div id=\"address-2-city\" class=\"forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-address-2-city_69fde49614860\" class=\"forminator-label\" id=\"forminator-field-address-2-city_69fde49614860-label\">Ville<\/label><input type=\"text\" name=\"address-2-city\" placeholder=\"\" id=\"forminator-field-address-2-city_69fde49614860\" class=\"forminator-input\" data-required=\"\" aria-required=\"false\" value=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\" data-multiple=\"false\"><div id=\"address-2-zip\" class=\"forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-address-2-zip_69fde49614860\" class=\"forminator-label\" id=\"forminator-field-address-2-zip_69fde49614860-label\">Code postal<\/label><input type=\"text\" name=\"address-2-zip\" placeholder=\"\" id=\"forminator-field-address-2-zip_69fde49614860\" class=\"forminator-input\" value=\"\" \/><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-7\" class=\"forminator-field-section forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h2 class=\"forminator-title\">Garanties propos\u00e9es<\/h2><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-22\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-2589__field--select-22_69fde49614860\" id=\"forminator-form-2589__field--select-22_69fde49614860-label\" class=\"forminator-label\">FORMULES DE GARANTIES<\/label><select id=\"forminator-form-2589__field--select-22_69fde49614860\" class=\"forminator-select--field forminator-select2\" data-required=\"\" name=\"select-22\" data-default-value=\"\" data-placeholder=\"\" data-search=\"false\" aria-labelledby=\"forminator-form-2589__field--select-22_69fde49614860-label\" aria-describedby=\"forminator-form-2589__field--select-22_69fde49614860-description\"><option value=\"garantie-accident-frais-chirurgicaux\"  data-calculation=\"0\">Garantie Accident\/frais chirurgicaux<\/option><option value=\"garantie-maladieaccidentfraischirurgicaux\"  data-calculation=\"0\">Garantie maladie-accident-frais-chirurgicaux.<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-25\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-2589__field--select-25_69fde49614860\" id=\"forminator-form-2589__field--select-25_69fde49614860-label\" class=\"forminator-label\">Souhaitez vous b\u00e9n\u00e9ficier d&#039;un capital d\u00e9c\u00e8s ?<\/label><select id=\"forminator-form-2589__field--select-25_69fde49614860\" class=\"forminator-select--field forminator-select2\" data-required=\"\" name=\"select-25\" data-default-value=\"\" data-placeholder=\"\" data-search=\"false\" aria-labelledby=\"forminator-form-2589__field--select-25_69fde49614860-label\" aria-describedby=\"forminator-form-2589__field--select-25_69fde49614860-description\"><option value=\"oui\"  data-calculation=\"0\">OUI<\/option><option value=\"non\"  data-calculation=\"0\">NON<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-2\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-2_69fde49614860\" id=\"forminator-field-textarea-2_69fde49614860-label\" class=\"forminator-label\">Informations compl\u00e9mentaires<\/label><textarea name=\"textarea-2\" placeholder=\"Vous souhaitez apporter des pr\u00e9cisions ? \n\u00c9crivez les ici\" id=\"forminator-field-textarea-2_69fde49614860\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div class=\"forminator-row forminator-row-last\"><div class=\"forminator-col\"><div class=\"forminator-field\"><button class=\"forminator-button forminator-button-submit\">Envoyez la demande de devis<\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"fcdf951872\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F2617\" \/><input type=\"hidden\" name=\"form_id\" value=\"2589\"><input type=\"hidden\" name=\"page_id\" value=\"2617\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/aca-pl.com\/?page_id=2617\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><\/form><\/div>\n\n\n\n<p><\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"https:\/\/aca-pl.com\/wp-content\/uploads\/2019\/11\/ACA-15pxX15px-1.png\" alt=\"LOGO ACA\"\/><\/figure><\/div>\n\n\n\n<p class=\"has-text-align-center\"><strong>Quand la passion est un m\u00e9tier<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>L\u2019objectif de ce questionnaire est d\u2019obtenir les informations destin\u00e9es \u00e0 votre \u00e9tude personnalis\u00e9e. Ces informations ne seront en aucun cas transmis \u00e0 des tiers, hormis les assureurs interrog\u00e9s. Merci de s\u00e9lectionner les propositions ou bien de remplir les informations demand\u00e9es. Si certaines r\u00e9ponses propos\u00e9es, ne correspondent pas, indiquez-le-nous dans votre message d\u2019envoi. Quand la passion &hellip; <a href=\"https:\/\/aca-pl.com\/?page_id=2617\" class=\"more-link\">Continuer la lecture de <span class=\"screen-reader-text\">QUESTIONNAIRE CHIENS\/CHATS<\/span>  <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_themeisle_gutenberg_block_has_review":false,"footnotes":""},"class_list":["post-2617","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.9 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>QUESTIONNAIRE CHIENS\/CHATS -<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/aca-pl.com\/?page_id=2617\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"QUESTIONNAIRE CHIENS\/CHATS -\" \/>\n<meta property=\"og:description\" content=\"L\u2019objectif de ce questionnaire est d\u2019obtenir les informations destin\u00e9es \u00e0 votre \u00e9tude personnalis\u00e9e. Ces informations ne seront en aucun cas transmis \u00e0 des tiers, hormis les assureurs interrog\u00e9s. Merci de s\u00e9lectionner les propositions ou bien de remplir les informations demand\u00e9es. Si certaines r\u00e9ponses propos\u00e9es, ne correspondent pas, indiquez-le-nous dans votre message d\u2019envoi. Quand la passion &hellip; Continuer la lecture de QUESTIONNAIRE CHIENS\/CHATS &rarr;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/aca-pl.com\/?page_id=2617\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/groups\/1773349446235806\/?ref=bookmarks\" \/>\n<meta property=\"article:modified_time\" content=\"2020-12-21T14:53:43+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/aca-pl.com\/wp-content\/uploads\/2019\/11\/ACA-15pxX15px-1.png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@AssistanceAudit\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/aca-pl.com\/?page_id=2617\",\"url\":\"https:\/\/aca-pl.com\/?page_id=2617\",\"name\":\"QUESTIONNAIRE CHIENS\/CHATS -\",\"isPartOf\":{\"@id\":\"https:\/\/aca-pl.com\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/aca-pl.com\/?page_id=2617#primaryimage\"},\"image\":{\"@id\":\"https:\/\/aca-pl.com\/?page_id=2617#primaryimage\"},\"thumbnailUrl\":\"https:\/\/aca-pl.com\/wp-content\/uploads\/2019\/11\/ACA-15pxX15px-1.png\",\"datePublished\":\"2020-12-21T14:45:13+00:00\",\"dateModified\":\"2020-12-21T14:53:43+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/aca-pl.com\/?page_id=2617#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/aca-pl.com\/?page_id=2617\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/aca-pl.com\/?page_id=2617#primaryimage\",\"url\":\"https:\/\/aca-pl.com\/wp-content\/uploads\/2019\/11\/ACA-15pxX15px-1.png\",\"contentUrl\":\"https:\/\/aca-pl.com\/wp-content\/uploads\/2019\/11\/ACA-15pxX15px-1.png\",\"width\":125,\"height\":125,\"caption\":\"LOGO ACA\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/aca-pl.com\/?page_id=2617#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Accueil\",\"item\":\"https:\/\/aca-pl.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"QUESTIONNAIRE CHIENS\/CHATS\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/aca-pl.com\/#website\",\"url\":\"https:\/\/aca-pl.com\/\",\"name\":\"\",\"description\":\"Quand la passion est un m\u00e9tier\",\"publisher\":{\"@id\":\"https:\/\/aca-pl.com\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/aca-pl.com\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/aca-pl.com\/#organization\",\"name\":\"AUDIT CONSEIL ASSISTANCE\",\"url\":\"https:\/\/aca-pl.com\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/aca-pl.com\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/aca-pl.com\/wp-content\/uploads\/2019\/11\/ACA-15pxX15px-1.png\",\"contentUrl\":\"https:\/\/aca-pl.com\/wp-content\/uploads\/2019\/11\/ACA-15pxX15px-1.png\",\"width\":125,\"height\":125,\"caption\":\"AUDIT CONSEIL ASSISTANCE\"},\"image\":{\"@id\":\"https:\/\/aca-pl.com\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.facebook.com\/groups\/1773349446235806\/?ref=bookmarks\",\"https:\/\/x.com\/AssistanceAudit\",\"http:\/\/www.linkedin.com\/in\/philippe-b-7a43b342\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"QUESTIONNAIRE CHIENS\/CHATS -","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/aca-pl.com\/?page_id=2617","og_locale":"fr_FR","og_type":"article","og_title":"QUESTIONNAIRE CHIENS\/CHATS -","og_description":"L\u2019objectif de ce questionnaire est d\u2019obtenir les informations destin\u00e9es \u00e0 votre \u00e9tude personnalis\u00e9e. Ces informations ne seront en aucun cas transmis \u00e0 des tiers, hormis les assureurs interrog\u00e9s. Merci de s\u00e9lectionner les propositions ou bien de remplir les informations demand\u00e9es. Si certaines r\u00e9ponses propos\u00e9es, ne correspondent pas, indiquez-le-nous dans votre message d\u2019envoi. Quand la passion &hellip; Continuer la lecture de QUESTIONNAIRE CHIENS\/CHATS &rarr;","og_url":"https:\/\/aca-pl.com\/?page_id=2617","article_publisher":"https:\/\/www.facebook.com\/groups\/1773349446235806\/?ref=bookmarks","article_modified_time":"2020-12-21T14:53:43+00:00","og_image":[{"url":"https:\/\/aca-pl.com\/wp-content\/uploads\/2019\/11\/ACA-15pxX15px-1.png","type":"","width":"","height":""}],"twitter_card":"summary_large_image","twitter_site":"@AssistanceAudit","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/aca-pl.com\/?page_id=2617","url":"https:\/\/aca-pl.com\/?page_id=2617","name":"QUESTIONNAIRE CHIENS\/CHATS -","isPartOf":{"@id":"https:\/\/aca-pl.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/aca-pl.com\/?page_id=2617#primaryimage"},"image":{"@id":"https:\/\/aca-pl.com\/?page_id=2617#primaryimage"},"thumbnailUrl":"https:\/\/aca-pl.com\/wp-content\/uploads\/2019\/11\/ACA-15pxX15px-1.png","datePublished":"2020-12-21T14:45:13+00:00","dateModified":"2020-12-21T14:53:43+00:00","breadcrumb":{"@id":"https:\/\/aca-pl.com\/?page_id=2617#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/aca-pl.com\/?page_id=2617"]}]},{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/aca-pl.com\/?page_id=2617#primaryimage","url":"https:\/\/aca-pl.com\/wp-content\/uploads\/2019\/11\/ACA-15pxX15px-1.png","contentUrl":"https:\/\/aca-pl.com\/wp-content\/uploads\/2019\/11\/ACA-15pxX15px-1.png","width":125,"height":125,"caption":"LOGO ACA"},{"@type":"BreadcrumbList","@id":"https:\/\/aca-pl.com\/?page_id=2617#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Accueil","item":"https:\/\/aca-pl.com\/"},{"@type":"ListItem","position":2,"name":"QUESTIONNAIRE CHIENS\/CHATS"}]},{"@type":"WebSite","@id":"https:\/\/aca-pl.com\/#website","url":"https:\/\/aca-pl.com\/","name":"","description":"Quand la passion est un m\u00e9tier","publisher":{"@id":"https:\/\/aca-pl.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/aca-pl.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/aca-pl.com\/#organization","name":"AUDIT CONSEIL ASSISTANCE","url":"https:\/\/aca-pl.com\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/aca-pl.com\/#\/schema\/logo\/image\/","url":"https:\/\/aca-pl.com\/wp-content\/uploads\/2019\/11\/ACA-15pxX15px-1.png","contentUrl":"https:\/\/aca-pl.com\/wp-content\/uploads\/2019\/11\/ACA-15pxX15px-1.png","width":125,"height":125,"caption":"AUDIT CONSEIL ASSISTANCE"},"image":{"@id":"https:\/\/aca-pl.com\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/groups\/1773349446235806\/?ref=bookmarks","https:\/\/x.com\/AssistanceAudit","http:\/\/www.linkedin.com\/in\/philippe-b-7a43b342"]}]}},"_links":{"self":[{"href":"https:\/\/aca-pl.com\/index.php?rest_route=\/wp\/v2\/pages\/2617","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/aca-pl.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/aca-pl.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/aca-pl.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/aca-pl.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2617"}],"version-history":[{"count":4,"href":"https:\/\/aca-pl.com\/index.php?rest_route=\/wp\/v2\/pages\/2617\/revisions"}],"predecessor-version":[{"id":2625,"href":"https:\/\/aca-pl.com\/index.php?rest_route=\/wp\/v2\/pages\/2617\/revisions\/2625"}],"wp:attachment":[{"href":"https:\/\/aca-pl.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2617"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}