{"id":3977,"date":"2024-05-05T21:40:24","date_gmt":"2024-05-05T21:40:24","guid":{"rendered":"https:\/\/conmedicgroupe.com\/v1\/?page_id=3977"},"modified":"2024-05-19T13:29:15","modified_gmt":"2024-05-19T13:29:15","slug":"form-to-fill-out","status":"publish","type":"page","link":"https:\/\/conmedicgroupe.com\/v1\/form-to-fill-out\/","title":{"rendered":"Form to fill out"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"3977\" class=\"elementor elementor-3977\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4d610a7 e-con-full e-flex e-con e-parent\" data-id=\"4d610a7\" data-element_type=\"container\">\n\t\t\r\n\t\t<div class=\"elementor-element elementor-element-83975ee elementor-widget elementor-widget-image\" data-id=\"83975ee\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.21.0 - 25-04-2024 *\/\n.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=\".svg\"]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block}<\/style>\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"600\" height=\"332\" src=\"https:\/\/conmedicgroupe.com\/v1\/wp-content\/uploads\/2024\/05\/Design-sans-titre-33-600x332.png\" class=\"attachment-woocommerce_single size-woocommerce_single wp-image-4862\" alt=\"\" srcset=\"https:\/\/conmedicgroupe.com\/v1\/wp-content\/uploads\/2024\/05\/Design-sans-titre-33-600x332.png 600w, https:\/\/conmedicgroupe.com\/v1\/wp-content\/uploads\/2024\/05\/Design-sans-titre-33-300x166.png 300w, https:\/\/conmedicgroupe.com\/v1\/wp-content\/uploads\/2024\/05\/Design-sans-titre-33-1024x566.png 1024w, https:\/\/conmedicgroupe.com\/v1\/wp-content\/uploads\/2024\/05\/Design-sans-titre-33-768x425.png 768w, https:\/\/conmedicgroupe.com\/v1\/wp-content\/uploads\/2024\/05\/Design-sans-titre-33.png 1335w\" sizes=\"(max-width: 600px) 100vw, 600px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0d39902 elementor-widget__width-initial fluent-form-widget-step-header-yes fluent-form-widget-step-progressbar-yes fluentform-widget-submit-button-custom elementor-widget elementor-widget-fluent-form-widget\" data-id=\"0d39902\" data-element_type=\"widget\" data-widget_type=\"fluent-form-widget.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\n            <div class=\"fluentform-widget-wrapper fluentform-widget-custom-radio-checkbox fluentform-widget-align-default\">\n\n            \n            <div class='fluentform ff-default fluentform_wrapper_4 ffs_default_wrap'><form data-form_id=\"4\" id=\"fluentform_4\" class=\"frm-fluent-form fluent_form_4 ff-el-form-top ff_form_instance_4_1 ff-form-loading ffs_default\" data-form_instance=\"ff_form_instance_4_1\" method=\"POST\" ><fieldset  style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;box-shadow: none!important;outline: none!important; min-inline-size: 100%;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"display: block; margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;overflow:hidden;\">form to fill out<\/legend><input type='hidden' name='__fluent_form_embded_post_id' value='331' \/><input type=\"hidden\" id=\"_fluentform_4_fluentformnonce\" name=\"_fluentform_4_fluentformnonce\" value=\"ed5623808a\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/v1\/wp-json\/wp\/v2\/pages\/3977\" \/><div class='ff-el-group  ff-custom_html' data-name=\"custom_html-4_1\" ><h3 style=\"text-align: center\"><strong>Enterprise\u00a0\u00a0<\/strong><\/h3><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_4_company' aria-label=\"Company\">Company<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"company\" class=\"ff-el-form-control\" placeholder=\"Type your company name\" data-name=\"company\" id=\"ff_4_company\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class=\"ff-name-address-wrapper fluent-address ff_map_autocomplete\" data-type=\"address-element\" data-name=\"address_1\" data-ff_with_g_map=\"1\" data-ff_with_auto_locate=\"on_click\" ><div class='ff-el-input--content'><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_4_address_1_address_line_1_' aria-label=\"Address Line \">Address Line <\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[address_line_1]\" id=\"ff_4_address_1_address_line_1_\" class=\"ff-el-form-control\" placeholder=\"Address Line \" data-key_name=\"address_line_1\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_4_address_1_city_' aria-label=\"City\">City<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[city]\" id=\"ff_4_address_1_city_\" class=\"ff-el-form-control\" placeholder=\"City\" data-key_name=\"city\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group  ff-custom_html' data-name=\"custom_html-4_2\" ><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_4_input_text_1' aria-label=\"company&#039;s activity\">company's activity<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_1\" class=\"ff-el-form-control\" data-name=\"input_text_1\" id=\"ff_4_input_text_1\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group  ff-custom_html' data-name=\"custom_html-4_3\" ><h3 style=\"text-align: center\"><strong>Contact<\/strong><\/h3><\/div><div data-name=\"ff_cn_id_1\"  class='ff-t-container ff-column-container ff_columns_total_2 client_type '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 40%;'><div class='ff-el-group Column_type ff_list_buttons'><div class='ff-el-input--content'><div class=\"ff_el_checkable_photo_holders\"><div class='ff-el-form-check ff-el-form-check- ff-el-image-holder'><label style='background-image: url(https:\/\/conmedicgroupe.com\/v1\/wp-content\/uploads\/2024\/05\/courrier-de-livraison-1.png)' class='ff-el-image-input-src' for='input_radio_1ea3f99cc0e70478e0e2b3bd2985de7b' aria-label='Supplier '><\/label><label class='ff-el-form-check-label' for=input_radio_1ea3f99cc0e70478e0e2b3bd2985de7b><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Supplier \"  id='input_radio_1ea3f99cc0e70478e0e2b3bd2985de7b' aria-label='Supplier ' aria-invalid='false' aria-required=false> <span>Supplier <\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check- ff-el-image-holder'><label style='background-image: url(https:\/\/conmedicgroupe.com\/v1\/wp-content\/uploads\/2024\/05\/customer-review-1.png)' class='ff-el-image-input-src' for='input_radio_b362c9b08d46e42c142ae0525a91a2dd' aria-label='Costumer '><\/label><label class='ff-el-form-check-label' for=input_radio_b362c9b08d46e42c142ae0525a91a2dd><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Costumer \"  id='input_radio_b362c9b08d46e42c142ae0525a91a2dd' aria-label='Costumer ' aria-invalid='false' aria-required=false> <span>Costumer <\/span><\/label><\/div><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 40%;'><div class='ff-el-group Column_nat ff_list_buttons'><div class='ff-el-input--content'><div class=\"ff_el_checkable_photo_holders\"><div class='ff-el-form-check ff-el-form-check- ff-el-image-holder'><label style='background-image: url(https:\/\/conmedicgroupe.com\/v1\/wp-content\/uploads\/2024\/05\/maroc-1.png)' class='ff-el-image-input-src' for='input_radio_2_8605f7a5bd48882c0b37de217ded3885' aria-label='National'><\/label><label class='ff-el-form-check-label' for=input_radio_2_8605f7a5bd48882c0b37de217ded3885><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"National\"  id='input_radio_2_8605f7a5bd48882c0b37de217ded3885' aria-label='National' aria-invalid='false' aria-required=false> <span>National<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check- ff-el-image-holder'><label style='background-image: url(https:\/\/conmedicgroupe.com\/v1\/wp-content\/uploads\/2024\/05\/mondial-1.png)' class='ff-el-image-input-src' for='input_radio_2_eb9d92a691dc406217023f60e03937b9' aria-label='International '><\/label><label class='ff-el-form-check-label' for=input_radio_2_eb9d92a691dc406217023f60e03937b9><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"International \"  id='input_radio_2_eb9d92a691dc406217023f60e03937b9' aria-label='International ' aria-invalid='false' aria-required=false> <span>International <\/span><\/label><\/div><\/div><\/div><\/div><\/div><\/div><div data-type=\"name-element\" data-name=\"names\" class=\" ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_4_names_first_name_' aria-label=\"First Name\">First Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names[first_name]\" id=\"ff_4_names_first_name_\" class=\"ff-el-form-control\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_4_names_last_name_' aria-label=\"Last Name\">Last Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names[last_name]\" id=\"ff_4_names_last_name_\" class=\"ff-el-form-control\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_4_input_text' aria-label=\"Function\">Function<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text\" class=\"ff-el-form-control\" data-name=\"input_text\" id=\"ff_4_input_text\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_4_email' aria-label=\"Email\">Email<\/label><\/div><div class='ff-el-input--content'><input type=\"email\" name=\"email\" id=\"ff_4_email\" class=\"ff-el-form-control\" placeholder=\"you@domain.com\" data-name=\"email\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><input type=\"hidden\" name=\"client_code\" value=\"004\/16\/2026\" data-name=\"client_code\" ><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_4_phone_1' aria-label=\"Phone\">Phone<\/label><\/div><div class='ff-el-input--content'><input name=\"phone_1\" class=\"ff-el-form-control ff-el-phone ff_el_with_extended_validation\" type=\"tel\" placeholder=\"Phone  Number\" data-name=\"phone_1\" id=\"ff_4_phone_1\" inputmode=\"tel\"  aria-invalid='false' aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_4_message' aria-label=\"Message (if any)\">Message (if any)<\/label><\/div><div class='ff-el-input--content'><textarea aria-invalid=\"false\" aria-required=false name=\"message\" id=\"ff_4_message\" class=\"ff-el-form-control\" rows=\"4\" cols=\"2\" data-name=\"message\" ><\/textarea><\/div><\/div><div class='ff-el-group ff-text-center ff_submit_btn_wrapper'><button type=\"submit\" class=\"ff-btn ff-btn-submit ff-btn-md ff_btn_style\" >Send <\/button><\/div><\/fieldset><\/form><div id='fluentform_4_errors' class='ff-errors-in-stack ff_form_instance_4_1 ff-form-loading_errors ff_form_instance_4_1_errors'><\/div><\/div>        <script type=\"text\/javascript\">\n            window.fluent_form_ff_form_instance_4_1 = {\"id\":\"4\",\"settings\":{\"layout\":{\"labelPlacement\":\"top\",\"helpMessagePlacement\":\"with_label\",\"errorMessagePlacement\":\"inline\",\"cssClassName\":\"\",\"asteriskPlacement\":\"asterisk-right\"},\"restrictions\":{\"denyEmptySubmission\":{\"enabled\":false}}},\"form_instance\":\"ff_form_instance_4_1\",\"form_id_selector\":\"fluentform_4\",\"rules\":{\"company\":{\"required\":{\"value\":false,\"message\":\"Company field is required\",\"global\":false,\"global_message\":\"This field is required\"}},\"address_1[address_line_1]\":{\"required\":{\"value\":false,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"address_1[address_line_2]\":{\"required\":{\"value\":false,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"address_1[city]\":{\"required\":{\"value\":false,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"address_1[state]\":{\"required\":{\"value\":false,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"address_1[zip]\":{\"required\":{\"value\":false,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"address_1[country]\":{\"required\":{\"value\":false,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"input_text_1\":{\"required\":{\"value\":false,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"input_radio\":{\"required\":{\"value\":false,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"input_radio_2\":{\"required\":{\"value\":false,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"names[first_name]\":{\"required\":{\"value\":true,\"message\":\"This field is required\",\"global\":true,\"global_message\":\"This field is required\"}},\"names[middle_name]\":{\"required\":{\"value\":false,\"message\":\"This field is required\",\"global\":true,\"global_message\":\"This field is required\"}},\"names[last_name]\":{\"required\":{\"value\":true,\"message\":\"This field is required\",\"global\":true,\"global_message\":\"This field is required\"}},\"input_text\":{\"required\":{\"value\":false,\"message\":\"This field is required\",\"global_message\":\"This field is required\",\"global\":true}},\"email\":{\"required\":{\"value\":true,\"message\":\"Email field is required\",\"global\":false,\"global_message\":\"This field is required\"},\"email\":{\"value\":true,\"message\":\"This field must contain a valid email\",\"global\":true,\"global_message\":\"This field must contain a valid email\"}},\"phone_1\":{\"required\":{\"value\":true,\"global\":true,\"message\":\"This field is required\",\"global_message\":\"This field is required\"},\"valid_phone_number\":{\"value\":true,\"global\":true,\"message\":\"Phone number is not valid\",\"global_message\":\"Phone number is not valid\"}},\"message\":{\"required\":{\"value\":false,\"message\":\"This field is required\",\"global\":true,\"global_message\":\"This field is required\"}}}};\n                    <\/script>\n                    <\/div>\n\n            \t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>form to fill out Enterprise\u00a0\u00a0 CompanyAddress Line City Contact Supplier Costumer National International First NameLast NameFunctionEmailPhonecompany&#8217;s activityMessage (if any)Send<\/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-3977","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/conmedicgroupe.com\/v1\/wp-json\/wp\/v2\/pages\/3977","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/conmedicgroupe.com\/v1\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/conmedicgroupe.com\/v1\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/conmedicgroupe.com\/v1\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/conmedicgroupe.com\/v1\/wp-json\/wp\/v2\/comments?post=3977"}],"version-history":[{"count":74,"href":"https:\/\/conmedicgroupe.com\/v1\/wp-json\/wp\/v2\/pages\/3977\/revisions"}],"predecessor-version":[{"id":5040,"href":"https:\/\/conmedicgroupe.com\/v1\/wp-json\/wp\/v2\/pages\/3977\/revisions\/5040"}],"wp:attachment":[{"href":"https:\/\/conmedicgroupe.com\/v1\/wp-json\/wp\/v2\/media?parent=3977"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}