{"id":2114,"date":"2024-08-03T15:44:40","date_gmt":"2024-08-03T13:44:40","guid":{"rendered":"https:\/\/souslaileduphoenix.com\/?page_id=2114"},"modified":"2024-08-03T16:44:21","modified_gmt":"2024-08-03T14:44:21","slug":"quizz-quelle-seance-choisir","status":"publish","type":"page","link":"https:\/\/souslaileduphoenix.com\/index.php\/quizz-quelle-seance-choisir\/","title":{"rendered":"Questionnaire : Niromath\u00e9, Total Reset, Kin\u00e9siologie, \u2026 quelle s\u00e9ance choisir ?"},"content":{"rendered":"<p><div id=\"forminator-quiz-leads-2110\" class=\"forminator-ui forminator-quiz-leads forminator-quiz--list\" data-design=\"default\" data-color-option=\"default\" data-spacing=&quot;default&quot; data-alignment=&quot;center&quot;><div class=\"forminator-quiz-intro\">\n\t\t\t\t\t<h3 class=\"forminator-quiz--title\">Quelle s\u00e9ance choisir ?<\/h3>\n\t\t\n\t\t\n\t\t\t\t\t<div class=\"forminator-quiz--description\"><p>Total Reset, kin\u00e9siologie, m\u00e9thode Niromath\u00e9 \u2026 ce n\u2019est pas toujours simple de choisir entre mes diff\u00e9rentes pratiques.&nbsp;<br>Alors j\u2019ai cr\u00e9\u00e9 ce questionnaire pour que vous puissiez mieux vous orienter !&nbsp;<br><br><\/p>\n<p>Je serai \u00e9galement ravie de r\u00e9pondre \u00e0 vos questions par mail \u00e0 contact@souslaileduphoenix.com ou par t\u00e9l\u00e9phone au <a href=\"tel:06.61.08.68.28\">06.61.08.68.18<\/a>.<\/p>\n<p><em>Attention, les r\u00e9ponses du questionnaire sont \u00e0 titre indicatif, seul un entretien individuel me permettra de vous orienter au mieux.&nbsp;<\/em><\/p><\/div>\n\t\t\n\t\t<button class=\"forminator-button forminator-quiz-start\" style=\"margin: 0 auto; display: block;\">Commencer le questionnaire<\/button><\/div><form\n\t\t\t\tid=\"forminator-module-2110\"\n\t\t\t\tclass=\"forminator-ui forminator-quiz forminator-quiz-2110 forminator-quiz--list forminator-design--default  \"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"2110\"\n\t\t\t\t data-color-option=\"default\" data-design=\"default\" data-quiz=\"nowrong\" aria-live=\"polite\" data-spacing=\"default\" data-alignment=\"center\" style=\"display: none;\"\n\t\t\t\tdata-uid=\"6a8c21cd20d62\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error forminator-hidden\"><\/div><div role=\"tabpanel\" id=\"forminator-custom-form-2110--page-0\" class=\"forminator-pagination forminator-hidden\" aria-labelledby=\"forminator-custom-form-2110--page-0-label\" data-step=\"0\" data-label=\"Page 0\"><div class=\"forminator-pagination--content\"><div class=\"forminator-page-indicator\"><span>Page 1 sur 4<\/span><\/div>\n\t\t<div\n\t\t\ttabindex=\"0\"\n\t\t\trole=\"radiogroup\"\n\t\t\tid=\"question-1225-4650\"\n\t\t\tclass=\"forminator-question\"\n\t\t\tdata-question-type=\"personality\"\n\t\t\taria-labelledby=\"question-1225-4650-label\"\n\t\t\taria-describedby=\"question-1225-4650-description\"\n\t\t\taria-required=\"true\"\n\t\t>\n\n\t\t\t<span id=\"question-1225-4650-label\" class=\"forminator-legend\">Quel est l\u2019\u00e2ge de la personne concern\u00e9e par la s\u00e9ance ?<\/span>\n\t\t\t\n\t\t\t\t\t<label for=\"question-1225-4650-0-6a8c21cd22114\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-1225-4650]\"\n\t\t\t\t\t\t\tvalue=\"0\"\n\t\t\t\t\t\t\tid=\"question-1225-4650-0-6a8c21cd22114\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-1225-4650-0-6a8c21cd22114\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Moins de 4 ans<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-1225-4650-1-6a8c21cd22114\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-1225-4650]\"\n\t\t\t\t\t\t\tvalue=\"1\"\n\t\t\t\t\t\t\tid=\"question-1225-4650-1-6a8c21cd22114\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-1225-4650-1-6a8c21cd22114\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">4 \u00e0 8 ans<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-1225-4650-2-6a8c21cd22114\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-1225-4650]\"\n\t\t\t\t\t\t\tvalue=\"2\"\n\t\t\t\t\t\t\tid=\"question-1225-4650-2-6a8c21cd22114\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-1225-4650-2-6a8c21cd22114\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">8 ans et +<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-1225-4650-3-6a8c21cd22114\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-1225-4650]\"\n\t\t\t\t\t\t\tvalue=\"3\"\n\t\t\t\t\t\t\tid=\"question-1225-4650-3-6a8c21cd22114\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-1225-4650-3-6a8c21cd22114\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Adulte<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t<\/div>\n\n\t\t<\/div><\/div><div role=\"tabpanel\" id=\"forminator-custom-form-2110--page-1\" class=\"forminator-pagination forminator-hidden\" aria-labelledby=\"forminator-custom-form-2110--page-1-label\" data-step=\"1\" data-label=\"Page 1\"><div class=\"forminator-pagination--content\"><div class=\"forminator-page-indicator\"><span>Page 2 sur 4<\/span><\/div>\n\t\t<div\n\t\t\ttabindex=\"0\"\n\t\t\trole=\"radiogroup\"\n\t\t\tid=\"question-9701-9827\"\n\t\t\tclass=\"forminator-question\"\n\t\t\tdata-question-type=\"personality\"\n\t\t\taria-labelledby=\"question-9701-9827-label\"\n\t\t\taria-describedby=\"question-9701-9827-description\"\n\t\t\taria-required=\"true\"\n\t\t>\n\n\t\t\t<span id=\"question-9701-9827-label\" class=\"forminator-legend\">Quel genre d\u2019accompagnement cherchez-vous ?<\/span>\n\t\t\t\n\t\t\t\t\t<label for=\"question-9701-9827-0-6a8c21cd2218b\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-9701-9827]\"\n\t\t\t\t\t\t\tvalue=\"0\"\n\t\t\t\t\t\t\tid=\"question-9701-9827-0-6a8c21cd2218b\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-9701-9827-0-6a8c21cd2218b\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Rapide, efficace, cibl\u00e9<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-9701-9827-1-6a8c21cd2218b\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-9701-9827]\"\n\t\t\t\t\t\t\tvalue=\"1\"\n\t\t\t\t\t\t\tid=\"question-9701-9827-1-6a8c21cd2218b\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-9701-9827-1-6a8c21cd2218b\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Soulagement de la douleur physique uniquement<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-9701-9827-2-6a8c21cd2218b\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-9701-9827]\"\n\t\t\t\t\t\t\tvalue=\"2\"\n\t\t\t\t\t\t\tid=\"question-9701-9827-2-6a8c21cd2218b\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-9701-9827-2-6a8c21cd2218b\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Global et profond<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t<\/div>\n\n\t\t<\/div><\/div><div role=\"tabpanel\" id=\"forminator-custom-form-2110--page-2\" class=\"forminator-pagination forminator-hidden\" aria-labelledby=\"forminator-custom-form-2110--page-2-label\" data-step=\"2\" data-label=\"Page 2\"><div class=\"forminator-pagination--content\"><div class=\"forminator-page-indicator\"><span>Page 3 sur 4<\/span><\/div>\n\t\t<div\n\t\t\ttabindex=\"0\"\n\t\t\trole=\"radiogroup\"\n\t\t\tid=\"question-1097-1910\"\n\t\t\tclass=\"forminator-question\"\n\t\t\tdata-question-type=\"personality\"\n\t\t\taria-labelledby=\"question-1097-1910-label\"\n\t\t\taria-describedby=\"question-1097-1910-description\"\n\t\t\taria-required=\"true\"\n\t\t>\n\n\t\t\t<span id=\"question-1097-1910-label\" class=\"forminator-legend\">Quel est votre motif principal de consultation ?<\/span>\n\t\t\t\n\t\t\t\t\t<label for=\"question-1097-1910-0-6a8c21cd221cc\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-1097-1910]\"\n\t\t\t\t\t\t\tvalue=\"0\"\n\t\t\t\t\t\t\tid=\"question-1097-1910-0-6a8c21cd221cc\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-1097-1910-0-6a8c21cd221cc\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">D\u00e9veloppement personnel<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-1097-1910-1-6a8c21cd221cc\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-1097-1910]\"\n\t\t\t\t\t\t\tvalue=\"1\"\n\t\t\t\t\t\t\tid=\"question-1097-1910-1-6a8c21cd221cc\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-1097-1910-1-6a8c21cd221cc\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">\u00c9motionnel : gestion, stress, deuil, addictions, traumatismes, \u2026<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-1097-1910-2-6a8c21cd221cc\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-1097-1910]\"\n\t\t\t\t\t\t\tvalue=\"2\"\n\t\t\t\t\t\t\tid=\"question-1097-1910-2-6a8c21cd221cc\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-1097-1910-2-6a8c21cd221cc\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Douleurs chroniques, aigues<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-1097-1910-3-6a8c21cd221cc\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-1097-1910]\"\n\t\t\t\t\t\t\tvalue=\"3\"\n\t\t\t\t\t\t\tid=\"question-1097-1910-3-6a8c21cd221cc\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-1097-1910-3-6a8c21cd221cc\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Relationnel : communication, savoir dire non, poser ses limites, \u2026<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-1097-1910-4-6a8c21cd221cc\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-1097-1910]\"\n\t\t\t\t\t\t\tvalue=\"4\"\n\t\t\t\t\t\t\tid=\"question-1097-1910-4-6a8c21cd221cc\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-1097-1910-4-6a8c21cd221cc\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Vie quotidienne : alimentation, sommeil, \u2026<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-1097-1910-5-6a8c21cd221cc\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-1097-1910]\"\n\t\t\t\t\t\t\tvalue=\"5\"\n\t\t\t\t\t\t\tid=\"question-1097-1910-5-6a8c21cd221cc\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-1097-1910-5-6a8c21cd221cc\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Apprentissages : scolarit\u00e9, propret\u00e9, TDA, TDAH \u2026<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-1097-1910-6-6a8c21cd221cc\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-1097-1910]\"\n\t\t\t\t\t\t\tvalue=\"6\"\n\t\t\t\t\t\t\tid=\"question-1097-1910-6-6a8c21cd221cc\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-1097-1910-6-6a8c21cd221cc\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Syst\u00e8me immunitaire : allergies, intol\u00e9rances, maladies auto-immunes, asthme, \u2026<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-1097-1910-7-6a8c21cd221cc\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-1097-1910]\"\n\t\t\t\t\t\t\tvalue=\"7\"\n\t\t\t\t\t\t\tid=\"question-1097-1910-7-6a8c21cd221cc\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-1097-1910-7-6a8c21cd221cc\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Probl\u00e8mes de peaux<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-1097-1910-8-6a8c21cd221cc\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-1097-1910]\"\n\t\t\t\t\t\t\tvalue=\"8\"\n\t\t\t\t\t\t\tid=\"question-1097-1910-8-6a8c21cd221cc\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-1097-1910-8-6a8c21cd221cc\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Autres<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t<\/div>\n\n\t\t<\/div><\/div><div role=\"tabpanel\" id=\"forminator-custom-form-2110--page-3\" class=\"forminator-pagination forminator-hidden\" aria-labelledby=\"forminator-custom-form-2110--page-3-label\" data-step=\"3\" data-label=\"Page 3\"><div class=\"forminator-pagination--content\"><div class=\"forminator-page-indicator\"><span>Page 4 sur 4<\/span><\/div>\n\t\t<div\n\t\t\ttabindex=\"0\"\n\t\t\trole=\"radiogroup\"\n\t\t\tid=\"question-2295-2062\"\n\t\t\tclass=\"forminator-question\"\n\t\t\tdata-question-type=\"personality\"\n\t\t\taria-labelledby=\"question-2295-2062-label\"\n\t\t\taria-describedby=\"question-2295-2062-description\"\n\t\t\taria-required=\"true\"\n\t\t>\n\n\t\t\t<span id=\"question-2295-2062-label\" class=\"forminator-legend\">Pr\u00e9cisons un peu votre demande<\/span>\n\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-0-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"0\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-0-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-0-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Douleurs chroniques<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-1-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"1\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-1-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-1-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Douleurs aigu\u00ebs<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-2-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"2\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-2-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-2-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Anxi\u00e9t\u00e9, stress, peurs, crises d\u2019angoisse<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-3-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"3\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-3-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-3-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Troubles du sommeil<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-4-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"4\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-4-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-4-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Fatigue chronique<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-5-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"5\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-5-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-5-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Addictions, compulsions, TOC, tabac, drogues<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-6-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"6\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-6-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-6-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Alimentation, poids<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-7-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"7\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-7-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-7-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Allergies, intol\u00e9rances<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-8-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"8\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-8-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-8-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Maladies auto-immunes<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-9-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"9\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-9-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-9-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Probl\u00e8mes de peau<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-10-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"10\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-10-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-10-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Difficult\u00e9s relationnelles<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-11-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"11\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-11-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-11-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Difficult\u00e9s d\u2019apprentissages, retard de langage, \u2026<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-12-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"12\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-12-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-12-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Troubles dys., TDA, TDAH, \u2026<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-13-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"13\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-13-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-13-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Deuil, peine de c\u0153ur<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-14-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"14\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-14-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-14-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Asthme<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-15-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"15\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-15-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-15-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Tristesse excessive<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-16-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"16\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-16-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-16-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Gestion de la col\u00e8re<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-17-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"17\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-17-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-17-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">\u00c9nur\u00e9sie<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-18-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"18\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-18-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-18-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Difficult\u00e9s \u00e0 se s\u00e9parer<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-19-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"19\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-19-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-19-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Gestion d\u2019un traumatisme<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-20-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"20\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-20-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-20-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Apprendre \u00e0 mieux se conna\u00eetre<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-21-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"21\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-21-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-21-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Augmenter sa confiance en soi<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-22-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"22\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-22-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-22-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Troubles digestifs<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-23-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"23\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-23-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-23-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Maladies du syst\u00e8me digestif<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-24-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"24\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-24-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-24-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">D\u00e9r\u00e8glements hormonaux<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t\t\t\t<label for=\"question-2295-2062-25-6a8c21cd2222d\" class=\"forminator-answer forminator-only--text\">\n\n\t\t\t\t\t\t<input\n\t\t\t\t\t\t\ttype=\"radio\"\n\t\t\t\t\t\t\tname=\"answers[question-2295-2062]\"\n\t\t\t\t\t\t\tvalue=\"25\"\n\t\t\t\t\t\t\tid=\"question-2295-2062-25-6a8c21cd2222d\"\n\t\t\t\t\t\t\tclass=\"\"\n\t\t\t\t\t\t\/>\n\n\t\t\t\t\t\t<span class=\"forminator-answer--design\" for=\"question-2295-2062-25-6a8c21cd2222d\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t<span class=\"forminator-answer--status\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t<i class=\"forminator-icon-check\"><\/i>\n\t\t\t\t\t\t<\/span>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"forminator-answer--name\">Autres<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/label>\n\n\t\t\t\t\t\n\t\t<\/div>\n\n\t\t<\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div role=\"tabpanel\" id=\"forminator-custom-form-2110--page-4\" class=\"forminator-pagination forminator-hidden\" aria-labelledby=\"forminator-custom-form-2110--page-4-label\" data-step=\"4\" data-label=\"Page 4\"><div class=\"forminator-pagination--content\"><div class=\"forminator-quiz--result\"><button class=\"forminator-button forminator-button-submit  forminator-pagination-submit\" data-loading=\"Calcul du r\u00e9sultat\" >Pr\u00eat \u00e0 envoyer<\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"3752596fee\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php\/wp-json\/wp\/v2\/pages\/2114\" \/><input type=\"hidden\" name=\"has_lead\" value=\"1\"><input type=\"hidden\" name=\"form_id\" value=\"2110\"><input type=\"hidden\" name=\"page_id\" value=\"2114\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/souslaileduphoenix.com\/index.php\/quizz-quelle-seance-choisir\/\"><input type=\"hidden\" name=\"entry_id\" value=\"\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_quizzes\" \/><\/form><div class=\"forminator-ui forminator-custom-form forminator-custom-form-2109 forminator-design--default  forminator_ajax forminator-leads-form\" data-forminator-render=\"0\" data-form=\"forminator-module-2109\" data-uid=\"6a8c21cd22387\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-2109\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-2109 forminator-design--default  forminator_ajax forminator-leads-form\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"2109\"\n\t\t\t\t data-color-option=\"default\" data-design=\"default\" data-grid=\"open\" style=\"display: none;\"\n\t\t\t\tdata-uid=\"6a8c21cd22387\"\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-1\" class=\"forminator-field-html forminator-col forminator-col-12 \"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-1\"><p>Please provide your contact information to proceed.<\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_6a8c21cd22387\" id=\"forminator-field-email-1_6a8c21cd22387-label\" class=\"forminator-label\">Adresse de messagerie <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"Par exemple\u00a0: jacques@martin.com\" id=\"forminator-field-email-1_6a8c21cd22387\" class=\"forminator-input forminator-email--field\" data-required=\"true\" aria-required=\"true\" autocomplete=\"email\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-1_6a8c21cd22387\" id=\"forminator-field-name-1_6a8c21cd22387-label\" class=\"forminator-label\">Pr\u00e9nom <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"Par exemple\u00a0: Jean\" id=\"forminator-field-name-1_6a8c21cd22387\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" autocomplete=\"name\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-2\" class=\"forminator-field-name forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-2_6a8c21cd22387\" id=\"forminator-field-name-2_6a8c21cd22387-label\" class=\"forminator-label\">Nom <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-2\" value=\"\" placeholder=\"Par exemple\u00a0: Jacques Martin\" id=\"forminator-field-name-2_6a8c21cd22387\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" autocomplete=\"name\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"consent-2\" class=\"forminator-field-consent forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-consent-2_6a8c21cd22387\" id=\"forminator-field-consent-2_6a8c21cd22387-label\" class=\"forminator-label\">Information <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-2_6a8c21cd22387__label\" class=\"forminator-checkbox forminator-consent\"><input type=\"checkbox\" name=\"consent-2\" id=\"forminator-field-consent-2_6a8c21cd22387\" value=\"checked\" aria-labelledby=\"forminator-field-consent-2_6a8c21cd22387-label\" aria-describedby=\"forminator-field-consent-2_6a8c21cd22387__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-2_6a8c21cd22387__description\" class=\"forminator-checkbox__label forminator-consent__label\"><p>J\u2019ai connaissance que ce questionnaire me donne des informations \u00e0 titre indicatif seulement.&nbsp;<\/p><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"consent-1\" class=\"forminator-field-consent forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-consent-1_6a8c21cd22387\" id=\"forminator-field-consent-1_6a8c21cd22387-label\" class=\"forminator-label\">Consentement <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-1_6a8c21cd22387__label\" class=\"forminator-checkbox forminator-consent\"><input type=\"checkbox\" name=\"consent-1\" id=\"forminator-field-consent-1_6a8c21cd22387\" value=\"checked\" aria-labelledby=\"forminator-field-consent-1_6a8c21cd22387-label\" aria-describedby=\"forminator-field-consent-1_6a8c21cd22387__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-1_6a8c21cd22387__description\" class=\"forminator-checkbox__label forminator-consent__label\"><p>Oui, j\u2019accepte la <a href=\"https:\/\/souslaileduphoenix.com\/index.php\/politique-de-confidentialite\/\">politique de confidentialit\u00e9<\/a> et les <a href=\"https:\/\/souslaileduphoenix.com\/index.php\/conditions-generales-de-vente-cgv\/\">conditions g\u00e9n\u00e9rales de vente.<\/a><\/p><\/div><\/div><\/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\">Envoyer<\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"68864a50ee\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php\/wp-json\/wp\/v2\/pages\/2114\" \/><input type=\"hidden\" name=\"form_id\" value=\"2109\"><input 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