{"id":1830,"date":"2023-09-15T14:36:42","date_gmt":"2023-09-15T14:36:42","guid":{"rendered":"https:\/\/www.aristoassurance.ca\/index.php\/jet-popup\/classic-2\/"},"modified":"2025-02-21T15:15:26","modified_gmt":"2025-02-21T20:15:26","slug":"classic-2","status":"publish","type":"jet-popup","link":"https:\/\/www.aristoassurance.ca\/index.php\/jet-popup\/classic-2\/","title":{"rendered":"Demande de soumissions"},"content":{"rendered":"\t\t<div data-elementor-type=\"jet-popup\" data-elementor-id=\"1830\" class=\"elementor elementor-1830\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-af57686 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"af57686\" data-element_type=\"section\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-93fa962\" data-id=\"93fa962\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9706e95 elementor-widget elementor-widget-heading\" data-id=\"9706e95\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.16.0 - 14-09-2023 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h2 class=\"elementor-heading-title elementor-size-default\">Demande de soumission!<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d481680 raven-form-button-align-spaced raven-form-button-icon-left elementor-widget elementor-widget-raven-form\" data-id=\"d481680\" data-element_type=\"widget\" data-settings=\"{&quot;fields&quot;:[{&quot;label&quot;:&quot;Pr\\u00e9nom&quot;,&quot;field_custom_id&quot;:&quot;name&quot;,&quot;placeholder&quot;:&quot;Pr\\u00e9nom&quot;,&quot;_id&quot;:&quot;b3bb42c&quot;,&quot;acceptance_text&quot;:null,&quot;step_previous_button&quot;:null,&quot;step_next_button&quot;:null,&quot;width&quot;:&quot;50&quot;,&quot;required&quot;:&quot;true&quot;,&quot;type&quot;:&quot;text&quot;,&quot;recaptcha_badge&quot;:null,&quot;recaptcha_theme&quot;:null,&quot;recaptcha_size&quot;:null,&quot;checked_by_default&quot;:null,&quot;min_time&quot;:null,&quot;max_time&quot;:null,&quot;min_date&quot;:null,&quot;max_date&quot;:null,&quot;localization&quot;:null,&quot;min&quot;:null,&quot;max&quot;:null,&quot;field_options&quot;:null,&quot;inline_list&quot;:null,&quot;native_html5&quot;:null,&quot;multiple_selection&quot;:null,&quot;rows&quot;:null,&quot;iti_tel&quot;:null,&quot;iti_tel_tel_type&quot;:null,&quot;iti_tel_require_area&quot;:null,&quot;iti_tel_allow_dropdown&quot;:null,&quot;iti_tel_country_include&quot;:null,&quot;iti_tel_ip_detect&quot;:null,&quot;iti_tel_internationalize&quot;:null,&quot;file_sizes&quot;:null,&quot;file_types&quot;:null,&quot;allow_multiple_upload&quot;:null,&quot;max_files&quot;:null,&quot;step_icon&quot;:null,&quot;field_value&quot;:&quot;&quot;},{&quot;label&quot;:&quot;Nom de famille&quot;,&quot;field_custom_id&quot;:&quot;field_f5acf00&quot;,&quot;placeholder&quot;:&quot;Nom de famille&quot;,&quot;acceptance_text&quot;:null,&quot;step_previous_button&quot;:null,&quot;step_next_button&quot;:null,&quot;width&quot;:&quot;50&quot;,&quot;_id&quot;:&quot;f5acf00&quot;,&quot;required&quot;:&quot;true&quot;,&quot;type&quot;:&quot;text&quot;,&quot;recaptcha_badge&quot;:null,&quot;recaptcha_theme&quot;:null,&quot;recaptcha_size&quot;:null,&quot;checked_by_default&quot;:null,&quot;min_time&quot;:null,&quot;max_time&quot;:null,&quot;min_date&quot;:null,&quot;max_date&quot;:null,&quot;localization&quot;:null,&quot;min&quot;:null,&quot;max&quot;:null,&quot;field_options&quot;:null,&quot;inline_list&quot;:null,&quot;native_html5&quot;:null,&quot;multiple_selection&quot;:null,&quot;rows&quot;:null,&quot;iti_tel&quot;:null,&quot;iti_tel_tel_type&quot;:null,&quot;iti_tel_require_area&quot;:null,&quot;iti_tel_allow_dropdown&quot;:null,&quot;iti_tel_country_include&quot;:null,&quot;iti_tel_ip_detect&quot;:null,&quot;iti_tel_internationalize&quot;:null,&quot;file_sizes&quot;:null,&quot;file_types&quot;:null,&quot;allow_multiple_upload&quot;:null,&quot;max_files&quot;:null,&quot;step_icon&quot;:null,&quot;field_value&quot;:&quot;&quot;},{&quot;label&quot;:&quot;T\\u00e9l\\u00e9phone&quot;,&quot;field_custom_id&quot;:&quot;email&quot;,&quot;type&quot;:&quot;tel&quot;,&quot;placeholder&quot;:&quot;T\\u00e9l\\u00e9phone&quot;,&quot;_id&quot;:&quot;ebd9a80&quot;,&quot;acceptance_text&quot;:null,&quot;step_previous_button&quot;:null,&quot;step_next_button&quot;:null,&quot;width&quot;:&quot;50&quot;,&quot;required&quot;:&quot;true&quot;,&quot;recaptcha_badge&quot;:null,&quot;recaptcha_theme&quot;:null,&quot;recaptcha_size&quot;:null,&quot;checked_by_default&quot;:null,&quot;min_time&quot;:null,&quot;max_time&quot;:null,&quot;min_date&quot;:null,&quot;max_date&quot;:null,&quot;localization&quot;:null,&quot;min&quot;:null,&quot;max&quot;:null,&quot;field_options&quot;:null,&quot;inline_list&quot;:null,&quot;native_html5&quot;:null,&quot;multiple_selection&quot;:null,&quot;rows&quot;:null,&quot;iti_tel&quot;:&quot;&quot;,&quot;iti_tel_tel_type&quot;:null,&quot;iti_tel_require_area&quot;:null,&quot;iti_tel_allow_dropdown&quot;:null,&quot;iti_tel_country_include&quot;:null,&quot;iti_tel_ip_detect&quot;:null,&quot;iti_tel_internationalize&quot;:null,&quot;file_sizes&quot;:null,&quot;file_types&quot;:null,&quot;allow_multiple_upload&quot;:null,&quot;max_files&quot;:null,&quot;step_icon&quot;:null,&quot;field_value&quot;:&quot;&quot;},{&quot;label&quot;:&quot;Courriel&quot;,&quot;field_custom_id&quot;:&quot;field_b09d48b&quot;,&quot;type&quot;:&quot;email&quot;,&quot;placeholder&quot;:&quot;Courriel&quot;,&quot;acceptance_text&quot;:null,&quot;step_previous_button&quot;:null,&quot;step_next_button&quot;:null,&quot;width&quot;:&quot;50&quot;,&quot;_id&quot;:&quot;b09d48b&quot;,&quot;recaptcha_badge&quot;:null,&quot;recaptcha_theme&quot;:null,&quot;recaptcha_size&quot;:null,&quot;checked_by_default&quot;:null,&quot;min_time&quot;:null,&quot;max_time&quot;:null,&quot;min_date&quot;:null,&quot;max_date&quot;:null,&quot;localization&quot;:null,&quot;min&quot;:null,&quot;max&quot;:null,&quot;field_options&quot;:null,&quot;inline_list&quot;:null,&quot;native_html5&quot;:null,&quot;multiple_selection&quot;:null,&quot;rows&quot;:null,&quot;required&quot;:&quot;&quot;,&quot;iti_tel&quot;:null,&quot;iti_tel_tel_type&quot;:null,&quot;iti_tel_require_area&quot;:null,&quot;iti_tel_allow_dropdown&quot;:null,&quot;iti_tel_country_include&quot;:null,&quot;iti_tel_ip_detect&quot;:null,&quot;iti_tel_internationalize&quot;:null,&quot;file_sizes&quot;:null,&quot;file_types&quot;:null,&quot;allow_multiple_upload&quot;:null,&quot;max_files&quot;:null,&quot;step_icon&quot;:null,&quot;field_value&quot;:&quot;&quot;},{&quot;_id&quot;:&quot;a83d4d6&quot;,&quot;label&quot;:&quot;Date de naissance&quot;,&quot;acceptance_text&quot;:null,&quot;step_previous_button&quot;:null,&quot;step_next_button&quot;:null,&quot;width&quot;:&quot;25&quot;,&quot;field_custom_id&quot;:&quot;field_a83d4d6&quot;,&quot;type&quot;:&quot;date&quot;,&quot;native_html5&quot;:&quot;true&quot;,&quot;required&quot;:&quot;true&quot;,&quot;localization&quot;:&quot;&quot;,&quot;placeholder&quot;:&quot;&quot;,&quot;recaptcha_badge&quot;:null,&quot;recaptcha_theme&quot;:null,&quot;recaptcha_size&quot;:null,&quot;checked_by_default&quot;:null,&quot;min_time&quot;:null,&quot;max_time&quot;:null,&quot;min_date&quot;:&quot;&quot;,&quot;max_date&quot;:&quot;&quot;,&quot;min&quot;:null,&quot;max&quot;:null,&quot;field_options&quot;:null,&quot;inline_list&quot;:null,&quot;multiple_selection&quot;:null,&quot;rows&quot;:null,&quot;iti_tel&quot;:null,&quot;iti_tel_tel_type&quot;:null,&quot;iti_tel_require_area&quot;:null,&quot;iti_tel_allow_dropdown&quot;:null,&quot;iti_tel_country_include&quot;:null,&quot;iti_tel_ip_detect&quot;:null,&quot;iti_tel_internationalize&quot;:null,&quot;file_sizes&quot;:null,&quot;file_types&quot;:null,&quot;allow_multiple_upload&quot;:null,&quot;max_files&quot;:null,&quot;step_icon&quot;:null,&quot;field_value&quot;:&quot;&quot;},{&quot;_id&quot;:&quot;0cbc387&quot;,&quot;type&quot;:&quot;checkbox&quot;,&quot;label&quot;:&quot;Type d&#039;assurance pour laquelle j&#039;aimerais avoir une soumission&quot;,&quot;acceptance_text&quot;:null,&quot;field_options&quot;:&quot;Assurance vie\\nAssurance frais fun\\u00e9raires\\nAssurance salaire et invalidit\\u00e9\\nAssurance soins m\\u00e9dicaux\\nAssurance maladies graves\\nAssurance voyage&quot;,&quot;step_previous_button&quot;:null,&quot;step_next_button&quot;:null,&quot;field_custom_id&quot;:&quot;field_0cbc387&quot;,&quot;required&quot;:&quot;true&quot;,&quot;placeholder&quot;:null,&quot;recaptcha_badge&quot;:null,&quot;recaptcha_theme&quot;:null,&quot;recaptcha_size&quot;:null,&quot;checked_by_default&quot;:null,&quot;min_time&quot;:null,&quot;max_time&quot;:null,&quot;min_date&quot;:null,&quot;max_date&quot;:null,&quot;localization&quot;:null,&quot;min&quot;:null,&quot;max&quot;:null,&quot;inline_list&quot;:&quot;&quot;,&quot;native_html5&quot;:null,&quot;multiple_selection&quot;:null,&quot;rows&quot;:null,&quot;iti_tel&quot;:null,&quot;iti_tel_tel_type&quot;:null,&quot;iti_tel_require_area&quot;:null,&quot;iti_tel_allow_dropdown&quot;:null,&quot;iti_tel_country_include&quot;:null,&quot;iti_tel_ip_detect&quot;:null,&quot;iti_tel_internationalize&quot;:null,&quot;file_sizes&quot;:null,&quot;file_types&quot;:null,&quot;allow_multiple_upload&quot;:null,&quot;max_files&quot;:null,&quot;step_icon&quot;:null,&quot;width&quot;:&quot;100&quot;,&quot;field_value&quot;:null},{&quot;label&quot;:&quot;Quel est le montant approximatif de la couverture d&#039;assurance d\\u00e9sir\\u00e9 (si connu)&quot;,&quot;acceptance_text&quot;:null,&quot;step_previous_button&quot;:null,&quot;step_next_button&quot;:null,&quot;field_custom_id&quot;:&quot;field_05df176&quot;,&quot;type&quot;:&quot;select&quot;,&quot;native_html5&quot;:null,&quot;localization&quot;:null,&quot;field_options&quot;:&quot;500\\n750\\n1000\\n1500\\n2000\\n2500\\n3000\\n4000\\n5000\\n6000\\n7000\\n8000\\n9000\\n10 000\\n12 000\\n15 000\\n20 000\\n25 000\\n35 000\\n50 000\\n75 000\\n100 000\\n150 000\\n200 000\\n250 000\\n300 000\\n400 000\\n500 000\\n600 000\\n750 000\\n900 000\\n1 000 000\\n1 500 000\\n2 000 000\\n3 000 000\\n5 000 000 ou +&quot;,&quot;max_time&quot;:null,&quot;min&quot;:null,&quot;max&quot;:null,&quot;_id&quot;:&quot;05df176&quot;,&quot;placeholder&quot;:null,&quot;recaptcha_badge&quot;:null,&quot;recaptcha_theme&quot;:null,&quot;recaptcha_size&quot;:null,&quot;checked_by_default&quot;:null,&quot;min_time&quot;:null,&quot;min_date&quot;:null,&quot;max_date&quot;:null,&quot;inline_list&quot;:null,&quot;multiple_selection&quot;:&quot;&quot;,&quot;rows&quot;:null,&quot;required&quot;:&quot;&quot;,&quot;iti_tel&quot;:null,&quot;iti_tel_tel_type&quot;:null,&quot;iti_tel_require_area&quot;:null,&quot;iti_tel_allow_dropdown&quot;:null,&quot;iti_tel_country_include&quot;:null,&quot;iti_tel_ip_detect&quot;:null,&quot;iti_tel_internationalize&quot;:null,&quot;file_sizes&quot;:null,&quot;file_types&quot;:null,&quot;allow_multiple_upload&quot;:null,&quot;max_files&quot;:null,&quot;step_icon&quot;:null,&quot;width&quot;:&quot;100&quot;,&quot;field_value&quot;:&quot;&quot;},{&quot;_id&quot;:&quot;b46fc1b&quot;,&quot;type&quot;:&quot;textarea&quot;,&quot;acceptance_text&quot;:null,&quot;field_options&quot;:null,&quot;inline_list&quot;:null,&quot;step_previous_button&quot;:null,&quot;step_next_button&quot;:null,&quot;field_custom_id&quot;:&quot;field_b46fc1b&quot;,&quot;label&quot;:&quot;Maladies connues&quot;,&quot;placeholder&quot;:&quot;Avez-vous des maladies connues? Si oui, lesquelles?&quot;,&quot;width&quot;:&quot;50&quot;,&quot;recaptcha_badge&quot;:null,&quot;recaptcha_theme&quot;:null,&quot;recaptcha_size&quot;:null,&quot;checked_by_default&quot;:null,&quot;min_time&quot;:null,&quot;max_time&quot;:null,&quot;min_date&quot;:null,&quot;max_date&quot;:null,&quot;localization&quot;:null,&quot;min&quot;:null,&quot;max&quot;:null,&quot;native_html5&quot;:null,&quot;multiple_selection&quot;:null,&quot;rows&quot;:5,&quot;required&quot;:&quot;&quot;,&quot;iti_tel&quot;:null,&quot;iti_tel_tel_type&quot;:null,&quot;iti_tel_require_area&quot;:null,&quot;iti_tel_allow_dropdown&quot;:null,&quot;iti_tel_country_include&quot;:null,&quot;iti_tel_ip_detect&quot;:null,&quot;iti_tel_internationalize&quot;:null,&quot;file_sizes&quot;:null,&quot;file_types&quot;:null,&quot;allow_multiple_upload&quot;:null,&quot;max_files&quot;:null,&quot;step_icon&quot;:null,&quot;field_value&quot;:&quot;&quot;},{&quot;type&quot;:&quot;textarea&quot;,&quot;acceptance_text&quot;:null,&quot;field_options&quot;:null,&quot;inline_list&quot;:null,&quot;step_previous_button&quot;:null,&quot;step_next_button&quot;:null,&quot;field_custom_id&quot;:&quot;field_6aa6b87&quot;,&quot;label&quot;:&quot;M\\u00e9dicaments&quot;,&quot;placeholder&quot;:&quot;Prenez-vous des m\\u00e9dicaments? Si oui, lesquels?&quot;,&quot;width&quot;:&quot;50&quot;,&quot;_id&quot;:&quot;6aa6b87&quot;,&quot;recaptcha_badge&quot;:null,&quot;recaptcha_theme&quot;:null,&quot;recaptcha_size&quot;:null,&quot;checked_by_default&quot;:null,&quot;min_time&quot;:null,&quot;max_time&quot;:null,&quot;min_date&quot;:null,&quot;max_date&quot;:null,&quot;localization&quot;:null,&quot;min&quot;:null,&quot;max&quot;:null,&quot;native_html5&quot;:null,&quot;multiple_selection&quot;:null,&quot;rows&quot;:5,&quot;required&quot;:&quot;&quot;,&quot;iti_tel&quot;:null,&quot;iti_tel_tel_type&quot;:null,&quot;iti_tel_require_area&quot;:null,&quot;iti_tel_allow_dropdown&quot;:null,&quot;iti_tel_country_include&quot;:null,&quot;iti_tel_ip_detect&quot;:null,&quot;iti_tel_internationalize&quot;:null,&quot;file_sizes&quot;:null,&quot;file_types&quot;:null,&quot;allow_multiple_upload&quot;:null,&quot;max_files&quot;:null,&quot;step_icon&quot;:null,&quot;field_value&quot;:&quot;&quot;},{&quot;_id&quot;:&quot;89c5964&quot;,&quot;type&quot;:&quot;recaptcha_v3&quot;,&quot;label&quot;:&quot;captcha&quot;,&quot;acceptance_text&quot;:null,&quot;step_previous_button&quot;:null,&quot;step_next_button&quot;:null,&quot;field_custom_id&quot;:&quot;field_89c5964&quot;,&quot;placeholder&quot;:null,&quot;recaptcha_badge&quot;:&quot;inline&quot;,&quot;recaptcha_theme&quot;:null,&quot;recaptcha_size&quot;:null,&quot;checked_by_default&quot;:null,&quot;min_time&quot;:null,&quot;max_time&quot;:null,&quot;min_date&quot;:null,&quot;max_date&quot;:null,&quot;localization&quot;:null,&quot;min&quot;:null,&quot;max&quot;:null,&quot;field_options&quot;:null,&quot;inline_list&quot;:null,&quot;native_html5&quot;:null,&quot;multiple_selection&quot;:null,&quot;rows&quot;:null,&quot;required&quot;:null,&quot;iti_tel&quot;:null,&quot;iti_tel_tel_type&quot;:null,&quot;iti_tel_require_area&quot;:null,&quot;iti_tel_allow_dropdown&quot;:null,&quot;iti_tel_country_include&quot;:null,&quot;iti_tel_ip_detect&quot;:null,&quot;iti_tel_internationalize&quot;:null,&quot;file_sizes&quot;:null,&quot;file_types&quot;:null,&quot;allow_multiple_upload&quot;:null,&quot;max_files&quot;:null,&quot;step_icon&quot;:null,&quot;width&quot;:null,&quot;field_value&quot;:null},{&quot;_id&quot;:&quot;bd06514&quot;,&quot;label&quot;:&quot;Domaine de travail ou occupation principale (si retrait\\u00e9, veuillez le mentionner)&quot;,&quot;acceptance_text&quot;:null,&quot;step_previous_button&quot;:null,&quot;step_next_button&quot;:null,&quot;field_custom_id&quot;:&quot;field_bd06514&quot;,&quot;type&quot;:&quot;text&quot;,&quot;placeholder&quot;:&quot;&quot;,&quot;recaptcha_badge&quot;:null,&quot;recaptcha_theme&quot;:null,&quot;recaptcha_size&quot;:null,&quot;checked_by_default&quot;:null,&quot;min_time&quot;:null,&quot;max_time&quot;:null,&quot;min_date&quot;:null,&quot;max_date&quot;:null,&quot;localization&quot;:null,&quot;min&quot;:null,&quot;max&quot;:null,&quot;field_options&quot;:null,&quot;inline_list&quot;:null,&quot;native_html5&quot;:null,&quot;multiple_selection&quot;:null,&quot;rows&quot;:null,&quot;required&quot;:&quot;&quot;,&quot;iti_tel&quot;:null,&quot;iti_tel_tel_type&quot;:null,&quot;iti_tel_require_area&quot;:null,&quot;iti_tel_allow_dropdown&quot;:null,&quot;iti_tel_country_include&quot;:null,&quot;iti_tel_ip_detect&quot;:null,&quot;iti_tel_internationalize&quot;:null,&quot;file_sizes&quot;:null,&quot;file_types&quot;:null,&quot;allow_multiple_upload&quot;:null,&quot;max_files&quot;:null,&quot;step_icon&quot;:null,&quot;width&quot;:&quot;100&quot;,&quot;field_value&quot;:&quot;&quot;}],&quot;steps_type&quot;:&quot;none&quot;}\" data-widget_type=\"raven-form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<form class=\"raven-form raven-flex raven-flex-wrap raven-flex-bottom\" method=\"post\" name=\"Demande de soumission\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"1830\" \/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"d481680\" \/>\n\t\t\t\t\t<div id=\"raven-field-group-b3bb42c\" class=\"raven-flex-wrap raven-field-type-text raven-field-group elementor-column elementor-col-50 raven-field-required\">\n\t\t\t\t\t<label\n\t\t\tfor=\"form-field-b3bb42c\"\n\t\t\tclass=\"raven-field-label\">\n\t\t\tPr\u00e9nom\t\t\t\t\t\t\t<span class=\"required-mark-label\"><\/span>\n\t\t\t\t\t\t<\/label>\n\t\t\t\t<input\n\t\t\toninput=\"onInvalidRavenFormField(event)\"\n\t\t\toninvalid=\"onInvalidRavenFormField(event)\"\n\t\t\ttype=\"text\" name=\"fields[b3bb42c]\" id=\"form-field-b3bb42c\" class=\"raven-field\" placeholder=\"Pr\u00e9nom\" data-type=\"text\" required=\"required\">\n\t\t\t\t<\/div>\n\t\t\t\t<div id=\"raven-field-group-f5acf00\" class=\"raven-flex-wrap raven-field-type-text raven-field-group elementor-column elementor-col-50 raven-field-required\">\n\t\t\t\t\t<label\n\t\t\tfor=\"form-field-f5acf00\"\n\t\t\tclass=\"raven-field-label\">\n\t\t\tNom de famille\t\t\t\t\t\t\t<span class=\"required-mark-label\"><\/span>\n\t\t\t\t\t\t<\/label>\n\t\t\t\t<input\n\t\t\toninput=\"onInvalidRavenFormField(event)\"\n\t\t\toninvalid=\"onInvalidRavenFormField(event)\"\n\t\t\ttype=\"text\" name=\"fields[f5acf00]\" id=\"form-field-f5acf00\" class=\"raven-field\" placeholder=\"Nom de famille\" data-type=\"text\" required=\"required\">\n\t\t\t\t<\/div>\n\t\t\t\t<div id=\"raven-field-group-ebd9a80\" class=\"raven-flex-wrap raven-field-type-tel raven-field-group elementor-column elementor-col-50 raven-field-required\">\n\t\t\t\t\t<label\n\t\t\tfor=\"form-field-ebd9a80\"\n\t\t\tclass=\"raven-field-label\">\n\t\t\tT\u00e9l\u00e9phone\t\t\t\t\t\t\t<span class=\"required-mark-label\"><\/span>\n\t\t\t\t\t\t<\/label>\n\t\t\t\t<input\n\t\t\toninput=\"onInvalidRavenFormField(event)\"\n\t\t\toninvalid=\"onInvalidRavenFormField(event)\"\n\t\t\ttype=\"tel\" name=\"fields[ebd9a80]\" id=\"form-field-ebd9a80\" class=\"raven-field\" placeholder=\"T\u00e9l\u00e9phone\" data-type=\"tel\" required=\"required\" pattern=\"^[0-9\\-\\+\\s\\(\\)]*$\" title=\"The value should only consist numbers and phone characters (-, +, (), etc)\">\n\t\t\t\t<\/div>\n\t\t\t\t<div id=\"raven-field-group-b09d48b\" class=\"raven-flex-wrap raven-field-type-email raven-field-group elementor-column elementor-col-50\">\n\t\t\t\t\t<label\n\t\t\tfor=\"form-field-b09d48b\"\n\t\t\tclass=\"raven-field-label\">\n\t\t\tCourriel\t\t\t\t\t\t<\/label>\n\t\t\t\t<input\n\t\t\toninput=\"onInvalidRavenFormField(event)\"\n\t\t\toninvalid=\"onInvalidRavenFormField(event)\"\n\t\t\ttype=\"email\" name=\"fields[b09d48b]\" id=\"form-field-b09d48b\" class=\"raven-field\" placeholder=\"Courriel\" data-type=\"email\">\n\t\t\t\t<\/div>\n\t\t\t\t<div id=\"raven-field-group-a83d4d6\" class=\"raven-flex-wrap raven-field-type-date raven-field-group elementor-column elementor-col-25 raven-field-required\">\n\t\t\t\t\t<label\n\t\t\tfor=\"form-field-a83d4d6\"\n\t\t\tclass=\"raven-field-label\">\n\t\t\tDate de naissance\t\t\t\t\t\t\t<span class=\"required-mark-label\"><\/span>\n\t\t\t\t\t\t<\/label>\n\t\t\t\t<input\n\t\t\toninput=\"onInvalidRavenFormField(event)\"\n\t\t\toninvalid=\"onInvalidRavenFormField(event)\"\n\t\t\ttype=\"date\" name=\"fields[a83d4d6]\" id=\"form-field-a83d4d6\" class=\"raven-field flatpickr\" placeholder=\"\" data-type=\"date\" required=\"required\"\t\t\tmin=\"\"\t\t\t\t\t\tmax=\"\">\n\t\t\t\t<\/div>\n\t\t\t\t<div id=\"raven-field-group-0cbc387\" class=\"raven-flex-wrap raven-field-type-checkbox raven-field-group elementor-column elementor-col-100 raven-field-required\">\n\t\t\t\t\t<label\n\t\t\tfor=\"form-field-0cbc387\"\n\t\t\tclass=\"raven-field-label\">\n\t\t\tType d'assurance pour laquelle j'aimerais avoir une soumission\t\t\t\t\t\t\t<span class=\"required-mark-label\"><\/span>\n\t\t\t\t\t\t<\/label>\n\t\t<div class=\"raven-field-subgroup \"><span class=\"raven-field-option raven-field-option-checkbox\"><input type=\"checkbox\" value=\"Assurance vie\" id=\"form-field-0cbc387-0-1mhu\" name=\"fields[0cbc387][]\"  class=\"raven-field\"> <label for=\"form-field-0cbc387-0-1mhu\" class=\"raven-field-label\">Assurance vie<\/label><\/span><span class=\"raven-field-option raven-field-option-checkbox\"><input type=\"checkbox\" value=\"Assurance frais fun\u00e9raires\" id=\"form-field-0cbc387-1-1mhu\" name=\"fields[0cbc387][]\"  class=\"raven-field\"> <label for=\"form-field-0cbc387-1-1mhu\" class=\"raven-field-label\">Assurance frais fun\u00e9raires<\/label><\/span><span class=\"raven-field-option raven-field-option-checkbox\"><input type=\"checkbox\" value=\"Assurance salaire et invalidit\u00e9\" id=\"form-field-0cbc387-2-1mhu\" name=\"fields[0cbc387][]\"  class=\"raven-field\"> <label for=\"form-field-0cbc387-2-1mhu\" class=\"raven-field-label\">Assurance salaire et invalidit\u00e9<\/label><\/span><span class=\"raven-field-option raven-field-option-checkbox\"><input type=\"checkbox\" value=\"Assurance soins m\u00e9dicaux\" id=\"form-field-0cbc387-3-1mhu\" name=\"fields[0cbc387][]\"  class=\"raven-field\"> <label for=\"form-field-0cbc387-3-1mhu\" class=\"raven-field-label\">Assurance soins m\u00e9dicaux<\/label><\/span><span class=\"raven-field-option raven-field-option-checkbox\"><input type=\"checkbox\" value=\"Assurance maladies graves\" id=\"form-field-0cbc387-4-1mhu\" name=\"fields[0cbc387][]\"  class=\"raven-field\"> <label for=\"form-field-0cbc387-4-1mhu\" class=\"raven-field-label\">Assurance maladies graves<\/label><\/span><span class=\"raven-field-option raven-field-option-checkbox\"><input type=\"checkbox\" value=\"Assurance voyage\" id=\"form-field-0cbc387-5-1mhu\" name=\"fields[0cbc387][]\"  class=\"raven-field\"> <label for=\"form-field-0cbc387-5-1mhu\" class=\"raven-field-label\">Assurance voyage<\/label><\/span><\/div>\t\t<\/div>\n\t\t\t\t<div id=\"raven-field-group-05df176\" class=\"raven-flex-wrap raven-field-type-select raven-field-group elementor-column elementor-col-100\">\n\t\t\t\t\t<label\n\t\t\tfor=\"form-field-05df176\"\n\t\t\tclass=\"raven-field-label\">\n\t\t\tQuel est le montant approximatif de la couverture d'assurance d\u00e9sir\u00e9 (si connu)\t\t\t\t\t\t<\/label>\n\t\t\t\t<div class=\"raven-field-subgroup\">\n\t\t<i aria-hidden=\"true\" class=\"raven-field-select-arrow fas fa-angle-down\"><\/i><select oninput=\"onInvalidRavenFormField(event)\" oninvalid=\"onInvalidRavenFormField(event)\" type=\"select\" name=\"fields[05df176]\" id=\"form-field-05df176\" class=\"raven-field\" placeholder=\"\" data-type=\"select\"><option value=\"500\">500<\/option><option value=\"750\">750<\/option><option value=\"1000\">1000<\/option><option value=\"1500\">1500<\/option><option value=\"2000\">2000<\/option><option value=\"2500\">2500<\/option><option value=\"3000\">3000<\/option><option value=\"4000\">4000<\/option><option value=\"5000\">5000<\/option><option value=\"6000\">6000<\/option><option value=\"7000\">7000<\/option><option value=\"8000\">8000<\/option><option value=\"9000\">9000<\/option><option value=\"10 000\">10 000<\/option><option value=\"12 000\">12 000<\/option><option value=\"15 000\">15 000<\/option><option value=\"20 000\">20 000<\/option><option value=\"25 000\">25 000<\/option><option value=\"35 000\">35 000<\/option><option value=\"50 000\">50 000<\/option><option value=\"75 000\">75 000<\/option><option value=\"100 000\">100 000<\/option><option value=\"150 000\">150 000<\/option><option value=\"200 000\">200 000<\/option><option value=\"250 000\">250 000<\/option><option value=\"300 000\">300 000<\/option><option value=\"400 000\">400 000<\/option><option value=\"500 000\">500 000<\/option><option value=\"600 000\">600 000<\/option><option value=\"750 000\">750 000<\/option><option value=\"900 000\">900 000<\/option><option value=\"1 000 000\">1 000 000<\/option><option value=\"1 500 000\">1 500 000<\/option><option value=\"2 000 000\">2 000 000<\/option><option value=\"3 000 000\">3 000 000<\/option><option value=\"5 000 000 ou +\">5 000 000 ou +<\/option><\/select><\/div>\t\t<\/div>\n\t\t\t\t<div id=\"raven-field-group-b46fc1b\" class=\"raven-flex-wrap raven-field-type-textarea raven-field-group elementor-column elementor-col-50\">\n\t\t\t\t\t<label\n\t\t\tfor=\"form-field-b46fc1b\"\n\t\t\tclass=\"raven-field-label\">\n\t\t\tMaladies connues\t\t\t\t\t\t<\/label>\n\t\t\t\t<textarea\n\t\t\toninput=\"onInvalidRavenFormField(event)\"\n\t\t\toninvalid=\"onInvalidRavenFormField(event)\"\n\t\t\ttype=\"textarea\" name=\"fields[b46fc1b]\" id=\"form-field-b46fc1b\" class=\"raven-field\" placeholder=\"Avez-vous des maladies connues? Si oui, lesquelles?\" data-type=\"textarea\"\t\t\trows=\"5\"><\/textarea>\n\t\t\t\t<\/div>\n\t\t\t\t<div id=\"raven-field-group-6aa6b87\" class=\"raven-flex-wrap raven-field-type-textarea raven-field-group elementor-column elementor-col-50\">\n\t\t\t\t\t<label\n\t\t\tfor=\"form-field-6aa6b87\"\n\t\t\tclass=\"raven-field-label\">\n\t\t\tM\u00e9dicaments\t\t\t\t\t\t<\/label>\n\t\t\t\t<textarea\n\t\t\toninput=\"onInvalidRavenFormField(event)\"\n\t\t\toninvalid=\"onInvalidRavenFormField(event)\"\n\t\t\ttype=\"textarea\" name=\"fields[6aa6b87]\" id=\"form-field-6aa6b87\" class=\"raven-field\" placeholder=\"Prenez-vous des m\u00e9dicaments? Si oui, lesquels?\" data-type=\"textarea\"\t\t\trows=\"5\"><\/textarea>\n\t\t\t\t<\/div>\n\t\t\t\t<div id=\"raven-field-group-89c5964\" class=\"raven-flex-wrap raven-field-type-recaptcha_v3 raven-field-group elementor-column elementor-col-\">\n\t\t\t<div class=\"raven-field-subgroup\" id=\"form-field-89c5964\"><div class=\"raven-g-recaptcha\" data-sitekey=\"6LeXEQ0oAAAAAJOVSWbCVeZ9HRTgcbRp9dtw9xQ0\" data-badge=\"inline\" data-type=\"v3\" data-size=\"invisible\" data-action=\"Form\"><\/div><\/div>\t\t<\/div>\n\t\t\t\t<div id=\"raven-field-group-bd06514\" class=\"raven-flex-wrap raven-field-type-text raven-field-group elementor-column elementor-col-100\">\n\t\t\t\t\t<label\n\t\t\tfor=\"form-field-bd06514\"\n\t\t\tclass=\"raven-field-label\">\n\t\t\tDomaine de travail ou occupation principale (si retrait\u00e9, veuillez le mentionner)\t\t\t\t\t\t<\/label>\n\t\t\t\t<input\n\t\t\toninput=\"onInvalidRavenFormField(event)\"\n\t\t\toninvalid=\"onInvalidRavenFormField(event)\"\n\t\t\ttype=\"text\" name=\"fields[bd06514]\" id=\"form-field-bd06514\" class=\"raven-field\" placeholder=\"\" data-type=\"text\">\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"raven-field-group raven-field-type-submit-button elementor-column elementor-col-\">\n\t\t\t\t\t\t\t\t\t<button class=\"raven-submit-button\" type=\"submit\">\n\t\t\t<i aria-hidden=\"true\" class=\"far fa-file-alt\"><\/i>\t\t\t<span>Envoyer<\/span>\n\t\t<\/button>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/form>\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t<\/div>\n\t\t","protected":false},"author":1,"template":"","meta":{"_styles":{"container_width":"800px","container_custom_height":false,"container_height":"","container_hor_position":"center","container_ver_position":"center","content_ver_position":"flex-start","container_bg_color":"#fff","container_bg":{"type":"classic","color":"#fff","bg_image_id":"","bg_image_url":"","bg_position":"center center","bg_repeat":"no-repeat","bg_size":"auto","gradient":"linear-gradient(160deg, rgba(85,85,85,0.8477984943977591) 0%, rgba(0,0,0,0.8505996148459384) 100%)"},"container_hor_padding":"20px","container_ver_padding":"20px","container_hor_margin":"0px","container_ver_margin":"0px","container_border":"0px solid #fff","container_border_color":"#fff","container_border_style":"solid","container_border_width":"1px","container_border_radius":"0px","container_box_shadow":"none","overlay_bg_color":"#0000007D","overlay_bg":{"type":"classic","color":"#0000007D","bg_image_id":"","bg_image_url":"","bg_position":"center center","bg_repeat":"no-repeat","bg_size":"auto","gradient":"linear-gradient(160deg, rgba(85,85,85,0.8477984943977591) 0%, rgba(0,0,0,0.8505996148459384) 100%)"},"close_button_icon_color":"#fff","close_button_icon_size":"16px","close_button_bg_color":"#000","close_button_size":"32px","close_button_border":"1px solid #000","close_button_border_radius":"0px","close_button_translate_x":"0px","close_button_translate_y":"0px","z_index":"999"},"_settings":{"jet_popup_type":"default","jet_popup_animation":"fade","jet_popup_open_trigger":"attach","jet_popup_page_load_delay":1,"jet_popup_user_inactivity_time":1,"jet_popup_scrolled_to_value":10,"jet_popup_on_date_value":"2025-03-21 15:15","jet_popup_on_time_start_value":"","jet_popup_on_time_end_value":"","jet_popup_custom_selector":".custom","jet_popup_prevent_scrolling":"no","jet_popup_show_once":"no","jet_popup_show_again_delay":"none","jet_popup_use_ajax":"no","jet_popup_force_ajax":"no","jet_role_condition":[],"use_close_button":"yes","close_button_icon":"","use_overlay":"yes","close_on_overlay_click":"yes"}},"acf":[],"_links":{"self":[{"href":"https:\/\/www.aristoassurance.ca\/index.php\/wp-json\/wp\/v2\/jet-popup\/1830"}],"collection":[{"href":"https:\/\/www.aristoassurance.ca\/index.php\/wp-json\/wp\/v2\/jet-popup"}],"about":[{"href":"https:\/\/www.aristoassurance.ca\/index.php\/wp-json\/wp\/v2\/types\/jet-popup"}],"author":[{"embeddable":true,"href":"https:\/\/www.aristoassurance.ca\/index.php\/wp-json\/wp\/v2\/users\/1"}],"version-history":[{"count":24,"href":"https:\/\/www.aristoassurance.ca\/index.php\/wp-json\/wp\/v2\/jet-popup\/1830\/revisions"}],"predecessor-version":[{"id":2745,"href":"https:\/\/www.aristoassurance.ca\/index.php\/wp-json\/wp\/v2\/jet-popup\/1830\/revisions\/2745"}],"wp:attachment":[{"href":"https:\/\/www.aristoassurance.ca\/index.php\/wp-json\/wp\/v2\/media?parent=1830"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}