{"id":9806,"date":"2019-12-14T15:32:35","date_gmt":"2019-12-14T14:32:35","guid":{"rendered":"https:\/\/dermoscent.com\/contact-form\/"},"modified":"2026-06-25T11:43:26","modified_gmt":"2026-06-25T09:43:26","slug":"contact-form","status":"publish","type":"page","link":"https:\/\/dermoscent.com\/en\/contact-form\/","title":{"rendered":"Contact form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"9806\" class=\"elementor elementor-9806 elementor-71\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"has_eae_slider elementor-section elementor-top-section elementor-element elementor-element-5f06102 elementor-section-full_width elementor-section-height-min-height elementor-section-height-default elementor-section-items-middle wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-eae-slider=\"218\" data-id=\"5f06102\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"has_eae_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-a3185d7\" data-eae-slider=\"9150\" data-id=\"a3185d7\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"has_eae_slider elementor-section elementor-top-section elementor-element elementor-element-faef22c elementor-reverse-tablet elementor-reverse-mobile elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-eae-slider=\"59875\" data-id=\"faef22c\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"has_eae_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-08e7048\" data-eae-slider=\"39454\" data-id=\"08e7048\" data-element_type=\"column\" data-e-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<div class=\"elementor-element elementor-element-d25d5d2 elementor-widget elementor-widget-heading\" data-id=\"d25d5d2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Contact form<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c4935b6 elementor-widget elementor-widget-shortcode\" data-id=\"c4935b6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f55971-o1\" lang=\"fr-FR\" dir=\"ltr\" data-wpcf7-id=\"55971\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/pages\/9806#wpcf7-f55971-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formulaire de contact\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"55971\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"fr_FR\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f55971-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<div class=\"contact-form\">\n\t<div class=\"form-left\">\n\t\t<p><label> Last Name*: <span class=\"wpcf7-form-control-wrap\" data-name=\"last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"last-name\" \/><\/span> <\/label><br \/>\n<label> First Name*: <span class=\"wpcf7-form-control-wrap\" data-name=\"first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-name\" \/><\/span> <\/label><br \/>\n<label> Address*: <span class=\"wpcf7-form-control-wrap\" data-name=\"address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"address\" \/><\/span> <\/label><br \/>\n<label> Zip Code*: <span class=\"wpcf7-form-control-wrap\" data-name=\"zipcode\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-required wpcf7-validates-as-number\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"zipcode\" \/><\/span> <\/label><br \/>\n<label> City*: <span class=\"wpcf7-form-control-wrap\" data-name=\"city\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"city\" \/><\/span> <\/label><br \/>\n<label> Country*: <span class=\"wpcf7-form-control-wrap\" data-name=\"country\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"country\" \/><\/span> <\/label><br \/>\n<label> Email*: <span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email\" \/><\/span> <\/label>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"form-right\">\n\t\t<p><label> Subject of Request*:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"subject\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" id=\"subject\" aria-required=\"true\" aria-invalid=\"false\" name=\"subject\"><option value=\"\">&#8212;Veuillez choisir une option&#8212;<\/option><option value=\"My Order\">My Order<\/option><option value=\"Product Information\">Product Information<\/option><option value=\"Partnership\">Partnership<\/option><option value=\"Distribution - France\">Distribution - France<\/option><option value=\"Distribution - USA\">Distribution - USA<\/option><option value=\"Distribution - Others\">Distribution - Others<\/option><option value=\"Joins us\">Joins us<\/option><option value=\"Others\">Others<\/option><\/select><\/span><br \/>\n<\/label>\n\t\t<\/p>\n\t\t<div id=\"product-container\" style=\"display: none;\">\n\t\t\t<p><label> Product Concerned*:<br \/>\n<select name=\"product\" id=\"product-list\">\n <option value=\"\" disabled selected>Please select a product<\/option>\n <option>Essential 6<sup><sup>&reg;<\/sup><\/sup> spot-on<\/option>\n <option>Essential Mousse<sup><sup>&reg;<\/sup><\/sup><\/option>\n <option>Dermoscent BIO BALM<sup><sup>&reg;<\/sup><\/sup><\/option>\n <option>Essential 6<sup><sup>&reg;<\/sup><\/sup> Sebo Shampoo<\/option>\n <option>Essential 6<sup><sup>&reg;<\/sup><\/sup> spot-on horses<\/option>\n <option>Dermoscent BIO BALM<sup><sup>&reg;<\/sup><\/sup> horses<\/option>\n <option>ATOP 7<sup><sup>&reg;<\/sup><\/sup> spot-on<\/option>\n <option>ATOP 7<sup><sup>&reg;<\/sup><\/sup> Spray<\/option>\n <option>ATOP 7<sup><sup>&reg;<\/sup><\/sup> Hydra Cream<\/option>\n <option>ATOP 7<sup><sup>&reg;<\/sup><\/sup> MAX hydra<\/option>\n <option>ATOP 7<sup><sup>&reg;<\/sup><\/sup> Shampoo<\/option>\n <option>ATOP 7<sup><sup>&reg;<\/sup><\/sup> Mousse<\/option>\n <option>ATOP 7<sup><sup>&reg;<\/sup><\/sup> Wipes<\/option>\n <option>PYOspot<sup><sup>&reg;<\/sup><\/sup><\/option>\n <option>PYOclean<sup><sup>&reg;<\/sup><\/sup> Oto<\/option>\n <option>PYOclean<sup><sup>&reg;<\/sup><\/sup> Spray<\/option>\n <option>PYOclean<sup><sup>&reg;<\/sup><\/sup> Shampoo<\/option>\n <option>PYOclean<sup><sup>&reg;<\/sup><\/sup> Mousse<\/option>\n <option>PYOclean<sup><sup>&reg;<\/sup><\/sup> Wipes<\/option>\n <option>EFA Physio Shampoo<\/option>\n <option>Essential Oto<sup><sup>&reg;<\/sup><\/sup><\/option>\n <option>PHYSIO Easy Brush<\/option>\n <option>Cicafolia<sup><sup>&reg;<\/sup><\/sup><\/option>\n <option>Aromacalm<sup><sup>&reg;<\/sup><\/sup><\/option>\n <option>SunFREE<\/option>\n <option>Uti-Zen<sup><sup>&reg;<\/sup><\/sup><\/option>\n <option>Keravita<sup><sup>&reg;<\/sup><\/sup><\/option>\n <option>SILVER Massage Oil<\/option>\n <option>SENIOR Spot<sup><sup>&reg;<\/sup><\/sup><\/option>\n <\/select><br \/>\n<\/label>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<p><label> Message*: <span class=\"wpcf7-form-control-wrap\" data-name=\"message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"message\"><\/textarea><\/span> <\/label>\n\t\t<\/p>\n\t\t<p><label>Attachment<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"piece-jointe\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\"audio\/*,video\/*,image\/*\" aria-invalid=\"false\" type=\"file\" name=\"piece-jointe\" \/><\/span>\n\t\t<\/p>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"accepter\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"accepter[]\" value=\"By submitting this form, you agree that your data will be used to process your request.\" \/><span class=\"wpcf7-list-item-label\">By submitting this form, you agree that your data will be used to process your request.<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\n\n <!-- Information and Submit button -->\n\t\t<div class=\"info-content\">\n\t\t\t<p><br \/>\nFor any questions regarding the personal data collected, please refer to the<br \/>\n<a href=\"https:\/\/dermoscent.com\/accueil\/en\/personal-data-cookies\/\">Personal Data & Cookies<\/a>.\n\t\t\t<\/p>\n\t\t\t<p>* Required fields\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"g-recaptcha-wrap\" style=\"padding:10px 0 10px 0\">\n\t\t\t<div  class=\"g-recaptcha\" data-sitekey=\"6LcF-D0tAAAAANe6D8f_GKj_AdBeMJNIa1BklF_L\">\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<p><span class='wpcf7-form-control-wrap' data-name='aiowps-captcha'><\/span>\n\t\t<\/p>\n\t\t<div class=\"btn-submit\">\n\t\t\t<p><button type=\"submit\">Send<\/button>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<p><script>\n document.addEventListener(\"DOMContentLoaded\", function() {\n var subjectDropdown = document.getElementById(\"subject\");\n var productContainer = document.getElementById(\"product-container\");\n\n subjectDropdown.addEventListener(\"change\", function() {\n if (subjectDropdown.value.includes(\"Product Information\")) {\n productContainer.style.display = \"block\";\n } else {\n productContainer.style.display = \"none\";\n }\n });\n });\n<\/script>\n<\/p>\n<style>\n\/* Layout in 2 columns *\/\n.contact-form {\n display: flex;\n justify-content: space-between;\n flex-wrap: wrap;\n gap: 0; \/* Reduces spacing between columns *\/\n}\n\n.form-left, .form-right {\n width: 48%; \/* Column width adjustment *\/\n display: flex;\n flex-direction: column;\n}\n\nlabel {\n font-size: 16px;\n margin-bottom: 5px; \/* Reduces space between label and field *\/\n}\n\n\/* Style for the button *\/\n.btn-submit {\n margin-top: 10px; \/* Space above the button *\/\n display: flex;\n justify-content: center; \/* Center the button *\/\n width: 100%; \/* Maximum width *\/\n}\n\n\n.btn-submit button {\n background-color: #145186;\n color: #fff;\n font-size: 15px;\n padding: 15px;\n border: none;\n border-radius: 5px;\n cursor: pointer;\n width: 100%;\n margin : 0;\n}\n\n.btn-submit button:hover {\n background-color: #5a5a5a; \/* Gris plus fonc\u00e9 au survol *\/\n}\n\n\n\/* Reduces space around text fields *\/\ntextarea, select, input {\n width: 100%;\n padding: 8px;\n font-size: 14px;\n border: 1px solid #ccc;\n border-radius: 4px;\n margin-bottom: 10px; \/* Space between fields *\/\n}\n\n\/* Adjusts space around information text *\/\n.info-content {\n margin-top: 5px; \/* Smaller space for information text *\/\n<\/style><input type='hidden' class='wpcf7-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\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<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Contact form<\/p>\n","protected":false},"author":174,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"closed","template":"elementor_header_footer","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-9806","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dermoscent.com\/en\/wp-json\/wp\/v2\/pages\/9806","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dermoscent.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dermoscent.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dermoscent.com\/en\/wp-json\/wp\/v2\/users\/174"}],"replies":[{"embeddable":true,"href":"https:\/\/dermoscent.com\/en\/wp-json\/wp\/v2\/comments?post=9806"}],"version-history":[{"count":0,"href":"https:\/\/dermoscent.com\/en\/wp-json\/wp\/v2\/pages\/9806\/revisions"}],"wp:attachment":[{"href":"https:\/\/dermoscent.com\/en\/wp-json\/wp\/v2\/media?parent=9806"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}