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<form class="webform-submission-form webform-submission-add-form webform-submission-nous-contacter-form webform-submission-nous-contacter-add-form js-webform-details-toggle webform-details-toggle" data-drupal-selector="webform-submission-nous-contacter-add-form" action="/en/contact" method="post" id="webform-submission-nous-contacter-add-form" accept-charset="UTF-8"> <div id="edit-body" class="js-form-item form-item js-form-type-processed-text form-type-processed-text js-form-item- form-item- form-no-label"> <p>Would you like more information about MedVallée? Fill in the form below and we will get back to you as quickly as possible.</p> </div> <div class="js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-prenom form-item-prenom"> <label for="edit-prenom" class="js-form-required form-required">First name</label> <input data-drupal-selector="edit-prenom" type="text" id="edit-prenom" name="prenom" value="" size="60" maxlength="255" class="form-text required form-control" required="required" aria-required="true" /> </div> <div class="js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-nom form-item-nom"> <label for="edit-nom" class="js-form-required form-required">Last name</label> <input data-drupal-selector="edit-nom" type="text" id="edit-nom" name="nom" value="" size="60" maxlength="255" class="form-text required form-control" required="required" aria-required="true" /> </div> <div class="js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-raison-sociale form-item-raison-sociale"> <label for="edit-raison-sociale" class="js-form-required form-required">Company</label> <input data-drupal-selector="edit-raison-sociale" type="text" id="edit-raison-sociale" name="raison_sociale" value="" size="60" maxlength="255" class="form-text required form-control" required="required" aria-required="true" /> </div> <div class="js-form-item form-item js-form-type-email form-type-email js-form-item-email form-item-email"> <label for="edit-email" class="js-form-required form-required">E-mail</label> <input data-drupal-selector="edit-email" type="email" id="edit-email" name="email" value="" size="60" maxlength="254" class="form-email required form-control" required="required" aria-required="true" /> </div> <div class="js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-phone form-item-phone"> <label for="edit-phone" class="js-form-required form-required">Phone</label> <input data-drupal-selector="edit-phone" type="text" id="edit-phone" name="phone" value="" size="60" maxlength="255" class="form-text required form-control" required="required" aria-required="true" /> </div> <div class="js-form-item form-item js-form-type-textarea form-type-textarea js-form-item-votre-demande form-item-votre-demande"> <label for="edit-votre-demande" class="js-form-required form-required">Your request</label> <div class="form-textarea-wrapper"> <textarea data-drupal-selector="edit-votre-demande" id="edit-votre-demande" name="votre_demande" rows="5" cols="60" class="form-textarea required form-control form-textarea resize-vertical required" required="required" aria-required="true"></textarea> </div> </div> <div id="edit-mention" class="js-form-item form-item js-form-type-processed-text form-type-processed-text js-form-item- form-item- form-no-label"> <p>Please check our <a href="https://www.medvallee.fr/en/legal-notices" target="_blank">legal mentions</a> regarding data privacy.</p> </div> <div data-drupal-selector="edit-captcha" class="captcha captcha-type-challenge--default-recaptcha-v3" data-nosnippet> <div class="captcha__element"> <input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="114308" /> <input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="pikHaIqfGo1hlC7JvR4a-WmJvTsHFRQ-R_9nbGTT5A8" /> <input id="recaptcha-v3-token" class="recaptcha-v3-token" data-recaptcha-v3-action="default_recaptcha_v3" data-recaptcha-v3-site-key="6LewnqwrAAAAABHs6kX8anYpeI5U_StMtS_wLFHq" data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="" /> <input data-drupal-selector="edit-is-recaptcha-v3" type="hidden" name="is_recaptcha_v3" value="1" /> </div> </div> <div data-drupal-selector="edit-actions" class="form-actions webform-actions js-form-wrapper form-wrapper" id="edit-actions"><input class="webform-button--submit button button--primary js-form-submit form-submit" data-drupal-selector="edit-actions-submit" data-disable-refocus="true" type="submit" id="edit-actions-submit" name="op" value="Submit" /> </div> <input autocomplete="off" data-drupal-selector="form-kpfvnfsrgtqhwxfivmv0t9ofyexf7hd7vjorzxvvths" type="hidden" name="form_build_id" value="form-kPFvnFSRgtqhWXfivMv0T9OFYeXf7HD7VJorzXvVThs" /> <input data-drupal-selector="edit-webform-submission-nous-contacter-add-form" type="hidden" name="form_id" value="webform_submission_nous_contacter_add_form" /> <input data-drupal-selector="edit-honeypot-time" type="hidden" name="honeypot_time" value="5m9Zl0JjHPtQMQcH_xM7Ih42Ij6dTEAQcAlMaPeQNgg" /> <div class="url-textfield js-form-wrapper form-wrapper" style="display: none !important;"><div class="js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-url form-item-url"> <label for="edit-url">Leave this field blank</label> <input autocomplete="off" data-drupal-selector="edit-url" type="text" id="edit-url" name="url" value="" size="20" maxlength="128" class="form-text form-control" /> </div> </div> </form>
