{"id":19847,"date":"2023-03-20T08:47:26","date_gmt":"2023-03-20T08:47:26","guid":{"rendered":"https:\/\/weemaes.be\/fr\/ontvang-je-offerte-voor-een-glasherstelling\/"},"modified":"2026-06-08T07:26:27","modified_gmt":"2026-06-08T07:26:27","slug":"demander-un-devis-pour-une-reparation-de-vitre","status":"publish","type":"page","link":"https:\/\/weemaes.be\/fr\/demander-un-devis-pour-une-reparation-de-vitre\/","title":{"rendered":"Recevez votre devis pour une r\u00e9paration de vitre"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"author":4,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"flexible-content.php","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-19847","page","type-page","status-publish","hentry"],"acf":{"zichtbaarheid_usp_offerteknop":"","zichtbaarheid_usp":"","usp":false,"link_offerteknop_header":"","content":[{"acf_fc_layout":"tekst_met_foto_rechts_sectie","id_voor_anchor":"","background_color":"","padding_boven_120px":"","padding_onder_120px":"","padding_boven_40px":"ja","padding_onder_40px":"ja","titel":"Obtenez votre devis gratuit","inhoud_eerste_kolom":"<p>Recevez votre devis pour la r\u00e9paration de votre vitre dans les 48 heures en remplissant le formulaire ci-dessous.<\/p>\n<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]&gt; *\/\n<\/script>\n\n                <div class='gf_browser_unknown gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_53' style='display:none'><div id='gf_53' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_53'  action='\/fr\/wp-json\/wp\/v2\/pages\/19847\/#gf_53' data-formid='53' novalidate>\n        <div id='gf_progressbar_wrapper_53' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>2<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_50' style='width:50%;'><span>50%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_53_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_53' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_53_54\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_53_54'><span class='gform-field-label__text'>X\/Twitter<\/span><\/label><div class='ginput_container'><input name='input_54' id='input_53_54' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_53_54'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_53_13\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">1. Quel dommage souhaitez-vous faire r\u00e9parer ?<\/h3><\/div><div id=\"field_53_22\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_53_22'><span class='gform-field-label__text'>Combien de vitres sont endommag\u00e9es ?<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_22' id='input_53_22' type='text' step='any'   value='' class='small'      aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_53_19\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Quel est le dommage \u00e0 votre vitrage ?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_53_19'>\n\t\t\t<div class='gchoice gchoice_53_19_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='Le vitrage est cass\u00e9'  id='choice_53_19_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_19_0' id='label_53_19_0' class='gform-field-label gform-field-label--type-inline'>Le vitrage est cass\u00e9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_19_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='Le vitrage pr\u00e9sente de la condensation'  id='choice_53_19_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_19_1' id='label_53_19_1' class='gform-field-label gform-field-label--type-inline'>Le vitrage pr\u00e9sente de la condensation<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_19_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='Je ne sais pas'  id='choice_53_19_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_19_2' id='label_53_19_2' class='gform-field-label gform-field-label--type-inline'>Je ne sais pas<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_53_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Quel est le dommage \u00e0 vos vitrages ?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_53_23'>\n\t\t\t<div class='gchoice gchoice_53_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Les vitrages sont cass\u00e9s'  id='choice_53_23_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_23_0' id='label_53_23_0' class='gform-field-label gform-field-label--type-inline'>Les vitrages sont cass\u00e9s<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Les vitrages pr\u00e9sentent de la condensation'  id='choice_53_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_23_1' id='label_53_23_1' class='gform-field-label gform-field-label--type-inline'>Les vitrages pr\u00e9sentent de la condensation<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_23_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Il y a des vitrages cass\u00e9s et condens\u00e9s'  id='choice_53_23_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_23_2' id='label_53_23_2' class='gform-field-label gform-field-label--type-inline'>Il y a des vitrages cass\u00e9s et condens\u00e9s<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_23_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Je ne sais pas'  id='choice_53_23_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_23_3' id='label_53_23_3' class='gform-field-label gform-field-label--type-inline'>Je ne sais pas<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_53_20\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>O\u00f9 se situe le vitrage endommag\u00e9 ?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_53_20'>\n\t\t\t<div class='gchoice gchoice_53_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='Au rez-de-chauss\u00e9e'  id='choice_53_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_20_0' id='label_53_20_0' class='gform-field-label gform-field-label--type-inline'>Au rez-de-chauss\u00e9e<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='\u00c0 l\u2019\u00e9tage'  id='choice_53_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_20_1' id='label_53_20_1' class='gform-field-label gform-field-label--type-inline'>\u00c0 l\u2019\u00e9tage<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_20_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='Je ne sais pas'  id='choice_53_20_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_20_2' id='label_53_20_2' class='gform-field-label gform-field-label--type-inline'>Je ne sais pas<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_53_21\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>O\u00f9 se situe le vitrage endommag\u00e9 ?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_53_21'>\n\t\t\t<div class='gchoice gchoice_53_21_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Au rez-de-chauss\u00e9e'  id='choice_53_21_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_21_0' id='label_53_21_0' class='gform-field-label gform-field-label--type-inline'>Au rez-de-chauss\u00e9e<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_21_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='\u00c0 l\u2019\u00e9tage'  id='choice_53_21_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_21_1' id='label_53_21_1' class='gform-field-label gform-field-label--type-inline'>\u00c0 l\u2019\u00e9tage<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_21_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Au rez-de-chauss\u00e9e et \u00e0 l&#039;\u00e9tage'  id='choice_53_21_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_21_2' id='label_53_21_2' class='gform-field-label gform-field-label--type-inline'>Au rez-de-chauss\u00e9e et \u00e0 l'\u00e9tage<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_21_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Je ne sais pas'  id='choice_53_21_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_21_3' id='label_53_21_3' class='gform-field-label gform-field-label--type-inline'>Je ne sais pas<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_53_47\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_53_47'><span class='gform-field-label__text'>\u00c0 quel \u00e9tage se situe le vitrage endommag\u00e9 ?<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_47' id='input_53_47' type='text' step='any'   value='' class='small'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_53_49\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_53_49'><span class='gform-field-label__text'>\u00c0 quel(s) \u00e9tage(s) se situent les vitrages endommag\u00e9s ?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_53_49' type='text' value='' class='small'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_53_34\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Pouvons-nous utiliser un escalier ou un ascenseur pour monter le nouveau vitrage ?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_53_34'>\n\t\t\t<div class='gchoice gchoice_53_34_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Oui, c&#039;est possible'  id='choice_53_34_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_34_0' id='label_53_34_0' class='gform-field-label gform-field-label--type-inline'>Oui, c'est possible<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_34_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Non, ce n&#039;est pas possible'  id='choice_53_34_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_34_1' id='label_53_34_1' class='gform-field-label gform-field-label--type-inline'>Non, ce n'est pas possible<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_34_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Je ne sais pas'  id='choice_53_34_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_34_2' id='label_53_34_2' class='gform-field-label gform-field-label--type-inline'>Je ne sais pas<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_53_35\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Pouvons-nous utiliser un escalier ou un ascenseur pour monter le nouveau vitrage ?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_53_35'>\n\t\t\t<div class='gchoice gchoice_53_35_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Oui, c&#039;est possible'  id='choice_53_35_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_35_0' id='label_53_35_0' class='gform-field-label gform-field-label--type-inline'>Oui, c'est possible<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_35_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Non, c&#039;est possible'  id='choice_53_35_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_35_1' id='label_53_35_1' class='gform-field-label gform-field-label--type-inline'>Non, c'est possible<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_35_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Je ne sais pas'  id='choice_53_35_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_35_2' id='label_53_35_2' class='gform-field-label gform-field-label--type-inline'>Je ne sais pas<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_53_30\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Le bas de la vitre endommag\u00e9e se situe-t-il \u00e0 moins de 90 cm du sol ?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_53_30'>\n\t\t\t<div class='gchoice gchoice_53_30_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Oui'  id='choice_53_30_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_53_30\"   \/>\n\t\t\t\t\t<label for='choice_53_30_0' id='label_53_30_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_30_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Non'  id='choice_53_30_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_30_1' id='label_53_30_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_30_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Je ne sais pas'  id='choice_53_30_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_30_2' id='label_53_30_2' class='gform-field-label gform-field-label--type-inline'>Je ne sais pas<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_53_30'>Pour les vitrages dont partie se situe \u00e0 moins de 90 cm du sol, nous sommes oblig\u00e9s de pr\u00e9voir un vitrage de s\u00e9curit\u00e9.<\/div><\/fieldset><fieldset id=\"field_53_32\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Le bas des vitres endommag\u00e9es se situe-t-il \u00e0 moins de 90 cm du sol ?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_53_32'>\n\t\t\t<div class='gchoice gchoice_53_32_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Oui'  id='choice_53_32_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_53_32\"   \/>\n\t\t\t\t\t<label for='choice_53_32_0' id='label_53_32_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_32_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Non'  id='choice_53_32_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_32_1' id='label_53_32_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_32_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Oui, mais pas partout'  id='choice_53_32_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_32_2' id='label_53_32_2' class='gform-field-label gform-field-label--type-inline'>Oui, mais pas partout<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_32_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Je ne sais pas'  id='choice_53_32_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_32_3' id='label_53_32_3' class='gform-field-label gform-field-label--type-inline'>Je ne sais pas<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_53_32'>Pour les vitrages dont partie se situe \u00e0 moins de 90 cm du sol, nous sommes oblig\u00e9s de pr\u00e9voir un vitrage de s\u00e9curit\u00e9.<\/div><\/fieldset><fieldset id=\"field_53_36\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Le vitrage actuel est-il un simple, double ou triple vitrage ?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_53_36'>\n\t\t\t<div class='gchoice gchoice_53_36_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Simple vitrage'  id='choice_53_36_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_36_0' id='label_53_36_0' class='gform-field-label gform-field-label--type-inline'>Simple vitrage<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_36_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Double vitrage'  id='choice_53_36_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_36_1' id='label_53_36_1' class='gform-field-label gform-field-label--type-inline'>Double vitrage<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_36_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Triple vitrage'  id='choice_53_36_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_36_2' id='label_53_36_2' class='gform-field-label gform-field-label--type-inline'>Triple vitrage<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_36_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Je ne sais pas'  id='choice_53_36_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_36_3' id='label_53_36_3' class='gform-field-label gform-field-label--type-inline'>Je ne sais pas<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_53_37\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Les vitrages actuels sont-ils des vitrages simples, doubles ou triples ?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_53_37'>\n\t\t\t<div class='gchoice gchoice_53_37_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='Simple vitrage'  id='choice_53_37_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_37_0' id='label_53_37_0' class='gform-field-label gform-field-label--type-inline'>Simple vitrage<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_37_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='Double vitrage'  id='choice_53_37_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_37_1' id='label_53_37_1' class='gform-field-label gform-field-label--type-inline'>Double vitrage<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_37_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='Triple vitrage'  id='choice_53_37_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_37_2' id='label_53_37_2' class='gform-field-label gform-field-label--type-inline'>Triple vitrage<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_37_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='Une combinaison'  id='choice_53_37_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_37_3' id='label_53_37_3' class='gform-field-label gform-field-label--type-inline'>Une combinaison<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_37_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='Je ne sais pas'  id='choice_53_37_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_37_4' id='label_53_37_4' class='gform-field-label gform-field-label--type-inline'>Je ne sais pas<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_53_33\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_53_33'><span class='gform-field-label__text'>Quelles sont les dimensions (approximatives) du vitrage ?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_33' id='input_53_33' type='text' value='' class='medium'  aria-describedby=\"gfield_description_53_33\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_53_33'>Largeur x hauteur approximatives, en mm.\nVous pouvez indiquer les dimensions du vitrage visible. Apr\u00e8s approbation du devis, l\u2019un de nos techniciens passera pour prendre les mesures d\u00e9finitives. <strong><a href=\"https:\/\/weemaes.be\/fr\/gegevens-voor-je-offerte\/#opmeten\" target=\"_blank\">Comment mesurer mon vitrage ?<\/a><\/strong><\/div><\/div><fieldset id=\"field_53_28\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Quelles sont les dimensions (approximatives) des vitrages ?<\/span><\/legend><div class='ginput_container ginput_container_list ginput_list '><div class='gfield_list gfield_list_container'><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_28_cell1 gform-grid-col' ><input aria-invalid='false'  aria-describedby=\"gfield_description_53_28\" aria-label='Quelles sont les dimensions (approximatives) des vitrages ?, Row 1' data-aria-label-template='Quelles sont les dimensions (approximatives) des vitrages ?, Row {0}' type='text' name='input_28[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><div class='gfield_description' id='gfield_description_53_28'>Dimensions approximatives : largeur x hauteur, en mm.\nIndiquez les dimensions du vitrage visible pour chaque vitre dans un champ s\u00e9par\u00e9. Cliquez sur l\u2019ic\u00f4ne + pour ajouter une vitre suppl\u00e9mentaire.\n\nApr\u00e8s approbation, l\u2019un de nos techniciens passera chez vous pour prendre les mesures d\u00e9finitives. <strong><a href=\"https:\/\/weemaes.be\/fr\/gegevens-voor-je-offerte\/#opmeten\" target=\"_blank\">Comment mesurer mon vitrage ?<\/a><\/strong><\/div><\/fieldset><fieldset id=\"field_53_31\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Votre habitation a-t-elle plus ou moins de 10 ans ?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_53_31'>\n\t\t\t<div class='gchoice gchoice_53_31_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Plus de 10 ans'  id='choice_53_31_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_53_31\"   \/>\n\t\t\t\t\t<label for='choice_53_31_0' id='label_53_31_0' class='gform-field-label gform-field-label--type-inline'>Plus de 10 ans<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_31_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Moins de 10 ans'  id='choice_53_31_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_31_1' id='label_53_31_1' class='gform-field-label gform-field-label--type-inline'>Moins de 10 ans<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_31_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Je ne sais pas'  id='choice_53_31_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_31_2' id='label_53_31_2' class='gform-field-label gform-field-label--type-inline'>Je ne sais pas<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_53_31'>Nous utilisons cette information pour d\u00e9terminer le taux de TVA applicable \u00e0 votre devis.<\/div><\/fieldset><div id=\"field_53_8\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_53_8'><span class='gform-field-label__text'>T\u00e9l\u00e9chargez ici vos photo(s) du dommage (sans photos, nous ne pouvons pas \u00e9tablir de devis correct)<\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_53_8' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_53_8&quot;,&quot;container&quot;:&quot;gform_multifile_upload_53_8&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_53_8&quot;,&quot;filelist&quot;:&quot;gform_preview_53_8&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/weemaes.be\\\/fr\\\/?gf_page=6c5c8165a1b5d3e&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/weemaes.be\\\/fr\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/weemaes.be\\\/fr\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;4194304b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:53,&quot;field_id&quot;:8,&quot;_gform_file_upload_nonce_53_8&quot;:&quot;8b16857afc&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;20&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_53_8&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_53_8' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_53_8' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_53_8 gfield_description_53_8\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_53_8'>Max. file size: 4 MB, Max. files: 20.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_53_8'><\/ul> <div id='gform_preview_53_8' class='ginput_preview_list'><\/div><\/div><div class='gfield_description' id='gfield_description_53_8'>Gr\u00e2ce \u00e0 ces photos, nous pouvons \u00e9tablir un devis plus pr\u00e9cis et vous l\u2019envoyer plus rapidement. <a href=\"https:\/\/weemaes.be\/fr\/gegevens-voor-je-offerte\/#foto\" target=\"_blank\">Voici les photos \u00e0 pr\u00e9voir de pr\u00e9f\u00e9rence :<\/a>: une photo de l'ensemble, une photo d\u00e9taill\u00e9e d'un coin inf\u00e9rieur incluant le ch\u00e2ssis, une photo de la situation autour du vitrage.<\/div><\/div><div id=\"field_53_7\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_53_7'><span class='gform-field-label__text'>Souhaitez-vous nous transmettre des informations compl\u00e9mentaires concernant votre dommage vitrage ?<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_7' id='input_53_7' class='textarea medium'  aria-describedby=\"gfield_description_53_7\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_53_7'>Y a-t-il des \u00e9l\u00e9ments sp\u00e9cifiques que nous devons encore savoir ?\nVous pourrez renseigner vos coordonn\u00e9es, votre num\u00e9ro de TVA et d\u2019autres informations \u00e0 la page suivante.<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_53_25' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Suivant<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_53_2' class='gform_page' data-js='page-field-id-25' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_53_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_53_14\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">2. Comment pouvons-nous vous contacter ?<\/h3><\/div><fieldset id=\"field_53_15\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Votre nom<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_53_15'>\n                            \n                            <span id='input_53_15_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_53_15_3' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                    <input type='text' name='input_15.3' id='input_53_15_3' value=''   aria-required='true'    autocomplete=\"given-name\" \/>\n                                                <\/span>\n                            \n                            <span id='input_53_15_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_53_15_6' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                            <input type='text' name='input_15.6' id='input_53_15_6' value=''   aria-required='true'    autocomplete=\"family-name\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_53_2\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_53_2'><span class='gform-field-label__text'>Votre adresse e-mail<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_53_2' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_53_2\" autocomplete=\"email\"\/>\n                        <\/div><div class='gfield_description' id='gfield_description_53_2'>Vous recevrez notre devis par e-mail.<\/div><\/div><div id=\"field_53_9\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_53_9'><span class='gform-field-label__text'>Votre num\u00e9ro de t\u00e9l\u00e9phone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_53_9' type='text' value='' class='medium'  aria-describedby=\"gfield_description_53_9\"   aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"tel\" \/><\/div><div class='gfield_description' id='gfield_description_53_9'>Nous utilisons ce num\u00e9ro si nous avons des questions pour \u00e9tablir votre devis.<\/div><\/div><div id=\"field_53_39\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_53_39'><span class='gform-field-label__text'>Avez-vous un num\u00e9ro de TVA ?<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_39' id='input_53_39' type='tel' value='' class='medium'    aria-invalid=\"false\" aria-describedby=\"gfield_description_53_39\"   \/><\/div><div class='gfield_description' id='gfield_description_53_39'>Indiquez ici votre num\u00e9ro de TVA afin que nous puissions le mentionner sur votre devis.\nSi vous n\u2019avez pas de num\u00e9ro de TVA, vous pouvez laisser ce champ vide.<\/div><\/div><fieldset id=\"field_53_17\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Votre adresse<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip ginput_container_address gform-grid-row' id='input_53_17' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_53_17_1_container' >\n                                        <input type='text' name='input_17.1' id='input_53_17_1' value=''    aria-required='true'   autocomplete=\"address-line1\" \/>\n                                        <label for='input_53_17_1' id='input_53_17_1_label' class='gform-field-label gform-field-label--type-sub '>Rue et num\u00e9ro<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_53_17_3_container' >\n                                    <input type='text' name='input_17.3' id='input_53_17_3' value=''    aria-required='true'   autocomplete=\"address-level2\" \/>\n                                    <label for='input_53_17_3' id='input_53_17_3_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_17.4' id='input_53_17_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_53_17_5_container' >\n                                    <input type='text' name='input_17.5' id='input_53_17_5' value=''    aria-required='true'   autocomplete=\"postal-code\" \/>\n                                    <label for='input_53_17_5' id='input_53_17_5_label' class='gform-field-label gform-field-label--type-sub '>Ville ou commune<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_17.6' id='input_53_17_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><div class='gfield_description' id='gfield_description_53_17'>Il s\u2019agit de l\u2019adresse o\u00f9 les travaux seront r\u00e9alis\u00e9s. Ces donn\u00e9es figureront \u00e9galement sur votre devis, sauf si l\u2019adresse de facturation est diff\u00e9rente.<\/div><\/fieldset><fieldset id=\"field_53_42\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>L\u2019adresse du chantier est-elle identique \u00e0 l\u2019adresse de facturation ?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_53_42'>\n\t\t\t<div class='gchoice gchoice_53_42_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='Oui'  id='choice_53_42_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_42_0' id='label_53_42_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_42_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='Non'  id='choice_53_42_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_42_1' id='label_53_42_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_53_42_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='Je ne sais pas'  id='choice_53_42_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_53_42_2' id='label_53_42_2' class='gform-field-label gform-field-label--type-inline'>Je ne sais pas<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_53_44\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Donn\u00e9es de facturation : votre nom<\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_53_44'>\n                            \n                            <span id='input_53_44_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_53_44_3' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                    <input type='text' name='input_44.3' id='input_53_44_3' value=''   aria-required='false'     \/>\n                                                <\/span>\n                            \n                            <span id='input_53_44_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_53_44_6' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                            <input type='text' name='input_44.6' id='input_53_44_6' value=''   aria-required='false'     \/>\n                                                        <\/span>\n                            \n                        <\/div><div class='gfield_description' id='gfield_description_53_44'>Il s\u2019agit du nom qui figurera sur les donn\u00e9es de facturation de votre devis.<\/div><\/fieldset><fieldset id=\"field_53_41\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Donn\u00e9es de facturation : adresse<\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip ginput_container_address gform-grid-row' id='input_53_41' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_53_41_1_container' >\n                                        <label for='input_53_41_1' id='input_53_41_1_label' class='gform-field-label gform-field-label--type-sub '>Rue et num\u00e9ro<\/label>\n                                        <input type='text' name='input_41.1' id='input_53_41_1' value=''    aria-required='false'    \/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_53_41_3_container' >\n                                    <label for='input_53_41_3' id='input_53_41_3_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                    <input type='text' name='input_41.3' id='input_53_41_3' value=''    aria-required='false'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_41.4' id='input_53_41_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_53_41_5_container' >\n                                    <label for='input_53_41_5' id='input_53_41_5_label' class='gform-field-label gform-field-label--type-sub '>Ville ou commune<\/label>\n                                    <input type='text' name='input_41.5' id='input_53_41_5' value=''    aria-required='false'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_41.6' id='input_53_41_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><div class='gfield_description' id='gfield_description_53_41'>Il s\u2019agit de l\u2019adresse qui figurera sur votre devis.<\/div><\/fieldset><fieldset id=\"field_53_45\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Avez-vous d\u00e9j\u00e0 d\u00e9clar\u00e9 le dommage \u00e0 votre assurance ? Indiquez ci-dessous les coordonn\u00e9es de votre courtier ou agent. Nous lui enverrons directement notre devis.<\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name no_last_name no_suffix gf_name_has_1 ginput_container_name gform-grid-row' id='input_53_45'>\n                            \n                            <span id='input_53_45_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_53_45_3' class='gform-field-label gform-field-label--type-sub '>Nom de votre courtier\/de votre agent d\u2019assurance<\/label>\n                                                    <input type='text' name='input_45.3' id='input_53_45_3' value=''   aria-required='false'     \/>\n                                                <\/span>\n                            \n                            \n                            \n                        <\/div><\/fieldset><div id=\"field_53_46\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_53_46'><span class='gform-field-label__text'>Adresse e-mail de votre courtier\/de votre agent<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_46' id='input_53_46' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_53_43\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Privacy<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_53_43'><div class='gchoice gchoice_53_43_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.1' type='checkbox'  value='J\u2019accepte &lt;a href=&quot;https:\/\/weemaes.be\/fr\/privacy\/&quot;&gt;la d\u00e9claration de confidentialit\u00e9&lt;\/a&gt;.*'  id='choice_53_43_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_53_43_1' id='label_53_43_1' class='gform-field-label gform-field-label--type-inline'>J\u2019accepte <a href=\"https:\/\/weemaes.be\/fr\/privacy\/\">la d\u00e9claration de confidentialit\u00e9<\/a>.*<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_53_11\" class=\"gfield gfield--type-textarea gfield--input-type-textarea tgm_hidden_field field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_53_11'><span class='gform-field-label__text'>Tag manager info<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_11' id='input_53_11' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_53_50\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full hidden-gclid field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_53_50'><span class='gform-field-label__text'>gclid<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_50' id='input_53_50' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_53_51\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full hidden-mscklid field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_53_51'><span class='gform-field-label__text'>mscklid<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_51' id='input_53_51' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_53_52\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full hidden-fbc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_53_52'><span class='gform-field-label__text'>fbc<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_52' id='input_53_52' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_53_53\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full hidden-fbp field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_53_53'><span class='gform-field-label__text'>fbp<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_53' id='input_53_53' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_53_12\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_12' id='input_53_12' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><button type='submit' id='gform_previous_button_53' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='submit' id='gform_submit_button_53' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Envoyer<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_53' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_53' id='gform_theme_53' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_53' id='gform_style_settings_53' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_53' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='53' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='EUR' value='eoa8Fv0RJeUyVIlm6u\/8TetEi1y6Lg1G4HY47AcknEXWnjLy61H3WJ0sztc\/QStnnkEssjDc7+7Z9GziWlQ8vrgw0C+K87mIdigjSPifAFOezOM=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_53' 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