{"id":3379,"date":"2026-05-11T09:50:27","date_gmt":"2026-05-11T09:50:27","guid":{"rendered":"https:\/\/www.penisprothese.com\/evaluation-ed\/"},"modified":"2026-05-11T09:50:27","modified_gmt":"2026-05-11T09:50:27","slug":"evaluation-ed","status":"publish","type":"page","link":"https:\/\/www.penisprothese.com\/fr\/evaluation-ed\/","title":{"rendered":"\u00c9valuation de la DE"},"content":{"rendered":"<h3>\u00c9valuation de la DE ~ 5 min<\/h3>\n<hr>\n<div>\n<script>\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<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework gppt-has-page-transitions_wrapper gform-theme__no-reset--el_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_2' >\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_2' id='gform_2' class='gppt-has-page-transitions gform-theme__no-reset--el ' action='\/fr\/wp-json\/wp\/v2\/pages\/3379' data-formid='2' novalidate><input type=\"hidden\" name=\"gpuid_existing_value_41\" id=\"gpuid_existing_value_41\" value=\"b80cf66691c7a1ad28962e2f3a58df0d\" \/><input type=\"hidden\" value=\"0\" name=\"gpps_page_progression_2\" \/>\n        <div id='gf_progressbar_wrapper_2' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">\u00c9tape <span class='gf_step_current_page'>1<\/span> sur <span class='gf_step_page_count'>9<\/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_11' style='width:11%;'><span>11%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_2_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_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_2_43\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class=\"uk-alert uk-alert-primary\" data-id=\"page#6\">\n    \n                <h5 class=\"el-title\">Il existe de nombreuses raisons pourED. Ce quiz simple sur la dysfonction \u00e9rectile vous aidera \u00e0 \u00e9valuer la gravit\u00e9 de vos sympt\u00f4mes de dysfonction \u00e9rectile et l\u2019impact que la dysfonction \u00e9rectile peut avoir sur votre vie. \u2705 Soyez assur\u00e9 qu'aucune information personnelle telle que votre nom n'est requise pour cr\u00e9er votreED-Affichez les r\u00e9sultats de l'\u00e9valuation et le syst\u00e8me g\u00e9n\u00e9rera un identifiant al\u00e9atoire pour vous.\n\nRemarque : Ce quiz ne remplace pas un diagnostic m\u00e9dical. Vos donn\u00e9es seront trait\u00e9es conform\u00e9ment au RGPD et \u00e0 la HIPAA.\n\n\n\n<\/h5>        \n        \n    \n<\/div><\/div><fieldset id=\"field_2_38\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gppt-auto-progress-field gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible image-choices-field image-choices-use-images image-choices-show-labels ic-lightbox-captions has-jetsloth-lazy \"  data-field-class=\"image-choices-field image-choices-use-images image-choices-show-labels ic-lightbox-captions has-jetsloth-lazy\" ><legend class='gfield_label gform-field-label' >Vous ou votre partenaire avez-vous des \u00e9rections matinales ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_38'>\n\t\t\t<div class='gchoice gchoice_2_38_0 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='Ja'  id='choice_2_38_0' onchange='gformToggleRadioOther( this )'  tabindex='49'  \/>\n\t\t\t\t\t<label  for='choice_2_38_0' id='label_2_38_0' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/user.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/user.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"\" \/><\/span><span class=\"image-choices-choice-text\">Oui<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_38_1 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='Nein'  id='choice_2_38_1' onchange='gformToggleRadioOther( this )'  tabindex='50'  \/>\n\t\t\t\t\t<label  for='choice_2_38_1' id='label_2_38_1' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/user.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/user.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"\" \/><\/span><span class=\"image-choices-choice-text\">Non<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_2_7' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Suivant' tabindex='51' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_2' class='gform_page' data-js='page-field-id-7' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_2_8\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gppt-auto-progress-field gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible image-choices-field image-choices-use-images image-choices-show-labels ic-lightbox-captions has-jetsloth-lazy \"  data-field-class=\"image-choices-field image-choices-use-images image-choices-show-labels ic-lightbox-captions has-jetsloth-lazy\" ><legend class='gfield_label gform-field-label' >Comment \u00e9valuez-vous votre capacit\u00e9 \u00e0 obtenir et \u00e0 maintenir une \u00e9rection ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_8'>\n\t\t\t<div class='gchoice gchoice_2_8_0 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='1'  id='choice_2_8_0' onchange='gformToggleRadioOther( this )'  tabindex='52'  \/>\n\t\t\t\t\t<label  for='choice_2_8_0' id='label_2_8_0' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-1-01-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-1-01-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-1-01.png\" \/><\/span><span class=\"image-choices-choice-text\">Tr\u00e8s faible<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_8_1 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='2'  id='choice_2_8_1' onchange='gformToggleRadioOther( this )'  tabindex='53'  \/>\n\t\t\t\t\t<label  for='choice_2_8_1' id='label_2_8_1' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-1-02-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-1-02-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-1-02.png\" \/><\/span><span class=\"image-choices-choice-text\">Faible<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_8_2 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='3'  id='choice_2_8_2' onchange='gformToggleRadioOther( this )'  tabindex='54'  \/>\n\t\t\t\t\t<label  for='choice_2_8_2' id='label_2_8_2' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/Medium.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/Medium.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"\" \/><\/span><span class=\"image-choices-choice-text\">Mod\u00e9r\u00e9<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_8_3 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='4'  id='choice_2_8_3' onchange='gformToggleRadioOther( this )'  tabindex='55'  \/>\n\t\t\t\t\t<label  for='choice_2_8_3' id='label_2_8_3' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-1-04-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-1-04-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-1-04.png\" \/><\/span><span class=\"image-choices-choice-text\">\u00c9lev\u00e9<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_8_4 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_8' type='radio' value='5'  id='choice_2_8_4' onchange='gformToggleRadioOther( this )'  tabindex='56'  \/>\n\t\t\t\t\t<label  for='choice_2_8_4' id='label_2_8_4' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-1-05-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-1-05-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-1-05.png\" \/><\/span><span class=\"image-choices-choice-text\">Tr\u00e8s \u00e9lev\u00e9<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_2_10' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Pr\u00e9c\u00e9dent' tabindex='57' \/> <input type='button' id='gform_next_button_2_10' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Suivant' tabindex='58' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_3' class='gform_page' data-js='page-field-id-10' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_2_9\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gppt-auto-progress-field gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible image-choices-field image-choices-use-images image-choices-show-labels ic-lightbox-captions has-jetsloth-lazy \"  data-field-class=\"image-choices-field image-choices-use-images image-choices-show-labels ic-lightbox-captions has-jetsloth-lazy\" ><legend class='gfield_label gform-field-label' >Si vous avez eu une \u00e9rection pendant une stimulation sexuelle\u00a0; Pendant combien de temps votre \u00e9rection a-t-elle \u00e9t\u00e9 suffisamment forte et rigide pour la p\u00e9n\u00e9tration ? (P\u00e9n\u00e9trer votre partenaire<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_9'>\n\t\t\t<div class='gchoice gchoice_2_9_0 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='0'  id='choice_2_9_0' onchange='gformToggleRadioOther( this )'  tabindex='59'  \/>\n\t\t\t\t\t<label  for='choice_2_9_0' id='label_2_9_0' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-01-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-01-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-01.png\" \/><\/span><span class=\"image-choices-choice-text\">Aucune activit\u00e9 sexuelle<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_9_1 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='1'  id='choice_2_9_1' onchange='gformToggleRadioOther( this )'  tabindex='60'  \/>\n\t\t\t\t\t<label  for='choice_2_9_1' id='label_2_9_1' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-02-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-02-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-02.png\" \/><\/span><span class=\"image-choices-choice-text\">Presque jamais ou jamais<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_9_2 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='2'  id='choice_2_9_2' onchange='gformToggleRadioOther( this )'  tabindex='61'  \/>\n\t\t\t\t\t<label  for='choice_2_9_2' id='label_2_9_2' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-03-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-03-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-03.png\" \/><\/span><span class=\"image-choices-choice-text\">Quelques fois (moins de la moiti\u00e9 du temps)<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_9_3 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='3'  id='choice_2_9_3' onchange='gformToggleRadioOther( this )'  tabindex='62'  \/>\n\t\t\t\t\t<label  for='choice_2_9_3' id='label_2_9_3' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-04-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-04-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-04.png\" \/><\/span><span class=\"image-choices-choice-text\">Parfois (environ la moiti\u00e9 du temps)<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_9_4 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='4'  id='choice_2_9_4' onchange='gformToggleRadioOther( this )'  tabindex='63'  \/>\n\t\t\t\t\t<label  for='choice_2_9_4' id='label_2_9_4' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-05-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-05-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-05.png\" \/><\/span><span class=\"image-choices-choice-text\">La plupart du temps (plus de la moiti\u00e9 du temps)<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_9_5 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='5'  id='choice_2_9_5' onchange='gformToggleRadioOther( this )'  tabindex='64'  \/>\n\t\t\t\t\t<label  for='choice_2_9_5' id='label_2_9_5' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-06-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-06-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-2-06.png\" \/><\/span><span class=\"image-choices-choice-text\">Presque toujours ou toujours<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_2_11' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Pr\u00e9c\u00e9dent' tabindex='65' \/> <input type='button' id='gform_next_button_2_11' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Suivant' tabindex='66' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_4' class='gform_page' data-js='page-field-id-11' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_2_12\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gppt-auto-progress-field gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible image-choices-field image-choices-use-images image-choices-show-labels ic-lightbox-captions has-jetsloth-lazy \"  data-field-class=\"image-choices-field image-choices-use-images image-choices-show-labels ic-lightbox-captions has-jetsloth-lazy\" ><legend class='gfield_label gform-field-label' >\u00c0 quelle fr\u00e9quence avez-vous r\u00e9ussi \u00e0 maintenir une \u00e9rection pendant un rapport sexuel apr\u00e8s avoir p\u00e9n\u00e9tr\u00e9 votre partenaire\u00a0?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_12'>\n\t\t\t<div class='gchoice gchoice_2_12_0 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='0'  id='choice_2_12_0' onchange='gformToggleRadioOther( this )'  tabindex='67'  \/>\n\t\t\t\t\t<label  for='choice_2_12_0' id='label_2_12_0' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-01-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-01-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-01.png\" \/><\/span><span class=\"image-choices-choice-text\">Arr\u00eatez d'essayer d'avoir des rapports sexuels<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_12_1 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='1'  id='choice_2_12_1' onchange='gformToggleRadioOther( this )'  tabindex='68'  \/>\n\t\t\t\t\t<label  for='choice_2_12_1' id='label_2_12_1' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-02-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-02-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-02.png\" \/><\/span><span class=\"image-choices-choice-text\">Presque jamais ou jamais<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_12_2 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='2'  id='choice_2_12_2' onchange='gformToggleRadioOther( this )'  tabindex='69'  \/>\n\t\t\t\t\t<label  for='choice_2_12_2' id='label_2_12_2' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-03-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-03-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-03.png\" \/><\/span><span class=\"image-choices-choice-text\">Quelques fois (moins de la moiti\u00e9 du temps)<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_12_3 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='3'  id='choice_2_12_3' onchange='gformToggleRadioOther( this )'  tabindex='70'  \/>\n\t\t\t\t\t<label  for='choice_2_12_3' id='label_2_12_3' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-04-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-04-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-04.png\" \/><\/span><span class=\"image-choices-choice-text\">Parfois (environ la moiti\u00e9 du temps)<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_12_4 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='4'  id='choice_2_12_4' onchange='gformToggleRadioOther( this )'  tabindex='71'  \/>\n\t\t\t\t\t<label  for='choice_2_12_4' id='label_2_12_4' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-05-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-05-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-05.png\" \/><\/span><span class=\"image-choices-choice-text\">La plupart du temps (plus de la moiti\u00e9 du temps)<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_12_5 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='5'  id='choice_2_12_5' onchange='gformToggleRadioOther( this )'  tabindex='72'  \/>\n\t\t\t\t\t<label  for='choice_2_12_5' id='label_2_12_5' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-06-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-06-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-3-06.png\" \/><\/span><span class=\"image-choices-choice-text\">Presque toujours ou toujours<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_2_13' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Pr\u00e9c\u00e9dent' tabindex='73' \/> <input type='button' id='gform_next_button_2_13' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Suivant' tabindex='74' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_5' class='gform_page' data-js='page-field-id-13' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_2_15\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gppt-auto-progress-field gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible image-choices-field image-choices-use-images image-choices-show-labels ic-lightbox-captions has-jetsloth-lazy \"  data-field-class=\"image-choices-field image-choices-use-images image-choices-show-labels ic-lightbox-captions has-jetsloth-lazy\" ><legend class='gfield_label gform-field-label' >Dans quelle mesure a-t-il \u00e9t\u00e9 difficile de maintenir votre \u00e9rection pendant les rapports sexuels jusqu&#039;\u00e0 la fin des rapports sexuels\u00a0?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_15'>\n\t\t\t<div class='gchoice gchoice_2_15_0 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='0'  id='choice_2_15_0' onchange='gformToggleRadioOther( this )'  tabindex='75'  \/>\n\t\t\t\t\t<label  for='choice_2_15_0' id='label_2_15_0' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-01-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-01-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-01.png\" \/><\/span><span class=\"image-choices-choice-text\">N'a pas tent\u00e9 d'avoir des rapports sexuels<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_15_1 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='1'  id='choice_2_15_1' onchange='gformToggleRadioOther( this )'  tabindex='76'  \/>\n\t\t\t\t\t<label  for='choice_2_15_1' id='label_2_15_1' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-02-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-02-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-02.png\" \/><\/span><span class=\"image-choices-choice-text\">Extr\u00eamement difficile<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_15_2 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='2'  id='choice_2_15_2' onchange='gformToggleRadioOther( this )'  tabindex='77'  \/>\n\t\t\t\t\t<label  for='choice_2_15_2' id='label_2_15_2' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-03-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-03-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-03.png\" \/><\/span><span class=\"image-choices-choice-text\">Tr\u00e8s difficile<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_15_3 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='3'  id='choice_2_15_3' onchange='gformToggleRadioOther( this )'  tabindex='78'  \/>\n\t\t\t\t\t<label  for='choice_2_15_3' id='label_2_15_3' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-04-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-04-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-04.png\" \/><\/span><span class=\"image-choices-choice-text\">Difficile<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_15_4 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='4'  id='choice_2_15_4' onchange='gformToggleRadioOther( this )'  tabindex='79'  \/>\n\t\t\t\t\t<label  for='choice_2_15_4' id='label_2_15_4' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-05-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-05-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-05.png\" \/><\/span><span class=\"image-choices-choice-text\">Un peu difficile<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_15_5 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='5'  id='choice_2_15_5' onchange='gformToggleRadioOther( this )'  tabindex='80'  \/>\n\t\t\t\t\t<label  for='choice_2_15_5' id='label_2_15_5' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-06-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-06-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-4-06.png\" \/><\/span><span class=\"image-choices-choice-text\">Pas difficile<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_2_16' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Pr\u00e9c\u00e9dent' tabindex='81' \/> <input type='button' id='gform_next_button_2_16' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Suivant' tabindex='82' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_6' class='gform_page' data-js='page-field-id-16' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_6' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_2_17\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gppt-auto-progress-field gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible image-choices-field image-choices-use-images image-choices-show-labels ic-lightbox-captions has-jetsloth-lazy \"  data-field-class=\"image-choices-field image-choices-use-images image-choices-show-labels ic-lightbox-captions has-jetsloth-lazy\" ><legend class='gfield_label gform-field-label' >Si vous avez essay\u00e9 d\u2019avoir des rapports sexuels, \u00e0 quelle fr\u00e9quence les avez-vous trouv\u00e9s satisfaisants\u00a0?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_17'>\n\t\t\t<div class='gchoice gchoice_2_17_0 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='0'  id='choice_2_17_0' onchange='gformToggleRadioOther( this )'  tabindex='83'  \/>\n\t\t\t\t\t<label  for='choice_2_17_0' id='label_2_17_0' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-01-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-01-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-01.png\" \/><\/span><span class=\"image-choices-choice-text\">Presque jamais ou jamais<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_17_1 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='1'  id='choice_2_17_1' onchange='gformToggleRadioOther( this )'  tabindex='84'  \/>\n\t\t\t\t\t<label  for='choice_2_17_1' id='label_2_17_1' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-02-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-02-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-02.png\" \/><\/span><span class=\"image-choices-choice-text\">Quelques fois (moins de la moiti\u00e9 du temps)<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_17_2 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='2'  id='choice_2_17_2' onchange='gformToggleRadioOther( this )'  tabindex='85'  \/>\n\t\t\t\t\t<label  for='choice_2_17_2' id='label_2_17_2' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-03-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-03-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-03.png\" \/><\/span><span class=\"image-choices-choice-text\">Parfois (environ la moiti\u00e9 du temps)<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_17_3 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='3'  id='choice_2_17_3' onchange='gformToggleRadioOther( this )'  tabindex='86'  \/>\n\t\t\t\t\t<label  for='choice_2_17_3' id='label_2_17_3' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-04-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-04-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-04.png\" \/><\/span><span class=\"image-choices-choice-text\">La plupart du temps (plus de la moiti\u00e9 du temps)<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_17_4 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='4'  id='choice_2_17_4' onchange='gformToggleRadioOther( this )'  tabindex='87'  \/>\n\t\t\t\t\t<label  for='choice_2_17_4' id='label_2_17_4' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-05-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-05-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-05.png\" \/><\/span><span class=\"image-choices-choice-text\">La plupart du temps (plus de la moiti\u00e9 du temps)<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_17_5 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='5'  id='choice_2_17_5' onchange='gformToggleRadioOther( this )'  tabindex='88'  \/>\n\t\t\t\t\t<label  for='choice_2_17_5' id='label_2_17_5' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-06-300x300.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-06-300x300.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2023\/06\/step-5-06.png\" \/><\/span><span class=\"image-choices-choice-text\">Presque toujours ou toujours<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_2_18' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Pr\u00e9c\u00e9dent' tabindex='89' \/> <input type='button' id='gform_next_button_2_18' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Suivant' tabindex='90' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_7' class='gform_page' data-js='page-field-id-18' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_7' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_2_24\" 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 field_validation_below gfield_visibility_visible image-choices-field image-choices-use-images image-choices-show-labels ic-lightbox-captions has-jetsloth-lazy \"  data-field-class=\"image-choices-field image-choices-use-images image-choices-show-labels ic-lightbox-captions has-jetsloth-lazy\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >S\u00e9lectionnez tous les traitements que vous avez essay\u00e9s. (plusieurs s\u00e9lections possibles)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_24'><div class='gchoice gchoice_2_24_1 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.1' type='checkbox'  value='Pillen'  id='choice_2_24_1' tabindex='91'  \/>\n\t\t\t\t\t\t\t\t<label  for='choice_2_24_1' id='label_2_24_1' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/pill.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/pill.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/pill.png\" \/><\/span><span class=\"image-choices-choice-text\">Comprim\u00e9s<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_24_2 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.2' type='checkbox'  value='Vakuumpumpe'  id='choice_2_24_2' tabindex='92'  \/>\n\t\t\t\t\t\t\t\t<label  for='choice_2_24_2' id='label_2_24_2' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/Vacuum.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/Vacuum.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/Vacuum.png\" \/><\/span><span class=\"image-choices-choice-text\">Pompe \u00e0 vide<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_24_3 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.3' type='checkbox'  value='Injektion'  id='choice_2_24_3' tabindex='93'  \/>\n\t\t\t\t\t\t\t\t<label  for='choice_2_24_3' id='label_2_24_3' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/injections.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/injections.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/injections.png\" \/><\/span><span class=\"image-choices-choice-text\">Injection<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_24_4 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.4' type='checkbox'  value='Z\u00e4pfchen'  id='choice_2_24_4' tabindex='94'  \/>\n\t\t\t\t\t\t\t\t<label  for='choice_2_24_4' id='label_2_24_4' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/Supp.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/Supp.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/Supp.png\" \/><\/span><span class=\"image-choices-choice-text\">Suppositoire<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_24_5 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.5' type='checkbox'  value='Nichts'  id='choice_2_24_5' tabindex='95'  \/>\n\t\t\t\t\t\t\t\t<label  for='choice_2_24_5' id='label_2_24_5' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/none.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/none.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/none.png\" \/><\/span><span class=\"image-choices-choice-text\">Rien<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_2_20' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Pr\u00e9c\u00e9dent' tabindex='96' \/> <input type='button' id='gform_next_button_2_20' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Suivant' tabindex='97' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_8' class='gform_page' data-js='page-field-id-20' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_8' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_2_23\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible image-choices-field image-choices-use-images image-choices-show-labels ic-lightbox-captions has-jetsloth-lazy \"  data-field-class=\"image-choices-field image-choices-use-images image-choices-show-labels ic-lightbox-captions has-jetsloth-lazy\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Avez-vous re\u00e7u un diagnostic de l\u2019une des conditions m\u00e9dicales suivantes pouvant \u00eatre li\u00e9es \u00e0 la dysfonction \u00e9rectile\u00a0? (plusieurs s\u00e9lections possibles)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_2_23'><div class='gchoice gchoice_2_23_1 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.1' type='checkbox'  value='Diabetes'  id='choice_2_23_1' tabindex='98'  \/>\n\t\t\t\t\t\t\t\t<label  for='choice_2_23_1' id='label_2_23_1' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/Diabetes.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/Diabetes.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/Diabetes.png\" \/><\/span><span class=\"image-choices-choice-text\">diab\u00e8te<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_23_2 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.2' type='checkbox'  value='Prostatakrebs'  id='choice_2_23_2' tabindex='99'  \/>\n\t\t\t\t\t\t\t\t<label  for='choice_2_23_2' id='label_2_23_2' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/prostate-cancer.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/prostate-cancer.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/prostate-cancer.png\" \/><\/span><span class=\"image-choices-choice-text\">Cancer de la prostate<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_23_3 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.3' type='checkbox'  value='Kardiopathie'  id='choice_2_23_3' tabindex='100'  \/>\n\t\t\t\t\t\t\t\t<label  for='choice_2_23_3' id='label_2_23_3' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/heart.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/heart.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/heart.png\" \/><\/span><span class=\"image-choices-choice-text\">Cardiopathie<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_2_23_4 image-choices-choice gform-theme__no-reset--children'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.4' type='checkbox'  value='Nichts'  id='choice_2_23_4' tabindex='101'  \/>\n\t\t\t\t\t\t\t\t<label  for='choice_2_23_4' id='label_2_23_4' class='gform-field-label gform-field-label--type-inline' ><span class=\"image-choices-choice-image-wrap\" style=\"background-image:url(https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/none.png)\"><img decoding=\"async\" src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/none.png\" alt=\"\" class=\"image-choices-choice-image\" data-lightbox-src=\"https:\/\/www.penisprothese.com\/wp-content\/uploads\/2021\/11\/none.png\" \/><\/span><span class=\"image-choices-choice-text\">Rien<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_2_25' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Pr\u00e9c\u00e9dent' tabindex='102' \/> <input type='button' id='gform_next_button_2_25' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Suivant' tabindex='103' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_9' class='gform_page' data-js='page-field-id-25' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_9' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_2_33\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3>Recevez vos r\u00e9sultats personnalis\u00e9s dans votre bo\u00eete de r\u00e9ception.<\/h3><\/div><div id=\"field_2_41\" class=\"gfield gfield--type-uid gfield--input-type-uid gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><label class='gfield_label gform-field-label' for='input_2_41'>IDENTIFIANT<\/label><div class='ginput_container ginput_container_hidden'><input name='input_41' id='input_2_41' type='hidden' value=''  \/><\/div><\/div><div id=\"field_2_28\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_28'>Vieux<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_28' id='input_2_28' type='number' step='any' min='18' max='120' value='' class='large' tabindex='104'    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_2_28\" \/><div class='gfield_description instruction ' id='gfield_instruction_2_28'>Veuillez saisir un nombre entre <strong>18<\/strong> et <strong>120<\/strong>.<\/div><\/div><\/div><div id=\"field_2_34\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_34'>T\u00e9l\u00e9phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_34' id='input_2_34' type='tel' value='' class='large' tabindex='105' placeholder='Exemple\u00a0: +49 1725351114' aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"tel\" \/><\/div><\/div><div id=\"field_2_27\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_27'>E-mail<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_27' id='input_2_27' type='email' value='' class='large' tabindex='106'   aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"email\"\/>\n                        <\/div><\/div><div id=\"field_2_44\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class=\"uk-alert uk-alert-primary boxdarius\">Pourquoi? Nous demandons votre e-mail et votre num\u00e9ro de t\u00e9l\u00e9phone dans cette phase finale du processusED-\u00c9valuation afin que des experts puissent vous contacter, vous aider et vous mettre en contact avec un m\u00e9decin.<\/div>\n<hr><\/div><div id=\"field_2_40\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gppt-auto-progress-field gfield_contains_required 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=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_2_40'>Pays<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_40' id='input_2_40' class='large gfield_select' tabindex='107'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>- Choisir -<\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Egypt' >Egypte<\/option><option value='Albania' >Albanie<\/option><option value='Algeria' >Alg\u00e9rie<\/option><option value='Andorra' >Andorre<\/option><option value='Angola' >Angola<\/option><option value='Antigua &amp; Deps' >Antigua etamp; D\u00e9p\u00f4ts<\/option><option value='Equatorial Guinea' >Guin\u00e9e \u00e9quatoriale<\/option><option value='Argentina' >Argentine<\/option><option value='Armenia' >Arm\u00e9nie<\/option><option value='Azerbaijan' >Azerba\u00efdjan<\/option><option value='Ethiopia' >Ethiopie<\/option><option value='Australia' >Australie<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahre\u00efn<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbade<\/option><option value='Belgium' selected='selected'>Belgique<\/option><option value='Belize' >B\u00e9lize<\/option><option value='Benin' >B\u00e9nin<\/option><option value='Bhutan' >Bhoutan<\/option><option value='Bolivia' >Bolivie<\/option><option value='Bosnia Herzegovina' >Bosnie-Herz\u00e9govine<\/option><option value='Botswana' >Botswana<\/option><option value='Brazil' >Br\u00e9sil<\/option><option value='Brunei' >Brun\u00e9i<\/option><option value='Bulgaria' >Bulgarie<\/option><option value='Burkina' >Burkinab\u00e9<\/option><option value='Burundi' >Burundi<\/option><option value='Chile' >Chili<\/option><option value='China' >Chine<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Denmark' >Danemark<\/option><option value='Germany' >Allemagne<\/option><option value='Dominica' >Dominique<\/option><option value='Dominican Republic' >R\u00e9publique dominicaine<\/option><option value='Djibouti' >Djibouti<\/option><option value='Ecuador' >\u00c9quateur<\/option><option value='El Salvador' >Salvador<\/option><option value='Ivory Coast' >C\u00f4te d&#039;Ivoire<\/option><option value='Eritrea' >\u00c9rythr\u00e9e<\/option><option value='Estonia' >Estonie<\/option><option value='Fiji' >Fidji<\/option><option value='Finland' >Finlande<\/option><option value='France' >France<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambie<\/option><option value='Togo' >Aller<\/option><option value='Georgia' >G\u00e9orgie<\/option><option value='Ghana' >Ghana<\/option><option value='Grenada' >Grenade<\/option><option value='Greece' >Gr\u00e8ce<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guinea' >Guin\u00e9e<\/option><option value='Guinea-Bissau' >Guin\u00e9e Bissau<\/option><option value='Guyana' >Guyane<\/option><option value='Haiti' >Ha\u00efti<\/option><option value='Honduras' >Honduras<\/option><option value='India' >Inde<\/option><option value='Indonesia' >Indon\u00e9sie<\/option><option value='Iraq' >Irak<\/option><option value='Iran' >L&#039;Iran<\/option><option value='Ireland {Republic}' >Irlande{Republik}<\/option><option value='Iceland' >Islande<\/option><option value='Israel' >Isra\u00ebl<\/option><option value='Italy' >Italie<\/option><option value='Jamaica' >Jama\u00efque<\/option><option value='Japan' >Japon<\/option><option value='Yemen' >Y\u00e9men<\/option><option value='Jordan' >Jordanie<\/option><option value='Cambodia' >Cambodge<\/option><option value='Cameroon' >Cameroun<\/option><option value='Canada' >Canada<\/option><option value='Cape Verde' >Cap-Vert<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Qatar' >Qatar<\/option><option value='Kenya' >Kenya<\/option><option value='Kyrgyzstan' >Kirghizistan<\/option><option value='Kiribati' >Kiribati<\/option><option value='Colombia' >Colombie<\/option><option value='Comoros' >Comores<\/option><option value='Congo' >Congo<\/option><option value='Congo {Democratic Rep}' >Congo{Demokratische Republik}<\/option><option value='Korea North' >Cor\u00e9e du Nord<\/option><option value='Korea South' >Cor\u00e9e du Sud<\/option><option value='Kosovo' >Kosovo<\/option><option value='Croatia' >Croatie<\/option><option value='Cuba' >Cuba<\/option><option value='Kuwait' >Koweit<\/option><option value='Laos' >Laos<\/option><option value='Lesotho' >Lesotho<\/option><option value='Latvia' >Lettonie<\/option><option value='Lebanon' >Liban<\/option><option value='Liberia' >Lib\u00e9ria<\/option><option value='Libya' >Libye<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lituanie<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaisie<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malte<\/option><option value='Morocco' >Maroc<\/option><option value='Marshall Islands' >\u00celes Marshall<\/option><option value='Mauritania' >Mauritanie<\/option><option value='Mauritius' >Maurice<\/option><option value='Macedonia' >Mac\u00e9doine<\/option><option value='Mexico' >Mexique<\/option><option value='Micronesia' >Micron\u00e9sie<\/option><option value='Moldova' >Moldavie<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolie<\/option><option value='Montenegro' >Mont\u00e9n\u00e9gro<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar, {Burma}' >Myanmar (Birmanie)<\/option><option value='Namibia' >Namibie<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >N\u00e9pal<\/option><option value='New Zealand' >Nouvelle-Z\u00e9lande<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Netherlands' >Pays-Bas<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Norway' >Norv\u00e8ge<\/option><option value='Oman' >Oman<\/option><option value='East Timor' >Timor oriental<\/option><option value='Austria' >Autriche<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palaos<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papouasie-Nouvelle-Guin\u00e9e<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >P\u00e9rou<\/option><option value='Philippines' >Philippines<\/option><option value='Poland' >Pologne<\/option><option value='Portugal' >Portugal<\/option><option value='Rwanda' >Rwanda<\/option><option value='Romania' >Roumanie<\/option><option value='Russian Federation' >F\u00e9d\u00e9ration de Russie<\/option><option value='Solomon Islands' >\u00celes Salomon<\/option><option value='Zambia' >Zambie<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >Saint-Marin<\/option><option value='Sao Tome &amp; Principe' >Sao Tom\u00e9 etamp; Principe<\/option><option value='Saudi Arabia' >Arabie Saoudite<\/option><option value='Sweden' >Su\u00e8de<\/option><option value='Switzerland' >Suisse<\/option><option value='Senegal' >S\u00e9n\u00e9gal<\/option><option value='Serbia' >Serbie<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapour<\/option><option value='Slovakia' >Slovaquie<\/option><option value='Slovenia' >Slov\u00e9nie<\/option><option value='Somalia' >Somalie<\/option><option value='Spain' >Espagne<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='St Kitts &amp; Nevis' >Saint-Kitts-et-Nevis<\/option><option value='St Lucia' >Sainte-Lucie<\/option><option value='Saint Vincent &amp; the Grenadines' >Saint-Vincent-et-les Grenadines<\/option><option value='Sudan' >Soudan<\/option><option value='Suriname' >Surinam<\/option><option value='South Africa' >Afrique du Sud<\/option><option value='South Sudan' >Soudan du Sud<\/option><option value='Swaziland' >Swaziland<\/option><option value='Syria' >Syrie<\/option><option value='Tajikistan' >Tadjikistan<\/option><option value='Taiwan' >Ta\u00efwan<\/option><option value='Tanzania' >Tanzanie<\/option><option value='Thailand' >Tha\u00eflande<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad &amp; Tobago' >Trinit\u00e9 et amp; Tobago<\/option><option value='Turkey' >dinde<\/option><option value='Chad' >Tchad<\/option><option value='Czech Republic' >R\u00e9publique tch\u00e8que<\/option><option value='Tunisia' >Tunisie<\/option><option value='Turkmenistan' >Turkm\u00e9nistan<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='Uganda' >Ouganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='Hungary' >Hongrie<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Ouzb\u00e9kistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Vatican City' >Cit\u00e9 du Vatican<\/option><option value='Venezuela' >Venezuela<\/option><option value='United Arab Emirates' >\u00c9mirats arabes unis<\/option><option value='United States' >\u00c9tats-Unis<\/option><option value='United Kingdom' >Royaume-Uni<\/option><option value='Vietnam' >Vi\u00eat Nam<\/option><option value='Belarus' >Bi\u00e9lorussie<\/option><option value='Central African Rep' >R\u00e9p Centrafricaine<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='Cyprus' >Chypre<\/option><\/select><\/div><\/div><fieldset id=\"field_2_30\" 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_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><legend class='gfield_label gform-field-label gfield_label_before_complex' >Ville\/Pays<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_city has_country ginput_container_address gform-grid-row' id='input_2_30' >\n                        <span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_2_30_3_container' >\n                                    <input type='text' name='input_30.3' id='input_2_30_3' value='216.73.217.21' tabindex='109'   aria-required='true'   autocomplete=\"address-level2\" \/>\n                                    <label for='input_2_30_3' id='input_2_30_3_label' class='gform-field-label gform-field-label--type-sub '>Ville<\/label>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_30.4' id='input_2_30_4' value='216.73.217.21'\/><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_2_30_6_container' >\n                                        <select name='input_30.6' id='input_2_30_6' tabindex='111'  aria-required='true'   autocomplete=\"country-name\" ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Afrique du Sud' >Afrique du Sud<\/option><option value='Albanie' >Albanie<\/option><option value='Alg\u00e9rie' >Alg\u00e9rie<\/option><option value='Allemagne' >Allemagne<\/option><option value='Andorre' >Andorre<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctique' >Antarctique<\/option><option value='Antigua-et-Barbuda' >Antigua-et-Barbuda<\/option><option value='Arabie Saoudite' >Arabie Saoudite<\/option><option value='Argentine' >Argentine<\/option><option value='Arm\u00e9nie' >Arm\u00e9nie<\/option><option value='Aruba' >Aruba<\/option><option value='Australie' >Australie<\/option><option value='Autriche' >Autriche<\/option><option value='Azerba\u00efdjan' >Azerba\u00efdjan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahre\u00efn' >Bahre\u00efn<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Belarus' >Belarus<\/option><option value='Belgique' >Belgique<\/option><option value='Belize' >Belize<\/option><option value='Bermudes' >Bermudes<\/option><option value='Bhoutan' >Bhoutan<\/option><option value='Bolivie' >Bolivie<\/option><option value='Bonaire, Saint-Eustache et Saba' >Bonaire, Saint-Eustache et Saba<\/option><option value='Bosnie-Herz\u00e9govine' >Bosnie-Herz\u00e9govine<\/option><option value='Botswana' >Botswana<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Br\u00e9sil' >Br\u00e9sil<\/option><option value='Bulgarie' >Bulgarie<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='B\u00e9nin' >B\u00e9nin<\/option><option value='Cambodge' >Cambodge<\/option><option value='Cameroun' >Cameroun<\/option><option value='Canada' >Canada<\/option><option value='Cap-Vert' >Cap-Vert<\/option><option value='Chili' >Chili<\/option><option value='Chine' >Chine<\/option><option value='Chypre' >Chypre<\/option><option value='Colombie' >Colombie<\/option><option value='Comores' >Comores<\/option><option value='Congo' >Congo<\/option><option value='Cor\u00e9e (R\u00e9publique de)' >Cor\u00e9e (R\u00e9publique de)<\/option><option value='Cor\u00e9e (R\u00e9publique populaire d\u00e9mocratique de)' >Cor\u00e9e (R\u00e9publique populaire d\u00e9mocratique de)<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatie' >Croatie<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='C\u00f4te d\u2019Ivoire' >C\u00f4te d\u2019Ivoire<\/option><option value='Danemark' >Danemark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominique' >Dominique<\/option><option value='Espagne' >Espagne<\/option><option value='Estonie' >Estonie<\/option><option value='Eswatini' >Eswatini<\/option><option value='Fidji' >Fidji<\/option><option value='Finlande' >Finlande<\/option><option value='France' >France<\/option><option value='F\u00e9d\u00e9ration Russe' >F\u00e9d\u00e9ration Russe<\/option><option value='Gabon' >Gabon<\/option><option value='Gambie' >Gambie<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Grenade' >Grenade<\/option><option value='Groenland' >Groenland<\/option><option value='Gr\u00e8ce' >Gr\u00e8ce<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guin\u00e9e' >Guin\u00e9e<\/option><option value='Guin\u00e9e \u00e9quatoriale' >Guin\u00e9e \u00e9quatoriale<\/option><option value='Guin\u00e9e-Bissau' >Guin\u00e9e-Bissau<\/option><option value='Guyane' >Guyane<\/option><option value='Guyane' >Guyane<\/option><option value='G\u00e9orgie' >G\u00e9orgie<\/option><option value='G\u00e9orgie du Sud et \u00celes Sandwich du Sud' >G\u00e9orgie du Sud et \u00celes Sandwich du Sud<\/option><option value='Ha\u00efti' >Ha\u00efti<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hongrie' >Hongrie<\/option><option value='Inde' >Inde<\/option><option value='Indon\u00e9sie' >Indon\u00e9sie<\/option><option value='Irak' >Irak<\/option><option value='Iran' >Iran<\/option><option value='Irlande' >Irlande<\/option><option value='Islande' >Islande<\/option><option value='Isra\u00ebl' >Isra\u00ebl<\/option><option value='Italie' >Italie<\/option><option value='Jama\u00efque' >Jama\u00efque<\/option><option value='Japon' >Japon<\/option><option value='Jersey' >Jersey<\/option><option value='Jordanie' >Jordanie<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kirghizistan' >Kirghizistan<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kowe\u00eft' >Kowe\u00eft<\/option><option value='La Barbade' >La Barbade<\/option><option value='La R\u00e9union' >La R\u00e9union<\/option><option value='Lesotho' >Lesotho<\/option><option value='Lettonie' >Lettonie<\/option><option value='Liban' >Liban<\/option><option value='Liberia' >Liberia<\/option><option value='Libye' >Libye<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lituanie' >Lituanie<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Mac\u00e9doine du Nord' >Mac\u00e9doine du Nord<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malaisie' >Malaisie<\/option><option value='Malawi' >Malawi<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malte' >Malte<\/option><option value='Maroc' >Maroc<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritanie' >Mauritanie<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexique' >Mexique<\/option><option value='Micron\u00e9sie' >Micron\u00e9sie<\/option><option value='Moldavie' >Moldavie<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolie' >Mongolie<\/option><option value='Montserrat' >Montserrat<\/option><option value='Mont\u00e9n\u00e9gro' >Mont\u00e9n\u00e9gro<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibie' >Namibie<\/option><option value='Nauru' >Nauru<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nig\u00e9ria' >Nig\u00e9ria<\/option><option value='Niu\u00e9' >Niu\u00e9<\/option><option value='Norv\u00e8ge' >Norv\u00e8ge<\/option><option value='Nouvelle-Cal\u00e9donie' >Nouvelle-Cal\u00e9donie<\/option><option value='Nouvelle-Z\u00e9lande' >Nouvelle-Z\u00e9lande<\/option><option value='N\u00e9pal' >N\u00e9pal<\/option><option value='Oman' >Oman<\/option><option value='Ouganda' >Ouganda<\/option><option value='Ouzb\u00e9kistan' >Ouzb\u00e9kistan<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Panama' >Panama<\/option><option value='Papouasie-Nouvelle-Guin\u00e9e' >Papouasie-Nouvelle-Guin\u00e9e<\/option><option value='Paraguay' >Paraguay<\/option><option value='Pays-Bas' >Pays-Bas<\/option><option value='Philippines' >Philippines<\/option><option value='Pologne' >Pologne<\/option><option value='Polyn\u00e9sie fran\u00e7aise' >Polyn\u00e9sie fran\u00e7aise<\/option><option value='Porto Rico' >Porto Rico<\/option><option value='Portugal' >Portugal<\/option><option value='P\u00e9rou' >P\u00e9rou<\/option><option value='Qatar' >Qatar<\/option><option value='Roumanie' >Roumanie<\/option><option value='Royaume-Uni' >Royaume-Uni<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9publique Dominicaine' >R\u00e9publique Dominicaine<\/option><option value='R\u00e9publique Tch\u00e8que' >R\u00e9publique Tch\u00e8que<\/option><option value='R\u00e9publique arabe syrienne' >R\u00e9publique arabe syrienne<\/option><option value='R\u00e9publique centrafricaine' >R\u00e9publique centrafricaine<\/option><option value='R\u00e9publique d\u00e9mocratique du Congo' >R\u00e9publique d\u00e9mocratique du Congo<\/option><option value='R\u00e9publique d\u00e9mocratique populaire du Laos' >R\u00e9publique d\u00e9mocratique populaire du Laos<\/option><option value='Sahara occidental' >Sahara occidental<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre et Miquelon' >Saint Pierre et Miquelon<\/option><option value='Saint-Christophe-et-Nevis' >Saint-Christophe-et-Nevis<\/option><option value='Saint-Marin' >Saint-Marin<\/option><option value='Saint-Si\u00e8ge' >Saint-Si\u00e8ge<\/option><option value='Saint-Vincent-et-les Grenadines' >Saint-Vincent-et-les Grenadines<\/option><option value='Sainte-H\u00e9l\u00e8ne, Ascension et Tristan da Cunha' >Sainte-H\u00e9l\u00e8ne, Ascension et Tristan da Cunha<\/option><option value='Sainte-Lucie' >Sainte-Lucie<\/option><option value='Salvador' >Salvador<\/option><option value='Samoa' >Samoa<\/option><option value='Samoa am\u00e9ricaines' >Samoa am\u00e9ricaines<\/option><option value='Sao Tom\u00e9 et Principe' >Sao Tom\u00e9 et Principe<\/option><option value='Serbie' >Serbie<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapour' >Singapour<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovaquie' >Slovaquie<\/option><option value='Slov\u00e9nie' >Slov\u00e9nie<\/option><option value='Somalie' >Somalie<\/option><option value='Soudan' >Soudan<\/option><option value='Soudan du Sud' >Soudan du Sud<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Suisse' >Suisse<\/option><option value='Suriname' >Suriname<\/option><option value='Su\u00e8de' >Su\u00e8de<\/option><option value='S\u00e9n\u00e9gal' >S\u00e9n\u00e9gal<\/option><option value='Tadjikistan' >Tadjikistan<\/option><option value='Tanzanie (R\u00e9publique-Unie de)' >Tanzanie (R\u00e9publique-Unie de)<\/option><option value='Ta\u00efwan' >Ta\u00efwan<\/option><option value='Tchad' >Tchad<\/option><option value='Terres Australes Fran\u00e7aises' >Terres Australes Fran\u00e7aises<\/option><option value='Territoire britannique de l\u2019oc\u00e9an Indien' >Territoire britannique de l\u2019oc\u00e9an Indien<\/option><option value='Tha\u00eflande' >Tha\u00eflande<\/option><option value='Timor oriental' >Timor oriental<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinit\u00e9 et Tobago' >Trinit\u00e9 et Tobago<\/option><option value='Tunisie' >Tunisie<\/option><option value='Turkm\u00e9nistan' >Turkm\u00e9nistan<\/option><option value='Turquie' >Turquie<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='Ukraine' >Ukraine<\/option><option value='Uruguay' >Uruguay<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='Wallis et Futuna' >Wallis et Futuna<\/option><option value='Y\u00e9men' >Y\u00e9men<\/option><option value='Zambie' >Zambie<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c9gypte' >\u00c9gypte<\/option><option value='\u00c9mirats arabes unis' >\u00c9mirats arabes unis<\/option><option value='\u00c9quateur' >\u00c9quateur<\/option><option value='\u00c9rythr\u00e9e' >\u00c9rythr\u00e9e<\/option><option value='\u00c9tat palestinien' >\u00c9tat palestinien<\/option><option value='\u00c9tats-Unis' >\u00c9tats-Unis<\/option><option value='\u00c9thiopie' >\u00c9thiopie<\/option><option value='\u00cele Bouvet' >\u00cele Bouvet<\/option><option value='\u00cele Christmas' >\u00cele Christmas<\/option><option value='\u00cele Maurice' >\u00cele Maurice<\/option><option value='\u00cele Norfolk' >\u00cele Norfolk<\/option><option value='\u00cele de Man' >\u00cele de Man<\/option><option value='\u00celes Cayman' >\u00celes Cayman<\/option><option value='\u00celes Cocos' >\u00celes Cocos<\/option><option value='\u00celes Cook' >\u00celes Cook<\/option><option value='\u00celes Falkland' >\u00celes Falkland<\/option><option value='\u00celes F\u00e9ro\u00e9' >\u00celes F\u00e9ro\u00e9<\/option><option value='\u00celes Heard et McDonald' >\u00celes Heard et McDonald<\/option><option value='\u00celes Mariannes du Nord' >\u00celes Mariannes du Nord<\/option><option value='\u00celes Marshall' >\u00celes Marshall<\/option><option value='\u00celes Pitcairn' >\u00celes Pitcairn<\/option><option value='\u00celes Salomon' >\u00celes Salomon<\/option><option value='\u00celes Turques et Ca\u00efques' >\u00celes Turques et Ca\u00efques<\/option><option value='\u00celes Vierges am\u00e9ricaines' >\u00celes Vierges am\u00e9ricaines<\/option><option value='\u00celes Vierges britanniques' >\u00celes Vierges britanniques<\/option><option value='\u00celes de Svalbard et Jan Mayen' >\u00celes de Svalbard et Jan Mayen<\/option><option value='\u00celes mineures am\u00e9ricaines' >\u00celes mineures am\u00e9ricaines<\/option><option value='\u00celes \u00c5land' >\u00celes \u00c5land<\/option><\/select>\n                                        <label for='input_2_30_6' id='input_2_30_6_label' class='gform-field-label gform-field-label--type-sub '>Pays<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><div class='gfield_description' id='gfield_description_2_30'>Pourquoi? Nous demandons votre e-mail et votre num\u00e9ro de t\u00e9l\u00e9phone dans cette phase finale du processusED-\u00c9valuation afin que notre personnel puisse vous contacter et vous fournir des informations g\u00e9n\u00e9rales.\n<\/div><\/fieldset><div id=\"field_2_6\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_calculation 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=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_2_6'>Total<\/label><div class='ginput_container ginput_container_number'><input name='input_6' id='input_2_6' type='text' step='any'   value='' class='large gform-text-input-reset' tabindex='112' readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_2_35\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gppt-auto-progress-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=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_2_35'>Date du prospect<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_35' id='input_2_35' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon' tabindex='113'  placeholder='mm\/jj\/aaaa' aria-describedby=\"input_2_35_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_2_35_date_format' class='screen-reader-text'>MM slash JJ slash AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_35' class='gform_hidden' value='https:\/\/www.penisprothese.com\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_2_36\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gppt-auto-progress-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=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_2_36'>Condition<\/label><div class='ginput_container ginput_container_select'><select name='input_36' id='input_2_36' class='large gfield_select' tabindex='114'    aria-invalid=\"false\" ><option value='Erectile Dysfunction' >Dysfonction \u00e9rectile<\/option><option value='Urinary Incontinence' >Incontinence urinaire<\/option><option value='Testicular Replacement' >Remplacement testiculaire<\/option><\/select><\/div><\/div><div id=\"field_2_37\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gppt-auto-progress-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=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_2_37'>Source principale<\/label><div class='ginput_container ginput_container_select'><select name='input_37' id='input_2_37' class='large gfield_select' tabindex='115'    aria-invalid=\"false\" ><option value='Form' selected='selected'>Formulaire<\/option><option value='Whatsapp' >Whatsapp<\/option><option value='Phone' >T\u00e9l\u00e9phone<\/option><option value='Facebook' >Facebook<\/option><option value='Instagram' >Instagram<\/option><\/select><\/div><\/div><fieldset id=\"field_2_31\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gppt-auto-progress-field gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >approbation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_31.1' id='input_2_31_1' type='checkbox' value='1' tabindex='116'  aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_2_31_1' >J'accepte \u00e7a <a href=\"#modal-example\" uk-toggle>Informations sur la protection des donn\u00e9es pour l'entretien d'information<\/a>.<span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/label><input type='hidden' name='input_31.2' value='J&#039;accepte \u00e7a &lt;a href=&quot;#modal-example&quot; uk-toggle&gt;Informations sur la protection des donn\u00e9es pour l&#039;entretien d&#039;information&lt;\/a&gt;.' class='gform_hidden' \/><input type='hidden' name='input_31.3' value='7' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_2_42\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gppt-auto-progress-field gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >approbation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_42.1' id='input_2_42_1' type='checkbox' value='1' tabindex='117'  aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_2_42_1' >J'accepte \u00e7a <a href=\"https:\/\/w.rigicon.com\/privacy-policy\" rel=\"nofollow noreffer\" target=\"_blank\">politique de confidentialit\u00e9<\/a> | <a href=\"https:\/\/w.rigicon.com\/terms-of-use\" rel=\"nofollow noreffer\" target=\"_blank\">Conditions g\u00e9n\u00e9rales de vente<\/a>.<span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/label><input type='hidden' name='input_42.2' value='J&#039;accepte \u00e7a &lt;a href=&quot;https:\/\/w.rigicon.com\/privacy-policy&quot; rel=&quot;nofollow noreffer&quot; target=&quot;_blank&quot;&gt;politique de confidentialit\u00e9&lt;\/a&gt; | &lt;a href=&quot;https:\/\/w.rigicon.com\/terms-of-use&quot; rel=&quot;nofollow noreffer&quot; target=&quot;_blank&quot;&gt;Conditions g\u00e9n\u00e9rales de vente&lt;\/a&gt;.' class='gform_hidden' \/><input type='hidden' name='input_42.3' value='7' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_2_45\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div id=\"modal-example\" uk-modal>\n    <div class=\"uk-modal-dialog uk-modal-body\">\n        <h3 class=\"uk-modal-title\">Conditions de confidentialit\u00e9 de la consultation<\/h3>\n        <p>En cochant cette case, vous reconnaissez que les conseils des employ\u00e9s de Rigicon, Inc. fournissent uniquement des informations g\u00e9n\u00e9rales sur les produits et ne constituent pas un avis m\u00e9dical, un diagnostic ou des recommandations de traitement. Rigicon, Inc. n'est pas impliqu\u00e9 dans la prise de d\u00e9cision m\u00e9dicale et n'assume aucune responsabilit\u00e9 pour les d\u00e9cisions ou les traitements m\u00e9dicaux. Pour des diagnostics individuels, des d\u00e9cisions th\u00e9rapeutiques et des traitements, veuillez contacter uniquement votre m\u00e9decin traitant.<\/p>\n        <p class=\"uk-text-right\">\n            <button class=\"uk-button uk-button-default uk-modal-close\" type=\"button\">Fermer<\/button>\n        <\/p>\n    <\/div>\n<\/div>\n<\/div><div id=\"field_2_46\" 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_hidden\"  ><div class='ginput_container ginput_container_text'><input name='input_46' id='input_2_46' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='fr' \/><\/div><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_2' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Pr\u00e9c\u00e9dent' tabindex='118' \/> <input type='submit' id='gform_submit_button_2' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='VOIR LES R\u00c9SULTATS' tabindex='119' \/> <input type='hidden' name='gform_ajax' value='form_id=2&amp;title=&amp;description=1&amp;tabindex=49&amp;theme=gravity-theme&amp;styles=[]&amp;hash=26706039fbdf02b55a7557d5aeca488e' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_2' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_2' id='gform_theme_2' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_2' id='gform_style_settings_2' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_2' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='2' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='ogaK6v4s+ygJ0WA7LOfUuKjE\/EJX6v+xCLUQF76UUBcPjjbjxbwxhC9mjr9KbxiJ29mHag2BS\/BlCWvPUlxgssJGjt9b4vO4LOIjOv4wOVq1568=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_2' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_2' id='gform_target_page_number_2' value='2' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_2' id='gform_source_page_number_2' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n             <\/div><\/div>\n                        <\/form>\n                        <\/div>\n\t\t                <iframe style='display:none;width:0px;height:0px;' src='about:blank' name='gform_ajax_frame_2' id='gform_ajax_frame_2' title='Cette iframe contient la logique n\u00e9cessaire pour manipuler Gravity Forms avec Ajax.'><\/iframe>\n\t\t                <script>\ngform.initializeOnLoaded( function() {gformInitSpinner( 2, 'https:\/\/www.penisprothese.com\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_2').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_2');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_2').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){jQuery('#gform_wrapper_2').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_2').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_2').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/  }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_2').val();gformInitSpinner( 2, 'https:\/\/www.penisprothese.com\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [2, current_page]);window['gf_submitting_2'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_2').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [2]);window['gf_submitting_2'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_2').text());}else{jQuery('#gform_2').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"2\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_2\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_2\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_2\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 2, current_page );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} );\n<\/script>\n\n<\/div>\n<p><!--more--><br \/>\n<!-- {\"type\":\"layout\",\"children\":[{\"type\":\"section\",\"props\":{\"image_position\":\"center-center\",\"style\":\"default\",\"title_breakpoint\":\"xl\",\"title_position\":\"top-left\",\"title_rotation\":\"left\",\"vertical_align\":\"middle\",\"width\":\"default\"},\"children\":[{\"type\":\"row\",\"children\":[{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"position_sticky_breakpoint\":\"m\"},\"children\":[{\"path\":\"elements\",\"name\":\"Headline Decoration Bullet\",\"type\":\"headline\",\"props\":{\"block_align\":\"center\",\"content\":\"\u00c9valuation de la DE ~ 5 min\",\"id\":\"headline-decoration-bullet\",\"title_decoration\":\"bullet\",\"title_element\":\"h3\"},\"meta\":{\"type\":\"headline\",\"website\":\"elements\",\"image\":\"https:\\\/\\\/downloads-yootheme.storage.googleapis.com\\\/library\\\/elements\\\/elements\\\/headline-decoration-bullet.jpg\"},\"images\":[]},{\"type\":\"divider\",\"props\":{\"divider_element\":\"hr\"}},{\"type\":\"text\",\"props\":{\"column_breakpoint\":\"m\",\"content\":\"\n\n<p>[gravityform id=\\\"2\\\" title=\\\"false\\\" ajax=\\\"true\\\" tabindex=\\\"49\\\" ]<\\\/p>\",\"css\":\"#gform_submit_button_1 {\\nfont-family: Work Sans !important;\\n    width: auto !important;\\n    font-weight:500 !important;\\n\\n}\\n\\n#gform_submit_button_8 {\\nwidth:auto !important;\\n    font-family: Work Sans !important;\\n    font-weight:700 !important;\\n\\n}\\n\\n.el-element {\\n\\nbackground: radial-gradient(circle at 18.7% 37.8%, rgba(250, 250, 250, 0.5) 0%, rgba(225, 234, 238, 0.5) 90%);\\n\\n    padding:20px !important;\\n    border-radius:20px;\\n\\n}\\n\\n.boxradius\\n\\n{\\n    color: black !important;\\n    border-radius: 10px !important;\\n    padding: 20px !important;\\n    margin-top:20px !important;\\n}\",\"margin\":\"default\"}}]}]}]},{\"type\":\"section\",\"props\":{\"image_position\":\"center-center\",\"overlap\":false,\"style\":\"default\",\"title_breakpoint\":\"xl\",\"title_position\":\"top-left\",\"title_rotation\":\"left\",\"vertical_align\":\"middle\",\"width\":\"default\"},\"children\":[{\"type\":\"row\",\"children\":[{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"position_sticky_breakpoint\":\"m\"}}]}]}],\"version\":\"4.0.7\"} --><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00c9valuation de la DE ~ 5 min<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-3379","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.3 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>\u00c9valuation de la DE - PenisProthese.com<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.penisprothese.com\/fr\/evaluation-ed\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u00c9valuation de la DE - PenisProthese.com\" \/>\n<meta property=\"og:description\" content=\"\u00c9valuation de la DE ~ 5 min\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.penisprothese.com\/fr\/evaluation-ed\/\" \/>\n<meta property=\"og:site_name\" content=\"PenisProthese.com\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.penisprothese.com\/fr\/evaluation-ed\/\",\"url\":\"https:\/\/www.penisprothese.com\/fr\/evaluation-ed\/\",\"name\":\"\u00c9valuation de la DE - PenisProthese.com\",\"isPartOf\":{\"@id\":\"https:\/\/www.penisprothese.com\/fr\/#website\"},\"datePublished\":\"2026-05-11T09:50:27+00:00\",\"dateModified\":\"2026-05-11T09:50:27+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/www.penisprothese.com\/fr\/evaluation-ed\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.penisprothese.com\/fr\/evaluation-ed\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.penisprothese.com\/fr\/evaluation-ed\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.penisprothese.com\/fr\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"\u00c9valuation de la DE\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.penisprothese.com\/fr\/#website\",\"url\":\"https:\/\/www.penisprothese.com\/fr\/\",\"name\":\"PenisProthese.com\",\"description\":\"ED-Behandlung | Ursachen von ED und Behandlungsoptionen\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.penisprothese.com\/fr\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"fr-FR\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"\u00c9valuation de la DE - PenisProthese.com","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.penisprothese.com\/fr\/evaluation-ed\/","og_locale":"fr_FR","og_type":"article","og_title":"\u00c9valuation de la DE - PenisProthese.com","og_description":"\u00c9valuation de la DE ~ 5 min","og_url":"https:\/\/www.penisprothese.com\/fr\/evaluation-ed\/","og_site_name":"PenisProthese.com","twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.penisprothese.com\/fr\/evaluation-ed\/","url":"https:\/\/www.penisprothese.com\/fr\/evaluation-ed\/","name":"\u00c9valuation de la DE - PenisProthese.com","isPartOf":{"@id":"https:\/\/www.penisprothese.com\/fr\/#website"},"datePublished":"2026-05-11T09:50:27+00:00","dateModified":"2026-05-11T09:50:27+00:00","breadcrumb":{"@id":"https:\/\/www.penisprothese.com\/fr\/evaluation-ed\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.penisprothese.com\/fr\/evaluation-ed\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.penisprothese.com\/fr\/evaluation-ed\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.penisprothese.com\/fr\/"},{"@type":"ListItem","position":2,"name":"\u00c9valuation de la DE"}]},{"@type":"WebSite","@id":"https:\/\/www.penisprothese.com\/fr\/#website","url":"https:\/\/www.penisprothese.com\/fr\/","name":"PenisProthese.com","description":"ED-Behandlung | Ursachen von ED und Behandlungsoptionen","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.penisprothese.com\/fr\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"fr-FR"}]}},"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.penisprothese.com\/fr\/wp-json\/wp\/v2\/pages\/3379","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.penisprothese.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.penisprothese.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.penisprothese.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.penisprothese.com\/fr\/wp-json\/wp\/v2\/comments?post=3379"}],"version-history":[{"count":0,"href":"https:\/\/www.penisprothese.com\/fr\/wp-json\/wp\/v2\/pages\/3379\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.penisprothese.com\/fr\/wp-json\/wp\/v2\/media?parent=3379"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}