{"id":289,"date":"2025-11-14T13:25:19","date_gmt":"2025-11-14T13:25:19","guid":{"rendered":"https:\/\/rogeriosilva.pt\/?page_id=289"},"modified":"2026-01-09T12:33:07","modified_gmt":"2026-01-09T12:33:07","slug":"demander-une-simulation","status":"publish","type":"page","link":"https:\/\/rogeriosilva.pt\/fr\/demander-une-simulation\/","title":{"rendered":"Demande de simulation"},"content":{"rendered":"<div class=\"gb-element-312cd33b\">\n<div class=\"dng-content-section\">\n<div class=\"gb-element-8c982580\">\n<h1 class=\"gb-text gb-text-dab29cfe title2 mb-25 dng-heading-font fw-400\">Simuler votre assurance<\/h1>\n\n\n\n<div class=\"gb-element-510b8072\">\n<p class=\"gb-text gb-text-de9dc39f body1 m0 dng-body-font fw-400\"><br>Quelques clics, une d\u00e9cision s\u00fbre.<br> Envoyez-nous le formulaire et nous nous occuperons de votre simulation.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"dng-section-space-120 gb-element-2008d490\"><div class=\"rls-simulationForm\">\r\n    <div class=\"dng-content-section\">\r\n        <div class=\"rls-simulationForm--wrap\">\r\n            <div class=\"rls-simulationForm--tabs\">\r\n                <button type=\"button\" data-id=\"#form_PARTICULARES\" class=\"button-text fw-600\">PRIV\u00c9<\/button>\r\n                <button type=\"button\" data-id=\"#form_EMPRESAS\" class=\"button-text active fw-600\">ENTREPRISES<\/button>\r\n            <\/div>\r\n            <div class=\"rls-simulationForm--form rls-servicesForm\">\r\n                <div class=\"rlsSimulationForm\" id=\"form_PARTICULARES\" style=\"display: none;\">\r\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 gform-theme gform-theme--foundation gform-theme--framework gform-theme--orbital' data-form-theme='orbital' data-form-index='0' id='gform_wrapper_4' style='display:none'><style>#gform_wrapper_4[data-form-index=\"0\"].gform-theme,[data-parent-form=\"4_0\"]{--gf-color-primary: #204ce5;--gf-color-primary-rgb: 32, 76, 229;--gf-color-primary-contrast: #fff;--gf-color-primary-contrast-rgb: 255, 255, 255;--gf-color-primary-darker: #001AB3;--gf-color-primary-lighter: #527EFF;--gf-color-secondary: #fff;--gf-color-secondary-rgb: 255, 255, 255;--gf-color-secondary-contrast: #112337;--gf-color-secondary-contrast-rgb: 17, 35, 55;--gf-color-secondary-darker: #F5F5F5;--gf-color-secondary-lighter: #FFFFFF;--gf-color-out-ctrl-light: rgba(17, 35, 55, 0.1);--gf-color-out-ctrl-light-rgb: 17, 35, 55;--gf-color-out-ctrl-light-darker: rgba(104, 110, 119, 0.35);--gf-color-out-ctrl-light-lighter: #F5F5F5;--gf-color-out-ctrl-dark: #585e6a;--gf-color-out-ctrl-dark-rgb: 88, 94, 106;--gf-color-out-ctrl-dark-darker: #112337;--gf-color-out-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-color-in-ctrl: #fff;--gf-color-in-ctrl-rgb: 255, 255, 255;--gf-color-in-ctrl-contrast: #112337;--gf-color-in-ctrl-contrast-rgb: 17, 35, 55;--gf-color-in-ctrl-darker: #F5F5F5;--gf-color-in-ctrl-lighter: #FFFFFF;--gf-color-in-ctrl-primary: #204ce5;--gf-color-in-ctrl-primary-rgb: 32, 76, 229;--gf-color-in-ctrl-primary-contrast: #fff;--gf-color-in-ctrl-primary-contrast-rgb: 255, 255, 255;--gf-color-in-ctrl-primary-darker: #001AB3;--gf-color-in-ctrl-primary-lighter: #527EFF;--gf-color-in-ctrl-light: rgba(17, 35, 55, 0.1);--gf-color-in-ctrl-light-rgb: 17, 35, 55;--gf-color-in-ctrl-light-darker: rgba(104, 110, 119, 0.35);--gf-color-in-ctrl-light-lighter: #F5F5F5;--gf-color-in-ctrl-dark: #585e6a;--gf-color-in-ctrl-dark-rgb: 88, 94, 106;--gf-color-in-ctrl-dark-darker: #112337;--gf-color-in-ctrl-dark-lighter: rgba(17, 35, 55, 0.65);--gf-radius: 3px;--gf-font-size-secondary: 14px;--gf-font-size-tertiary: 13px;--gf-icon-ctrl-number: url(\"data:image\/svg+xml,%3Csvg width='8' height='14' viewBox='0 0 8 14' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M4 0C4.26522 5.96046e-08 4.51957 0.105357 4.70711 0.292893L7.70711 3.29289C8.09763 3.68342 8.09763 4.31658 7.70711 4.70711C7.31658 5.09763 6.68342 5.09763 6.29289 4.70711L4 2.41421L1.70711 4.70711C1.31658 5.09763 0.683417 5.09763 0.292893 4.70711C-0.0976311 4.31658 -0.097631 3.68342 0.292893 3.29289L3.29289 0.292893C3.48043 0.105357 3.73478 0 4 0ZM0.292893 9.29289C0.683417 8.90237 1.31658 8.90237 1.70711 9.29289L4 11.5858L6.29289 9.29289C6.68342 8.90237 7.31658 8.90237 7.70711 9.29289C8.09763 9.68342 8.09763 10.3166 7.70711 10.7071L4.70711 13.7071C4.31658 14.0976 3.68342 14.0976 3.29289 13.7071L0.292893 10.7071C-0.0976311 10.3166 -0.0976311 9.68342 0.292893 9.29289Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-select: url(\"data:image\/svg+xml,%3Csvg width='10' height='6' viewBox='0 0 10 6' fill='none' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath fill-rule='evenodd' clip-rule='evenodd' d='M0.292893 0.292893C0.683417 -0.097631 1.31658 -0.097631 1.70711 0.292893L5 3.58579L8.29289 0.292893C8.68342 -0.0976311 9.31658 -0.0976311 9.70711 0.292893C10.0976 0.683417 10.0976 1.31658 9.70711 1.70711L5.70711 5.70711C5.31658 6.09763 4.68342 6.09763 4.29289 5.70711L0.292893 1.70711C-0.0976311 1.31658 -0.0976311 0.683418 0.292893 0.292893Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-search: url(\"data:image\/svg+xml,%3Csvg width='640' height='640' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);--gf-ctrl-border-color: #686e77;--gf-ctrl-size: var(--gf-ctrl-size-md);--gf-ctrl-label-color-primary: #112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-file-btn-bg-color-hover: #EBEBEB;--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style>\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>\"<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\"indique les champs obligatoires<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_4'  action='\/fr\/wp-json\/wp\/v2\/pages\/289' data-formid='4' novalidate data-trp-original-action=\"\/fr\/wp-json\/wp\/v2\/pages\/289\">\n                        <div class='gform-body gform_body'><div id='gform_fields_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_4_15\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_15'>ASSURANCE<\/label><div class='ginput_container ginput_container_select'><select name='input_15' id='input_4_15' class='large gfield_select'     aria-invalid=\"false\" ><option value='Sa\u00fade' >Sant\u00e9<\/option><option value='Veiculos' selected='selected'>V\u00e9hicules<\/option><option value='Habita\u00e7\u00e3o' >Logement<\/option><option value='Acidentes de Trabalho' >Accidents du travail<\/option><option value='Viagem e Lazer' >Voyages et loisirs<\/option><option value='Acidentes Pessoais' >Accidents personnels<\/option><option value='Vida e Poupan\u00e7a' >Vie et \u00e9pargne<\/option><option value='Outros' >Autres<\/option><\/select><\/div><\/div><div id=\"field_4_16\" class=\"gfield gfield--type-text gfield--input-type-text 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_4_16'>NIF<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_4_16' type='text' value='' class='large'    placeholder='NIF' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_17\" class=\"gfield gfield--type-text gfield--input-type-text 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_4_17'>NOM<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_4_17' type='text' value='' class='large'    placeholder='NOM' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_25\" class=\"gfield gfield--type-number gfield--input-type-number 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_4_25'>Nombre de personnes<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_25' id='input_4_25' type='number' step='any'   value='' class='large'    placeholder='Nombre de personnes' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_4_26\" class=\"gfield gfield--type-post_custom_field gfield--input-type-list gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Dates de naissance selon les personnes<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_26_cell1 gform-grid-col' ><input aria-invalid='false' aria-required=\"true\"  aria-label='Dates de naissance selon les personnes, rang\u00e9e 1' data-aria-label-template='Datas de Nascimento consoante as pessoas, Row {0}' type='text' name='input_26[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item' aria-label='Ajouter une autre ligne' onclick='gformAddListItem(this, 0)'>Ajouter<\/button>   <button type='button'  class='delete_list_item' aria-label='Supprimer la ligne 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Retirer<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_39\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Dates de naissance<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_39_cell1 gform-grid-col' ><input aria-invalid='false' aria-required=\"true\"  aria-label='Dates de naissance, rang\u00e9e 1' data-aria-label-template='Datas de Nascimento, Row {0}' type='text' name='input_39[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item' aria-label='Ajouter une autre ligne' onclick='gformAddListItem(this, 0)'>Ajouter<\/button>   <button type='button'  class='delete_list_item' aria-label='Supprimer la ligne 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Retirer<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><div class=\"gfmc-container\"><div class=\"gfield gfmc-column gfmc-field rls-servicesForm--row\"><div id=\"field_4_41\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter 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_4_41'>INSCRIPTION<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_4_41' type='text' value='' class='large'    placeholder='INSCRIPTION' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div><div class=\"gfield gfmc-column gfmc-field rls-serviceForm--date\"><div id=\"field_4_43\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_43'>DATE DE NAISSANCE<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_43' id='input_4_43' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/jj\/aaaa' aria-describedby=\"input_4_43_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_4_43_date_format' class='screen-reader-text'>MM barre oblique DD barre oblique AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_4_43' class='gform_hidden' value='https:\/\/rogeriosilva.pt\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_4_44\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_44'>DATE DU PERMIS DE CONDUIRE<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_44' id='input_4_44' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/jj\/aaaa' aria-describedby=\"input_4_44_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_4_44_date_format' class='screen-reader-text'>MM barre oblique DD barre oblique AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_4_44' class='gform_hidden' value='https:\/\/rogeriosilva.pt\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><\/div><\/div><div id=\"field_4_28\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_28'>Adresse du lieu \u00e0 risque avec code postal<\/label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_4_28' type='text' value='' class='large'    placeholder='Adresse du lieu \u00e0 risque avec code postal'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_34\" class=\"gfield gfield--type-number gfield--input-type-number 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_4_34'>Salaire annuel estim\u00e9<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_34' id='input_4_34' type='number' step='any'   value='' class='large'    placeholder='Salaire annuel estim\u00e9' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_4_35\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_35'>Profession<\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_4_35' type='text' value='' class='large'    placeholder='Profession'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_36\" class=\"gfield gfield--type-text gfield--input-type-text 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_4_36'>Voyage (parents aller-retour)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_4_36' type='text' value='' class='large'    placeholder='Voyage (parents aller-retour)' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_37\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_37'>Date du voyage<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_37' id='input_4_37' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/jj\/aaaa' aria-describedby=\"input_4_37_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_4_37_date_format' class='screen-reader-text'>MM barre oblique DD barre oblique AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_4_37' class='gform_hidden' value='https:\/\/rogeriosilva.pt\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_4_22\" class=\"gfield gfield--type-text gfield--input-type-text 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_4_22'>EMAIL OU NUM\u00c9RO DE T\u00c9L\u00c9PHONE POUR RECEVOIR LA SIMULATION<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_4_22' type='text' value='' class='large'    placeholder='Courriel ou num\u00e9ro de t\u00e9l\u00e9phone pour recevoir la simulation' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_46\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_46'>Sujet<\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_4_46' type='text' value='' class='large'    placeholder='Sujet'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_4_23\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-half 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' >Consentement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_23.1' id='input_4_23_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_4_23_1' >J'autorise Rogerio Silva Media\u00e7\u00e3o de Seguros Lda \u00e0 stocker et \u00e0 traiter mes donn\u00e9es personnelles conform\u00e9ment \u00e0 sa politique de confidentialit\u00e9 et \u00e0 la l\u00e9gislation en vigueur.<span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/label><input type='hidden' name='input_23.2' value='Eu autorizo a Rogerio Silva Media\u00e7\u00e3o de Seguros Lda a armazenar e tratar os meus dados pessoais de acordo com a sua Pol\u00edtica de Privacidade, bem como com a legisla\u00e7\u00e3o em vigor.' class='gform_hidden' \/><input type='hidden' name='input_23.3' value='4' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_submit\" class=\"gfield gfield--type-submit gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-field-class=\"gform_editor_submit_container\" data-field-position=\"inline\" ><input type='submit' id='gform_submit_button_4' class='gform-button gform-button--white  button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='DEMANDE SIMULATION'  \/><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'>  \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_4' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_4' id='gform_theme_4' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_4' id='gform_style_settings_4' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_4' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='4' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' 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0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-search: url(\"data:image\/svg+xml,%3Csvg width='640' height='640' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);--gf-ctrl-border-color: #686e77;--gf-ctrl-size: var(--gf-ctrl-size-md);--gf-ctrl-label-color-primary: #112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: 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enctype='multipart\/form-data'  id='gform_3'  action='\/fr\/wp-json\/wp\/v2\/pages\/289' data-formid='3' novalidate data-trp-original-action=\"\/fr\/wp-json\/wp\/v2\/pages\/289\">\n                        <div class='gform-body gform_body'><div id='gform_fields_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_3_15\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_15'>ASSURANCE<\/label><div class='ginput_container ginput_container_select'><select name='input_15' id='input_3_15' class='large gfield_select'     aria-invalid=\"false\" ><option value='Acidentes de Trabalho' >Accidents du travail<\/option><option value='Sa\u00fade Empresas' >Sant\u00e9 des entreprises<\/option><option value='Solu\u00e7\u00f5es de Incentivo' >Solutions d'incitation<\/option><option value='Autom\u00f3vel' selected='selected'>Voitures<\/option><option value='Multirriscos' >Multirisque<\/option><option value='Transportes e Mercadorias' >Transports et marchandises<\/option><option value='Engenharias' >Ing\u00e9nierie<\/option><option value='Responsabilidade Civil' >Responsabilit\u00e9 civile<\/option><option value='Outros' >Autres<\/option><\/select><\/div><\/div><div id=\"field_3_16\" class=\"gfield gfield--type-text gfield--input-type-text 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_3_16'>NIF<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_3_16' type='text' value='' class='large'    placeholder='NIF' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_17\" class=\"gfield gfield--type-text gfield--input-type-text 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_3_17'>NOM<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_3_17' type='text' value='' class='large'    placeholder='NOM' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_26\" class=\"gfield gfield--type-text gfield--input-type-text 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_3_26'>Nom de l'entreprise<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_3_26' type='text' value='' class='large'    placeholder='Nom de l&#039;entreprise' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_24\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_24'>Nombre de salari\u00e9s<\/label><div class='ginput_container ginput_container_number'><input name='input_24' id='input_3_24' type='number' step='any'   value='' class='large'    placeholder='Nombre de salari\u00e9s'  aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_3_22\" class=\"gfield gfield--type-text gfield--input-type-text 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_3_22'>EMAIL OU NUM\u00c9RO DE T\u00c9L\u00c9PHONE POUR RECEVOIR LA SIMULATION<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_3_22' type='text' value='' class='large'    placeholder='Courriel ou num\u00e9ro de t\u00e9l\u00e9phone pour recevoir la simulation' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_29\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_29'>Type de CR<\/label><div class='ginput_container ginput_container_text'><input name='input_29' id='input_3_29' type='text' value='' class='large'    placeholder='Type de CR'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_3_23\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-half 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' >Consentement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_23.1' id='input_3_23_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_3_23_1' >J'autorise Rog\u00e9rio Silva Media\u00e7\u00e3o de Seguros Lda \u00e0 stocker et \u00e0 traiter mes donn\u00e9es personnelles conform\u00e9ment \u00e0 sa politique de confidentialit\u00e9 et \u00e0 la l\u00e9gislation en vigueur.<span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/label><input type='hidden' name='input_23.2' value='Eu autorizo a Rog\u00e9rio Silva Media\u00e7\u00e3o de Seguros Lda a armazenar e tratar os meus dados pessoais de acordo com a sua Pol\u00edtica de Privacidade, bem como com a legisla\u00e7\u00e3o em vigor.' class='gform_hidden' \/><input type='hidden' name='input_23.3' value='3' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_submit\" class=\"gfield gfield--type-submit gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-field-class=\"gform_editor_submit_container\" data-field-position=\"inline\" ><input type='submit' 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