{"id":848,"date":"2023-04-05T09:20:31","date_gmt":"2023-04-05T09:20:31","guid":{"rendered":"https:\/\/laserclinictaous.be\/?page_id=848"},"modified":"2023-04-05T12:54:51","modified_gmt":"2023-04-05T12:54:51","slug":"checklist-traitement-laser","status":"publish","type":"page","link":"https:\/\/laserclinictaous.be\/fr\/checklist-traitement-laser\/","title":{"rendered":"Liste de contr\u00f4le du traitement au laser"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"848\" class=\"elementor elementor-848\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-342c30c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"342c30c\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b585fe4\" data-id=\"b585fe4\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-601de0d elementor-widget elementor-widget-image\" data-id=\"601de0d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/laserclinictaous.be\/wp-content\/uploads\/elementor\/thumbs\/cropped-taous-logo-pvs3z441ywggo1r3ouhfe9qhcy7nboazzk8rerk6bk.png\" title=\"logo-taous-recadr\u00e9.png\" alt=\"cropped-taous-logo.png\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d2b5ba7 elementor-widget elementor-widget-heading\" data-id=\"d2b5ba7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Liste de contr\u00f4le du traitement au laser<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-ef4e2f6 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"ef4e2f6\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-52bac7f\" data-id=\"52bac7f\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-cb4cc78 elementor-widget elementor-widget-shortcode\" data-id=\"cb4cc78\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><div class='fluentform ff-default fluentform_wrapper_3 ffs_default_wrap'><form data-form_id=\"3\" id=\"fluentform_3\" class=\"frm-fluent-form fluent_form_3 ff-el-form-top ff_form_instance_3_1 ff-form-loading ffs_default\" data-form_instance=\"ff_form_instance_3_1\" method=\"POST\" action=\"\" ><fieldset  style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;box-shadow: none!important;outline: none!important; min-inline-size: 100%;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"display: block; margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;overflow:hidden;\">Liste de contr\u00f4le du traitement au laser<\/legend><input type='hidden' name='__fluent_form_embded_post_id' value='848' \/><input type=\"hidden\" id=\"_fluentform_3_fluentformnonce\" name=\"_fluentform_3_fluentformnonce\" value=\"10cfa706ba\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/fr\/wp-json\/wp\/v2\/pages\/848\" \/><div data-name=\"ff_cn_id_1\"  class='ff-t-container ff-column-container ff_columns_total_2'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  >Exposition au soleil moins d&#039;un mois<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_c12f048c1563d835217eba1ab57389db'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_c12f048c1563d835217eba1ab57389db' aria-label='Oui' aria-invalid='false' aria-required=\"false\"> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2438565de2142d0f9e05a5a4cf8ad9da'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_2438565de2142d0f9e05a5a4cf8ad9da' aria-label='Non' aria-invalid='false' aria-required=\"false\"> <span>Non<\/span><\/label><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description' id='label_ff_3_description'>Indication<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description\" name=\"description\" id=\"ff_3_description\" class=\"ff-el-form-control\" rows=\"2\" cols=\"2\" data-name=\"description\" ><\/textarea><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_2\"  class='ff-t-container ff-column-container ff_columns_total_2'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  >Cabine UV moins d&#039;un mois<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_8_55d840352524e2215c61cab23517b108'><input  type=\"radio\" name=\"input_radio_8\" data-name=\"input_radio_8\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_8_55d840352524e2215c61cab23517b108' aria-label='Oui' aria-invalid='false' aria-required=\"false\"> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_8_28b76f1624062b2743021778c0fe484e'><input  type=\"radio\" name=\"input_radio_8\" data-name=\"input_radio_8\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_8_28b76f1624062b2743021778c0fe484e' aria-label='Non' aria-invalid='false' aria-required=\"false\"> <span>Non<\/span><\/label><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_8' id='label_ff_3_description_8'>Indication<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_8\" name=\"description_8\" id=\"ff_3_description_8\" class=\"ff-el-form-control\" rows=\"2\" cols=\"2\" data-name=\"description_8\" ><\/textarea><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_3\"  class='ff-t-container ff-column-container ff_columns_total_2'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  >Cosm\u00e9tique r\u00e9v\u00e9latrice de m\u00e9lanine (cr\u00e8me auto-bronzante)<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_7_44c010b0cdb443d600d38c9b10dcbaa3'><input  type=\"radio\" name=\"input_radio_7\" data-name=\"input_radio_7\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_7_44c010b0cdb443d600d38c9b10dcbaa3' aria-label='Oui' aria-invalid='false' aria-required=\"false\"> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_7_4559a75798d79f5652df13dcce200bc5'><input  type=\"radio\" name=\"input_radio_7\" data-name=\"input_radio_7\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_7_4559a75798d79f5652df13dcce200bc5' aria-label='Non' aria-invalid='false' aria-required=\"false\"> <span>Non<\/span><\/label><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_7' id='label_ff_3_description_7'>Indication<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_7\" name=\"description_7\" id=\"ff_3_description_7\" class=\"ff-el-form-control\" rows=\"2\" cols=\"2\" data-name=\"description_7\" ><\/textarea><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_4\"  class='ff-t-container ff-column-container ff_columns_total_2'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  >Prenez-vous des m\u00e9dicaments ou avez-vous pris des m\u00e9dicaments ces derniers 3 mois ? (ATB, accutane, cortico\u00efdes\u2026)<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_6_b1e40a132134e99534de2d72b182ca18'><input  type=\"radio\" name=\"input_radio_6\" data-name=\"input_radio_6\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_6_b1e40a132134e99534de2d72b182ca18' aria-label='Oui' aria-invalid='false' aria-required=\"false\"> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_6_0639e369fcf9076576d34b14061da57f'><input  type=\"radio\" name=\"input_radio_6\" data-name=\"input_radio_6\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_6_0639e369fcf9076576d34b14061da57f' aria-label='Non' aria-invalid='false' aria-required=\"false\"> <span>Non<\/span><\/label><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_6' id='label_ff_3_description_6'>Indication<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_6\" name=\"description_6\" id=\"ff_3_description_6\" class=\"ff-el-form-control\" rows=\"2\" cols=\"2\" data-name=\"description_6\" ><\/textarea><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_5\"  class='ff-t-container ff-column-container ff_columns_total_2'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  >Affection dermatologique en cours (ecz\u00e9ma, herp\u00e8s, vitiligo\u2026)<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_5_26f91dff8262b7459a77273765b69dfa'><input  type=\"radio\" name=\"input_radio_5\" data-name=\"input_radio_5\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_5_26f91dff8262b7459a77273765b69dfa' aria-label='Oui' aria-invalid='false' aria-required=\"false\"> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_5_7b44b9951d8592a64fc9c80abb8207b8'><input  type=\"radio\" name=\"input_radio_5\" data-name=\"input_radio_5\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_5_7b44b9951d8592a64fc9c80abb8207b8' aria-label='Non' aria-invalid='false' aria-required=\"false\"> <span>Non<\/span><\/label><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_5' id='label_ff_3_description_5'>Indication<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_5\" name=\"description_5\" id=\"ff_3_description_5\" class=\"ff-el-form-control\" rows=\"2\" cols=\"2\" data-name=\"description_5\" ><\/textarea><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_6\"  class='ff-t-container ff-column-container ff_columns_total_2'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  >Maladie photosensible (lupus, \u00e9pilepsie\u2026)<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_4_f65508aab1c527032a9b998ca5ba45a2'><input  type=\"radio\" name=\"input_radio_4\" data-name=\"input_radio_4\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_4_f65508aab1c527032a9b998ca5ba45a2' aria-label='Oui' aria-invalid='false' aria-required=\"false\"> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_4_9e4e265d5a058492569529fc061dab92'><input  type=\"radio\" name=\"input_radio_4\" data-name=\"input_radio_4\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_4_9e4e265d5a058492569529fc061dab92' aria-label='Non' aria-invalid='false' aria-required=\"false\"> <span>Non<\/span><\/label><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_4' id='label_ff_3_description_4'>Indication<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_4\" name=\"description_4\" id=\"ff_3_description_4\" class=\"ff-el-form-control\" rows=\"2\" cols=\"2\" data-name=\"description_4\" ><\/textarea><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_7\"  class='ff-t-container ff-column-container ff_columns_total_2'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  >Troubles hormonaux, pubert\u00e9, forte croissance ces derni\u00e8res ann\u00e9es<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_3_c7c78d665be6c14a8ca3ed7b691ce5d3'><input  type=\"radio\" name=\"input_radio_3\" data-name=\"input_radio_3\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_3_c7c78d665be6c14a8ca3ed7b691ce5d3' aria-label='Oui' aria-invalid='false' aria-required=\"false\"> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_3_3b8d90ab2b2594ea7989911edbeb63e7'><input  type=\"radio\" name=\"input_radio_3\" data-name=\"input_radio_3\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_3_3b8d90ab2b2594ea7989911edbeb63e7' aria-label='Non' aria-invalid='false' aria-required=\"false\"> <span>Non<\/span><\/label><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_3' id='label_ff_3_description_3'>Indication<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_3\" name=\"description_3\" id=\"ff_3_description_3\" class=\"ff-el-form-control\" rows=\"2\" cols=\"2\" data-name=\"description_3\" ><\/textarea><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_8\"  class='ff-t-container ff-column-container ff_columns_total_2'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  >Grain de beaut\u00e9 \u00e9pais ou \u00e0 suivre par dermatologue (unicit\u00e9 sur la zone \u00e0 traiter)<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_355680f7f91a00c18b4e43fd63932c63'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_2_355680f7f91a00c18b4e43fd63932c63' aria-label='Oui' aria-invalid='false' aria-required=\"false\"> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_531ad09b54b3c16a5faf9d0c98307b6b'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_2_531ad09b54b3c16a5faf9d0c98307b6b' aria-label='Non' aria-invalid='false' aria-required=\"false\"> <span>Non<\/span><\/label><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_2' id='label_ff_3_description_2'>Indication<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_2\" name=\"description_2\" id=\"ff_3_description_2\" class=\"ff-el-form-control\" rows=\"2\" cols=\"2\" data-name=\"description_2\" ><\/textarea><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_9\"  class='ff-t-container ff-column-container ff_columns_total_2'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  >Tatouages (unicit\u00e9 sur la zone \u00e0 traiter)<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_1_0ac2f0862a1b29835e2176c09c025101'><input  type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_1_0ac2f0862a1b29835e2176c09c025101' aria-label='Oui' aria-invalid='false' aria-required=\"false\"> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_1_8922c16082d416244d62fa7ebc4082f7'><input  type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_1_8922c16082d416244d62fa7ebc4082f7' aria-label='Non' aria-invalid='false' aria-required=\"false\"> <span>Non<\/span><\/label><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_1' id='label_ff_3_description_1'>Indication<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_1\" name=\"description_1\" id=\"ff_3_description_1\" class=\"ff-el-form-control\" rows=\"2\" cols=\"2\" data-name=\"description_1\" ><\/textarea><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_10\"  class='ff-t-container ff-column-container ff_columns_total_2'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  >Corps \u00e9tranger ou dispositif m\u00e9dical m\u00e9tallique<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_14_63c05f7c7cad6796862ee890c4566143'><input  type=\"radio\" name=\"input_radio_14\" data-name=\"input_radio_14\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_14_63c05f7c7cad6796862ee890c4566143' aria-label='Oui' aria-invalid='false' aria-required=\"false\"> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_14_7b23239bfa005c092899e573db4e58a3'><input  type=\"radio\" name=\"input_radio_14\" data-name=\"input_radio_14\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_14_7b23239bfa005c092899e573db4e58a3' aria-label='Non' aria-invalid='false' aria-required=\"false\"> <span>Non<\/span><\/label><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_14' id='label_ff_3_description_14'>Indication<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_14\" name=\"description_14\" id=\"ff_3_description_14\" class=\"ff-el-form-control\" rows=\"2\" cols=\"2\" data-name=\"description_14\" ><\/textarea><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_11\"  class='ff-t-container ff-column-container ff_columns_total_2'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  >Grossesse en cours\/pr\u00e9vue\/allaitement<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_13_c38b7c9e62e733afb0bd39b713b3b728'><input  type=\"radio\" name=\"input_radio_13\" data-name=\"input_radio_13\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_13_c38b7c9e62e733afb0bd39b713b3b728' aria-label='Oui' aria-invalid='false' aria-required=\"false\"> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_13_1fbdd9cfd55743dacc77b4e2145e025a'><input  type=\"radio\" name=\"input_radio_13\" data-name=\"input_radio_13\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_13_1fbdd9cfd55743dacc77b4e2145e025a' aria-label='Non' aria-invalid='false' aria-required=\"false\"> <span>Non<\/span><\/label><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_13' id='label_ff_3_description_13'>Indication<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_13\" name=\"description_13\" id=\"ff_3_description_13\" class=\"ff-el-form-control\" rows=\"2\" cols=\"2\" data-name=\"description_13\" ><\/textarea><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_12\"  class='ff-t-container ff-column-container ff_columns_total_2'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  >Poils blancs, blonds ou roux<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_12_4569415fce8593aa07910273511db7b7'><input  type=\"radio\" name=\"input_radio_12\" data-name=\"input_radio_12\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_12_4569415fce8593aa07910273511db7b7' aria-label='Oui' aria-invalid='false' aria-required=\"false\"> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_12_0994b1d798375a866493c151f75bee43'><input  type=\"radio\" name=\"input_radio_12\" data-name=\"input_radio_12\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_12_0994b1d798375a866493c151f75bee43' aria-label='Non' aria-invalid='false' aria-required=\"false\"> <span>Non<\/span><\/label><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_12' id='label_ff_3_description_12'>Indication<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_12\" name=\"description_12\" id=\"ff_3_description_12\" class=\"ff-el-form-control\" rows=\"2\" cols=\"2\" data-name=\"description_12\" ><\/textarea><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_13\"  class='ff-t-container ff-column-container ff_columns_total_2'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  >Utilisation d&#039;huiles essentielles dans les 15 derniers jours<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_11_0d3f0ecd81fa2c715f51187b5917ab00'><input  type=\"radio\" name=\"input_radio_11\" data-name=\"input_radio_11\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_11_0d3f0ecd81fa2c715f51187b5917ab00' aria-label='Oui' aria-invalid='false' aria-required=\"false\"> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_11_3629d79f53ac9bd1965ec21b79bea9c3'><input  type=\"radio\" name=\"input_radio_11\" data-name=\"input_radio_11\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_11_3629d79f53ac9bd1965ec21b79bea9c3' aria-label='Non' aria-invalid='false' aria-required=\"false\"> <span>Non<\/span><\/label><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_11' id='label_ff_3_description_11'>Indication<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_11\" name=\"description_11\" id=\"ff_3_description_11\" class=\"ff-el-form-control\" rows=\"2\" cols=\"2\" data-name=\"description_11\" ><\/textarea><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_14\"  class='ff-t-container ff-column-container ff_columns_total_2'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  >Allergies au soleil, froid, chaleur<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_10_68ce77c1dc6453e159dfcb533a7363e9'><input  type=\"radio\" name=\"input_radio_10\" data-name=\"input_radio_10\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_10_68ce77c1dc6453e159dfcb533a7363e9' aria-label='Oui' aria-invalid='false' aria-required=\"false\"> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_10_4d837dd7994ef8d58878d8dc2b6aaab0'><input  type=\"radio\" name=\"input_radio_10\" data-name=\"input_radio_10\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_10_4d837dd7994ef8d58878d8dc2b6aaab0' aria-label='Non' aria-invalid='false' aria-required=\"false\"> <span>Non<\/span><\/label><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_10' id='label_ff_3_description_10'>Indication<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_10\" name=\"description_10\" id=\"ff_3_description_10\" class=\"ff-el-form-control\" rows=\"2\" cols=\"2\" data-name=\"description_10\" ><\/textarea><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_15\"  class='ff-t-container ff-column-container ff_columns_total_2'><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label  >Sauna, hammam, gommage 72 H avant<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_9_bad3e4a9e9a74887898236903ab2281f'><input  type=\"radio\" name=\"input_radio_9\" data-name=\"input_radio_9\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_9_bad3e4a9e9a74887898236903ab2281f' aria-label='Oui' aria-invalid='false' aria-required=\"false\"> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_9_826c8a0b8be989862a8801635bff3afd'><input  type=\"radio\" name=\"input_radio_9\" data-name=\"input_radio_9\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_9_826c8a0b8be989862a8801635bff3afd' aria-label='Non' aria-invalid='false' aria-required=\"false\"> <span>Non<\/span><\/label><\/div><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_description_9' id='label_ff_3_description_9'>Indication<\/label><\/div><div class='ff-el-input--content'><textarea aria-required=\"false\" aria-labelledby=\"label_ff_3_description_9\" name=\"description_9\" id=\"ff_3_description_9\" class=\"ff-el-form-control\" rows=\"2\" cols=\"2\" data-name=\"description_9\" ><\/textarea><\/div><\/div><\/div><\/div><div class='ff-form-inline-style' hidden><style>form.fluent_form_3 .wpf_has_custom_css.ff-btn-submit { background-color:rgba(0, 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{\"id\":\"3\",\"ajaxUrl\":\"https:\\\/\\\/laserclinictaous.be\\\/wp-admin\\\/admin-ajax.php\",\"settings\":{\"layout\":{\"labelPlacement\":\"top\",\"helpMessagePlacement\":\"with_label\",\"errorMessagePlacement\":\"inline\",\"cssClassName\":\"\",\"asteriskPlacement\":\"asterisk-right\"},\"restrictions\":{\"denyEmptySubmission\":{\"enabled\":false}}},\"form_instance\":\"ff_form_instance_3_1\",\"form_id_selector\":\"fluentform_3\",\"rules\":{\"input_radio\":{\"required\":{\"value\":false,\"message\":\"This field is required\"}},\"description\":{\"required\":{\"value\":false,\"message\":\"This field is required\"}},\"input_radio_8\":{\"required\":{\"value\":false,\"message\":\"This field is required\"}},\"description_8\":{\"required\":{\"value\":false,\"message\":\"This field is required\"}},\"input_radio_7\":{\"required\":{\"value\":false,\"message\":\"This field is required\"}},\"description_7\":{\"required\":{\"value\":false,\"message\":\"This field is 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