{"id":45,"date":"2026-09-16T07:39:07","date_gmt":"2026-09-16T07:39:07","guid":{"rendered":"https:\/\/wordpress.dressilk.com\/en\/sample-request\/"},"modified":"2026-09-16T07:42:57","modified_gmt":"2026-09-16T07:42:57","slug":"demande-d-echantillon","status":"publish","type":"page","link":"https:\/\/www.dressilk.com\/fr\/sample-request\/","title":{"rendered":"Demande d'\u00e9chantillon"},"content":{"rendered":"<main id='oxy-main'><main class=\"oxy-container-45-103 oxy-container dressilk-page\"><h1 class=\"oxy-text-45-100 oxy-text dressilk-page-title\">\nDemande d'\u00e9chantillon\n<\/h1><p class=\"oxy-text-45-101 oxy-text dressilk-prose-p\">\nFaire une demande d'\u00e9chantillon.\n<\/p><div class=\"oxy-container-45-102 oxy-container dressilk-form-slot\"><div class=\"oxy-shortcode-45-104 oxy-shortcode\"><div class=\"forminator-ui forminator-custom-form forminator-custom-form-55 forminator-design--material  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-55\" data-uid=\"6ac4c4e995a6a\"><br\/><\/div><form\r\n\t\t\t\tid=\"forminator-module-55\"\r\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-55 forminator-design--material  forminator_ajax\"\r\n\t\t\t\tmethod=\"post\"\r\n\t\t\t\tdata-forminator-render=\"0\"\r\n\t\t\t\tdata-form-id=\"55\"\r\n\t\t\t\t data-color-option=\"theme\" data-design=\"material\" data-grid=\"open\" style=\"display: none;\"\r\n\t\t\t\tdata-uid=\"6ac4c4e995a6a\" action=\"\"\r\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"select-1\" class=\"forminator-field-select forminator-col forminator-col-3\"><div class=\"forminator-field\"><label for=\"forminator-form-55__field--select-1_6ac4c4e995a6a\" id=\"forminator-form-55__field--select-1_6ac4c4e995a6a-label\" class=\"forminator-label\">Mme\/M.<\/label><select  id=\"forminator-form-55__field--select-1_6ac4c4e995a6a\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"\" name=\"select-1\" data-default-value=\"\" data-placeholder=\"\" data-search=\"false\" data-search-placeholder=\"\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-55__field--select-1_6ac4c4e995a6a-label\"><option value=\"Ms\"  data-calculation=\"0\">Mme<\/option><option value=\"Mr\"  data-calculation=\"0\">M.<\/option><\/select><\/div><\/div><div id=\"text-1\" class=\"forminator-field-text forminator-col forminator-col-4\"><div class=\"forminator-field\"><label for=\"forminator-field-text-1_6ac4c4e995a6a\" id=\"forminator-field-text-1_6ac4c4e995a6a-label\" class=\"forminator-label\">Pr\u00e9nom <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"\" id=\"forminator-field-text-1_6ac4c4e995a6a\" class=\"forminator-input forminator-name--field\" data-required=\"true\" \/><\/div><\/div><div id=\"text-2\" class=\"forminator-field-text forminator-col forminator-col-5\"><div class=\"forminator-field\"><label for=\"forminator-field-text-2_6ac4c4e995a6a\" id=\"forminator-field-text-2_6ac4c4e995a6a-label\" class=\"forminator-label\">Nom <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-2\" value=\"\" placeholder=\"\" id=\"forminator-field-text-2_6ac4c4e995a6a\" class=\"forminator-input forminator-name--field\" data-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_6ac4c4e995a6a\" id=\"forminator-field-email-1_6ac4c4e995a6a-label\" class=\"forminator-label\">Email <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"\" id=\"forminator-field-email-1_6ac4c4e995a6a\" class=\"forminator-input forminator-email--field\" data-required=\"true\" aria-required=\"true\" autocomplete=\"email\" \/><\/div><\/div><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_6ac4c4e995a6a\" id=\"forminator-field-phone-1_6ac4c4e995a6a-label\" class=\"forminator-label\">T\u00e9l.<\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-1_6ac4c4e995a6a\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-3\" class=\"forminator-field-text forminator-col forminator-col-4\"><div class=\"forminator-field\"><label for=\"forminator-field-text-3_6ac4c4e995a6a\" id=\"forminator-field-text-3_6ac4c4e995a6a-label\" class=\"forminator-label\">Profession <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-3\" value=\"\" placeholder=\"\" id=\"forminator-field-text-3_6ac4c4e995a6a\" class=\"forminator-input forminator-name--field\" data-required=\"true\" \/><\/div><\/div><div id=\"text-4\" class=\"forminator-field-text forminator-col forminator-col-4\"><div class=\"forminator-field\"><label for=\"forminator-field-text-4_6ac4c4e995a6a\" id=\"forminator-field-text-4_6ac4c4e995a6a-label\" class=\"forminator-label\">Service \/ Sp\u00e9cialit\u00e9 <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-4\" value=\"\" placeholder=\"\" id=\"forminator-field-text-4_6ac4c4e995a6a\" class=\"forminator-input forminator-name--field\" data-required=\"false\" \/><\/div><\/div><div id=\"text-5\" class=\"forminator-field-text forminator-col forminator-col-4\"><div class=\"forminator-field\"><label for=\"forminator-field-text-5_6ac4c4e995a6a\" id=\"forminator-field-text-5_6ac4c4e995a6a-label\" class=\"forminator-label\">Nom de l'\u00e9tablissement <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-5\" value=\"\" placeholder=\"\" id=\"forminator-field-text-5_6ac4c4e995a6a\" class=\"forminator-input forminator-name--field\" data-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-6\" class=\"forminator-field-text forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-text-6_6ac4c4e995a6a\" id=\"forminator-field-text-6_6ac4c4e995a6a-label\" class=\"forminator-label\">Adresse <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-6\" value=\"\" placeholder=\"\" id=\"forminator-field-text-6_6ac4c4e995a6a\" class=\"forminator-input forminator-name--field\" data-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-7\" class=\"forminator-field-text forminator-col forminator-col-4\"><div class=\"forminator-field\"><label for=\"forminator-field-text-7_6ac4c4e995a6a\" id=\"forminator-field-text-7_6ac4c4e995a6a-label\" class=\"forminator-label\">Ville <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-7\" value=\"\" placeholder=\"\" id=\"forminator-field-text-7_6ac4c4e995a6a\" class=\"forminator-input forminator-name--field\" data-required=\"true\" \/><\/div><\/div><div id=\"text-8\" class=\"forminator-field-text forminator-col forminator-col-4\"><div class=\"forminator-field\"><label for=\"forminator-field-text-8_6ac4c4e995a6a\" id=\"forminator-field-text-8_6ac4c4e995a6a-label\" class=\"forminator-label\">Code postal <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-8\" value=\"\" placeholder=\"\" id=\"forminator-field-text-8_6ac4c4e995a6a\" class=\"forminator-input forminator-name--field\" data-required=\"true\" \/><\/div><\/div><div id=\"text-9\" class=\"forminator-field-text forminator-col forminator-col-4\"><div class=\"forminator-field\"><label for=\"forminator-field-text-9_6ac4c4e995a6a\" id=\"forminator-field-text-9_6ac4c4e995a6a-label\" class=\"forminator-label\">Pays <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-9\" value=\"\" placeholder=\"\" id=\"forminator-field-text-9_6ac4c4e995a6a\" class=\"forminator-input forminator-name--field\" data-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-2\" class=\"forminator-field-select forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-form-55__field--select-2_6ac4c4e995a6a\" id=\"forminator-form-55__field--select-2_6ac4c4e995a6a-label\" class=\"forminator-label\">Produit souhait\u00e9 <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-55__field--select-2_6ac4c4e995a6a\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-2\" data-default-value=\"\" data-placeholder=\"Please select an option\" data-search=\"false\" data-search-placeholder=\"Please select an option\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-55__field--select-2_6ac4c4e995a6a-label\"><option value=\"\"  >Please select an option<\/option><option value=\"SILK1010\"  data-calculation=\"0\">SILK1010<\/option><option value=\"SILK2030\"  data-calculation=\"0\">SILK2030<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-1\" class=\"forminator-field-checkbox forminator-col forminator-col-12\"><div role=\"group\" class=\"forminator-field required\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-1-6ac4c4e995a6a-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-1-6ac4c4e995a6a-label\" class=\"forminator-label\">Type de plaies superficielles <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-checkbox-1-1-6ac4c4e995a6a-label\" for=\"forminator-field-checkbox-1-1-6ac4c4e995a6a\" class=\"forminator-checkbox\" title=\"Dermabrasion\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Dermabrasion\" id=\"forminator-field-checkbox-1-1-6ac4c4e995a6a\" aria-labelledby=\"forminator-field-checkbox-1-1-6ac4c4e995a6a-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Dermabrasion<\/span><\/label><label id=\"forminator-field-checkbox-1-2-6ac4c4e995a6a-label\" for=\"forminator-field-checkbox-1-2-6ac4c4e995a6a\" class=\"forminator-checkbox\" title=\"Br\u00fblure superficielle\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Superficial burn\" id=\"forminator-field-checkbox-1-2-6ac4c4e995a6a\" aria-labelledby=\"forminator-field-checkbox-1-2-6ac4c4e995a6a-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Br\u00fblure superficielle<\/span><\/label><label id=\"forminator-field-checkbox-1-3-6ac4c4e995a6a-label\" for=\"forminator-field-checkbox-1-3-6ac4c4e995a6a\" class=\"forminator-checkbox\" title=\"Plaie traumatique\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Trauma wound\" id=\"forminator-field-checkbox-1-3-6ac4c4e995a6a\" aria-labelledby=\"forminator-field-checkbox-1-3-6ac4c4e995a6a-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Plaie traumatique<\/span><\/label><label id=\"forminator-field-checkbox-1-4-6ac4c4e995a6a-label\" for=\"forminator-field-checkbox-1-4-6ac4c4e995a6a\" class=\"forminator-checkbox\" title=\"Site donneur de greffe\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Graft donor site\" id=\"forminator-field-checkbox-1-4-6ac4c4e995a6a\" aria-labelledby=\"forminator-field-checkbox-1-4-6ac4c4e995a6a-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Site donneur de greffe<\/span><\/label><label id=\"forminator-field-checkbox-1-5-6ac4c4e995a6a-label\" for=\"forminator-field-checkbox-1-5-6ac4c4e995a6a\" class=\"forminator-checkbox\" title=\"Autre\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Other\" id=\"forminator-field-checkbox-1-5-6ac4c4e995a6a\" aria-labelledby=\"forminator-field-checkbox-1-5-6ac4c4e995a6a-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Autre<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"consent-1\" class=\"forminator-field-consent forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-consent-1_6ac4c4e995a6a\" id=\"forminator-field-consent-1_6ac4c4e995a6a-label\" class=\"forminator-label\">Consentement <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-1_6ac4c4e995a6a__label\" class=\"forminator-checkbox forminator-consent\"><input type=\"checkbox\" name=\"consent-1\" id=\"forminator-field-consent-1_6ac4c4e995a6a\" value=\"checked\" aria-labelledby=\"forminator-field-consent-1_6ac4c4e995a6a-label\" aria-describedby=\"forminator-field-consent-1_6ac4c4e995a6a__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-1_6ac4c4e995a6a__description\" class=\"forminator-checkbox__label forminator-consent__label\">Vous venez de demander des informations sur les produits PREVOR et nous vous en remercions. En cochant \u00ab J'accepte \u00bb, vous confirmez l'envoi de votre demande ainsi que la collecte et l'utilisation de vos donn\u00e9es personnelles par PREVOR pour y r\u00e9pondre, dans le respect et conform\u00e9ment \u00e0 notre politique de protection des donn\u00e9es.<\/div><\/div><\/div><\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div class=\"forminator-row forminator-row-last\"><div class=\"forminator-col\"><div class=\"forminator-field\"><button class=\"forminator-button forminator-button-submit\"><span>Submit<\/span><span aria-hidden=\"true\"><\/span><\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"f8443dc430\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/fr\/wp-json\/wp\/v2\/pages\/45\" \/><input type=\"hidden\" name=\"form_id\" value=\"55\"><input type=\"hidden\" name=\"page_id\" value=\"45\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/www.dressilk.com\/fr\/sample-request\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><label for=\"input_16\" class=\"forminator-hidden\" aria-hidden=\"true\">Please do not fill in this field. <input id=\"input_16\" type=\"text\" name=\"input_16\" value=\"\" autocomplete=\"off\"><\/label><input type=\"hidden\" name=\"trp-form-language\" value=\"fr\"\/><\/form><\/div><\/div><\/main><\/main>","protected":false},"excerpt":{"rendered":"<p>Sample Request Request your sample here. Ms\/MrMsMrFirst Name *Last Name *Email *TelOccupation *Department\/Specialty *Name of the institution *Address *City *ZIP code *Country\/State *Product of interest *Please select an optionSILK1010SILK2030Kind of superficial wounds *DermabrasionSuperficial burnTrauma woundGraft donor siteOtherConsent *You have just requested information about PREVOR products and we thank you for it. By ticking &#8220;I agree&#8221;, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_oxygen_hide_in_design_set":false,"_oxygen_tags":"","footnotes":""},"class_list":["post-45","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.dressilk.com\/fr\/wp-json\/wp\/v2\/pages\/45","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.dressilk.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.dressilk.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.dressilk.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.dressilk.com\/fr\/wp-json\/wp\/v2\/comments?post=45"}],"version-history":[{"count":2,"href":"https:\/\/www.dressilk.com\/fr\/wp-json\/wp\/v2\/pages\/45\/revisions"}],"predecessor-version":[{"id":59,"href":"https:\/\/www.dressilk.com\/fr\/wp-json\/wp\/v2\/pages\/45\/revisions\/59"}],"wp:attachment":[{"href":"https:\/\/www.dressilk.com\/fr\/wp-json\/wp\/v2\/media?parent=45"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}