{"id":2421,"date":"2024-01-07T17:12:04","date_gmt":"2024-01-07T16:12:04","guid":{"rendered":"https:\/\/inalme.it\/?page_id=2421"},"modified":"2026-11-03T16:32:55","modified_gmt":"2026-11-03T15:32:55","slug":"demande-complement-alimentaire","status":"publish","type":"page","link":"https:\/\/inalme.it\/fr\/demande-complement-alimentaire\/","title":{"rendered":"Demande de compl\u00e9ment alimentaire"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:35px;--awb-padding-bottom:30px;--awb-background-color:var(--awb-color5);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-motion-effects=\"[{&quot;type&quot;:&quot;&quot;,&quot;scroll_type&quot;:&quot;transition&quot;,&quot;scroll_direction&quot;:&quot;up&quot;,&quot;transition_speed&quot;:&quot;1&quot;,&quot;fade_type&quot;:&quot;in&quot;,&quot;scale_type&quot;:&quot;up&quot;,&quot;initial_scale&quot;:&quot;1&quot;,&quot;max_scale&quot;:&quot;1.5&quot;,&quot;min_scale&quot;:&quot;0.5&quot;,&quot;initial_rotate&quot;:&quot;0&quot;,&quot;end_rotate&quot;:&quot;30&quot;,&quot;initial_blur&quot;:&quot;0&quot;,&quot;end_blur&quot;:&quot;3&quot;,&quot;start_element&quot;:&quot;top&quot;,&quot;start_viewport&quot;:&quot;bottom&quot;,&quot;end_element&quot;:&quot;bottom&quot;,&quot;end_viewport&quot;:&quot;top&quot;,&quot;mouse_effect&quot;:&quot;track&quot;,&quot;mouse_effect_direction&quot;:&quot;opposite&quot;,&quot;mouse_effect_speed&quot;:&quot;2&quot;,&quot;infinite_animation&quot;:&quot;float&quot;,&quot;infinite_animation_speed&quot;:&quot;2&quot;}]\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-1 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-three\" style=\"--awb-text-color:var(--awb-color1);--awb-margin-bottom:0px;\"><h3 class=\"fusion-title-heading title-heading-center fusion-responsive-typography-calculated\" style=\"margin:0;letter-spacing:1px;text-transform:uppercase;--fontSize:36;line-height:var(--awb-typography1-line-height);\">Votre projet de compl\u00e9ment alimentaire<\/h3><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-margin-top:100px;--awb-margin-bottom:80px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><p>Pour envoyer votre demande, remplissez le formulaire ci-dessous. Votre demande sera transmise \u00e0 notre export manager, qui vous r\u00e9pondra sous 48 heures ouvr\u00e9es.<\/p>\n<\/div><div class=\"fusion-form fusion-form-builder fusion-form-form-wrapper fusion-form-2425\" style=\"--awb-tooltip-text-color:#ffffff;--awb-tooltip-background-color:#333333;--awb-form-border-color:rgba(51,51,51,0.4);\" data-form-id=\"2425\" data-config=\"{&quot;form_id&quot;:2425,&quot;form_post_id&quot;:2425,&quot;post_id&quot;:2421,&quot;form_type&quot;:&quot;ajax&quot;,&quot;confirmation_type&quot;:&quot;message&quot;,&quot;redirect_url&quot;:&quot;&quot;,&quot;field_labels&quot;:{&quot;referente_azienda&quot;:&quot;Personne de contact&quot;,&quot;azienda&quot;:&quot;Entreprise&quot;,&quot;email&quot;:&quot;E-mail&quot;,&quot;telefono&quot;:&quot;T\\u00e9l\\u00e9phone&quot;,&quot;nome_definitivo_del_prodotto&quot;:&quot;Nom d\\u00e9finitif du produit&quot;,&quot;disturbo_malattia_effetto&quot;:&quot;Trouble, pathologie ou effet physiologique vis\\u00e9&quot;,&quot;paesi_di_distribuzione&quot;:&quot;Pays de distribution&quot;,&quot;paesi_extra_ue&quot;:&quot;Indiquez les pays hors UE&quot;,&quot;tipo_di_progetto&quot;:&quot;Type de projet&quot;,&quot;forma_farmaceutica&quot;:&quot;&quot;,&quot;altro&quot;:&quot;Autre&quot;,&quot;formato&quot;:&quot;&quot;,&quot;numero_unita_dosaggio&quot;:&quot;Nombre d\\u2019unit\\u00e9s de dosage (ex. : 30 comprim\\u00e9s, flacon de 30 ml, etc.)&quot;,&quot;dose_massima_giornaliera&quot;:&quot;Dose journali\\u00e8re maximale (ex. : 2 comprim\\u00e9s, 20 ml, etc.)&quot;,&quot;posologia&quot;:&quot;Posologie (ex. : 1 comprim\\u00e9 2 fois par jour, 10 ml 2 fois par jour, etc.)&quot;,&quot;pezzi_da_preventivare&quot;:&quot;Quantit\\u00e9s \\u00e0 chiffrer&quot;,&quot;altro_pezzi_da_preventivare&quot;:&quot;Autre&quot;,&quot;tipo_di_packaging&quot;:&quot;Type de conditionnement&quot;,&quot;packaging_altro&quot;:&quot;Pr\\u00e9cisez le conditionnement&quot;,&quot;etichetta&quot;:&quot;\\u00c9tiquette&quot;,&quot;serigrafia&quot;:&quot;S\\u00e9rigraphie&quot;,&quot;packaging_secondario&quot;:&quot;&quot;,&quot;altro_packaging_secondario&quot;:&quot;Pr\\u00e9cisez&quot;,&quot;nome_e_quantita_per_100g_di_formula_%&quot;:&quot;Nom et quantit\\u00e9 pour 100 g de formule (%)&quot;,&quot;grafica&quot;:&quot;&quot;,&quot;altre_attivita_grafiche&quot;:&quot;Autres prestations graphiques&quot;,&quot;testi&quot;:&quot;&quot;,&quot;assistenza_notifica_al_registro_integratori&quot;:&quot;&quot;,&quot;altre_attivita_richieste_per_lassistenza_alla_notifica_al_cpnp&quot;:&quot;Autres prestations souhait\\u00e9es pour la notification&quot;,&quot;codice_a_barre&quot;:&quot;&quot;,&quot;test_senza_glutine&quot;:&quot;&quot;,&quot;test_senza_lattosio&quot;:&quot;&quot;,&quot;protocollo_stabilita_accellerata&quot;:&quot;Protocole de stabilit\\u00e9 acc\\u00e9l\\u00e9r\\u00e9e&quot;,&quot;dossier_prodotto&quot;:&quot;&quot;,&quot;eventuali_richieste_aggiuntive&quot;:&quot;Demandes compl\\u00e9mentaires&quot;,&quot;privacy&quot;:&quot;&quot;},&quot;field_logics&quot;:{&quot;referente_azienda&quot;:&quot;&quot;,&quot;azienda&quot;:&quot;&quot;,&quot;email&quot;:&quot;&quot;,&quot;telefono&quot;:&quot;&quot;,&quot;nome_definitivo_del_prodotto&quot;:&quot;&quot;,&quot;disturbo_malattia_effetto&quot;:&quot;&quot;,&quot;paesi_di_distribuzione&quot;:&quot;&quot;,&quot;paesi_extra_ue&quot;:&quot;[{\\&quot;operator\\&quot;:\\&quot;and\\&quot;,\\&quot;comparison\\&quot;:\\&quot;contains\\&quot;,\\&quot;field\\&quot;:\\&quot;paesi_di_distribuzione[]\\&quot;,\\&quot;value\\&quot;:\\&quot;Hors UE\\&quot;}]&quot;,&quot;tipo_di_progetto&quot;:&quot;&quot;,&quot;forma_farmaceutica&quot;:&quot;&quot;,&quot;altro&quot;:&quot;&quot;,&quot;formato&quot;:&quot;&quot;,&quot;numero_unita_dosaggio&quot;:&quot;&quot;,&quot;dose_massima_giornaliera&quot;:&quot;&quot;,&quot;posologia&quot;:&quot;&quot;,&quot;pezzi_da_preventivare&quot;:&quot;&quot;,&quot;altro_pezzi_da_preventivare&quot;:&quot;[{\\&quot;operator\\&quot;:\\&quot;and\\&quot;,\\&quot;comparison\\&quot;:\\&quot;contains\\&quot;,\\&quot;field\\&quot;:\\&quot;pezzi_da_preventivare[]\\&quot;,\\&quot;value\\&quot;:\\&quot;Autre\\&quot;}]&quot;,&quot;tipo_di_packaging&quot;:&quot;&quot;,&quot;packaging_altro&quot;:&quot;[{\\&quot;operator\\&quot;:\\&quot;and\\&quot;,\\&quot;comparison\\&quot;:\\&quot;equal\\&quot;,\\&quot;field\\&quot;:\\&quot;tipo_di_packaging\\&quot;,\\&quot;value\\&quot;:\\&quot;Autre\\&quot;}]&quot;,&quot;etichetta&quot;:&quot;[{\\&quot;operator\\&quot;:\\&quot;or\\&quot;,\\&quot;comparison\\&quot;:\\&quot;equal\\&quot;,\\&quot;field\\&quot;:\\&quot;tipo_di_packaging\\&quot;,\\&quot;value\\&quot;:\\&quot;Spray\\&quot;},{\\&quot;operator\\&quot;:\\&quot;or\\&quot;,\\&quot;comparison\\&quot;:\\&quot;equal\\&quot;,\\&quot;field\\&quot;:\\&quot;tipo_di_packaging\\&quot;,\\&quot;value\\&quot;:\\&quot;Flacon\\&quot;},{\\&quot;operator\\&quot;:\\&quot;or\\&quot;,\\&quot;comparison\\&quot;:\\&quot;equal\\&quot;,\\&quot;field\\&quot;:\\&quot;tipo_di_packaging\\&quot;,\\&quot;value\\&quot;:\\&quot;Pilulier\\&quot;},{\\&quot;operator\\&quot;:\\&quot;and\\&quot;,\\&quot;comparison\\&quot;:\\&quot;equal\\&quot;,\\&quot;field\\&quot;:\\&quot;tipo_di_packaging\\&quot;,\\&quot;value\\&quot;:\\&quot;DDC\\u00ae\\&quot;}]&quot;,&quot;serigrafia&quot;:&quot;[{\\&quot;operator\\&quot;:\\&quot;or\\&quot;,\\&quot;comparison\\&quot;:\\&quot;equal\\&quot;,\\&quot;field\\&quot;:\\&quot;tipo_di_packaging\\&quot;,\\&quot;value\\&quot;:\\&quot;Spray\\&quot;},{\\&quot;operator\\&quot;:\\&quot;or\\&quot;,\\&quot;comparison\\&quot;:\\&quot;equal\\&quot;,\\&quot;field\\&quot;:\\&quot;tipo_di_packaging\\&quot;,\\&quot;value\\&quot;:\\&quot;Flacon\\&quot;},{\\&quot;operator\\&quot;:\\&quot;or\\&quot;,\\&quot;comparison\\&quot;:\\&quot;equal\\&quot;,\\&quot;field\\&quot;:\\&quot;tipo_di_packaging\\&quot;,\\&quot;value\\&quot;:\\&quot;Pilulier\\&quot;},{\\&quot;operator\\&quot;:\\&quot;and\\&quot;,\\&quot;comparison\\&quot;:\\&quot;equal\\&quot;,\\&quot;field\\&quot;:\\&quot;tipo_di_packaging\\&quot;,\\&quot;value\\&quot;:\\&quot;DDC\\u00ae\\&quot;}]&quot;,&quot;packaging_secondario&quot;:&quot;&quot;,&quot;altro_packaging_secondario&quot;:&quot;[{\\&quot;operator\\&quot;:\\&quot;and\\&quot;,\\&quot;comparison\\&quot;:\\&quot;equal\\&quot;,\\&quot;field\\&quot;:\\&quot;packaging_secondario[]\\&quot;,\\&quot;value\\&quot;:\\&quot;Autre\\&quot;}]&quot;,&quot;nome_e_quantita_per_100g_di_formula_%&quot;:&quot;&quot;,&quot;grafica&quot;:&quot;&quot;,&quot;altre_attivita_grafiche&quot;:&quot;&quot;,&quot;testi&quot;:&quot;&quot;,&quot;assistenza_notifica_al_registro_integratori&quot;:&quot;&quot;,&quot;altre_attivita_richieste_per_lassistenza_alla_notifica_al_cpnp&quot;:&quot;&quot;,&quot;codice_a_barre&quot;:&quot;&quot;,&quot;test_senza_glutine&quot;:&quot;&quot;,&quot;test_senza_lattosio&quot;:&quot;&quot;,&quot;protocollo_stabilita_accellerata&quot;:&quot;&quot;,&quot;dossier_prodotto&quot;:&quot;&quot;,&quot;eventuali_richieste_aggiuntive&quot;:&quot;&quot;,&quot;privacy&quot;:&quot;&quot;,&quot;notice_1&quot;:&quot;&quot;},&quot;field_types&quot;:{&quot;referente_azienda&quot;:&quot;text&quot;,&quot;azienda&quot;:&quot;text&quot;,&quot;email&quot;:&quot;email&quot;,&quot;telefono&quot;:&quot;text&quot;,&quot;nome_definitivo_del_prodotto&quot;:&quot;text&quot;,&quot;disturbo_malattia_effetto&quot;:&quot;text&quot;,&quot;paesi_di_distribuzione&quot;:&quot;checkbox&quot;,&quot;paesi_extra_ue&quot;:&quot;text&quot;,&quot;tipo_di_progetto&quot;:&quot;radio&quot;,&quot;forma_farmaceutica&quot;:&quot;checkbox&quot;,&quot;altro&quot;:&quot;text&quot;,&quot;formato&quot;:&quot;checkbox&quot;,&quot;numero_unita_dosaggio&quot;:&quot;text&quot;,&quot;dose_massima_giornaliera&quot;:&quot;text&quot;,&quot;posologia&quot;:&quot;text&quot;,&quot;pezzi_da_preventivare&quot;:&quot;checkbox&quot;,&quot;altro_pezzi_da_preventivare&quot;:&quot;text&quot;,&quot;tipo_di_packaging&quot;:&quot;radio&quot;,&quot;packaging_altro&quot;:&quot;text&quot;,&quot;etichetta&quot;:&quot;radio&quot;,&quot;serigrafia&quot;:&quot;radio&quot;,&quot;packaging_secondario&quot;:&quot;checkbox&quot;,&quot;altro_packaging_secondario&quot;:&quot;text&quot;,&quot;nome_e_quantita_per_100g_di_formula_%&quot;:&quot;textarea&quot;,&quot;grafica&quot;:&quot;radio&quot;,&quot;altre_attivita_grafiche&quot;:&quot;text&quot;,&quot;testi&quot;:&quot;radio&quot;,&quot;assistenza_notifica_al_registro_integratori&quot;:&quot;radio&quot;,&quot;altre_attivita_richieste_per_lassistenza_alla_notifica_al_cpnp&quot;:&quot;text&quot;,&quot;codice_a_barre&quot;:&quot;radio&quot;,&quot;test_senza_glutine&quot;:&quot;radio&quot;,&quot;test_senza_lattosio&quot;:&quot;radio&quot;,&quot;protocollo_stabilita_accellerata&quot;:&quot;radio&quot;,&quot;dossier_prodotto&quot;:&quot;radio&quot;,&quot;eventuali_richieste_aggiuntive&quot;:&quot;textarea&quot;,&quot;privacy&quot;:&quot;consent&quot;,&quot;hypot_field&quot;:&quot;honeypot&quot;,&quot;submit_1&quot;:&quot;submit&quot;,&quot;notice_1&quot;:&quot;notice&quot;},&quot;nonce_method&quot;:&quot;ajax&quot;}\"><form action=\"https:\/\/inalme.it\/fr\/demande-complement-alimentaire\/\" method=\"post\" class=\"fusion-form fusion-form-2425\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-right:0px;--awb-padding-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-2 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom:0px;\"><h4 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:24;line-height:var(--awb-typography1-line-height);\">Informations g\u00e9n\u00e9rales<\/h4><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:3.84%;--awb-spacing-left-medium:3.84%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><label for=\"referente_azienda\">Personne de contact<\/label><\/div><input type=\"text\" name=\"referente_azienda\" id=\"referente_azienda\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:3.84%;--awb-spacing-left-medium:3.84%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><label for=\"azienda\">Entreprise<\/label><\/div><input type=\"text\" name=\"azienda\" id=\"azienda\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:3.84%;--awb-spacing-left-medium:3.84%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-email-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><label for=\"email\">E-mail <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"email\" name=\"email\" id=\"email\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:3.84%;--awb-spacing-left-medium:3.84%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><label for=\"telefono\">T\u00e9l\u00e9phone<\/label><\/div><input type=\"text\" name=\"telefono\" id=\"telefono\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-7 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:3.84%;--awb-spacing-left-medium:3.84%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><label for=\"nome_definitivo_del_prodotto\">Nom d\u00e9finitif du produit<\/label><\/div><input type=\"text\" name=\"nome_definitivo_del_prodotto\" id=\"nome_definitivo_del_prodotto\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-8 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:3.84%;--awb-spacing-left-medium:3.84%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><label for=\"disturbo_malattia_effetto\">Trouble, pathologie ou effet physiologique vis\u00e9<\/label><\/div><input type=\"text\" name=\"disturbo_malattia_effetto\" id=\"disturbo_malattia_effetto\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-9 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-checkbox-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><span class=\"label\">Pays de distribution<\/span><div class=\"fusion-form-tooltip\"><i class=\"awb-icon-question-circle\"><\/i><span class=\"fusion-form-tooltip-content\">S\u00e9lectionnez tous les pays o\u00f9 vous souhaitez distribuer votre produit<\/span><\/div><\/div><fieldset><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-0\" type=\"checkbox\" value=\"Autriche\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-0\">Autriche<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-1\" type=\"checkbox\" value=\"Belgique\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-1\">Belgique<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-2\" type=\"checkbox\" value=\"Bulgarie\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-2\">Bulgarie<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-3\" type=\"checkbox\" value=\"Chypre\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-3\">Chypre<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-4\" type=\"checkbox\" value=\"Croatie\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-4\">Croatie<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-5\" type=\"checkbox\" value=\"Danemark\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-5\">Danemark<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-6\" type=\"checkbox\" value=\"Estonie\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-6\">Estonie<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-7\" type=\"checkbox\" value=\"Finlande\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-7\">Finlande<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-8\" type=\"checkbox\" value=\"France\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-8\">France<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-9\" type=\"checkbox\" value=\"Allemagne\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-9\">Allemagne<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-10\" type=\"checkbox\" value=\"Gr\u00e8ce\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-10\">Gr\u00e8ce<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-11\" type=\"checkbox\" value=\"Irlande\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-11\">Irlande<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-12\" type=\"checkbox\" value=\"Italie\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-12\">Italie<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-13\" type=\"checkbox\" value=\"Lettonie\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-13\">Lettonie<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-14\" type=\"checkbox\" value=\"Lituanie\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-14\">Lituanie<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-15\" type=\"checkbox\" value=\"Luxembourg\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-15\">Luxembourg<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-16\" type=\"checkbox\" value=\"Malte\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-16\">Malte<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-17\" type=\"checkbox\" value=\"Pays-Bas\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-17\">Pays-Bas<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-18\" type=\"checkbox\" value=\"Pologne\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-18\">Pologne<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-19\" type=\"checkbox\" value=\"Portugal\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-19\">Portugal<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-20\" type=\"checkbox\" value=\"R\u00e9publique tch\u00e8que\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-20\">R\u00e9publique tch\u00e8que<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-21\" type=\"checkbox\" value=\"Roumanie\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-21\">Roumanie<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-22\" type=\"checkbox\" value=\"Slovaquie\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-22\">Slovaquie<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-23\" type=\"checkbox\" value=\"Slov\u00e9nie\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-23\">Slov\u00e9nie<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-24\" type=\"checkbox\" value=\"Espagne\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-24\">Espagne<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-25\" type=\"checkbox\" value=\"Su\u00e8de\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-25\">Su\u00e8de<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-26\" type=\"checkbox\" value=\"Hongrie\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-26\">Hongrie<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-paesi_di_distribuzione-1-27\" type=\"checkbox\" value=\"Hors UE\" name=\"paesi_di_distribuzione[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-paesi_di_distribuzione-1-27\">Hors UE<\/label><\/div><\/fieldset><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above fusion-form-field-hidden\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><label for=\"paesi_extra_ue\">Indiquez les pays hors UE<\/label><\/div><input type=\"text\" name=\"paesi_extra_ue\" id=\"paesi_extra_ue\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><span class=\"label\">Type de projet<\/span><\/div><fieldset><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-tipo_di_progetto-1-0\" type=\"radio\" value=\"Nouveau projet\" name=\"tipo_di_progetto\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-tipo_di_progetto-1-0\">Nouveau projet<\/label><\/div><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-tipo_di_progetto-1-1\" type=\"radio\" value=\"R\u00e9vision d\u2019un produit d\u00e9j\u00e0 fabriqu\u00e9\" name=\"tipo_di_progetto\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-tipo_di_progetto-1-1\">R\u00e9vision d\u2019un produit d\u00e9j\u00e0 fabriqu\u00e9<\/label><\/div><\/fieldset><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color5);border-color:var(--awb-color5);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-title title fusion-title-3 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom:0px;\"><h4 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:24;line-height:var(--awb-typography1-line-height);\">Forme gal\u00e9nique<\/h4><\/div><div class=\"fusion-form-field fusion-form-checkbox-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><fieldset><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-forma_farmaceutica-2-0\" type=\"checkbox\" value=\"Comprim\u00e9s\" name=\"forma_farmaceutica[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-forma_farmaceutica-2-0\">Comprim\u00e9s<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-forma_farmaceutica-2-1\" type=\"checkbox\" value=\"Flacon avec bouchon unidose\" name=\"forma_farmaceutica[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-forma_farmaceutica-2-1\">Flacon avec bouchon unidose<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-forma_farmaceutica-2-2\" type=\"checkbox\" value=\"Solution\" name=\"forma_farmaceutica[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-forma_farmaceutica-2-2\">Solution<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-forma_farmaceutica-2-3\" type=\"checkbox\" value=\"Sirop\" name=\"forma_farmaceutica[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-forma_farmaceutica-2-3\">Sirop<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-forma_farmaceutica-2-4\" type=\"checkbox\" value=\"Sachets\" name=\"forma_farmaceutica[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-forma_farmaceutica-2-4\">Sachets<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-forma_farmaceutica-2-5\" type=\"checkbox\" value=\"G\u00e9lules\" name=\"forma_farmaceutica[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-forma_farmaceutica-2-5\">G\u00e9lules<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-forma_farmaceutica-2-6\" type=\"checkbox\" value=\"Spray\" name=\"forma_farmaceutica[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-forma_farmaceutica-2-6\">Spray<\/label><\/div><\/fieldset><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><label for=\"altro\">Autre<\/label><\/div><input type=\"text\" name=\"altro\" id=\"altro\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color5);border-color:var(--awb-color5);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-title title fusion-title-4 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom:0px;\"><h4 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:24;line-height:var(--awb-typography1-line-height);\">Format<\/h4><\/div><div class=\"fusion-form-field fusion-form-checkbox-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><fieldset><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-formato-3-0\" type=\"checkbox\" value=\"Vente\" name=\"formato[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-formato-3-0\">Vente<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-formato-3-1\" type=\"checkbox\" value=\"\u00c9chantillon gratuit\" name=\"formato[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-formato-3-1\">\u00c9chantillon gratuit<\/label><\/div><\/fieldset><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color5);border-color:var(--awb-color5);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-title title fusion-title-5 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom:0px;\"><h4 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:24;line-height:var(--awb-typography1-line-height);\">Unit\u00e9s de dosage et dose journali\u00e8re maximale<\/h4><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><label for=\"numero_unita_dosaggio\">Nombre d\u2019unit\u00e9s de dosage (ex. : 30 comprim\u00e9s, flacon de 30 ml, etc.)<\/label><\/div><input type=\"text\" name=\"numero_unita_dosaggio\" id=\"numero_unita_dosaggio\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><label for=\"dose_massima_giornaliera\">Dose journali\u00e8re maximale (ex. : 2 comprim\u00e9s, 20 ml, etc.)<\/label><\/div><input type=\"text\" name=\"dose_massima_giornaliera\" id=\"dose_massima_giornaliera\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><label for=\"posologia\">Posologie (ex. : 1 comprim\u00e9 2 fois par jour, 10 ml 2 fois par jour, etc.)<\/label><\/div><input type=\"text\" name=\"posologia\" id=\"posologia\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-checkbox-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><span class=\"label\">Quantit\u00e9s \u00e0 chiffrer <abbr class=\"fusion-form-element-required\" title=\"Please select between 1 and 3 checkboxes from this field.\">*<\/abbr><\/span><div class=\"fusion-form-tooltip\"><i class=\"awb-icon-question-circle\"><\/i><span class=\"fusion-form-tooltip-content\">S\u00e9lectionnez de une \u00e0 trois quantit\u00e9s.<\/span><\/div><\/div><fieldset data-awb-fieldset-min-required=\"1\" data-awb-fieldset-max-required=\"3\" data-awb-fieldset-error=\"Please select between 1 and 3 checkboxes from this field.\"><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-pezzi_da_preventivare-4-0\" type=\"checkbox\" value=\"1000\" name=\"pezzi_da_preventivare[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-pezzi_da_preventivare-4-0\">1000<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-pezzi_da_preventivare-4-1\" type=\"checkbox\" value=\"3000\" name=\"pezzi_da_preventivare[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-pezzi_da_preventivare-4-1\">3000<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-pezzi_da_preventivare-4-2\" type=\"checkbox\" value=\"5000\" name=\"pezzi_da_preventivare[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-pezzi_da_preventivare-4-2\">5000<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-pezzi_da_preventivare-4-3\" type=\"checkbox\" value=\"10000\" name=\"pezzi_da_preventivare[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-pezzi_da_preventivare-4-3\">10000<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-pezzi_da_preventivare-4-4\" type=\"checkbox\" value=\"15000\" name=\"pezzi_da_preventivare[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-pezzi_da_preventivare-4-4\">15000<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-pezzi_da_preventivare-4-5\" type=\"checkbox\" value=\"Autre\" name=\"pezzi_da_preventivare[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-pezzi_da_preventivare-4-5\">Autre<\/label><\/div><\/fieldset><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above fusion-form-field-hidden\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><label for=\"altro_pezzi_da_preventivare\">Autre <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" name=\"altro_pezzi_da_preventivare\" id=\"altro_pezzi_da_preventivare\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color5);border-color:var(--awb-color5);border-top-width:1px;\"><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2-2 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-right:0px;--awb-padding-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-10 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-6 fusion-sep-none fusion-title-text fusion-title-size-three\" style=\"--awb-text-color:var(--awb-color5);--awb-margin-top:20px;--awb-margin-bottom:40px;\"><h3 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:36;line-height:var(--awb-typography1-line-height);\">Conditionnement<\/h3><\/div><div class=\"fusion-title title fusion-title-7 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom:0px;\"><h4 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:24;line-height:var(--awb-typography1-line-height);\">Conditionnement primaire et accessoires<\/h4><\/div><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><span class=\"label\">Type de conditionnement <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/span><\/div><fieldset><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-tipo_di_packaging-2-0\" type=\"radio\" value=\"Blister\" name=\"tipo_di_packaging\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-tipo_di_packaging-2-0\">Blister<\/label><\/div><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-tipo_di_packaging-2-1\" type=\"radio\" value=\"Spray\" name=\"tipo_di_packaging\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-tipo_di_packaging-2-1\">Spray<\/label><\/div><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-tipo_di_packaging-2-2\" type=\"radio\" value=\"Flacon\" name=\"tipo_di_packaging\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-tipo_di_packaging-2-2\">Flacon<\/label><\/div><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-tipo_di_packaging-2-3\" type=\"radio\" value=\"Pilulier\" name=\"tipo_di_packaging\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-tipo_di_packaging-2-3\">Pilulier<\/label><\/div><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-tipo_di_packaging-2-4\" type=\"radio\" value=\"Bouchon doseur\" name=\"tipo_di_packaging\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-tipo_di_packaging-2-4\">Bouchon doseur<\/label><\/div><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-tipo_di_packaging-2-5\" type=\"radio\" value=\"Compte-gouttes\" name=\"tipo_di_packaging\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-tipo_di_packaging-2-5\">Compte-gouttes<\/label><\/div><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-tipo_di_packaging-2-6\" type=\"radio\" value=\"DDC\u00ae\" name=\"tipo_di_packaging\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-tipo_di_packaging-2-6\">DDC\u00ae<\/label><\/div><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-tipo_di_packaging-2-7\" type=\"radio\" value=\"Bouchon\" name=\"tipo_di_packaging\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-tipo_di_packaging-2-7\">Bouchon<\/label><\/div><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-tipo_di_packaging-2-8\" type=\"radio\" value=\"Autre\" name=\"tipo_di_packaging\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-tipo_di_packaging-2-8\">Autre<\/label><\/div><\/fieldset><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above fusion-form-field-hidden\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><label for=\"packaging_altro\">Pr\u00e9cisez le conditionnement<\/label><\/div><input type=\"text\" name=\"packaging_altro\" id=\"packaging_altro\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above fusion-form-field-hidden\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><span class=\"label\">\u00c9tiquette<\/span><\/div><fieldset><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-etichetta-3-0\" type=\"radio\" value=\"Oui\" name=\"etichetta\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-etichetta-3-0\">Oui<\/label><\/div><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-etichetta-3-1\" type=\"radio\" value=\"Non\" name=\"etichetta\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-etichetta-3-1\">Non<\/label><\/div><\/fieldset><\/div><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above fusion-form-field-hidden\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><span class=\"label\">S\u00e9rigraphie<\/span><\/div><fieldset><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-serigrafia-4-0\" type=\"radio\" value=\"Oui\" name=\"serigrafia\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-serigrafia-4-0\">Oui<\/label><\/div><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-serigrafia-4-1\" type=\"radio\" value=\"Non\" name=\"serigrafia\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-serigrafia-4-1\">Non<\/label><\/div><\/fieldset><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color5);border-color:var(--awb-color5);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-title title fusion-title-8 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom:0px;\"><h4 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:24;line-height:var(--awb-typography1-line-height);\">Conditionnement secondaire<\/h4><\/div><div class=\"fusion-form-field fusion-form-checkbox-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><fieldset><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-packaging_secondario-5-0\" type=\"checkbox\" value=\"\u00c9tui\" name=\"packaging_secondario[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-packaging_secondario-5-0\">\u00c9tui<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-packaging_secondario-5-1\" type=\"checkbox\" value=\"Notice\" name=\"packaging_secondario[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-packaging_secondario-5-1\">Notice<\/label><\/div><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"checkbox-packaging_secondario-5-2\" type=\"checkbox\" value=\"Autre\" name=\"packaging_secondario[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-packaging_secondario-5-2\">Autre<\/label><\/div><\/fieldset><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above fusion-form-field-hidden\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><label for=\"altro_packaging_secondario\">Pr\u00e9cisez<\/label><\/div><input type=\"text\" name=\"altro_packaging_secondario\" id=\"altro_packaging_secondario\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color5);border-color:var(--awb-color5);border-top-width:1px;\"><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2-3 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-right:0px;--awb-padding-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-11 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-9 fusion-sep-none fusion-title-text fusion-title-size-three\" style=\"--awb-text-color:var(--awb-color5);--awb-margin-top:20px;--awb-margin-bottom:20px;\"><h3 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:36;line-height:var(--awb-typography1-line-height);\">Ingr\u00e9dients souhait\u00e9s<\/h3><\/div><div class=\"fusion-form-field fusion-form-textarea-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><label for=\"nome_e_quantita_per_100g_di_formula_%\">Nom et quantit\u00e9 pour 100 g de formule (%)<\/label><textarea cols=\"40\"  minlength=\"0\"  rows=\"4\" tabindex=\"\" id=\"nome_e_quantita_per_100g_di_formula_%\" name=\"nome_e_quantita_per_100g_di_formula_%\" class=\"fusion-form-input\" data-holds-private-data=\"false\"><\/textarea><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color5);border-color:var(--awb-color5);border-top-width:1px;\"><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2-4 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-right:0px;--awb-padding-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-12 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-10 fusion-sep-none fusion-title-text fusion-title-size-three\" style=\"--awb-text-color:var(--awb-color5);--awb-margin-top:20px;--awb-margin-bottom:40px;\"><h3 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:36;line-height:var(--awb-typography1-line-height);\">Services compl\u00e9mentaires<\/h3><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-13 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-11 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom:0px;\"><h4 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:24;line-height:var(--awb-typography1-line-height);\">Graphisme<\/h4><\/div><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><fieldset><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-grafica-5-0\" type=\"radio\" value=\"Oui\" name=\"grafica\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-grafica-5-0\">Oui<\/label><\/div><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-grafica-5-1\" type=\"radio\" value=\"Non\" name=\"grafica\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-grafica-5-1\">Non<\/label><\/div><\/fieldset><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><label for=\"altre_attivita_grafiche\">Autres prestations graphiques<\/label><\/div><input type=\"text\" name=\"altre_attivita_grafiche\" id=\"altre_attivita_grafiche\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color5);border-color:var(--awb-color5);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-title title fusion-title-12 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom:0px;\"><h4 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:24;line-height:var(--awb-typography1-line-height);\">Textes<\/h4><\/div><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><fieldset><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-testi-6-0\" type=\"radio\" value=\"Oui\" name=\"testi\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-testi-6-0\">Oui<\/label><\/div><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-testi-6-1\" type=\"radio\" value=\"Non\" name=\"testi\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-testi-6-1\">Non<\/label><\/div><\/fieldset><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color5);border-color:var(--awb-color5);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-title title fusion-title-13 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom:0px;\"><h4 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:24;line-height:var(--awb-typography1-line-height);\">Assistance \u00e0 la notification du compl\u00e9ment alimentaire<\/h4><\/div><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><fieldset><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-assistenza_notifica_al_registro_integratori-7-0\" type=\"radio\" value=\"Oui\" name=\"assistenza_notifica_al_registro_integratori\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-assistenza_notifica_al_registro_integratori-7-0\">Oui<\/label><\/div><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-assistenza_notifica_al_registro_integratori-7-1\" type=\"radio\" value=\"Non\" name=\"assistenza_notifica_al_registro_integratori\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-assistenza_notifica_al_registro_integratori-7-1\">Non<\/label><\/div><\/fieldset><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><label for=\"altre_attivita_richieste_per_lassistenza_alla_notifica_al_cpnp\">Autres prestations souhait\u00e9es pour la notification<\/label><\/div><input type=\"text\" name=\"altre_attivita_richieste_per_lassistenza_alla_notifica_al_cpnp\" id=\"altre_attivita_richieste_per_lassistenza_alla_notifica_al_cpnp\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color5);border-color:var(--awb-color5);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-title title fusion-title-14 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom:0px;\"><h4 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:24;line-height:var(--awb-typography1-line-height);\">Cr\u00e9ation du code-barres<\/h4><\/div><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><fieldset><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-codice_a_barre-8-0\" type=\"radio\" value=\"Oui\" name=\"codice_a_barre\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-codice_a_barre-8-0\">Oui<\/label><\/div><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-codice_a_barre-8-1\" type=\"radio\" value=\"Non\" name=\"codice_a_barre\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-codice_a_barre-8-1\">Non<\/label><\/div><\/fieldset><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color5);border-color:var(--awb-color5);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-title title fusion-title-15 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom:0px;\"><h4 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:24;line-height:var(--awb-typography1-line-height);\">Test sans gluten<\/h4><\/div><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><fieldset><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-test_senza_glutine-9-0\" type=\"radio\" value=\"Oui\" name=\"test_senza_glutine\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-test_senza_glutine-9-0\">Oui<\/label><\/div><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-test_senza_glutine-9-1\" type=\"radio\" value=\"Non\" name=\"test_senza_glutine\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-test_senza_glutine-9-1\">Non<\/label><\/div><\/fieldset><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color5);border-color:var(--awb-color5);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-title title fusion-title-16 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom:0px;\"><h4 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:24;line-height:var(--awb-typography1-line-height);\">Test sans lactose<\/h4><\/div><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><fieldset><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-test_senza_lattosio-10-0\" type=\"radio\" value=\"Oui\" name=\"test_senza_lattosio\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-test_senza_lattosio-10-0\">Oui<\/label><\/div><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-test_senza_lattosio-10-1\" type=\"radio\" value=\"Non\" name=\"test_senza_lattosio\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-test_senza_lattosio-10-1\">Non<\/label><\/div><\/fieldset><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color5);border-color:var(--awb-color5);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above prtc\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-label-wrapper\"><span class=\"label\">Protocole de stabilit\u00e9 acc\u00e9l\u00e9r\u00e9e<\/span><\/div><fieldset><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-protocollo_stabilita_accellerata-11-0\" type=\"radio\" value=\"Oui\" name=\"protocollo_stabilita_accellerata\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-protocollo_stabilita_accellerata-11-0\">Oui<\/label><\/div><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-protocollo_stabilita_accellerata-11-1\" type=\"radio\" value=\"Non\" name=\"protocollo_stabilita_accellerata\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-protocollo_stabilita_accellerata-11-1\">Non<\/label><\/div><\/fieldset><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color5);border-color:var(--awb-color5);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-title title fusion-title-17 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-bottom:0px;\"><h4 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:24;line-height:var(--awb-typography1-line-height);\">Assistance pour le dossier produit<\/h4><\/div><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><fieldset><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-dossier_prodotto-12-0\" type=\"radio\" value=\"Oui\" name=\"dossier_prodotto\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-dossier_prodotto-12-0\">Oui<\/label><\/div><div class=\"fusion-form-radio option-inline\"><input tabindex=\"\" id=\"radio-dossier_prodotto-12-1\" type=\"radio\" value=\"Non\" name=\"dossier_prodotto\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-dossier_prodotto-12-1\">Non<\/label><\/div><\/fieldset><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2-5 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-right:0px;--awb-padding-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-14 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color5);border-color:var(--awb-color5);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-form-field fusion-form-textarea-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><label for=\"eventuali_richieste_aggiuntive\">Demandes compl\u00e9mentaires<\/label><textarea cols=\"40\"  minlength=\"0\"  rows=\"4\" tabindex=\"\" id=\"eventuali_richieste_aggiuntive\" name=\"eventuali_richieste_aggiuntive\" class=\"fusion-form-input\" data-holds-private-data=\"false\"><\/textarea><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><div class=\"fusion-separator-border sep-single\" style=\"--awb-height:20px;--awb-amount:20px;--awb-sep-color:var(--awb-color5);border-color:var(--awb-color5);border-top-width:3px;\"><\/div><\/div><div class=\"fusion-form-field fusion-form-consent-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div class=\"fusion-form-checkbox option-inline\"><input tabindex=\"\" id=\"privacy\" type=\"checkbox\" value=\"1\" name=\"privacy\" class=\"fusion-form-input\"\/><label for=\"privacy\">En envoyant votre demande via ce formulaire, vous consentez au <b><a href=\"\/privacy-policy\">traitement de vos donn\u00e9es<\/a><\/b> pour la cr\u00e9ation de votre fiche contact, afin de g\u00e9rer vos demandes plus facilement. Ce site est prot\u00e9g\u00e9 par reCAPTCHA et Google. Les <b><a href=\"https:\/\/policies.google.com\/privacy\" target=\"_blank\">r\u00e8gles de confidentialit\u00e9<\/a><\/b> et les <b><a href=\"https:\/\/policies.google.com\/terms\" target=\"_blank\">conditions d\u2019utilisation<\/a><\/b> de Google s\u2019appliquent.<\/label><\/div><\/div><div class=\"fusion-form-field fusion-form-honeypot-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><input type=\"hidden\" tabindex=\"-1\" name=\"hypot_field\" class=\"fusion-form-input\" autocomplete=\"hypot-6aeb1bae7629e\" aria-hidden=\"true\" data-fusion-is-honeypot=\"true\"><\/div><div class=\"fusion-form-field fusion-form-submit-field fusion-form-label-above\" style=\"\" data-form-id=\"2425\"><div ><button type=\"submit\" class=\"fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-1 fusion-button-span-yes  form-form-submit button-default\" style=\"--button-border-radius-top-left:100px;--button-border-radius-top-right:100px;--button-border-radius-bottom-right:100px;--button-border-radius-bottom-left:100px;\" data-form-number=\"2425\" tabindex=\"\"><span class=\"fusion-button-text\">Envoyer la demande<\/span><\/button><\/div><\/div><div class=\"form-submission-notices data-notice_1\" id=\"fusion-notices-1\"><div class=\"fusion-alert alert success alert-success fusion-alert-center fusion-form-response fusion-form-response-success awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"alert-icon\"><i class=\"awb-icon-check-circle\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-alert-content\">Merci, votre demande a bien \u00e9t\u00e9 envoy\u00e9e. Notre export manager vous r\u00e9pondra sous 48 heures ouvr\u00e9es.<\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">&times;<\/button><\/div><div class=\"fusion-alert alert error alert-danger fusion-alert-center fusion-form-response fusion-form-response-error awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"alert-icon\"><i class=\"awb-icon-exclamation-triangle\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-alert-content\">Une erreur s\u2019est produite lors de l\u2019envoi de votre message. Veuillez actualiser la page et r\u00e9essayer.<\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">&times;<\/button><\/div><\/div><\/div><\/div><\/div><\/div><\/form><\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":1064,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-2421","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Demande de devis compl\u00e9ment alimentaire | Inalme<\/title>\n<meta name=\"description\" content=\"D\u00e9crivez votre projet de compl\u00e9ment alimentaire : notre export manager vous r\u00e9pond sous 48 heures ouvr\u00e9es avec une premi\u00e8re 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