{"id":114592,"date":"2026-01-29T15:52:15","date_gmt":"2026-01-29T14:52:15","guid":{"rendered":"https:\/\/medischecheckup.com\/?page_id=114592"},"modified":"2026-01-29T16:04:28","modified_gmt":"2026-01-29T15:04:28","slug":"formulaire-dadmission-complete","status":"publish","type":"page","link":"https:\/\/medischecheckup.com\/fr\/formulaire-dadmission-complete\/","title":{"rendered":"Formulaire d'admission compl\u00e9t\u00e9"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><div data-parent=\"true\" class=\"vc_row section-intake has-bg need-focus style-color-145652-bg row-container\" id=\"row-unique-0\"><div class=\"row single-top-padding single-bottom-padding single-h-padding limit-width row-parent\"><div class=\"wpb_row row-inner\"><div class=\"wpb_column pos-middle pos-center align_left align_left_mobile column_parent col-lg-12 no-internal-gutter\"><div class=\"uncol style-light\"  ><div class=\"uncoltable\"><div class=\"uncell\" ><div class=\"uncont no-block-padding col-custom-width\" style=\" max-width:69%;\" ><div class=\"empty-space empty-double tablet-hidden mobile-hidden\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<div class=\"empty-space empty-single\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<div class=\"vc_custom_heading_wrap mobile_25px\"><div class=\"heading-text el-text\" ><h2 class=\"h2 font-weight-700 text-color-jevc-color\" ><span>Nous sommes en train d'\u00e9laborer votre conseil personnalis\u00e9.<\/span><\/h2><\/div><div class=\"clear\"><\/div><\/div><div class=\"empty-space empty-quart\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<div class=\"vc_custom_heading_wrap mobile_16px\"><div class=\"heading-text el-text alpha-anim animate_when_almost_visible\" data-delay=\"200\"><div class=\"font-488263 fontsize-501377 fontheight-357766 font-weight-500 text-color-jevc-color\" ><span>Dans quelques instants, vous recevrez vos conseils personnalis\u00e9s dans votre bo\u00eete aux lettres. N'oubliez pas de v\u00e9rifier votre dossier spam si vous n'avez rien re\u00e7u.<\/span><\/div><\/div><div class=\"clear\"><\/div><\/div><div class=\"empty-space empty-single\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<div class=\"empty-space empty-double tablet-hidden mobile-hidden\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<\/div><\/div><\/div><\/div><\/div><script id=\"script-row-unique-0\" data-row=\"script-row-unique-0\" type=\"text\/javascript\" class=\"vc_controls\">UNCODE.initRow(document.getElementById(\"row-unique-0\"));<\/script><\/div><\/div><\/div><div data-parent=\"true\" class=\"vc_row row-container tablet-hidden mobile-hidden\" id=\"row-unique-1\"><div class=\"row no-top-padding no-bottom-padding single-h-padding limit-width row-parent\"><div class=\"wpb_row row-inner\"><div class=\"wpb_column pos-top pos-center align_left column_parent col-lg-12 single-internal-gutter\"><div class=\"uncol style-light\"  ><div class=\"uncoltable\"><div class=\"uncell no-block-padding\" ><div class=\"uncont\" ><div class=\"empty-space empty-single\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<\/div><\/div><\/div><\/div><\/div><script id=\"script-row-unique-1\" data-row=\"script-row-unique-1\" type=\"text\/javascript\" class=\"vc_controls\">UNCODE.initRow(document.getElementById(\"row-unique-1\"));<\/script><\/div><\/div><\/div><div data-parent=\"true\" class=\"vc_row section-form-text row-container\" id=\"row-unique-2\"><div class=\"row double-top-padding double-bottom-padding double-h-padding full-width row-parent\"><div class=\"wpb_row row-inner\"><div class=\"wpb_column pos-middle pos-right align_left column_parent col-lg-6 form-text col-md-50 no-internal-gutter\"><div class=\"uncol style-light\"  ><div class=\"uncoltable\"><div class=\"uncell no-block-padding\" ><div class=\"uncont\" style=\" max-width:90%;\" ><div class=\"empty-space empty-double mobile-hidden\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<div class=\"vc_row row-internal row-container\"><div class=\"row row-child\"><div class=\"wpb_row row-inner\"><div class=\"wpb_column pos-top pos-left align_left column_child col-lg-12 no-internal-gutter\"><div class=\"uncol style-light\" ><div class=\"uncoltable\"><div class=\"uncell no-block-padding\" ><div class=\"uncont\" style=\" max-width:75%;\" ><div class=\"vc_custom_heading_wrap mobile_25px\"><div class=\"heading-text el-text alpha-anim animate_when_almost_visible\" data-delay=\"200\"><h2 class=\"font-161437 h2 font-weight-500 text-color-jevc-color\" ><span>Contactez nous<\/span><\/h2><\/div><div class=\"clear\"><\/div><\/div><div class=\"empty-space empty-single tablet-hidden mobile-hidden\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<div class=\"empty-space empty-half desktop-hidden\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<div class=\"vc_custom_heading_wrap mobile_16px\"><div class=\"heading-text el-text alpha-anim animate_when_almost_visible\" data-delay=\"200\"><div class=\"font-488263 fontsize-168927 fontheight-357766 font-weight-500 text-color-jevc-color\" ><span>Vous avez des questions ou souhaitez obtenir plus d'informations sur les services de Medical Checkup ? En utilisant le formulaire de contact ci-dessous, vous pouvez facilement soumettre votre question. Nous sommes pr\u00eats \u00e0 y r\u00e9pondre et \u00e0 vous fournir toutes les informations dont vous avez besoin. N'h\u00e9sitez pas \u00e0 nous contacter !<\/span><\/div><\/div><div class=\"clear\"><\/div><\/div><div class=\"empty-space empty-single\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<div class=\"vc_custom_heading_wrap\"><div class=\"heading-text el-text alpha-anim animate_when_almost_visible\" data-delay=\"200\"><div class=\"font-161437 fontsize-168927 fontheight-954288 font-weight-500 text-color-169961-color\" ><span>Contact info<\/span><\/div><\/div><div class=\"clear\"><\/div><\/div><div class=\"vc_custom_heading_wrap\"><div class=\"heading-text el-text alpha-anim animate_when_almost_visible\" data-delay=\"200\"><div class=\"font-488263 fontsize-168927 fontheight-954288 font-weight-500 text-color-169961-color\" ><span><a href=\"mailto:info@medischecheckup.com\">info@medischecheckup.com<\/a><\/p><\/span><span><p><a class=\"cursor-init\" href=\"callto:+3235352040\">+32 3 535 20 40<\/a><\/span><\/div><\/div><div class=\"clear\"><\/div><\/div><div class=\"empty-space empty-single\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<div class=\"vc_custom_heading_wrap\"><div class=\"heading-text el-text alpha-anim animate_when_almost_visible\" data-delay=\"200\"><div class=\"font-161437 fontsize-168927 fontheight-954288 font-weight-500 text-color-169961-color\" ><span>Adresse<\/span><\/div><\/div><div class=\"clear\"><\/div><\/div><div class=\"vc_custom_heading_wrap\"><div class=\"heading-text el-text alpha-anim animate_when_almost_visible\" data-delay=\"200\"><div class=\"font-488263 fontsize-168927 fontheight-954288 font-weight-500 text-color-169961-color\" ><span><\/p><\/span><span><p><a class=\"cursor-init\" href=\"https:\/\/g.co\/kgs\/gyFm8xx\" target=\"_blank\" rel=\"noopener\">Uitbreidingstraat 2-8, 2600 Anvers<\/a><\/span><\/div><\/div><div class=\"clear\"><\/div><\/div><div class=\"empty-space empty-single\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<div class=\"vc_custom_heading_wrap\"><div class=\"heading-text el-text alpha-anim animate_when_almost_visible\" data-delay=\"200\"><div class=\"font-161437 fontsize-168927 fontheight-954288 font-weight-500 text-color-169961-color\" ><span>Heures d'ouverture<\/span><\/div><\/div><div class=\"clear\"><\/div><\/div><div class=\"vc_custom_heading_wrap\"><div class=\"heading-text el-text alpha-anim animate_when_almost_visible\" data-delay=\"200\"><div class=\"font-488263 fontsize-168927 fontheight-954288 font-weight-500 text-color-169961-color\" ><span>Du lundi au vendredi<\/p><\/span><span><p>08:00 - 18:00<\/span><\/div><\/div><div class=\"clear\"><\/div><\/div><div class=\"empty-space empty-double\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"wpb_column pos-middle pos-left align_left column_parent col-lg-6 col-md-50 single-internal-gutter\"><div class=\"uncol style-light\"  ><div class=\"uncoltable\"><div class=\"uncell no-block-padding\" ><div class=\"uncont\" style=\" max-width:95%;\" ><div class=\"vc_row row-internal row-container\"><div class=\"row row-child\"><div class=\"wpb_row row-inner\"><div class=\"wpb_column pos-top pos-center align_left column_child col-lg-12 form-block one-internal-gutter\"><div class=\"uncol style-light\" ><div class=\"uncoltable\"><div class=\"uncell single-block-padding style-color-169961-bg\" ><div class=\"uncont\" style=\" max-width:80%;\" ><div class=\"empty-space empty-single\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<div class=\"vc_custom_heading_wrap mobile_25px\"><div class=\"heading-text el-text alpha-anim animate_when_almost_visible\" data-delay=\"200\"><h3 class=\"font-161437 h2 fontheight-954288 font-weight-500 text-color-xsdn-color\" ><span>Compl\u00e9tez vos coordonn\u00e9es<\/span><\/h3><\/div><div class=\"clear\"><\/div><\/div><div class=\"empty-space empty-half\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<div class=\"vc_custom_heading_wrap\"><div class=\"heading-text el-text alpha-anim animate_when_almost_visible\" data-delay=\"200\"><div class=\"font-488263 fontsize-168927 fontheight-954288 font-weight-500 text-color-xsdn-color\" ><span><div class=\"forminator-ui forminator-custom-form forminator-custom-form-112278 forminator-design--default  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-112278\" data-uid=\"6a3b91ac2056d\"><br\/><\/div><form\r\n\t\t\t\tid=\"forminator-module-112278\"\r\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-112278 forminator-design--default  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=\"112278\"\r\n\t\t\t\t data-color-option=\"theme\" data-design=\"default\" data-grid=\"open\" style=\"display: none;\"\r\n\t\t\t\tdata-uid=\"6a3b91ac2056d\" 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=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-12\"><div class=\"forminator-field\"><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"Nom\" id=\"forminator-field-name-1_6a3b91ac2056d\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" autocomplete=\"name\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-12\"><div class=\"forminator-field\"><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"Adresse \u00e9lectronique\" id=\"forminator-field-email-1_6a3b91ac2056d\" class=\"forminator-input forminator-email--field\" data-required=\"true\" aria-required=\"true\" autocomplete=\"email\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-12\"><div class=\"forminator-field\"><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"T\u00e9l\u00e9phone\" id=\"forminator-field-phone-1_6a3b91ac2056d\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-1\" class=\"forminator-field-textarea forminator-col forminator-col-12\"><div class=\"forminator-field\"><textarea name=\"textarea-1\" placeholder=\"Que pouvons-nous faire pour vous ?\" id=\"forminator-field-textarea-1_6a3b91ac2056d\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" maxlength=\"180\" ><\/textarea><span id=\"forminator-field-textarea-1_6a3b91ac2056d-description\" class=\"forminator-description\"><span data-limit=\"180\" data-type=\"characters\" data-editor=\"\">0 \/ 180<\/span><\/span><\/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\">Plus d'informations<\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"a39b2dc24d\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/fr\/wp-json\/wp\/v2\/pages\/114592\" \/><input type=\"hidden\" name=\"form_id\" value=\"112278\"><input type=\"hidden\" name=\"page_id\" value=\"114592\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/medischecheckup.com\/fr\/formulaire-dadmission-complete\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><input type=\"hidden\" name=\"trp-form-language\" value=\"fr\"\/><\/form><\/span><\/div><\/div><div class=\"clear\"><\/div><\/div><div class=\"empty-space empty-single\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><script id=\"script-row-unique-2\" data-row=\"script-row-unique-2\" type=\"text\/javascript\" class=\"vc_controls\">UNCODE.initRow(document.getElementById(\"row-unique-2\"));<\/script><\/div><\/div><\/div><div data-parent=\"true\" class=\"vc_row row-container tablet-hidden mobile-hidden\" id=\"row-unique-3\"><div class=\"row no-top-padding no-bottom-padding single-h-padding limit-width row-parent\"><div class=\"wpb_row row-inner\"><div class=\"wpb_column pos-top pos-center align_left column_parent col-lg-12 single-internal-gutter\"><div class=\"uncol style-light\"  ><div class=\"uncoltable\"><div class=\"uncell no-block-padding\" ><div class=\"uncont\" ><div class=\"empty-space empty-single\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<\/div><\/div><\/div><\/div><\/div><script id=\"script-row-unique-3\" data-row=\"script-row-unique-3\" type=\"text\/javascript\" class=\"vc_controls\">UNCODE.initRow(document.getElementById(\"row-unique-3\"));<\/script><\/div><\/div><\/div><div data-parent=\"true\" class=\"vc_row row-container desktop-hidden tablet-hidden mobile-hidden\" id=\"row-unique-4\"><div class=\"row no-top-padding no-bottom-padding no-h-padding full-width row-parent\"><div class=\"wpb_row row-inner\"><div class=\"wpb_column pos-top pos-center align_left column_parent col-lg-12 single-internal-gutter\"><div class=\"uncol style-light\"  ><div class=\"uncoltable\"><div class=\"uncell no-block-padding\" ><div class=\"uncont\" >\n\t<div class=\"wpb_raw_code wpb_raw_js\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<iframe src=\"https:\/\/snazzymaps.com\/embed\/665016\" width=\"100%\" height=\"543.5px\" style=\"border:none;\"><\/iframe>\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div><\/div><script id=\"script-row-unique-4\" data-row=\"script-row-unique-4\" type=\"text\/javascript\" class=\"vc_controls\">UNCODE.initRow(document.getElementById(\"row-unique-4\"));<\/script><\/div><\/div><\/div><div data-parent=\"true\" class=\"vc_row section-image-quote row-container with-parallax\" id=\"row-unique-5\"><div class=\"row-background background-element\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"background-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"background-inner\" style=\"background-image: url(https:\/\/medischecheckup.com\/wp-content\/uploads\/2025\/11\/vitaly-gariev-dlkeCHsagmU-unsplash-scaled.jpg);background-repeat: no-repeat;background-position: center center;background-size: cover;\"><\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"block-bg-overlay style-overlay_color-941966-bg\" style=\"opacity: 0.35;\"><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<\/div><div class=\"row no-top-padding no-bottom-padding no-h-padding full-width row-parent\" data-height-ratio=\"70\"><div class=\"wpb_row row-inner\"><div class=\"wpb_column pos-middle pos-center align_center align_center_tablet align_center_mobile column_parent col-lg-12 width_contact_quote single-internal-gutter\"><div class=\"uncol style-light\"  ><div class=\"uncoltable\"><div class=\"uncell\" ><div class=\"uncont no-block-padding col-custom-width\" style=\" max-width:60%;\" ><div class=\"empty-space empty-double desktop-hidden\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<div class=\"vc_custom_heading_wrap mobile_25px\"><div class=\"heading-text el-text alpha-anim animate_when_almost_visible\" data-delay=\"200\"><div class=\"font-188146 fontsize-208892 fontheight-357766 font-weight-500 text-color-xsdn-color\" ><span>Les examens m\u00e9dicaux sont un gage de tranquillit\u00e9 d'esprit et peuvent am\u00e9liorer votre qualit\u00e9 de vie.<\/span><\/div><\/div><div class=\"clear\"><\/div><\/div><div class=\"empty-space empty-double desktop-hidden\" ><span class=\"empty-space-inner\"><\/span><\/div>\n<\/div><\/div><\/div><\/div><\/div><script id=\"script-row-unique-5\" data-row=\"script-row-unique-5\" type=\"text\/javascript\" class=\"vc_controls\">UNCODE.initRow(document.getElementById(\"row-unique-5\"));<\/script><\/div><\/div><\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"Nous sommes en train de compiler votre avis personnel. Dans quelques instants, vous recevrez vos conseils personnalis\u00e9s dans votre bo\u00eete aux lettres. V\u00e9rifiez [...]","protected":false},"author":17,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"wds_primary_page_category":0,"footnotes":""},"class_list":["post-114592","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/medischecheckup.com\/fr\/wp-json\/wp\/v2\/pages\/114592","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medischecheckup.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/medischecheckup.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/medischecheckup.com\/fr\/wp-json\/wp\/v2\/users\/17"}],"replies":[{"embeddable":true,"href":"https:\/\/medischecheckup.com\/fr\/wp-json\/wp\/v2\/comments?post=114592"}],"version-history":[{"count":4,"href":"https:\/\/medischecheckup.com\/fr\/wp-json\/wp\/v2\/pages\/114592\/revisions"}],"predecessor-version":[{"id":114598,"href":"https:\/\/medischecheckup.com\/fr\/wp-json\/wp\/v2\/pages\/114592\/revisions\/114598"}],"wp:attachment":[{"href":"https:\/\/medischecheckup.com\/fr\/wp-json\/wp\/v2\/media?parent=114592"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}