smartforms.ekomi.com
Open in
urlscan Pro
18.184.65.9
Public Scan
Submitted URL: https://srr.ekomi.com/update-click-rate?reviewUrl=https%3A%2F%2Fsmartforms.ekomi.com%2Freview%2F150965%2F84121b21f3d4f...
Effective URL: https://smartforms.ekomi.com/review/150965/84121b21f3d4f971befffd8d7234b85d?fid=412575&star_rating=0
Submission: On January 09 via manual from FR — Scanned from FR
Effective URL: https://smartforms.ekomi.com/review/150965/84121b21f3d4f971befffd8d7234b85d?fid=412575&star_rating=0
Submission: On January 09 via manual from FR — Scanned from FR
Form analysis 1 forms found in the DOM
POST https://smartforms.ekomi.com/submit
<form method="POST" action="https://smartforms.ekomi.com/submit" accept-charset="UTF-8" class="seller-standard-form" id="survey_submit_form" enctype="multipart/form-data"><input name="_token" type="hidden"
value="JbRTtvqYSAcVBM5dHJZ9lj6ugkiG2mpSfwy06yhz">
<div class="sff-form__legend">
</div>
<div class="form-fieldset">
<input id="shop_id" name="shop_id" type="hidden" value="150965">
<input id="review_hash" name="review_hash" type="hidden" value="84121b21f3d4f971befffd8d7234b85d">
<input id="order_id" name="order_id" type="hidden" value="658d6eec4f181b52610b5054/45299">
<input id="form_analytics_id" name="form_analytics_id" type="hidden" value="80497349">
<input id="product_id" name="product_id" type="hidden" value="">
<input id="products_data" name="products_data" type="hidden" value="">
<input id="selected_language" name="selected_language" type="hidden" value="6">
<input id="widget_check" name="widget_check" type="hidden" value="">
<input id="embed_widget" name="embed_widget" type="hidden" value="">
<input id="disable_auto_close" name="disable_auto_close" type="hidden" value="">
<input id="form_id" name="form_id" type="hidden" value="412575">
<input id="fingerprint_hash" name="fingerprint_hash" type="hidden">
<input id="chain" name="chain" type="hidden" value="{"412575":{"review_type":"seller","previous_name":null,"previous":null,"next":null,"next_name":null}}">
<input id="navigation_buttons" name="navigation_buttons" type="hidden" value="">
<input id="feedback_source" name="source" type="hidden" value="">
<input id="sff_hash" name="sff_hash" type="hidden" value="">
<input id="sff_shop_id" name="sff_shop_id" type="hidden" value="53957">
<input id="form_lang_id" name="form_lang_id" type="hidden" value="6">
<input id="shop_lang_id" name="shop_lang_id" type="hidden" value="2">
<input id="browser_lang_id" name="browser_lang_id" type="hidden" value="6">
<input id="default_lang_id" name="default_lang_id" type="hidden" value="1">
<div class="form__elem elem__conditional-container">
<!--Free text Start-->
<div class=" form__elem ref_selector_reference_id_412575_1645533456071" data-field-type="free text" data-is-required="optional">
<div class="elem__free-text">
<div class="form__elem__body" id="label_2289459">
<p><strong>Votre avis nous intéresse! </strong></p>
</div>
</div>
</div>
<!--Free text End-->
</div>
<div class="form__elem elem__conditional-container">
<!--Free text Start-->
<div class=" form__elem ref_selector_reference_id_412575_1645533511783" data-field-type="free text" data-is-required="optional">
<div class="elem__free-text">
<div class="form__elem__body" id="label_2289460">
<p>Grâce à vous, nous progressons ! Parce que nous sommes résolument attentifs à la satisfaction de nos assurés, nous vous invitons à remplir le formulaire de satisfaction ci-dessous. Cela vous prendra moins d’une minute.</p>
</div>
</div>
</div>
<!--Free text End-->
</div>
<div class=" form__elem ranking-scale ranking_scale
scroll_top_2289457
ranking-scale_2289457
ref_selector_reference_id_412575_1554370893835" id="ranking_scale_mandatory" data-field-type="ranking scale" data-is-required="mandatory" data-ranking_scale_id="2289457">
<!--Feedback Continuous-->
<article class="form__elem__no-border p__lf-15__mobile form__elem continuous js_ranking_scale rating-comp__2289457 ">
<div class="elem__feedback-continuous elem__feedback-continuous__thumbnail-false fixed__feedback__continuous">
<div class="elem__feedback__header elem__feedback__header__thumbnail-false">
<div class="elem_feedback__header-content">
<h3 class="form__elem__title" id="label1_2289457">Votre échange avec votre complémentaire santé Henner a-t-il répondu à vos attentes ?<sup> * </sup></h3>
<p class="form__elem__help-text" id="helping_text1_2289457_left"><i>1 étoile = pas du tout, 5 étoiles = parfaitement</i></p>
</div>
</div>
<div class="form__elem__body">
<div class="feedback__container feedback__continuous__container">
<div class="feedback__emo-list feedback__continuous__emo-list hide__radio subquestion__false">
<div class="feedback__continuous__emo-list__table-row shapes__lg js_rating-comp__icons-list feedback__continuous__selection-continuous main-ratting-conatiner enable_disable_class_2289457">
<div class="feedback__emo-list__item feedback__emo-list__description feedback__continuous__emo-list__item feedback__continuous__emo-list__description">
<p class="feedback__continuous__emo-list__description-count feedback__emo-list__description-count">
<span class="count__string translation_with_precedence_total_rating ">Total:</span>
<span class="count__submit figure_2289457">0</span>
<span class="count__separator ">/</span>
<span class="count__total ">5</span>
</p>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-1 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289457" id="star1_2289457_1" data-parent-class="ref_selector_reference_id_412575_1554370893835" data-notapplicable_id="continuous_notapplicable_2289457" data-parent_child_count="0"
data-parent_id="2289457" data-max_length="5" data-min_length="1" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289457" name="question_continuous_2289457"
type="radio" value="1">
<label class="feedback__item-label" for="star1_2289457_1">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-2 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289457" id="star1_2289457_2" data-parent-class="ref_selector_reference_id_412575_1554370893835" data-notapplicable_id="continuous_notapplicable_2289457" data-parent_child_count="0"
data-parent_id="2289457" data-max_length="5" data-min_length="1" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289457" name="question_continuous_2289457"
type="radio" value="2">
<label class="feedback__item-label" for="star1_2289457_2">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-3 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289457" id="star1_2289457_3" data-parent-class="ref_selector_reference_id_412575_1554370893835" data-notapplicable_id="continuous_notapplicable_2289457" data-parent_child_count="0"
data-parent_id="2289457" data-max_length="5" data-min_length="1" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289457" name="question_continuous_2289457"
type="radio" value="3">
<label class="feedback__item-label" for="star1_2289457_3">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-4 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289457" id="star1_2289457_4" data-parent-class="ref_selector_reference_id_412575_1554370893835" data-notapplicable_id="continuous_notapplicable_2289457" data-parent_child_count="0"
data-parent_id="2289457" data-max_length="5" data-min_length="1" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289457" name="question_continuous_2289457"
type="radio" value="4">
<label class="feedback__item-label" for="star1_2289457_4">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-5 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289457" id="star1_2289457_5" data-parent-class="ref_selector_reference_id_412575_1554370893835" data-notapplicable_id="continuous_notapplicable_2289457" data-parent_child_count="0"
data-parent_id="2289457" data-max_length="5" data-min_length="1" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289457" name="question_continuous_2289457"
type="radio" value="5">
<label class="feedback__item-label" for="star1_2289457_5">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</div>
</div>
</div>
<div id="product_description_content" class="trans_product_description feedback__container__product-description">
</div>
</div>
<p class="form__elem__error-text" id="error_text1_2289457">Merci d'évaluer notre service, cela aidera d'autres clients à faire le bon choix</p>
<p class="form__elem__error-text ranking_scale_dropdown_error ranking_scale_dropdown_error_2289457" id="ranking_scale_dropdown_error_2289457">Veuillez sélectionner une option dans le menu déroulant</p>
</div>
</div>
</article>
<!--Feedback Continuous--> <!--Ranking Scale Default-->
<article class="form__elem__no-border p__lf-15__mobile form__elem hidden grid js_ranking_scale rating-comp__2289457">
<div class="ranking-scale_2289457 elem__rating elem__ranking-scale__layout-default fixed__feedback__default ">
<h3 class="form__elem__title" id="label2_2289457">Votre échange avec votre complémentaire santé Henner a-t-il répondu à vos attentes ?<sup> * </sup></h3>
<div class="form__elem__body form__elem__adjust_spacing_for_elements ">
<div class="form__elem__help-text__multiple ">
<p class="form__elem__help-text form__elem__help-text__left" id="helping_text2_2289457_left"><i>1 étoile = pas du tout, 5 étoiles = parfaitement</i></p>
<p class="form__elem__help-text form__elem__help-text__right" id="helping_text2_2289457_right">
</p>
<div class="clearfix"></div>
</div>
<div class="ranking__container ">
<ul
class="js_rating-comp__icons-list ranking__list list-unstyled ranking__list__default elem__table rating-comp__icons-list rating-comp__selection-type__continuous hide__radio shapes__lg main-ratting-conatiner enable_disable_class_2289457">
<li class="ranking__list__item ranking__list__item-1 elem__table__cell">
<input class="test_class question_grid_2289457" id="star2_2289457_1" data-parent-class="ref_selector_reference_id_412575_1554370893835" data-notapplicable_id="grid_notapplicable_2289457" data-parent_id_prefix="grid"
data-parent_id="2289457" data-own_id="2289457" data-apply_axa_formula="false" data-max_length="5" data-min_length="1" name="question_grid_2289457" type="radio" value="1">
<div class="ranking__list__item__label">
<label for="star2_2289457_1">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-2 elem__table__cell">
<input class="test_class question_grid_2289457" id="star2_2289457_2" data-parent-class="ref_selector_reference_id_412575_1554370893835" data-notapplicable_id="grid_notapplicable_2289457" data-parent_id_prefix="grid"
data-parent_id="2289457" data-own_id="2289457" data-apply_axa_formula="false" data-max_length="5" data-min_length="1" name="question_grid_2289457" type="radio" value="2">
<div class="ranking__list__item__label">
<label for="star2_2289457_2">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-3 elem__table__cell">
<input class="test_class question_grid_2289457" id="star2_2289457_3" data-parent-class="ref_selector_reference_id_412575_1554370893835" data-notapplicable_id="grid_notapplicable_2289457" data-parent_id_prefix="grid"
data-parent_id="2289457" data-own_id="2289457" data-apply_axa_formula="false" data-max_length="5" data-min_length="1" name="question_grid_2289457" type="radio" value="3">
<div class="ranking__list__item__label">
<label for="star2_2289457_3">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-4 elem__table__cell">
<input class="test_class question_grid_2289457" id="star2_2289457_4" data-parent-class="ref_selector_reference_id_412575_1554370893835" data-notapplicable_id="grid_notapplicable_2289457" data-parent_id_prefix="grid"
data-parent_id="2289457" data-own_id="2289457" data-apply_axa_formula="false" data-max_length="5" data-min_length="1" name="question_grid_2289457" type="radio" value="4">
<div class="ranking__list__item__label">
<label for="star2_2289457_4">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-5 elem__table__cell">
<input class="test_class question_grid_2289457" id="star2_2289457_5" data-parent-class="ref_selector_reference_id_412575_1554370893835" data-notapplicable_id="grid_notapplicable_2289457" data-parent_id_prefix="grid"
data-parent_id="2289457" data-own_id="2289457" data-apply_axa_formula="false" data-max_length="5" data-min_length="1" name="question_grid_2289457" type="radio" value="5">
<div class="ranking__list__item__label">
<label for="star2_2289457_5">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</li>
</ul>
</div>
<p class="form__elem__error-text" id="error_text2_2289457">Merci d'évaluer notre service, cela aidera d'autres clients à faire le bon choix</p>
<p class="form__elem__error-text ranking_scale_dropdown_error ranking_scale_dropdown_error_2289457" id="ranking_scale_dropdown_error_2289457">Veuillez sélectionner une option dans le menu déroulant</p>
</div>
<div id="product_description_content" class="trans_product_description feedback__container__product-description">
</div>
</div>
</article>
<!--Ranking Scale Default-->
</div>
<!--Short text Start-->
<article class="cq_fid_2289457_1 cq_fid_2289457_2 form__elem ref_selector_reference_id_412575_1650497065410" data-field-type="short text" data-is-required="required">
<div class="elem__short-text">
<h3 class="form__elem__title" id="label_2289463">Votre Nom:<sup> * </sup></h3>
<div class="form__elem__body">
<p class="form__elem__help-text" id="helping_text_2289463">Veuillez entrer votre nom.</p>
<div class="elem-type__short-text">
<textarea id="question_2289463" class=" form-control form-textarea count_characters " placeholder="" data-default-country="us" name="question_2289463" cols="50" rows="10"></textarea>
</div>
<!--Starts : Remaining characters -->
<div class="minimum_characters_div minimum_characters_2289463">
<div>
<span id="min_limit_message_2289463" class="form__elem__error-text min_limit_message smt_min_limit_violation" style="display: none;">Ajoutez des caractères minimum: :show_min_characters</span>
</div>
</div>
<!--Ends: Remaining characters -->
<div class="hide
form__elem__disable-option">
<div class="checkbox-col">
<div class="elem-type__checkbox">
<input type="checkbox" class="cq_no_answer_2289457 form-checkbox" name="notapplicable_2289463" id="notapplicable_2289463" data-field-type="short text">
<label for="notapplicable_2289463">
<span id="no_answer_text_2289463">Cannot answer</span>
</label>
</div>
</div>
</div>
<p class="form__elem__error-text " id="error_text_2289463">Veuillez bien remplir cette colonne.</p>
<p class="form__elem__error-text you_entered_invalid_data" id="tag_error_text_2289463" style="display: none">Les informations saisies semblent incorrectes, veuillez entrer uniquement du texte brut.</p>
</div>
</div>
</article>
<!--Short text End-->
<!--Short text Start-->
<article class="cq_fid_2289457_1 cq_fid_2289457_2 form__elem ref_selector_reference_id_412575_1650497488623" data-field-type="short text" data-is-required="required">
<div class="elem__short-text">
<h3 class="form__elem__title" id="label_2289464">Votre Prénom:<sup> * </sup></h3>
<div class="form__elem__body">
<p class="form__elem__help-text" id="helping_text_2289464">Veuillez entrer votre prénom.</p>
<div class="elem-type__short-text">
<textarea id="question_2289464" class=" form-control form-textarea count_characters " placeholder="" data-default-country="us" name="question_2289464" cols="50" rows="10"></textarea>
</div>
<!--Starts : Remaining characters -->
<div class="minimum_characters_div minimum_characters_2289464">
<div>
<span id="min_limit_message_2289464" class="form__elem__error-text min_limit_message smt_min_limit_violation" style="display: none;">Ajoutez des caractères minimum: :show_min_characters</span>
</div>
</div>
<!--Ends: Remaining characters -->
<div class="hide
form__elem__disable-option">
<div class="checkbox-col">
<div class="elem-type__checkbox">
<input type="checkbox" class="cq_no_answer_2289457 form-checkbox" name="notapplicable_2289464" id="notapplicable_2289464" data-field-type="short text">
<label for="notapplicable_2289464">
<span id="no_answer_text_2289464">Cannot answer</span>
</label>
</div>
</div>
</div>
<p class="form__elem__error-text " id="error_text_2289464">Veuillez bien remplir cette colonne.</p>
<p class="form__elem__error-text you_entered_invalid_data" id="tag_error_text_2289464" style="display: none">Les informations saisies semblent incorrectes, veuillez entrer uniquement du texte brut.</p>
</div>
</div>
</article>
<!--Short text End-->
<!--Short text Start-->
<article class="cq_fid_2289457_1 cq_fid_2289457_2 form__elem ref_selector_reference_id_412575_1650497742671" data-field-type="short text" data-is-required="required">
<div class="elem__short-text">
<h3 class="form__elem__title" id="label_2289465">Votre numéro de téléphone:<sup> * </sup></h3>
<div class="form__elem__body">
<p class="form__elem__help-text" id="helping_text_2289465">Veuillez entrer votre numéro téléphone.</p>
<div class="elem-type__short-text">
<textarea id="question_2289465" class=" form-control form-textarea count_characters " placeholder="" data-default-country="us" name="question_2289465" cols="50" rows="10"></textarea>
</div>
<!--Starts : Remaining characters -->
<div class="minimum_characters_div minimum_characters_2289465">
<div>
<span id="min_limit_message_2289465" class="form__elem__error-text min_limit_message smt_min_limit_violation" style="display: none;">Ajoutez des caractères minimum: :show_min_characters</span>
</div>
</div>
<!--Ends: Remaining characters -->
<div class="hide
form__elem__disable-option">
<div class="checkbox-col">
<div class="elem-type__checkbox">
<input type="checkbox" class="cq_no_answer_2289457 form-checkbox" name="notapplicable_2289465" id="notapplicable_2289465" data-field-type="short text">
<label for="notapplicable_2289465">
<span id="no_answer_text_2289465">Cannot answer</span>
</label>
</div>
</div>
</div>
<p class="form__elem__error-text " id="error_text_2289465">Veuillez bien remplir cette colonne.</p>
<p class="form__elem__error-text you_entered_invalid_data" id="tag_error_text_2289465" style="display: none">Les informations saisies semblent incorrectes, veuillez entrer uniquement du texte brut.</p>
</div>
</div>
</article>
<!--Short text End-->
<div class=" form__elem ranking-scale ranking_scale
scroll_top_2289462
ranking-scale_2289462
ref_selector_reference_id_412575_1645534171195" id="ranking_scale_required" data-field-type="ranking scale" data-is-required="required" data-ranking_scale_id="2289462">
<!--Feedback Continuous-->
<article class="form__elem__no-border p__lf-15__mobile form__elem continuous js_ranking_scale rating-comp__2289462 ">
<div class="elem__feedback-continuous elem__feedback-continuous__thumbnail-false fixed__feedback__continuous">
<div class="elem__feedback__header elem__feedback__header__thumbnail-false">
<div class="elem_feedback__header-content">
<h3 class="form__elem__title" id="label1_2289462">Avez-vous facilement obtenu une réponse à votre demande ?<sup> * </sup></h3>
<p class="form__elem__help-text" id="helping_text1_2289462_left"><i>1 étoile = très compliqué, 5 étoiles = très facilement</i></p>
</div>
</div>
<div class="form__elem__body">
<div class="feedback__container feedback__continuous__container">
<div class="feedback__emo-list feedback__continuous__emo-list hide__radio subquestion__false">
<div class="feedback__continuous__emo-list__table-row shapes__lg js_rating-comp__icons-list feedback__continuous__selection-continuous main-ratting-conatiner enable_disable_class_2289462">
<div class="feedback__emo-list__item feedback__emo-list__description feedback__continuous__emo-list__item feedback__continuous__emo-list__description">
<p class="feedback__continuous__emo-list__description-count feedback__emo-list__description-count">
<span class="count__string translation_with_precedence_total_rating ">Total:</span>
<span class="count__submit figure_2289462">0</span>
<span class="count__separator ">/</span>
<span class="count__total ">5</span>
</p>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-1 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289462" id="star1_2289462_1" data-parent-class="ref_selector_reference_id_412575_1645534171195" data-notapplicable_id="continuous_notapplicable_2289462" data-parent_child_count="0"
data-parent_id="2289462" data-max_length="5" data-min_length="1" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289462" name="question_continuous_2289462"
type="radio" value="1">
<label class="feedback__item-label" for="star1_2289462_1">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-2 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289462" id="star1_2289462_2" data-parent-class="ref_selector_reference_id_412575_1645534171195" data-notapplicable_id="continuous_notapplicable_2289462" data-parent_child_count="0"
data-parent_id="2289462" data-max_length="5" data-min_length="1" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289462" name="question_continuous_2289462"
type="radio" value="2">
<label class="feedback__item-label" for="star1_2289462_2">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-3 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289462" id="star1_2289462_3" data-parent-class="ref_selector_reference_id_412575_1645534171195" data-notapplicable_id="continuous_notapplicable_2289462" data-parent_child_count="0"
data-parent_id="2289462" data-max_length="5" data-min_length="1" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289462" name="question_continuous_2289462"
type="radio" value="3">
<label class="feedback__item-label" for="star1_2289462_3">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-4 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289462" id="star1_2289462_4" data-parent-class="ref_selector_reference_id_412575_1645534171195" data-notapplicable_id="continuous_notapplicable_2289462" data-parent_child_count="0"
data-parent_id="2289462" data-max_length="5" data-min_length="1" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289462" name="question_continuous_2289462"
type="radio" value="4">
<label class="feedback__item-label" for="star1_2289462_4">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-5 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289462" id="star1_2289462_5" data-parent-class="ref_selector_reference_id_412575_1645534171195" data-notapplicable_id="continuous_notapplicable_2289462" data-parent_child_count="0"
data-parent_id="2289462" data-max_length="5" data-min_length="1" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289462" name="question_continuous_2289462"
type="radio" value="5">
<label class="feedback__item-label" for="star1_2289462_5">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</div>
</div>
</div>
</div>
<p class="form__elem__error-text" id="error_text1_2289462">Merci de partager votre opinion, cela aidera d'autres clients à faire le bon choix</p>
<p class="form__elem__error-text ranking_scale_dropdown_error ranking_scale_dropdown_error_2289462" id="ranking_scale_dropdown_error_2289462">Veuillez sélectionner une option dans le menu déroulant</p>
</div>
</div>
</article>
<!--Feedback Continuous--> <!--Ranking Scale Default-->
<article class="form__elem__no-border p__lf-15__mobile form__elem hidden grid js_ranking_scale rating-comp__2289462">
<div class="ranking-scale_2289462 elem__rating elem__ranking-scale__layout-default fixed__feedback__default ">
<h3 class="form__elem__title" id="label2_2289462">Avez-vous facilement obtenu une réponse à votre demande ?<sup> * </sup></h3>
<div class="form__elem__body form__elem__adjust_spacing_for_elements ">
<div class="form__elem__help-text__multiple ">
<p class="form__elem__help-text form__elem__help-text__left" id="helping_text2_2289462_left"><i>1 étoile = très compliqué, 5 étoiles = très facilement</i></p>
<p class="form__elem__help-text form__elem__help-text__right" id="helping_text2_2289462_right">
</p>
<div class="clearfix"></div>
</div>
<div class="ranking__container ">
<ul
class="js_rating-comp__icons-list ranking__list list-unstyled ranking__list__default elem__table rating-comp__icons-list rating-comp__selection-type__continuous hide__radio shapes__lg main-ratting-conatiner enable_disable_class_2289462">
<li class="ranking__list__item ranking__list__item-1 elem__table__cell">
<input class="test_class question_grid_2289462" id="star2_2289462_1" data-parent-class="ref_selector_reference_id_412575_1645534171195" data-notapplicable_id="grid_notapplicable_2289462" data-parent_id_prefix="grid"
data-parent_id="2289462" data-own_id="2289462" data-apply_axa_formula="false" data-max_length="5" data-min_length="1" name="question_grid_2289462" type="radio" value="1">
<div class="ranking__list__item__label">
<label for="star2_2289462_1">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-2 elem__table__cell">
<input class="test_class question_grid_2289462" id="star2_2289462_2" data-parent-class="ref_selector_reference_id_412575_1645534171195" data-notapplicable_id="grid_notapplicable_2289462" data-parent_id_prefix="grid"
data-parent_id="2289462" data-own_id="2289462" data-apply_axa_formula="false" data-max_length="5" data-min_length="1" name="question_grid_2289462" type="radio" value="2">
<div class="ranking__list__item__label">
<label for="star2_2289462_2">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-3 elem__table__cell">
<input class="test_class question_grid_2289462" id="star2_2289462_3" data-parent-class="ref_selector_reference_id_412575_1645534171195" data-notapplicable_id="grid_notapplicable_2289462" data-parent_id_prefix="grid"
data-parent_id="2289462" data-own_id="2289462" data-apply_axa_formula="false" data-max_length="5" data-min_length="1" name="question_grid_2289462" type="radio" value="3">
<div class="ranking__list__item__label">
<label for="star2_2289462_3">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-4 elem__table__cell">
<input class="test_class question_grid_2289462" id="star2_2289462_4" data-parent-class="ref_selector_reference_id_412575_1645534171195" data-notapplicable_id="grid_notapplicable_2289462" data-parent_id_prefix="grid"
data-parent_id="2289462" data-own_id="2289462" data-apply_axa_formula="false" data-max_length="5" data-min_length="1" name="question_grid_2289462" type="radio" value="4">
<div class="ranking__list__item__label">
<label for="star2_2289462_4">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-5 elem__table__cell">
<input class="test_class question_grid_2289462" id="star2_2289462_5" data-parent-class="ref_selector_reference_id_412575_1645534171195" data-notapplicable_id="grid_notapplicable_2289462" data-parent_id_prefix="grid"
data-parent_id="2289462" data-own_id="2289462" data-apply_axa_formula="false" data-max_length="5" data-min_length="1" name="question_grid_2289462" type="radio" value="5">
<div class="ranking__list__item__label">
<label for="star2_2289462_5">
<i class="ico ico-star icomoon-default"></i>
<i class="ico ico-star-selected icomoon-sudo"></i>
</label>
</div>
</li>
</ul>
</div>
<p class="form__elem__error-text" id="error_text2_2289462">Merci de partager votre opinion, cela aidera d'autres clients à faire le bon choix</p>
<p class="form__elem__error-text ranking_scale_dropdown_error ranking_scale_dropdown_error_2289462" id="ranking_scale_dropdown_error_2289462">Veuillez sélectionner une option dans le menu déroulant</p>
</div>
</div>
</article>
<!--Ranking Scale Default-->
</div>
<div class=" form__elem ranking-scale ranking_scale
scroll_top_2289461
ranking-scale_2289461
ref_selector_reference_id_412575_1645534009822" id="ranking_scale_required" data-field-type="ranking scale" data-is-required="required" data-ranking_scale_id="2289461">
<!--Feedback Continuous-->
<article class="form__elem__no-border p__lf-15__mobile form__elem continuous hidden-xs js_ranking_scale rating-comp__2289461 ">
<div class="elem__feedback-continuous elem__feedback-continuous__thumbnail-false fixed__feedback__continuous">
<div class="elem__feedback__header elem__feedback__header__thumbnail-false">
<div class="elem_feedback__header-content">
<h3 class="form__elem__title" id="label1_2289461">Dans quelle mesure recommanderiez-vous Henner à votre entourage ?<sup> * </sup></h3>
<p class="form__elem__help-text" id="helping_text1_2289461_left"><i>Notez de 0 (certainement pas) à 10 (sans hésitation)</i></p>
</div>
</div>
<div class="form__elem__body">
<div class="feedback__container feedback__continuous__container">
<div class="feedback__emo-list feedback__continuous__emo-list hide__radio subquestion__false">
<div class="feedback__continuous__emo-list__table-row js_rating-comp__icons-list feedback__continuous__selection-continuous main-ratting-conatiner enable_disable_class_2289461">
<div class="feedback__emo-list__item feedback__emo-list__description feedback__continuous__emo-list__item feedback__continuous__emo-list__description">
<p class="feedback__continuous__emo-list__description-count feedback__emo-list__description-count">
<span class="count__string translation_with_precedence_total_rating ">Total:</span>
<span class="count__submit figure_2289461">0</span>
<span class="count__separator ">/</span>
<span class="count__total ">10</span>
</p>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-0 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289461" id="star1_2289461_0" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="continuous_notapplicable_2289461" data-parent_child_count="0"
data-parent_id="2289461" data-max_length="10" data-min_length="0" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289461" name="question_continuous_2289461"
type="radio" value="0">
<label class="feedback__item-label" for="star1_2289461_0">
<i class="ico ico-square-0 icomoon-default"></i>
<i class="ico ico-square-0-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-1 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289461" id="star1_2289461_1" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="continuous_notapplicable_2289461" data-parent_child_count="0"
data-parent_id="2289461" data-max_length="10" data-min_length="0" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289461" name="question_continuous_2289461"
type="radio" value="1">
<label class="feedback__item-label" for="star1_2289461_1">
<i class="ico ico-square-1 icomoon-default"></i>
<i class="ico ico-square-1-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-2 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289461" id="star1_2289461_2" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="continuous_notapplicable_2289461" data-parent_child_count="0"
data-parent_id="2289461" data-max_length="10" data-min_length="0" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289461" name="question_continuous_2289461"
type="radio" value="2">
<label class="feedback__item-label" for="star1_2289461_2">
<i class="ico ico-square-2 icomoon-default"></i>
<i class="ico ico-square-2-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-3 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289461" id="star1_2289461_3" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="continuous_notapplicable_2289461" data-parent_child_count="0"
data-parent_id="2289461" data-max_length="10" data-min_length="0" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289461" name="question_continuous_2289461"
type="radio" value="3">
<label class="feedback__item-label" for="star1_2289461_3">
<i class="ico ico-square-3 icomoon-default"></i>
<i class="ico ico-square-3-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-4 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289461" id="star1_2289461_4" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="continuous_notapplicable_2289461" data-parent_child_count="0"
data-parent_id="2289461" data-max_length="10" data-min_length="0" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289461" name="question_continuous_2289461"
type="radio" value="4">
<label class="feedback__item-label" for="star1_2289461_4">
<i class="ico ico-square-4 icomoon-default"></i>
<i class="ico ico-square-4-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-5 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289461" id="star1_2289461_5" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="continuous_notapplicable_2289461" data-parent_child_count="0"
data-parent_id="2289461" data-max_length="10" data-min_length="0" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289461" name="question_continuous_2289461"
type="radio" value="5">
<label class="feedback__item-label" for="star1_2289461_5">
<i class="ico ico-square-5 icomoon-default"></i>
<i class="ico ico-square-5-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-6 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289461" id="star1_2289461_6" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="continuous_notapplicable_2289461" data-parent_child_count="0"
data-parent_id="2289461" data-max_length="10" data-min_length="0" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289461" name="question_continuous_2289461"
type="radio" value="6">
<label class="feedback__item-label" for="star1_2289461_6">
<i class="ico ico-square-6 icomoon-default"></i>
<i class="ico ico-square-6-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-7 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289461" id="star1_2289461_7" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="continuous_notapplicable_2289461" data-parent_child_count="0"
data-parent_id="2289461" data-max_length="10" data-min_length="0" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289461" name="question_continuous_2289461"
type="radio" value="7">
<label class="feedback__item-label" for="star1_2289461_7">
<i class="ico ico-square-7 icomoon-default"></i>
<i class="ico ico-square-7-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-8 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289461" id="star1_2289461_8" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="continuous_notapplicable_2289461" data-parent_child_count="0"
data-parent_id="2289461" data-max_length="10" data-min_length="0" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289461" name="question_continuous_2289461"
type="radio" value="8">
<label class="feedback__item-label" for="star1_2289461_8">
<i class="ico ico-square-8 icomoon-default"></i>
<i class="ico ico-square-8-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-9 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289461" id="star1_2289461_9" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="continuous_notapplicable_2289461" data-parent_child_count="0"
data-parent_id="2289461" data-max_length="10" data-min_length="0" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289461" name="question_continuous_2289461"
type="radio" value="9">
<label class="feedback__item-label" for="star1_2289461_9">
<i class="ico ico-square-9 icomoon-default"></i>
<i class="ico ico-square-9-selected icomoon-sudo"></i>
</label>
</div>
</div>
<div class="feedback__emo-list__item feedback__emo-list__shape-item feedback__emo-list__shape-item-10 feedback__continuous__emo-list__item
feedback__continuous__emo-list__shape-item" style="width: 43px;">
<div class="feedback__continuous__shapes-list__item">
<input class="question_continuous_2289461" id="star1_2289461_10" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="continuous_notapplicable_2289461" data-parent_child_count="0"
data-parent_id="2289461" data-max_length="10" data-min_length="0" data-parent_id_prefix="continuous" data-behavior_selection="continuous" data-apply_axa_formula="false" data-own_id="2289461" name="question_continuous_2289461"
type="radio" value="10">
<label class="feedback__item-label" for="star1_2289461_10">
<i class="ico ico-square-10 icomoon-default"></i>
<i class="ico ico-square-10-selected icomoon-sudo"></i>
</label>
</div>
</div>
</div>
</div>
</div>
<p class="form__elem__error-text" id="error_text1_2289461">Merci de partager votre opinion, cela aidera d'autres clients à faire le bon choix.</p>
<p class="form__elem__error-text ranking_scale_dropdown_error ranking_scale_dropdown_error_2289461" id="ranking_scale_dropdown_error_2289461">Veuillez sélectionner une option dans le menu déroulant</p>
</div>
</div>
</article>
<!--Feedback Continuous--> <!--Ranking Scale Default-->
<article class="form__elem__no-border p__lf-15__mobile form__elem visible-xs grid js_ranking_scale rating-comp__2289461">
<div class="ranking-scale_2289461 elem__rating elem__ranking-scale__layout-default fixed__feedback__default ">
<h3 class="form__elem__title" id="label2_2289461">Dans quelle mesure recommanderiez-vous Henner à votre entourage ?<sup> * </sup></h3>
<div class="form__elem__body form__elem__adjust_spacing_for_elements ">
<div class="form__elem__help-text__multiple ">
<p class="form__elem__help-text form__elem__help-text__left" id="helping_text2_2289461_left"><i>Notez de 0 (certainement pas) à 10 (sans hésitation)</i></p>
<p class="form__elem__help-text form__elem__help-text__right" id="helping_text2_2289461_right">
</p>
<div class="clearfix"></div>
</div>
<div class="ranking__container ">
<ul class="js_rating-comp__icons-list ranking__list list-unstyled ranking__list__default elem__table rating-comp__icons-list rating-comp__selection-type__continuous hide__radio main-ratting-conatiner enable_disable_class_2289461">
<li class="ranking__list__item ranking__list__item-0 elem__table__cell">
<input class="test_class question_grid_2289461" id="star2_2289461_0" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="grid_notapplicable_2289461" data-parent_id_prefix="grid"
data-parent_id="2289461" data-own_id="2289461" data-apply_axa_formula="false" data-max_length="10" data-min_length="0" name="question_grid_2289461" type="radio" value="0">
<div class="ranking__list__item__label">
<label for="star2_2289461_0">
<i class="ico ico-square-0 icomoon-default"></i>
<i class="ico ico-square-0-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-1 elem__table__cell">
<input class="test_class question_grid_2289461" id="star2_2289461_1" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="grid_notapplicable_2289461" data-parent_id_prefix="grid"
data-parent_id="2289461" data-own_id="2289461" data-apply_axa_formula="false" data-max_length="10" data-min_length="0" name="question_grid_2289461" type="radio" value="1">
<div class="ranking__list__item__label">
<label for="star2_2289461_1">
<i class="ico ico-square-1 icomoon-default"></i>
<i class="ico ico-square-1-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-2 elem__table__cell">
<input class="test_class question_grid_2289461" id="star2_2289461_2" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="grid_notapplicable_2289461" data-parent_id_prefix="grid"
data-parent_id="2289461" data-own_id="2289461" data-apply_axa_formula="false" data-max_length="10" data-min_length="0" name="question_grid_2289461" type="radio" value="2">
<div class="ranking__list__item__label">
<label for="star2_2289461_2">
<i class="ico ico-square-2 icomoon-default"></i>
<i class="ico ico-square-2-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-3 elem__table__cell">
<input class="test_class question_grid_2289461" id="star2_2289461_3" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="grid_notapplicable_2289461" data-parent_id_prefix="grid"
data-parent_id="2289461" data-own_id="2289461" data-apply_axa_formula="false" data-max_length="10" data-min_length="0" name="question_grid_2289461" type="radio" value="3">
<div class="ranking__list__item__label">
<label for="star2_2289461_3">
<i class="ico ico-square-3 icomoon-default"></i>
<i class="ico ico-square-3-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-4 elem__table__cell">
<input class="test_class question_grid_2289461" id="star2_2289461_4" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="grid_notapplicable_2289461" data-parent_id_prefix="grid"
data-parent_id="2289461" data-own_id="2289461" data-apply_axa_formula="false" data-max_length="10" data-min_length="0" name="question_grid_2289461" type="radio" value="4">
<div class="ranking__list__item__label">
<label for="star2_2289461_4">
<i class="ico ico-square-4 icomoon-default"></i>
<i class="ico ico-square-4-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-5 elem__table__cell">
<input class="test_class question_grid_2289461" id="star2_2289461_5" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="grid_notapplicable_2289461" data-parent_id_prefix="grid"
data-parent_id="2289461" data-own_id="2289461" data-apply_axa_formula="false" data-max_length="10" data-min_length="0" name="question_grid_2289461" type="radio" value="5">
<div class="ranking__list__item__label">
<label for="star2_2289461_5">
<i class="ico ico-square-5 icomoon-default"></i>
<i class="ico ico-square-5-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-6 elem__table__cell">
<input class="test_class question_grid_2289461" id="star2_2289461_6" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="grid_notapplicable_2289461" data-parent_id_prefix="grid"
data-parent_id="2289461" data-own_id="2289461" data-apply_axa_formula="false" data-max_length="10" data-min_length="0" name="question_grid_2289461" type="radio" value="6">
<div class="ranking__list__item__label">
<label for="star2_2289461_6">
<i class="ico ico-square-6 icomoon-default"></i>
<i class="ico ico-square-6-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-7 elem__table__cell">
<input class="test_class question_grid_2289461" id="star2_2289461_7" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="grid_notapplicable_2289461" data-parent_id_prefix="grid"
data-parent_id="2289461" data-own_id="2289461" data-apply_axa_formula="false" data-max_length="10" data-min_length="0" name="question_grid_2289461" type="radio" value="7">
<div class="ranking__list__item__label">
<label for="star2_2289461_7">
<i class="ico ico-square-7 icomoon-default"></i>
<i class="ico ico-square-7-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-8 elem__table__cell">
<input class="test_class question_grid_2289461" id="star2_2289461_8" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="grid_notapplicable_2289461" data-parent_id_prefix="grid"
data-parent_id="2289461" data-own_id="2289461" data-apply_axa_formula="false" data-max_length="10" data-min_length="0" name="question_grid_2289461" type="radio" value="8">
<div class="ranking__list__item__label">
<label for="star2_2289461_8">
<i class="ico ico-square-8 icomoon-default"></i>
<i class="ico ico-square-8-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-9 elem__table__cell">
<input class="test_class question_grid_2289461" id="star2_2289461_9" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="grid_notapplicable_2289461" data-parent_id_prefix="grid"
data-parent_id="2289461" data-own_id="2289461" data-apply_axa_formula="false" data-max_length="10" data-min_length="0" name="question_grid_2289461" type="radio" value="9">
<div class="ranking__list__item__label">
<label for="star2_2289461_9">
<i class="ico ico-square-9 icomoon-default"></i>
<i class="ico ico-square-9-selected icomoon-sudo"></i>
</label>
</div>
</li>
<li class="ranking__list__item ranking__list__item-10 elem__table__cell">
<input class="test_class question_grid_2289461" id="star2_2289461_10" data-parent-class="ref_selector_reference_id_412575_1645534009822" data-notapplicable_id="grid_notapplicable_2289461" data-parent_id_prefix="grid"
data-parent_id="2289461" data-own_id="2289461" data-apply_axa_formula="false" data-max_length="10" data-min_length="0" name="question_grid_2289461" type="radio" value="10">
<div class="ranking__list__item__label">
<label for="star2_2289461_10">
<i class="ico ico-square-10 icomoon-default"></i>
<i class="ico ico-square-10-selected icomoon-sudo"></i>
</label>
</div>
</li>
</ul>
</div>
<p class="form__elem__error-text" id="error_text2_2289461">Merci de partager votre opinion, cela aidera d'autres clients à faire le bon choix.</p>
<p class="form__elem__error-text ranking_scale_dropdown_error ranking_scale_dropdown_error_2289461" id="ranking_scale_dropdown_error_2289461">Veuillez sélectionner une option dans le menu déroulant</p>
</div>
</div>
</article>
<!--Ranking Scale Default-->
</div>
<!--Long text Start-->
<article class=" form__elem ref_selector_reference_id_412575_1554370893836 mandatory_long_text_field" id="long_text_field" data-field-type="long text" data-is-required="mandatory">
<div class="elem__long-text">
<h3 class="form__elem__title" id="label_2289458" style="">Avez-vous des remarques ou commentaires ?<sup> * </sup></h3>
<div class="form__elem__body">
<!--Add this for single Column layout-->
<div class="elem__long-text__one-col">
<p class="form__elem__help-text" id="helping_text_2289458"><i>Qu'avez-vous préféré ? Quels aspects, s'il y en a, pourrions-nous améliorer ?</i></p>
<div class="elem-type__textarea">
<textarea id="question_2289458" class="form-control form-textarea count_characters" placeholder="Merci de détailler votre avis, cela nous permettra d'améliorer encore notre service." name="question_2289458" cols="50"
rows="10"></textarea>
</div>
</div>
<!--Starts : Remaining characters -->
<div class="minimum_characters_div minimum_characters_2289458">
<div>
<span id="min_limit_message_2289458" class="form__elem__error-text min_limit_message smt_min_limit_violation" style="display: none;">Ajoutez des caractères minimum: :show_min_characters</span>
</div>
</div>
<!--Ends: Remaining characters -->
<p class="form__elem__error-text" id="error_text_2289458">Merci de partager votre opinion, cela aidera d'autres clients à faire le bon choix</p>
<p class="form__elem__error-text you_entered_invalid_data" id="tag_error_text_2289458">Les informations saisies semblent incorrectes, veuillez entrer uniquement du texte brut.</p>
<!--/ .Add this for single Column layout-->
</div>
</div>
</article>
<!--Long text End-->
</div>
</form>Text Content
https://smartforms.ekomi.com/update-cookie-consent × Ce site utilise des cookies pour activer certaines fonctionnalités et améliorer l'offre. Plus d'informations peuvent être trouvées sous la Protection des données. Je suis d'accord Votre avis nous intéresse! Grâce à vous, nous progressons ! Parce que nous sommes résolument attentifs à la satisfaction de nos assurés, nous vous invitons à remplir le formulaire de satisfaction ci-dessous. Cela vous prendra moins d’une minute. VOTRE ÉCHANGE AVEC VOTRE COMPLÉMENTAIRE SANTÉ HENNER A-T-IL RÉPONDU À VOS ATTENTES ? * 1 étoile = pas du tout, 5 étoiles = parfaitement Total: 0 / 5 Merci d'évaluer notre service, cela aidera d'autres clients à faire le bon choix Veuillez sélectionner une option dans le menu déroulant VOTRE ÉCHANGE AVEC VOTRE COMPLÉMENTAIRE SANTÉ HENNER A-T-IL RÉPONDU À VOS ATTENTES ? * 1 étoile = pas du tout, 5 étoiles = parfaitement * * * * * Merci d'évaluer notre service, cela aidera d'autres clients à faire le bon choix Veuillez sélectionner une option dans le menu déroulant VOTRE NOM: * Veuillez entrer votre nom. Ajoutez des caractères minimum: :show_min_characters Cannot answer Veuillez bien remplir cette colonne. Les informations saisies semblent incorrectes, veuillez entrer uniquement du texte brut. VOTRE PRÉNOM: * Veuillez entrer votre prénom. Ajoutez des caractères minimum: :show_min_characters Cannot answer Veuillez bien remplir cette colonne. Les informations saisies semblent incorrectes, veuillez entrer uniquement du texte brut. VOTRE NUMÉRO DE TÉLÉPHONE: * Veuillez entrer votre numéro téléphone. Ajoutez des caractères minimum: :show_min_characters Cannot answer Veuillez bien remplir cette colonne. Les informations saisies semblent incorrectes, veuillez entrer uniquement du texte brut. AVEZ-VOUS FACILEMENT OBTENU UNE RÉPONSE À VOTRE DEMANDE ? * 1 étoile = très compliqué, 5 étoiles = très facilement Total: 0 / 5 Merci de partager votre opinion, cela aidera d'autres clients à faire le bon choix Veuillez sélectionner une option dans le menu déroulant AVEZ-VOUS FACILEMENT OBTENU UNE RÉPONSE À VOTRE DEMANDE ? * 1 étoile = très compliqué, 5 étoiles = très facilement * * * * * Merci de partager votre opinion, cela aidera d'autres clients à faire le bon choix Veuillez sélectionner une option dans le menu déroulant DANS QUELLE MESURE RECOMMANDERIEZ-VOUS HENNER À VOTRE ENTOURAGE ? * Notez de 0 (certainement pas) à 10 (sans hésitation) Total: 0 / 10 Merci de partager votre opinion, cela aidera d'autres clients à faire le bon choix. Veuillez sélectionner une option dans le menu déroulant DANS QUELLE MESURE RECOMMANDERIEZ-VOUS HENNER À VOTRE ENTOURAGE ? * Notez de 0 (certainement pas) à 10 (sans hésitation) * * * * * * * * * * * Merci de partager votre opinion, cela aidera d'autres clients à faire le bon choix. Veuillez sélectionner une option dans le menu déroulant AVEZ-VOUS DES REMARQUES OU COMMENTAIRES ? * Qu'avez-vous préféré ? Quels aspects, s'il y en a, pourrions-nous améliorer ? Ajoutez des caractères minimum: :show_min_characters Merci de partager votre opinion, cela aidera d'autres clients à faire le bon choix Les informations saisies semblent incorrectes, veuillez entrer uniquement du texte brut. Envoyer Mentions Légales : Vous disposez d’un droit d’accès, de rectification et d’effacement de vos données personnelles, d’un droit à la limitation du traitement et à la portabilité de vos données, d’un droit d’opposition pour motif légitime de toutes données vous concernant et, le cas échéant, d’un droit de retirer votre consentement. Enfin, vous avez également le droit de définir des directives relatives au sort de vos données après votre décès. Pour exercer ces droits, vous pouvez écrire à : Henner, Délégué à la Protection des Données, Conformité/Relation Assureurs, 14 Boulevard du Général Leclerc 92 200 Neuilly-sur-Seine ou dpo@henner.com. Pour en savoir plus, reportez-vous à la Charte RGPD Assurés accessible dans votre Espace Client ou ici (si possible lien cliquable vers la Charte accessible à l’adresse suivante : https://clients.henner.com/henner/fr/page/charte_rgpd ) * Accueil * Règles de communication * Protection des données Propulsé par