forms.sbc29.com
Open in
urlscan Pro
185.75.141.220
Public Scan
Submitted URL: https://eye.servicesantetravail24.com/c?p=wAbNAszDxBAMNtDdU3DQg0XQj9Cp0IrQgCfQgHj7ScQQ0KD-HCQ80INC0NzQoCXQjtCCRyHQn0HZt2h0dHBzOi8vZm9y...
Effective URL: https://forms.sbc29.com/5c191302b85b53499eddf7fc/jAJcARNQQyOnssgzD0KQvA/gQem2o4vSRyvdmSPiZc-Vw/form.html?utm_source=Sarb...
Submission: On September 23 via manual from FR — Scanned from DE
Effective URL: https://forms.sbc29.com/5c191302b85b53499eddf7fc/jAJcARNQQyOnssgzD0KQvA/gQem2o4vSRyvdmSPiZc-Vw/form.html?utm_source=Sarb...
Submission: On September 23 via manual from FR — Scanned from DE
Form analysis
1 forms found in the DOMPOST
<form id="sb_form" onsubmit="process(); return false;" method="post">
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td id="innerForm" width="100%">
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<style type="text/css">
input::-webkit-input-placeholder {
color: #848484;
opacity: 0.6;
}
input:-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input::-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input:-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
input::-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
</style>
<tbody>
<tr>
<td>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td style="padding-top: 10px; padding-bottom: 10px;"><span style="display: flex;flex-direction: row;">
<div>
<p style="color: #393939;
font-size: 17px;
font-family: 'Arial';
font-style: inherit;
font-weight: inherit;line-height: 26px;text-align: left;
margin: 0;mso-line-height-rule: exactly;"><span style="font-size: 14px; font-family: 'Open Sans', Verdana, Arial, sans-serif; line-height: 26px; mso-line-height-rule: exactly;">Entreprise</span></p>
</div>
<div style="font-size: 13px;margin-left: 5px;font-family:'Open Sans', Verdana, Arial, sans-serif;
color:#393939;">*</div>
</span><input type="text" name="FIRSTNAME_ID" style="
border: 1px solid #e6e4e4;
background-color: #f1f1f1;height: 35px;
margin: 5px 0 10px 0;
font-size: 0.9em;
padding-left: 5px;
border-radius: 0px;
-webkit-border-radius: 0px;
-moz-border-radius: 0px;
-webkit-box-sizing: border-box;
box-sizing: border-box;
text-indent: 5px;width: 100%;" required="true"></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<style type="text/css">
input::-webkit-input-placeholder {
color: #848484;
opacity: 0.6;
}
input:-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input::-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input:-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
input::-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
</style>
<tbody>
<tr>
<td>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td style="padding-top: 10px; padding-bottom: 10px;"><span style="display: flex;flex-direction: row;">
<div>
<p style="color: #393939;
font-size: 17px;
font-family: 'Arial';
font-style: inherit;
font-weight: inherit;line-height: 26px;text-align: left;
margin: 0;mso-line-height-rule: exactly;"><span style="font-size: 14px; font-family: 'Open Sans', Verdana, Arial, sans-serif; line-height: 26px; mso-line-height-rule: exactly;">Email</span></p>
</div>
<div style="font-size: 13px;margin-left: 5px;font-family:'Open Sans', Verdana, Arial, sans-serif;
color:#393939;">*</div>
</span><input type="email" name="email" style="
border: 1px solid #e6e4e4;
background-color: #f1f1f1;height: 35px;
margin: 5px 0 10px 0;
font-size: 0.9em;
padding-left: 5px;
border-radius: 0px;
-webkit-border-radius: 0px;
-moz-border-radius: 0px;
-webkit-box-sizing: border-box;
box-sizing: border-box;
text-indent: 5px;width: 100%;" required="true"></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<style type="text/css">
input::-webkit-input-placeholder {
color: #848484;
opacity: 0.6;
}
input:-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input::-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input:-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
input::-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
</style>
<tbody>
<tr>
<td>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td style="padding-top: 10px; padding-bottom: 10px;"><span style="display: flex;flex-direction: row;">
<div>
<p style="color: #393939;
font-size: 17px;
font-family: 'Arial';
font-style: inherit;
font-weight: inherit;line-height: 26px;text-align: left;
margin: 0;mso-line-height-rule: exactly;"><span style="font-size: 14px; font-family: 'Open Sans', Verdana, Arial, sans-serif; line-height: 26px; mso-line-height-rule: exactly;">N° de téléphone pour vous joindre <br></span></p>
</div>
<div style="font-size: 13px;margin-left: 5px;font-family:'Open Sans', Verdana, Arial, sans-serif;
color:#393939;">*</div>
</span><input type="text" name="phone" style="
border: 1px solid #e6e4e4;
background-color: #f1f1f1;height: 35px;
margin: 5px 0 10px 0;
font-size: 0.9em;
padding-left: 5px;
border-radius: 0px;
-webkit-border-radius: 0px;
-moz-border-radius: 0px;
-webkit-box-sizing: border-box;
box-sizing: border-box;
text-indent: 5px;width: 100%;" required="true"></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<style type="text/css">
input::-webkit-input-placeholder {
color: #848484;
opacity: 0.6;
}
input:-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input::-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input:-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
input::-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
</style>
<tbody>
<tr>
<td>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td style="padding-top: 10px; padding-bottom: 10px;"><span style="display: flex;flex-direction: row;">
<div>
<p style="color: #393939;
font-size: 17px;
font-family: 'Arial';
font-style: inherit;
font-weight: inherit;line-height: 26px;text-align: left;
margin: 0;mso-line-height-rule: exactly;"><span style="font-size: 14px; font-family: 'Open Sans', Verdana, Arial, sans-serif; line-height: 26px; mso-line-height-rule: exactly;">Participant 1 : Nom et prénom <br></span></p>
</div>
<div style="font-size: 13px;margin-left: 5px;font-family:'Open Sans', Verdana, Arial, sans-serif;
color:#393939;">*</div>
</span><input type="text" name="Participant%201%20%3A%20Nom%20et%20pr%C3%A9nom" style="
border: 1px solid #e6e4e4;
background-color: #f1f1f1;height: 35px;
margin: 5px 0 10px 0;
font-size: 0.9em;
padding-left: 5px;
border-radius: 0px;
-webkit-border-radius: 0px;
-moz-border-radius: 0px;
-webkit-box-sizing: border-box;
box-sizing: border-box;
text-indent: 5px;width: 100%;" required="true"></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<style type="text/css">
input::-webkit-input-placeholder {
color: #848484;
opacity: 0.6;
}
input:-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input::-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input:-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
input::-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
</style>
<tbody>
<tr>
<td>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td style="padding-top: 10px; padding-bottom: 10px;"><span style="display: flex;flex-direction: row;">
<div>
<p style="color: #393939;
font-size: 17px;
font-family: 'Arial';
font-style: inherit;
font-weight: inherit;line-height: 26px;text-align: left;
margin: 0;mso-line-height-rule: exactly;"><span style="font-size: 14px; font-family: 'Open Sans', Verdana, Arial, sans-serif; line-height: 26px; mso-line-height-rule: exactly;">Participant 1 : adresse mail<br></span></p>
</div>
<div style="font-size: 13px;margin-left: 5px;font-family:'Open Sans', Verdana, Arial, sans-serif;
color:#393939;">*</div>
</span><input type="text" name="Participant%201%20%3A%20adresse%20mail" style="
border: 1px solid #e6e4e4;
background-color: #f1f1f1;height: 35px;
margin: 5px 0 10px 0;
font-size: 0.9em;
padding-left: 5px;
border-radius: 0px;
-webkit-border-radius: 0px;
-moz-border-radius: 0px;
-webkit-box-sizing: border-box;
box-sizing: border-box;
text-indent: 5px;width: 100%;" required="true"></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<style type="text/css">
input::-webkit-input-placeholder {
color: #848484;
opacity: 0.6;
}
input:-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input::-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input:-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
input::-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
</style>
<tbody>
<tr>
<td>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td style="padding-top: 10px; padding-bottom: 10px;"><span style="display: flex;flex-direction: row;">
<div>
<p style="color: #393939;
font-size: 17px;
font-family: 'Arial';
font-style: inherit;
font-weight: inherit;line-height: 26px;text-align: left;
margin: 0;mso-line-height-rule: exactly;"><span style="font-size: 14px; font-family: 'Open Sans', Verdana, Arial, sans-serif; line-height: 26px; mso-line-height-rule: exactly;">Participant 2 : Nom et prénom</span></p>
</div>
</span><input type="text" name="Participant%202%20%3A%20Nom%20et%20pr%C3%A9nom" style="
border: 1px solid #e6e4e4;
background-color: #f1f1f1;height: 35px;
margin: 5px 0 10px 0;
font-size: 0.9em;
padding-left: 5px;
border-radius: 0px;
-webkit-border-radius: 0px;
-moz-border-radius: 0px;
-webkit-box-sizing: border-box;
box-sizing: border-box;
text-indent: 5px;width: 100%;"></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<style type="text/css">
input::-webkit-input-placeholder {
color: #848484;
opacity: 0.6;
}
input:-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input::-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input:-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
input::-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
</style>
<tbody>
<tr>
<td>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td style="padding-top: 10px; padding-bottom: 10px;"><span style="display: flex;flex-direction: row;">
<div>
<p style="color: #393939;
font-size: 17px;
font-family: 'Arial';
font-style: inherit;
font-weight: inherit;line-height: 26px;text-align: left;
margin: 0;mso-line-height-rule: exactly;"><span style="font-size: 14px; line-height: 26px; mso-line-height-rule: exactly;"><span style="font-family: 'Arial'; font-weight: inherit; font-style: inherit;">Participant 2 : adresse
mail</span><br></span></p>
</div>
</span><input type="text" name="Participant%202%20%3A%20adresse%20mail" style="
border: 1px solid #e6e4e4;
background-color: #f1f1f1;height: 35px;
margin: 5px 0 10px 0;
font-size: 0.9em;
padding-left: 5px;
border-radius: 0px;
-webkit-border-radius: 0px;
-moz-border-radius: 0px;
-webkit-box-sizing: border-box;
box-sizing: border-box;
text-indent: 5px;width: 100%;"></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<style type="text/css">
input::-webkit-input-placeholder {
color: #848484;
opacity: 0.6;
}
input:-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input::-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input:-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
input::-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
</style>
<tbody>
<tr>
<td>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td style="padding-top: 10px; padding-bottom: 10px;"><span style="display: flex;flex-direction: row;">
<div>
<p style="color: #393939;
font-size: 17px;
font-family: 'Arial';
font-style: inherit;
font-weight: inherit;line-height: 26px;text-align: left;
margin: 0;mso-line-height-rule: exactly;"><span style="font-size: 14px; font-family: 'Open Sans', Verdana, Arial, sans-serif; line-height: 26px; mso-line-height-rule: exactly;">Participant 3 : Nom et prénom</span></p>
</div>
</span><input type="text" name="Participant%203%20%3A%20Nom%20et%20pr%C3%A9nom" style="
border: 1px solid #e6e4e4;
background-color: #f1f1f1;height: 35px;
margin: 5px 0 10px 0;
font-size: 0.9em;
padding-left: 5px;
border-radius: 0px;
-webkit-border-radius: 0px;
-moz-border-radius: 0px;
-webkit-box-sizing: border-box;
box-sizing: border-box;
text-indent: 5px;width: 100%;"></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<style type="text/css">
input::-webkit-input-placeholder {
color: #848484;
opacity: 0.6;
}
input:-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input::-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input:-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
input::-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
</style>
<tbody>
<tr>
<td>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td style="padding-top: 10px; padding-bottom: 10px;"><span style="display: flex;flex-direction: row;">
<div>
<p style="color: #393939;
font-size: 17px;
font-family: 'Arial';
font-style: inherit;
font-weight: inherit;line-height: 26px;text-align: left;
margin: 0;mso-line-height-rule: exactly;"><span style="font-size: 14px; font-family: 'Open Sans', Verdana, Arial, sans-serif; line-height: 26px; mso-line-height-rule: exactly;">Participant 3 : adresse mail</span></p>
</div>
</span><input type="text" name="Participant%203%20%3A%20adresse%20mail" style="
border: 1px solid #e6e4e4;
background-color: #f1f1f1;height: 35px;
margin: 5px 0 10px 0;
font-size: 0.9em;
padding-left: 5px;
border-radius: 0px;
-webkit-border-radius: 0px;
-moz-border-radius: 0px;
-webkit-box-sizing: border-box;
box-sizing: border-box;
text-indent: 5px;width: 100%;"></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<style type="text/css">
input::-webkit-input-placeholder {
color: #848484;
opacity: 0.6;
}
input:-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input::-moz-placeholder {
color: #848484;
opacity: 0.6;
}
input:-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
input::-ms-input-placeholder {
color: #848484;
opacity: 0.6;
}
</style>
<tbody>
<tr>
<td>
<table class="t" width="100%" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td style="padding-top: 10px; padding-bottom: 10px;"><span style="display: flex;flex-direction: row;">
<div>
<p style="color: #393939;
font-size: 17px;
font-family: 'Arial';
font-style: inherit;
font-weight: inherit;line-height: 26px;text-align: left;
margin: 0;mso-line-height-rule: exactly;"><span style="font-size: 14px; font-family: 'Open Sans', Verdana, Arial, sans-serif; line-height: 26px; mso-line-height-rule: exactly;">Vos questions ?<br></span></p>
</div>
</span><textarea style="
border: 1px solid #e6e4e4;
background-color: #f1f1f1;height: 65px;
width: 100%;
padding: 10px;
resize: vertical;
margin: 5px 0 10px 0;
font-size: 0.9em;
color: #848484;
border-radius: 0px;
-webkit-border-radius: 0px;
-moz-border-radius: 0px;
box-sizing: border-box;
outline: none;
font-family: " open="" sans",="" "helvetica="" neue" ,="" arial,="" verdana,="" sans-serif;"="" name="vos%20questions%20%3F"></textarea></td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
<table class="t" width="100%" cellpadding="0" cellspacing="0" style="margin-top:7px">
<tbody>
<tr>
<td align="left">
<div id="div-submitInput" style="display:flex; flex-direction:row;justify-content:flex-start">
<button id="submitInput" type="submit" value="VALIDER" class="mobile-FW"
style="border-style:solid;text-align:center;color:#ffffff;border-color:#ffffff;border-width:1px;border-radius:5px;padding:10px 25px;text-decoration:none;display:block;font-family:'Arial';font-style:inherit;font-weight:inherit;font-size:15px;background-color:#e6137f;cursor:pointer;"><span
style="margin:0px;">VALIDER</span>
</button>
<div class="loader" style="display:none"></div>
</div>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</form>
Text Content
Le SST 24 et l'AIST 19 vous proposent, le mardi 5 octobre, un webinaire : "Cancer du sein & retour en entreprise" Les Services de Santé au Travail de Dordogne (SST24) et de Corrèze (AIST 19) ont souhaité s'engager dans Octobre Rose, mois de mobilisation pour le dépistage du cancer du sein. Ils ont réuni des professionnels de santé autour d'un webinaire pour évoquer plus particulièrement le thème : "Cancer du sein & retour en entreprise " Nous avons prévu un temps d'échanges en clôture. Vous avez la possibilité de nous transmettre vos questions en amont grâce à la zone de texte à la fin du formulaire. Nous pourrons ainsi les intégrer d'ores et déjà dans le Questions/Réponses. > Un lien de connexion à la salle de réunion virtuelle vous sera envoyé quelques jours avant la session (connexion le jour J à partir de 13h45 pour assurer les aspects techniques). *Obligatoire Entreprise * Email * N° de téléphone pour vous joindre * Participant 1 : Nom et prénom * Participant 1 : adresse mail * Participant 2 : Nom et prénom Participant 2 : adresse mail Participant 3 : Nom et prénom Participant 3 : adresse mail Vos questions ? VALIDER * Champs obligatoires