{"id":1584,"date":"2023-10-10T13:50:26","date_gmt":"2023-10-10T17:50:26","guid":{"rendered":"https:\/\/dubreuilville.ca\/?page_id=1584"},"modified":"2026-03-06T10:28:05","modified_gmt":"2026-03-06T15:28:05","slug":"demande-preoccupation-suggestion","status":"publish","type":"page","link":"https:\/\/dubreuilville.ca\/fr\/notre-communite\/demande-preoccupation-suggestion\/","title":{"rendered":"Formulaire de demande et\/ou pr\u00e9occupation"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1584\" class=\"elementor elementor-1584 elementor-75\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0ade6e3 e-flex e-con-boxed e-con e-parent\" data-id=\"0ade6e3\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-771faaa elementor-widget elementor-widget-heading\" data-id=\"771faaa\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h6 class=\"elementor-heading-title elementor-size-default\">Formulaire de plainte, pr\u00e9occupation, suggestion ou demande<\/h6>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e2766f2 elementor-button-align-start elementor-widget elementor-widget-form\" data-id=\"e2766f2\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"Service Request\" aria-label=\"Service Request\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"1584\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"e2766f2\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"\" \/>\n\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNom\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_5872cdb elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_5872cdb\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAdresse\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_5872cdb]\" id=\"form-field-field_5872cdb\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCourriel\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-field_de482b2 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_de482b2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tT\u00e9l\u00e9phone\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[field_de482b2]\" id=\"form-field-field_de482b2\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Seuls les caract\u00e8res de num\u00e9ros de t\u00e9l\u00e9phone (#, -, *, etc.) sont accept\u00e9s.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_05586bc elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_05586bc\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSouhaitez-vous recevoir une r\u00e9ponse ?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Oui\" id=\"form-field-field_05586bc-0\" name=\"form_fields[field_05586bc]\" required=\"required\"> <label for=\"form-field-field_05586bc-0\">Oui<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Non\" id=\"form-field-field_05586bc-1\" name=\"form_fields[field_05586bc]\" required=\"required\"> <label for=\"form-field-field_05586bc-1\">Non<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-field_88f2728 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_88f2728\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCat\u00e9gorie\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-caret-down\"><\/i>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[field_88f2728]\" id=\"form-field-field_88f2728\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"ADMINISTRATION\">ADMINISTRATION<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"ANIMAUX\">ANIMAUX<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"APPLICATION DES R\u00c8GLEMENTS MUNICIPAUX\">APPLICATION DES R\u00c8GLEMENTS MUNICIPAUX<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"ARBRES\">ARBRES<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"CHEF DU SERVICE DU B\u00c2TIMENT (CBO)\">CHEF DU SERVICE DU B\u00c2TIMENT (CBO)<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"CONSEIL MUNICIPAL\">CONSEIL MUNICIPAL<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"D\u00c9CHETS ET RECYCLAGE\">D\u00c9CHETS ET RECYCLAGE<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"D\u00c9VELOPPEMENT \u00c9CONOMIQUE\">D\u00c9VELOPPEMENT \u00c9CONOMIQUE<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"DOMMAGES OU ENTRETIEN DES PROPRI\u00c9T\u00c9S MUNICIPALES\">DOMMAGES OU ENTRETIEN DES PROPRI\u00c9T\u00c9S MUNICIPALES<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"DRAINAGE DES EAUX \/ FOSS\u00c9S\">DRAINAGE DES EAUX \/ FOSS\u00c9S<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"EAU ET \u00c9GOUTS\">EAU ET \u00c9GOUTS<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"ENTRETIEN DES ROUTES (NIDS-DE-POULE, LAMPADAIRES, ETC.)\">ENTRETIEN DES ROUTES (NIDS-DE-POULE, LAMPADAIRES, ETC.)<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"ENTRETIEN HIVERNAL DES ROUTES\">ENTRETIEN HIVERNAL DES ROUTES<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"PARCS ET LOISIRS\">PARCS ET LOISIRS<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"SANT\u00c9 ET S\u00c9CURIT\u00c9\">SANT\u00c9 ET S\u00c9CURIT\u00c9<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"SERVICE D\u2019INCENDIE\">SERVICE D\u2019INCENDIE<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"TRAVAUX PUBLICS\">TRAVAUX PUBLICS<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"AUTRE (PR\u00c9CISEZ)\">AUTRE (PR\u00c9CISEZ)<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"\"><\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-Location elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-Location\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAdresse ou lieu concern\u00e9 (le cas \u00e9ch\u00e9ant) :\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[Location]\" id=\"form-field-Location\" rows=\"5\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_d01f186 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_d01f186\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDescription de la situation ou du service demand\u00e9 :\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_d01f186]\" id=\"form-field-field_d01f186\" rows=\"5\" required=\"required\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-field_2729df7 elementor-col-70 elementor-md-80\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2729df7\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tVous pouvez joindre des images ou des documents li\u00e9s \u00e0 cette situation. T\u00e9l\u00e9versement d\u2019images et de fichiers. Taille maximale du fichier : 5 Mo.\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[field_2729df7][]\" id=\"form-field-field_2729df7\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" multiple=\"multiple\" data-maxsize=\"6\" data-maxsize-message=\"Ce fichier d\u00e9passe la taille maximale autoris\u00e9e.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text\">\n\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_a86192c]\" id=\"form-field-field_a86192c\" class=\"elementor-field elementor-size-sm \" style=\"display:none !important;\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-arrow-right\"><\/i>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Soumettre<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Formulaire de plainte, pr\u00e9occupation, suggestion ou demande<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1562,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-1584","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dubreuilville.ca\/fr\/wp-json\/wp\/v2\/pages\/1584","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dubreuilville.ca\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dubreuilville.ca\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dubreuilville.ca\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/dubreuilville.ca\/fr\/wp-json\/wp\/v2\/comments?post=1584"}],"version-history":[{"count":0,"href":"https:\/\/dubreuilville.ca\/fr\/wp-json\/wp\/v2\/pages\/1584\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/dubreuilville.ca\/fr\/wp-json\/wp\/v2\/pages\/1562"}],"wp:attachment":[{"href":"https:\/\/dubreuilville.ca\/fr\/wp-json\/wp\/v2\/media?parent=1584"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}