{"id":176,"date":"2017-11-14T11:05:19","date_gmt":"2017-11-14T10:05:19","guid":{"rendered":"https:\/\/mes-formulaires.cpamcentre.fr\/?page_id=176"},"modified":"2017-11-15T12:33:16","modified_gmt":"2017-11-15T11:33:16","slug":"bilan-prado-maternite","status":"publish","type":"page","link":"https:\/\/mes-formulaires.cpamcentre.fr\/index.php\/bilan-prado-maternite\/","title":{"rendered":"PRADO Maternit\u00e9 : Bilan de votre retour \u00e0 domicile"},"content":{"rendered":"<p style=\"text-align: justify;\">Suite \u00e0 votre accouchement, vous avez b\u00e9n\u00e9fici\u00e9 du Programme de Retour \u00e0 Domicile (PRADO) offert par l&rsquo;Assurance Maladie. Soucieux de r\u00e9pondre au mieux aux diff\u00e9rentes attentes des mamans, votre avis nous int\u00e9resse. Pour cela, merci de bien vouloir compl\u00e9ter le formulaire\u00a0ci-dessous.<\/p>\n<hr \/>\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f172-o1\" lang=\"fr-FR\" dir=\"ltr\" data-wpcf7-id=\"172\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/176#wpcf7-f172-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formulaire de contact\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"172\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.0.6\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"fr_FR\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f172-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<table border=0>\n\t<tr>\n\t\t<td>\n\t\t\t<h4>Votre profil\n\t\t\t<\/h4>\n\t\t<\/td>\n\t\t<td style=\"padding-left:30px;\">\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p>Votre nom*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Nom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"Nom\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td style=\"padding-left:30px;\">\n\t\t\t<p>Votre pr\u00e9nom*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Prenom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"Prenom\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p>Votre date de naissance <i>(jj\/mm\/aaaa)<\/i>*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"DateNais\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"DateNais\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td style=\"padding-left:30px;\">\n\t\t\t<p>Votre adresse email*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"Email\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n<\/table>\n<table border=0>\n\t<tr>\n\t\t<td>\n\t\t\t<h4>Votre retour \u00e0 domicile\n\t\t\t<\/h4>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p>Avez-vous b\u00e9n\u00e9fici\u00e9 de l\u2019aide de la Conseill\u00e8re pour affilier votre b\u00e9b\u00e9 sur la carte Vitale ?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"AideAffiliation\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"AideAffiliation\" value=\"Oui&nbsp;&nbsp;&nbsp;&nbsp;\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Oui&nbsp;&nbsp;&nbsp;&nbsp;<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"AideAffiliation\" value=\"Non\" \/><span class=\"wpcf7-list-item-label\">Non<\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p>Avez-vous r\u00e9glez les soins lors de la visite de la sage-femme ?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ReglementSF\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"ReglementSF\" value=\"Oui&nbsp;&nbsp;&nbsp;&nbsp;\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Oui&nbsp;&nbsp;&nbsp;&nbsp;<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"ReglementSF\" value=\"Non\" \/><span class=\"wpcf7-list-item-label\">Non<\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p>Qu\u2019avez-vous le plus appr\u00e9ci\u00e9 dans le service PRADO ?*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Plus\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"Plus\"><option value=\"\">&#8212;Veuillez choisir une option&#8212;<\/option><option value=\"Avoir un interlocuteur de la CPAM\">Avoir un interlocuteur de la CPAM<\/option><option value=\"Ne pas avoir \u00e0 se d\u00e9placer\">Ne pas avoir \u00e0 se d\u00e9placer<\/option><option value=\"Faciliter les d\u00e9marches administratives\">Faciliter les d\u00e9marches administratives<\/option><option value=\"Etre prise en charge avec mon enfant par une Sage-Femme\">Etre prise en charge avec mon enfant par une Sage-Femme<\/option><option value=\"Ne pas avoir \u00e0 me d\u00e9placer au cabinet\">Ne pas avoir \u00e0 me d\u00e9placer au cabinet<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p>Qu\u2019avez-vous le moins appr\u00e9ci\u00e9 dans le service PRADO ?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Moins\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"Moins\"><option value=\"\">&#8212;Veuillez choisir une option&#8212;<\/option><option value=\"Faire l\u2019avance des frais\">Faire l\u2019avance des frais<\/option><option value=\"Le suivi m\u00e9dical ne me convenait pas\">Le suivi m\u00e9dical ne me convenait pas<\/option><option value=\"Le suivi administratif ne me convenait pas\">Le suivi administratif ne me convenait pas<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p>Quel est votre niveau de satisfaction global sur le service PRADO ?*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Satisfaction\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"Satisfaction\"><option value=\"\">&#8212;Veuillez choisir une option&#8212;<\/option><option value=\"Tout \u00e0 fait satisfait\">Tout \u00e0 fait satisfait<\/option><option value=\"Plut\u00f4t satisfait\">Plut\u00f4t satisfait<\/option><option value=\"Plut\u00f4t pas satisfait\">Plut\u00f4t pas satisfait<\/option><option value=\"Pas du tout satisfait\">Pas du tout satisfait<\/option><option value=\"Ne sait pas\">Ne sait pas<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p>Conseilleriez-vous ce service \u00e0 un proche ?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ConseillerPRADO\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"ConseillerPRADO\" value=\"Oui&nbsp;&nbsp;&nbsp;&nbsp;\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Oui&nbsp;&nbsp;&nbsp;&nbsp;<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"ConseillerPRADO\" value=\"Non\" \/><span class=\"wpcf7-list-item-label\">Non<\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n<\/table>\n<table>\n\t<tr>\n\t\t<td>\n\t\t\t<p><b>Merci de saisir le code affich\u00e9 ci-dessous pour valider votre envoi : <\/b><br \/>\n<input type=\"hidden\" name=\"_wpcf7_captcha_challenge_captcha-170\" value=\"268636393\" \/><img decoding=\"async\" class=\"wpcf7-form-control wpcf7-captchac wpcf7-captcha-captcha-170\" width=\"72\" height=\"24\" alt=\"captcha\" src=\"https:\/\/mes-formulaires.cpamcentre.fr\/wp-content\/uploads\/wpcf7_captcha\/268636393.png\" \/><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"captcha-170\"><input size=\"4\" maxlength=\"4\" class=\"wpcf7-form-control wpcf7-captchar\" autocomplete=\"off\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"captcha-170\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n<\/table>\n<table>\n\t<tr>\n\t\t<td style=\"padding:0;margin:0;\">\n\t\t\t<p align=center><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Envoyer\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n<\/table><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"238\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>Suite \u00e0 votre accouchement, vous avez b\u00e9n\u00e9fici\u00e9 du Programme de Retour \u00e0 Domicile (PRADO) offert par l&rsquo;Assurance Maladie. Soucieux de r\u00e9pondre au mieux aux diff\u00e9rentes attentes des mamans, votre avis nous int\u00e9resse. Pour cela, merci de bien vouloir compl\u00e9ter le formulaire\u00a0ci-dessous.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-176","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/mes-formulaires.cpamcentre.fr\/index.php\/wp-json\/wp\/v2\/pages\/176"}],"collection":[{"href":"https:\/\/mes-formulaires.cpamcentre.fr\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/mes-formulaires.cpamcentre.fr\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/mes-formulaires.cpamcentre.fr\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/mes-formulaires.cpamcentre.fr\/index.php\/wp-json\/wp\/v2\/comments?post=176"}],"version-history":[{"count":4,"href":"https:\/\/mes-formulaires.cpamcentre.fr\/index.php\/wp-json\/wp\/v2\/pages\/176\/revisions"}],"predecessor-version":[{"id":182,"href":"https:\/\/mes-formulaires.cpamcentre.fr\/index.php\/wp-json\/wp\/v2\/pages\/176\/revisions\/182"}],"wp:attachment":[{"href":"https:\/\/mes-formulaires.cpamcentre.fr\/index.php\/wp-json\/wp\/v2\/media?parent=176"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}