{"id":2236,"date":"2023-02-20T17:40:57","date_gmt":"2023-02-20T22:40:57","guid":{"rendered":"https:\/\/ciasf.org\/?page_id=2236"},"modified":"2023-03-31T15:46:47","modified_gmt":"2023-03-31T19:46:47","slug":"formulaire-de-reference","status":"publish","type":"page","link":"https:\/\/ciasf.org\/en\/formulaire-de-reference\/","title":{"rendered":"Formulaire de r\u00e9f\u00e9rence"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2236\" class=\"elementor elementor-2236\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"has_eae_slider elementor-section elementor-top-section elementor-element elementor-element-34eba63 elementor-section-full_width elementor-section-stretched elementor-section-height-default elementor-section-height-default\" data-eae-slider=\"81531\" data-id=\"34eba63\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;mdp_selection_sticky_effect_enable&quot;:false}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"has_eae_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5a466fd\" data-eae-slider=\"36775\" data-id=\"5a466fd\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;mdp_selection_sticky_column_effect_enable&quot;:false}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9770a7f elementor-widget elementor-widget-template\" data-id=\"9770a7f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"template.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-template\">\n\t\t\t\t\t<div data-elementor-type=\"section\" data-elementor-id=\"2117\" class=\"elementor elementor-2117 elementor-1752 elementor-1752\" data-elementor-post-type=\"elementor_library\">\n\t\t\t\t\t<section class=\"has_eae_slider elementor-section elementor-top-section elementor-element elementor-element-2328d41f elementor-section-full_width elementor-section-stretched elementor-section-height-default elementor-section-height-default\" data-eae-slider=\"35846\" data-id=\"2328d41f\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;mdp_selection_sticky_effect_enable&quot;:false}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"has_eae_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-66f2c980\" data-eae-slider=\"32666\" data-id=\"66f2c980\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;mdp_selection_sticky_column_effect_enable&quot;:false}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5bcdca4e e-transform e-transform sticky_btn_quitter_site elementor-widget elementor-widget-button\" data-id=\"5bcdca4e\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_transform_rotateZ_effect&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_rotateZ_effect_widescreen&quot;:{&quot;unit&quot;:&quot;deg&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_rotateZ_effect_laptop&quot;:{&quot;unit&quot;:&quot;deg&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_rotateZ_effect_tablet_extra&quot;:{&quot;unit&quot;:&quot;deg&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_rotateZ_effect_tablet&quot;:{&quot;unit&quot;:&quot;deg&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_rotateZ_effect_mobile_extra&quot;:{&quot;unit&quot;:&quot;deg&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_rotateZ_effect_mobile&quot;:{&quot;unit&quot;:&quot;deg&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_translateX_effect&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_translateX_effect_widescreen&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_translateX_effect_laptop&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_translateX_effect_tablet_extra&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_translateX_effect_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_translateX_effect_mobile_extra&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_translateX_effect_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_translateY_effect&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_translateY_effect_widescreen&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_translateY_effect_laptop&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_translateY_effect_tablet_extra&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_translateY_effect_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_translateY_effect_mobile_extra&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;_transform_translateY_effect_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]}}\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/www.google.com\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" fill=\"none\" height=\"19\" viewBox=\"0 0 19 19\" width=\"19\"><g stroke=\"#fff\" stroke-linecap=\"round\" stroke-linejoin=\"round\" stroke-width=\"2\"><path d=\"m11.7134 3.20413h3c.3978 0 .7793.15804 1.0606.43934.2813.28131.4394.66284.4394 1.06066v10.49997c0 .3979-.1581.7794-.4394 1.0607s-.6628.4393-1.0606.4393h-3\"><\/path><path d=\"m7.96338 13.7041 3.75002-3.74997-3.75002-3.75\"><\/path><path d=\"m11.7134 9.95413h-9.00002\"><\/path><\/g><\/svg>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Leave the site<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"has_eae_slider elementor-section elementor-top-section elementor-element elementor-element-7e2cb321 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-eae-slider=\"59794\" data-id=\"7e2cb321\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;mdp_selection_sticky_effect_enable&quot;:false}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"has_eae_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-1ac52904\" data-eae-slider=\"6559\" data-id=\"1ac52904\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;mdp_selection_sticky_column_effect_enable&quot;:false}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-72c545ec elementor-widget elementor-widget-heading\" data-id=\"72c545ec\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Formulaire de r\u00e9f\u00e9rence : Parents prot\u00e9geant<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"has_eae_slider elementor-section elementor-top-section elementor-element elementor-element-ae9aecb elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-eae-slider=\"46236\" data-id=\"ae9aecb\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;mdp_selection_sticky_effect_enable&quot;:false}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"has_eae_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-c31b160\" data-eae-slider=\"32191\" data-id=\"c31b160\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;mdp_selection_sticky_column_effect_enable&quot;:false}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-254c218 elementor-widget elementor-widget-text-editor\" data-id=\"254c218\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li>Dans les cas d\u2019abus sexuel <strong>o\u00f9 l\u2019auteur des gestes ne cohabitent pas avec la victime<\/strong>;<\/li><li>Lorsque le <strong>signalement est non-retenu<\/strong>;<\/li><li>Si les faits ont \u00e9t\u00e9 <strong>v\u00e9rifi\u00e9s et jug\u00e9s cr\u00e9dibles<\/strong> lors de la v\u00e9rification compl\u00e9mentaire terrain ou lors de l\u2019entrevue-vid\u00e9o;<\/li><li>Si le parent ou tuteur l\u00e9gal de l\u2019enfant ou\/et si l\u2019enfant de plus de 14 ans <strong>accepte que les informations soient transmises<\/strong>.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"has_eae_slider elementor-section elementor-top-section elementor-element elementor-element-f0fccd4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-eae-slider=\"18664\" data-id=\"f0fccd4\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;mdp_selection_sticky_effect_enable&quot;:false}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"has_eae_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6e49fbd\" data-eae-slider=\"65784\" data-id=\"6e49fbd\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;mdp_selection_sticky_column_effect_enable&quot;:false}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0ca5cc7 elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"0ca5cc7\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Suivant&quot;,&quot;step_previous_label&quot;:&quot;Pr\\u00e9c\\u00e9dent&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<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"Formulaire de r\u00e9f\u00e9rence\" aria-label=\"Formulaire de r\u00e9f\u00e9rence\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"2236\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"0ca5cc7\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Formulaire de r\u00e9f\u00e9rence\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"2236\"\/>\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-date elementor-field-group elementor-column elementor-field-group-name elementor-col-30 elementor-field-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\tDate de la r\u00e9f\u00e9rence\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" placeholder=\"Nom\" required=\"required\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_c677049 elementor-col-100\">\n\t\t\t\t\t<h3>1) Adolescente r\u00e9f\u00e9r\u00e9e:<\/h3>\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-email elementor-col-50 elementor-field-required\">\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\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[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Nom\" 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-message elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-message\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPr\u00e9nom\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[message]\" id=\"form-field-message\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Pr\u00e9nom\">\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-date elementor-field-group elementor-column elementor-field-group-field_0eda4e1 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_0eda4e1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDDN\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_0eda4e1]\" id=\"form-field-field_0eda4e1\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" placeholder=\"DDN\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\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_3efb63e elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_3efb63e\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t\u00c2ge\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_3efb63e]\" id=\"form-field-field_3efb63e\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"\u00c2ge\">\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_c3608fe elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_c3608fe\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNom du tuteur l\u00e9gal de l\u2019enfant:\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_c3608fe]\" id=\"form-field-field_c3608fe\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Nom du tuteur l\u00e9gal de l\u2019enfant:\">\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_032e09f elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_032e09f\" 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_032e09f]\" id=\"form-field-field_032e09f\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"T\u00e9l\u00e9phone\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\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_4ac2491 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_4ac2491\" 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_4ac2491]\" id=\"form-field-field_4ac2491\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Adresse\">\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_51541a3 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_51541a3\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tRTF  (milieu de vie) \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_51541a3]\" id=\"form-field-field_51541a3\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"RTF  (milieu de vie) \">\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-html elementor-field-group elementor-column elementor-field-group-field_8473da9 elementor-col-100\">\n\t\t\t\t\t<h3>2) Parents ou tuteur l\u00e9gal <\/h3>\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_82dda3c elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_82dda3c\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNom de la m\u00e8re \/tutrice l\u00e9gale \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_82dda3c]\" id=\"form-field-field_82dda3c\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Nom de la m\u00e8re \/tutrice l\u00e9gale \">\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_af99015 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_af99015\" 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_af99015]\" id=\"form-field-field_af99015\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Adresse\">\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_6025969 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_6025969\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tTel. (travail)\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_6025969]\" id=\"form-field-field_6025969\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Tel. (travail)\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\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_8647189 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_8647189\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPr\u00e9f\u00e9rence\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_8647189]\" id=\"form-field-field_8647189\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"--------\">--------<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"AM\">AM<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"PM\">PM<\/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-tel elementor-field-group elementor-column elementor-field-group-field_d7c5d26 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_d7c5d26\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCellulaire\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_d7c5d26]\" id=\"form-field-field_d7c5d26\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Cellulaire\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\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_014a9ea elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_014a9ea\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tTel. (Maison)\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_014a9ea]\" id=\"form-field-field_014a9ea\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Tel. (Maison)\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\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_eeec3c0 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_eeec3c0\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPr\u00e9f\u00e9rence\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_eeec3c0]\" id=\"form-field-field_eeec3c0\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"--------\">--------<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"AM\">AM<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"PM\">PM<\/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-html elementor-field-group elementor-column elementor-field-group-field_adbd53d elementor-col-100\">\n\t\t\t\t\t<hr style=\"margin-bottom:20px; margin-top:20px; border-width: 2px;\">\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_d43bd27 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_d43bd27\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNom du p\u00e8re \/tuteur l\u00e9gal \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_d43bd27]\" id=\"form-field-field_d43bd27\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Nom du p\u00e8re \/tuteur l\u00e9gal \">\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_cdb9176 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_cdb9176\" 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_cdb9176]\" id=\"form-field-field_cdb9176\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Adresse\">\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_f2d999d elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_f2d999d\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tTel. (travail)\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_f2d999d]\" id=\"form-field-field_f2d999d\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Tel. (travail)\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\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_787ed48 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_787ed48\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPr\u00e9f\u00e9rence\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_787ed48]\" id=\"form-field-field_787ed48\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"--------\">--------<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"AM\">AM<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"PM\">PM<\/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-tel elementor-field-group elementor-column elementor-field-group-field_abaf024 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_abaf024\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCellulaire\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_abaf024]\" id=\"form-field-field_abaf024\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Cellulaire\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\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_4662d32 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_4662d32\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tTel. (Maison)\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_4662d32]\" id=\"form-field-field_4662d32\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Tel. (Maison)\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\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_b27f46c elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_b27f46c\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPr\u00e9f\u00e9rence\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_b27f46c]\" id=\"form-field-field_b27f46c\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"--------\">--------<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"AM\">AM<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"PM\">PM<\/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-html elementor-field-group elementor-column elementor-field-group-field_4a7414c elementor-col-100\">\n\t\t\t\t\t<h3>R\u00e9sum\u00e9 des faits <\/h3>\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_a608577 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a608577\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\ta. Qui a abus\u00e9 l\u2019enfant (lien entre l\u2019auteur des gestes et l\u2019enfant, sexe et \u00e2ge de l\u2019auteur des gestes) ?\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_a608577]\" id=\"form-field-field_a608577\" rows=\"4\"><\/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_74f32aa elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_74f32aa\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tb.\tQuel est l\u2019ensemble des gestes qui ont \u00e9t\u00e9 pos\u00e9s? \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_74f32aa]\" id=\"form-field-field_74f32aa\" rows=\"4\"><\/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_19f1f99 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_19f1f99\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tc.\tDans quel contexte l\u2019enfant a-t-il d\u00e9voil\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_19f1f99]\" id=\"form-field-field_19f1f99\" rows=\"4\"><\/textarea>\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_63ab4c1 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_63ab4c1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\td.\tQuelles sont la fr\u00e9quence et la dur\u00e9e de l\u2019agression sexuelle? \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_63ab4c1]\" id=\"form-field-field_63ab4c1\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"\u00e9pisode unique\">\u00e9pisode unique<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"r\u00e9p\u00e9titif\">r\u00e9p\u00e9titif<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"chronique (plus de 6 mois)\">chronique (plus de 6 mois)<\/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-text elementor-field-group elementor-column elementor-field-group-field_7bd68a0 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_7bd68a0\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSi r\u00e9p\u00e9titif ou chronique : p\u00e9riode de temps sur laquelle les abus sexuels se sont d\u00e9roul\u00e9s\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_7bd68a0]\" id=\"form-field-field_7bd68a0\" 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-text elementor-field-group elementor-column elementor-field-group-field_e7ac7ff elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_e7ac7ff\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\te.\tQuel est l\u2019endroit o\u00f9 les abus sexuels ont eu lieu?\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_e7ac7ff]\" id=\"form-field-field_e7ac7ff\" 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-checkbox elementor-field-group elementor-column elementor-field-group-field_2033bd7 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2033bd7\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tQuel est le type de manipulation utilis\u00e9e?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"verbale (sous forme de jeu, menaces, chantage. \" id=\"form-field-field_2033bd7-0\" name=\"form_fields[field_2033bd7][]\"> <label for=\"form-field-field_2033bd7-0\">verbale (sous forme de jeu, menaces, chantage. <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"utilisation de la force. \" id=\"form-field-field_2033bd7-1\" name=\"form_fields[field_2033bd7][]\"> <label for=\"form-field-field_2033bd7-1\">utilisation de la force. <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"utilisation d\u2019une arme. \" id=\"form-field-field_2033bd7-2\" name=\"form_fields[field_2033bd7][]\"> <label for=\"form-field-field_2033bd7-2\">utilisation d\u2019une arme. <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"aucune. \" id=\"form-field-field_2033bd7-3\" name=\"form_fields[field_2033bd7][]\"> <label for=\"form-field-field_2033bd7-3\">aucune. <\/label><\/span><\/div>\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_0d76b59 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_0d76b59\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSp\u00e9cifiez\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_0d76b59]\" id=\"form-field-field_0d76b59\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_08a12b2 elementor-col-100\">\n\t\t\t\t\t<h4>4) Situation l\u00e9gale\u202f <\/h4>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_435036f elementor-col-100\">\n\t\t\t\t\t<h5><u>Direction de la protection de la jeunesse<\/u><\/h5>\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_d79f853 elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_d79f853\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSignalement effectu\u00e9 \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_d79f853]\" id=\"form-field-field_d79f853\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"---------\">---------<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Oui\">Oui<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Non\">Non<\/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-select elementor-field-group elementor-column elementor-field-group-field_53d5058 elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_53d5058\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tR\u00e9tention du signalement \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_53d5058]\" id=\"form-field-field_53d5058\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"------\">------<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Oui\">Oui<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Non\">Non<\/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-select elementor-field-group elementor-column elementor-field-group-field_fa9942f elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_fa9942f\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tTrousse m\u00e9dico-l\u00e9gale \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_fa9942f]\" id=\"form-field-field_fa9942f\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"--------\">--------<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Oui\">Oui<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Non\">Non<\/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-html elementor-field-group elementor-column elementor-field-group-field_88f1bb0 elementor-col-100\">\n\t\t\t\t\t<h5><u>Services policiers<\/u><\/h5>\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_297e792 elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_297e792\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPlainte d\u00e9pos\u00e9e\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_297e792]\" id=\"form-field-field_297e792\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"---------\">---------<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Oui\">Oui<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Non\">Non<\/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-select elementor-field-group elementor-column elementor-field-group-field_268f1ce elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_268f1ce\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEntrevue polici\u00e8re r\u00e9alis\u00e9e\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_268f1ce]\" id=\"form-field-field_268f1ce\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"------\">------<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Oui\">Oui<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Non\">Non<\/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-select elementor-field-group elementor-column elementor-field-group-field_b129b50 elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_b129b50\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDossier autoris\u00e9 par le directeur des poursuites criminelles et p\u00e9nales (DPCP)\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_b129b50]\" id=\"form-field-field_b129b50\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"--------\">--------<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Oui\">Oui<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Non\">Non<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Info \u00e0 venir\">Info \u00e0 venir<\/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-html elementor-field-group elementor-column elementor-field-group-field_3f3f055 elementor-col-100\">\n\t\t\t\t\t<h5><u>CAVAC<\/u><\/h5>\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_e22866d elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_e22866d\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDemande IVAC\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_e22866d]\" id=\"form-field-field_e22866d\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"---------\">---------<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Oui\">Oui<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Non\">Non<\/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-select elementor-field-group elementor-column elementor-field-group-field_04f239b elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_04f239b\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSuivi psychosocial enfant\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_04f239b]\" id=\"form-field-field_04f239b\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"---------\">---------<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Oui\">Oui<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Non\">Non<\/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-select elementor-field-group elementor-column elementor-field-group-field_0a130fd elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_0a130fd\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSuivi psychosocial parent\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_0a130fd]\" id=\"form-field-field_0a130fd\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"---------\">---------<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Oui\">Oui<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Non\">Non<\/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-select elementor-field-group elementor-column elementor-field-group-field_dc15c1a elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_dc15c1a\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tProgramme t\u00e9moin enfant\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_dc15c1a]\" id=\"form-field-field_dc15c1a\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"---------\">---------<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Oui\">Oui<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Non\">Non<\/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-date elementor-field-group elementor-column elementor-field-group-field_dc115c1 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_dc115c1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDate du t\u00e9moignage devant la Cour \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_dc115c1]\" id=\"form-field-field_dc115c1\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_3a8bd67 elementor-col-100\">\n\t\t\t\t\t<h3> 5) Professionnel responsable du dossier<\/h3>\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_3e922f6 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_3e922f6\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNom de l\u2019intervenant (e)  \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_3e922f6]\" id=\"form-field-field_3e922f6\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Nom de l\u2019intervenant (e)  \">\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_d79847b elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_d79847b\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tT\u00e9l\u00e9phone et poste\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_d79847b]\" id=\"form-field-field_d79847b\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"T\u00e9l\u00e9phone et poste\">\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-field_549527a elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_549527a\" 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[field_549527a]\" id=\"form-field-field_549527a\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Courriel\">\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_c23dec8 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_c23dec8\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tOrganisation\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_c23dec8]\" id=\"form-field-field_c23dec8\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Organisation\">\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-html elementor-field-group elementor-column elementor-field-group-field_31fbafd elementor-col-100\">\n\t\t\t\t\t<h3>6) Autres informations pertinentes <\/h3>\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_3b827ff elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_3b827ff\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDiagnostic connus tel qu\u2019une d\u00e9ficience intellectuelle ou un trouble du spectre de l\u2019autisme ; \u00e9v\u00e8nements particuliers entourant le d\u00e9voilement ; r\u00e9actions parentales atypiques, etc.\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_3b827ff]\" id=\"form-field-field_3b827ff\" rows=\"4\"><\/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_a919998 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a919998\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAjouter un fichier \u00e0 votre r\u00e9f\u00e9rence\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[field_a919998][]\" id=\"form-field-field_a919998\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" multiple=\"multiple\">\n\n\t\t\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\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Envoyer<\/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<input\n                    class=\"apbct_special_field apbct_email_id__elementor_form\"\n                    name=\"apbct__email_id__elementor_form\"\n                    aria-label=\"apbct__label_id__elementor_form\"\n                    type=\"text\" size=\"30\" maxlength=\"200\" autocomplete=\"off\"\n                    value=\"\"\n                \/><\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Formulaire de r\u00e9f\u00e9rence : Parents prot\u00e9geant Dans les cas d\u2019abus sexuel o\u00f9 l\u2019auteur des gestes ne cohabitent pas avec la victime; Lorsque le signalement est non-retenu; Si les faits ont \u00e9t\u00e9 v\u00e9rifi\u00e9s et jug\u00e9s cr\u00e9dibles lors de la v\u00e9rification compl\u00e9mentaire terrain ou lors de l\u2019entrevue-vid\u00e9o; Si le parent ou tuteur l\u00e9gal de l\u2019enfant ou\/et si [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"yes","_seopress_robots_follow":"yes","_seopress_robots_imageindex":"","_seopress_robots_snippet":"","_seopress_robots_primary_cat":"","_seopress_robots_breadcrumbs":"","_seopress_robots_freeze_modified_date":"","_seopress_robots_custom_modified_date":"","_seopress_robots_canonical":"","_seopress_social_fb_title":"","_seopress_social_fb_desc":"","_seopress_social_fb_img":"","_seopress_social_fb_img_attachment_id":0,"_seopress_social_fb_img_width":0,"_seopress_social_fb_img_height":0,"_seopress_social_twitter_title":"","_seopress_social_twitter_desc":"","_seopress_social_twitter_img":"","_seopress_social_twitter_img_attachment_id":0,"_seopress_social_twitter_img_width":0,"_seopress_social_twitter_img_height":0,"_seopress_redirections_value":"","_seopress_redirections_enabled":"","_seopress_redirections_enabled_regex":"","_seopress_redirections_logged_status":"both","_seopress_redirections_param":"","_seopress_redirections_type":301,"_seopress_analysis_target_kw":"","_seopress_news_disabled":"","_seopress_video_disabled":"","_seopress_video":[],"_seopress_pro_schemas_manual":[],"_seopress_pro_rich_snippets_disable_all":"","_seopress_pro_rich_snippets_disable":[],"_seopress_pro_schemas":[],"inline_featured_image":false,"footnotes":""},"class_list":["post-2236","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/ciasf.org\/en\/wp-json\/wp\/v2\/pages\/2236","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ciasf.org\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/ciasf.org\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/ciasf.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/ciasf.org\/en\/wp-json\/wp\/v2\/comments?post=2236"}],"version-history":[{"count":0,"href":"https:\/\/ciasf.org\/en\/wp-json\/wp\/v2\/pages\/2236\/revisions"}],"wp:attachment":[{"href":"https:\/\/ciasf.org\/en\/wp-json\/wp\/v2\/media?parent=2236"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}