?>
>
<?php
OutilsForm::validProblemePourNombreDeCaractere($valid["motifAutre"], "Le motif", strlen($motifAutre), 2, 128);
?>
</div>
</div>
<div class="form-group">
<div class="col-sm-12">
<label for="bilan">Bilan</label>
<textarea rows="8" class="form-control" name="bilan" id="bilan" maxlength="512" placeholder="Bilan"><?php
echo $bilan;
?>
</textarea>
<?php
OutilsForm::validProblemePourNombreDeCaractere($valid["bilan"], "Le bilan", strlen($bilan), 2, 512);
?>
</div>
</div>
<div class="form-group">
<div class="col-sm-6">
<label for="documentation"><input type="checkbox" name="documentation" id="documentation" <?php
OutilsForm::checked($documentation);
?>
> Documentation fournit</label>
</div>
</div>
<div class="form-group">
<div class="col-sm-12">
<?php
OutilsMultidataForm::implanter($echantillonsMultidataForm, '<i class="fa fa-list fa-fw"></i> Echantillons</h4>', array("Medicament", "Quantité offerte"));
OutilsForm::selectedCompose($question, "erreur");
?>
>Erreur/Bug</option>
</select>
<?php
OutilsForm::validProbleme($valid_question, "Question/Remarque/Bug");
?>
</div>
<div class="form-group">
<label for="message">Message</label>
<textarea rows="8" class="form-control" name="message" id="message" maxlength="512" placeholder="Message"><?php
echo $message;
?>
</textarea>
<?php
OutilsForm::validProblemePourNombreDeCaractere($valid_message, "Le message", strlen($message), 3, 512);
?>
</div>
<?php
OutilsForm::implanterFormulaireId("contact");
?>
<div class="col-md-6 col-md-offset-3">
<div class="form-group"><input class="btn btn-success form-control btn-success" type="submit" value="Envoyer le message"></div>
<div class="form-group"><input class="btn btn-default form-control" type="reset" value="Réinitialiser le formulaire"></div>
</div>
</form>
</div>
<?php
}
}
}
