?> > <?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 } } }