{"id":217,"date":"2025-04-15T13:49:19","date_gmt":"2025-04-15T11:49:19","guid":{"rendered":"https:\/\/cpts-ouest-herault.fr\/?page_id=217"},"modified":"2026-03-19T19:05:23","modified_gmt":"2026-03-19T18:05:23","slug":"formulaire-recherche-medecin-traitant","status":"publish","type":"page","link":"https:\/\/cpts-ouest-herault.fr\/index.php\/formulaire-recherche-medecin-traitant\/","title":{"rendered":"Formulaire &#8211; Recherche de m\u00e9decin traitant"},"content":{"rendered":"\n<p class=\"has-medium-font-size wp-block-paragraph\"><strong>Vous \u00eates \u00e0 la recherche d\u2019un m\u00e9decin traitant sur le territoire ?<br>Remplissez ce formulaire pour \u00eatre accompagn\u00e9 dans vos d\u00e9marches et faciliter votre acc\u00e8s aux soins.<\/strong><\/p>\n\n\n\n<details class=\"wp-block-details is-layout-flow wp-block-details-is-layout-flow\"><summary>Ce formulaire est destin\u00e9&nbsp;exclusivement aux habitants des communes membres de la CPTS Ouest H\u00e9rault. (Liste ci-dessous)<br>Toute demande \u00e9manant d\u2019une personne ne r\u00e9sidant pas dans l\u2019une de ces communes ne pourra pas faire l\u2019objet d\u2019un retour, la CPTS Ouest H\u00e9rault n\u2019\u00e9tant pas comp\u00e9tente en dehors de ce territoire.<\/summary>\n<p class=\"wp-block-paragraph\">Agel, Aigne, Aigues-Vives, Assignan, Autignac, Azillanet, Babeaux-Bouldoux, Beaufort, Berlou, B\u00e9ziers, Boisset, Boujan-sur-Libron, Caberolles, Capestang, Causses-et-Veyran, Caussiniojuls, Cazedarnes, Cazouls-l\u00e8s-B\u00e9ziers, C\u00e9bazan, Cers, Cessenon-sur-Orb, Cesseras, Colombiers, Corneilhan, Creissan, Cruzy, Faug\u00e8res, Ferri\u00e8res-Poussarou, La Caunettes, Laurens, Lespignan, Lignan-sur-Orb, Maraussan, Maureilhan, Minerve, Montady, Montels, Montouliers, Nissan-lez-Enserune,Olonzac, Oupiac, Pardailhan, Pierrerue, Poilhes, Prades-sur-Veznazobre, Pr\u00e9mian, Puisserguier, Quarante, Rieussec, Riols, Roquebrun, Saint-Chinian, Saint-Jean-de-Minervois, Saint-Nazaire-de-Ladarez, Sauvian, S\u00e9rignan, Siran, Th\u00e9zan-l\u00e8s-B\u00e9ziers, Valras-Plage, V\u00e9lieux, Vendres, Vieussan, Villeneuve-l\u00e8s-B\u00e9ziers, Villespassans<\/p>\n<\/details>\n\n\n\n<p class=\"has-ast-global-color-2-color has-text-color has-link-color wp-elements-aa4d8fdcfe2bbdd3874d61b1db9a072a wp-block-paragraph\"><strong>Un formulaire doit \u00eatre rempli pour une seule personne<\/strong>.<br>Toute demande concernant plusieurs personnes devra faire l\u2019objet de formulaires distincts.<\/p>\n\n\n<style id=\"wpforms-css-vars-214-block-0b84496e-abcd-46db-b71d-d3d2051f8935\">\n\t\t\t\t#wpforms-214.wpforms-block-0b84496e-abcd-46db-b71d-d3d2051f8935 {\n\t\t\t\t--wpforms-field-size-input-height: 43px;\n--wpforms-field-size-input-spacing: 15px;\n--wpforms-field-size-font-size: 16px;\n--wpforms-field-size-line-height: 19px;\n--wpforms-field-size-padding-h: 14px;\n--wpforms-field-size-checkbox-size: 16px;\n--wpforms-field-size-sublabel-spacing: 5px;\n--wpforms-field-size-icon-size: 1;\n--wpforms-label-size-font-size: 16px;\n--wpforms-label-size-line-height: 19px;\n--wpforms-label-size-sublabel-font-size: 14px;\n--wpforms-label-size-sublabel-line-height: 17px;\n--wpforms-button-size-font-size: 17px;\n--wpforms-button-size-height: 41px;\n--wpforms-button-size-padding-h: 15px;\n--wpforms-button-size-margin-top: 10px;\n\t\t\t}\n\t\t\t<\/style><div class=\"wpforms-container wpforms-container-full wpforms-block wpforms-block-0b84496e-abcd-46db-b71d-d3d2051f8935 wpforms-render-modern\" id=\"wpforms-214\"><form id=\"wpforms-form-214\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"214\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/index.php\/wp-json\/wp\/v2\/pages\/217\" data-token=\"c0017cc8bb43c0c2ca7860f85fff58ef\" data-token-time=\"1780773454\"><div class=\"wpforms-head-container\"><div class=\"wpforms-title\">Formulaire &#8211; Recherche de m\u00e9decin traitant<\/div><div class=\"wpforms-description\">Si vous \u00eates \u00e0 la recherche d\u2019un m\u00e9decin traitant, vous pouvez remplir le questionnaire.\r\n\r\nAttention &#8211; Chaque formulaire est individuel. Merci de remplir un formulaire par personne.<\/div><\/div><noscript class=\"wpforms-error-noscript\">Veuillez activer JavaScript dans votre navigateur pour remplir ce formulaire.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Veuillez activer JavaScript dans votre navigateur pour remplir ce formulaire.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-214-field_2-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-214-field_2\">NOM Pr\u00e9nom <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-214-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" aria-errormessage=\"wpforms-214-field_2-error\" required><\/div><div id=\"wpforms-214-field_32-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"32\"><label class=\"wpforms-field-label\" for=\"wpforms-214-field_32\">Date de naissance (format XX\/XX\/XXXX) <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-214-field_32\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][32]\" placeholder=\"JJ\/MM\/AAAA\" aria-errormessage=\"wpforms-214-field_32-error\" required><\/div><div id=\"wpforms-214-field_16-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-214-field_16\">Age<\/label><input type=\"text\" id=\"wpforms-214-field_16\" class=\"wpforms-field-medium\" name=\"wpforms[fields][16]\" aria-errormessage=\"wpforms-214-field_16-error\" ><\/div><div id=\"wpforms-214-field_5-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-214-field_5\">E-mail<\/label><input type=\"email\" id=\"wpforms-214-field_5\" class=\"wpforms-field-medium\" name=\"wpforms[fields][5]\" spellcheck=\"false\" aria-errormessage=\"wpforms-214-field_5-error\" ><\/div><div id=\"wpforms-214-field_6-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-214-field_6\">T\u00e9l\u00e9phone portable <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"number\" id=\"wpforms-214-field_6\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][6]\" step=\"any\" aria-errormessage=\"wpforms-214-field_6-error\" required><\/div><div id=\"wpforms-214-field_15-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-214-field_15\">T\u00e9l\u00e9phone fixe<\/label><input type=\"text\" id=\"wpforms-214-field_15\" class=\"wpforms-field-medium\" name=\"wpforms[fields][15]\" aria-errormessage=\"wpforms-214-field_15-error\" ><\/div><div id=\"wpforms-214-field_17-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-214-field_17\">Adresse<\/label><input type=\"text\" id=\"wpforms-214-field_17\" class=\"wpforms-field-medium\" name=\"wpforms[fields][17]\" aria-errormessage=\"wpforms-214-field_17-error\" ><\/div><div id=\"wpforms-214-field_18-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-214-field_18\">Commune <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-214-field_18\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][18]\" aria-errormessage=\"wpforms-214-field_18-error\" required><\/div><div id=\"wpforms-214-field_19-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"19\"><label class=\"wpforms-field-label\" for=\"wpforms-214-field_19\">Code postal <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-214-field_19\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][19]\" aria-errormessage=\"wpforms-214-field_19-error\" required><\/div><div id=\"wpforms-214-field_21-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"21\"><fieldset><legend class=\"wpforms-field-label\">Personne \u00e0 contacter <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-214-field_21\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_21_1\" name=\"wpforms[fields][21][]\" value=\"Demandeur lui-m\u00eame\" aria-errormessage=\"wpforms-214-field_21_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_21_1\">Demandeur lui-m\u00eame<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_21_2\" name=\"wpforms[fields][21][]\" value=\"Autre personne \u00e0 contacter\" aria-errormessage=\"wpforms-214-field_21_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_21_2\">Autre personne \u00e0 contacter<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-214-field_20-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"20\"><label class=\"wpforms-field-label\" for=\"wpforms-214-field_20\">Tiers \u00e0 contacter (NOM Pr\u00e9nom &#8211; qualit\u00e9 &#8211; t\u00e9l\u00e9phone)<\/label><textarea id=\"wpforms-214-field_20\" class=\"wpforms-field-medium\" name=\"wpforms[fields][20]\" aria-errormessage=\"wpforms-214-field_20-error\" ><\/textarea><\/div><div id=\"wpforms-214-field_8-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-214-field_8\">Qui \u00e9tait votre m\u00e9decin g\u00e9n\u00e9raliste ?<\/label><input type=\"text\" id=\"wpforms-214-field_8\" class=\"wpforms-field-medium\" name=\"wpforms[fields][8]\" aria-errormessage=\"wpforms-214-field_8-error\" ><\/div><div id=\"wpforms-214-field_9-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"9\"><fieldset><legend class=\"wpforms-field-label\">Avez vous une affectation de longue dur\u00e9e (ALD)? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-214-field_9\" class=\"wpforms-field-required\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_9_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][9][]\" value=\"Oui\" aria-errormessage=\"wpforms-214-field_9_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_9_1\">Oui<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_9_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][9][]\" value=\"Non\" aria-errormessage=\"wpforms-214-field_9_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_9_2\">Non<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-214-field_24-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"24\"><fieldset><legend class=\"wpforms-field-label\">Avez vous un traitement qui n\u00e9cessite un renouvellement r\u00e9gulier ? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-214-field_24\" class=\"wpforms-field-required\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_24_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][24][]\" value=\"Oui\" aria-errormessage=\"wpforms-214-field_24_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_24_1\">Oui<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_24_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][24][]\" value=\"Non\" aria-errormessage=\"wpforms-214-field_24_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_24_2\">Non<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-214-field_11-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"11\"><fieldset><legend class=\"wpforms-field-label\">Avez vous une couverture mutuelle sant\u00e9 ? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-214-field_11\" class=\"wpforms-field-required\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_11_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][11][]\" value=\"Oui\" aria-errormessage=\"wpforms-214-field_11_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_11_1\">Oui<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_11_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][11][]\" value=\"Non\" aria-errormessage=\"wpforms-214-field_11_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_11_2\">Non<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-214-field_26-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"26\"><fieldset><legend class=\"wpforms-field-label\">&#8211;\t\u00cates-vous b\u00e9n\u00e9ficiaire de la CSS (compl\u00e9mentaire sant\u00e9 solidaire) <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-214-field_26\" class=\"wpforms-field-required\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_26_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][26][]\" value=\"Oui\" aria-errormessage=\"wpforms-214-field_26_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_26_1\">Oui<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_26_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][26][]\" value=\"Non\" aria-errormessage=\"wpforms-214-field_26_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_26_2\">Non<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-214-field_27-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"27\"><fieldset><legend class=\"wpforms-field-label\">&#8211;\t\u00cates-vous b\u00e9n\u00e9ficiaire de l\u2019AME (aide m\u00e9dicale de l\u2019\u00e9tat) <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-214-field_27\" class=\"wpforms-field-required\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_27_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][27][]\" value=\"Oui\" aria-errormessage=\"wpforms-214-field_27_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_27_1\">Oui<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_27_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][27][]\" value=\"Non\" aria-errormessage=\"wpforms-214-field_27_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_27_2\">Non<\/label><\/li><\/ul><\/fieldset><\/div>\t\t<div id=\"wpforms-214-field_1-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"1\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-214-field_1\" >de &#8211; NOM<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-214-field_1\" class=\"wpforms-field-medium\" name=\"wpforms[fields][1]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-214-field_30-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"30\"><label class=\"wpforms-field-label\" for=\"wpforms-214-field_30\">Avez-vous des difficult\u00e9s pour vous d\u00e9placer ? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-214-field_30\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][30]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>&#8212; S\u00e9lectionner un choix &#8212;<\/option><option value=\"Oui\"  class=\"choice-1 depth-1\"  >Oui<\/option><option value=\"Non\"  class=\"choice-2 depth-1\"  >Non<\/option><\/select><\/div><div id=\"wpforms-214-field_23-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"23\"><fieldset><legend class=\"wpforms-field-label\">Le formulaire a-t-il \u00e9t\u00e9 compl\u00e9t\u00e9 \u00e0 l&#039;aide ou par l&#039;interm\u00e9diaire d&#039;un tiers ?<\/legend><ul id=\"wpforms-214-field_23\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_23_1\" name=\"wpforms[fields][23][]\" value=\"DAC 34\" aria-errormessage=\"wpforms-214-field_23_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_23_1\">DAC 34<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_23_5\" name=\"wpforms[fields][23][]\" value=\"CPAM\" aria-errormessage=\"wpforms-214-field_23_5-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_23_5\">CPAM<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_23_6\" name=\"wpforms[fields][23][]\" value=\"MISAS\" aria-errormessage=\"wpforms-214-field_23_6-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_23_6\">MISAS<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_23_2\" name=\"wpforms[fields][23][]\" value=\"Membre de la famille\" aria-errormessage=\"wpforms-214-field_23_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_23_2\">Membre de la famille<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_23_3\" name=\"wpforms[fields][23][]\" value=\"Autre\" aria-errormessage=\"wpforms-214-field_23_3-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_23_3\">Autre<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-214-field_23_4\" name=\"wpforms[fields][23][]\" value=\"Aucune aide\" aria-errormessage=\"wpforms-214-field_23_4-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-214-field_23_4\">Aucune aide<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-214-field_28-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"28\"><label class=\"wpforms-field-label\" for=\"wpforms-214-field_28\">Si, &quot;Autre&quot; :<\/label><input type=\"text\" id=\"wpforms-214-field_28\" class=\"wpforms-field-medium\" name=\"wpforms[fields][28]\" aria-errormessage=\"wpforms-214-field_28-error\" ><\/div><div id=\"wpforms-214-field_31-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"31\"><label class=\"wpforms-field-label\" for=\"wpforms-214-field_31\">Adresse mail du partenaire ou de la tierce personne (DAC, CPAM, MISAS&#8230;)<\/label><input type=\"email\" id=\"wpforms-214-field_31\" class=\"wpforms-field-medium\" name=\"wpforms[fields][31]\" spellcheck=\"false\" aria-errormessage=\"wpforms-214-field_31-error\" ><\/div><div id=\"wpforms-214-field_13-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-214-field_13\">Commentaire &#8211; Motif de la demande &#8211; Pr\u00e9conisation du partenaire<\/label><textarea id=\"wpforms-214-field_13\" class=\"wpforms-field-medium\" name=\"wpforms[fields][13]\" aria-errormessage=\"wpforms-214-field_13-error\" ><\/textarea><\/div><script>\n\t\t\t\t( function() {\n\t\t\t\t\tconst style = document.createElement( 'style' );\n\t\t\t\t\tstyle.appendChild( document.createTextNode( '#wpforms-214-field_1-container { position: absolute !important; overflow: hidden !important; display: inline !important; height: 1px !important; width: 1px !important; z-index: -1000 !important; padding: 0 !important; } #wpforms-214-field_1-container input { visibility: hidden; } #wpforms-conversational-form-page #wpforms-214-field_1-container label { counter-increment: none; }' ) );\n\t\t\t\t\tdocument.head.appendChild( style );\n\t\t\t\t\tdocument.currentScript?.remove();\n\t\t\t\t} )();\n\t\t\t<\/script><\/div><!-- .wpforms-field-container --><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"214\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/cpts-ouest-herault.fr\/index.php\/wp-json\/wp\/v2\/pages\/217\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-214\" class=\"wpforms-submit\" data-alt-text=\"Envoi...\" data-submit-text=\"Envoyer\" aria-live=\"assertive\" value=\"wpforms-submit\">Envoyer<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/cpts-ouest-herault.fr\/wp-content\/plugins\/wpforms-lite\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Chargement en cours\"><\/div><\/form><\/div>  <!-- .wpforms-container -->\n\n\n<p class=\"wp-block-paragraph\"><strong>Information importante : Certaines cat\u00e9gories de public seront trait\u00e9es prioritairement (personnes \u00e2g\u00e9e et\/ou ALD, C2S&#8230;). Les demandes sont \u00e9tudi\u00e9es en fonction de ces crit\u00e8res de priorit\u00e9 et des possibilit\u00e9s existantes sur le territoire.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Les informations recueillies sur ce formulaire sont enregistr\u00e9es par la CPTS Ouest H\u00e9rault pour la gestion des adh\u00e9sions et la communication avec ses membres. Elles sont conserv\u00e9es pendant une dur\u00e9e de 10 ans et sont destin\u00e9es uniquement \u00e0 l&rsquo;association. Conform\u00e9ment au RGPD, vous pouvez exercer vos droits d&rsquo;acc\u00e8s, de rectification ou d&rsquo;effacement de vos donn\u00e9es en contactant cptsouestherault@gmail.com.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Vous \u00eates \u00e0 la recherche d\u2019un m\u00e9decin traitant sur le territoire ?Remplissez ce formulaire pour \u00eatre accompagn\u00e9 dans vos d\u00e9marches [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-217","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Formulaire - Recherche de m\u00e9decin traitant - CPTS Ouest H\u00e9rault<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cpts-ouest-herault.fr\/index.php\/formulaire-recherche-medecin-traitant\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Formulaire - Recherche de m\u00e9decin traitant - CPTS Ouest H\u00e9rault\" \/>\n<meta property=\"og:description\" content=\"Vous \u00eates \u00e0 la recherche d\u2019un m\u00e9decin traitant sur le territoire ?Remplissez ce formulaire pour \u00eatre accompagn\u00e9 dans vos d\u00e9marches [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cpts-ouest-herault.fr\/index.php\/formulaire-recherche-medecin-traitant\/\" \/>\n<meta property=\"og:site_name\" content=\"CPTS Ouest H\u00e9rault\" \/>\n<meta property=\"article:modified_time\" content=\"2026-03-19T18:05:23+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data1\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/cpts-ouest-herault.fr\\\/index.php\\\/formulaire-recherche-medecin-traitant\\\/\",\"url\":\"https:\\\/\\\/cpts-ouest-herault.fr\\\/index.php\\\/formulaire-recherche-medecin-traitant\\\/\",\"name\":\"Formulaire - Recherche de m\u00e9decin traitant - CPTS Ouest H\u00e9rault\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/cpts-ouest-herault.fr\\\/#website\"},\"datePublished\":\"2025-04-15T11:49:19+00:00\",\"dateModified\":\"2026-03-19T18:05:23+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/cpts-ouest-herault.fr\\\/index.php\\\/formulaire-recherche-medecin-traitant\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/cpts-ouest-herault.fr\\\/index.php\\\/formulaire-recherche-medecin-traitant\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/cpts-ouest-herault.fr\\\/index.php\\\/formulaire-recherche-medecin-traitant\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Accueil\",\"item\":\"https:\\\/\\\/cpts-ouest-herault.fr\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Formulaire &#8211; Recherche de m\u00e9decin traitant\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/cpts-ouest-herault.fr\\\/#website\",\"url\":\"https:\\\/\\\/cpts-ouest-herault.fr\\\/\",\"name\":\"CPTS Ouest H\u00e9rault\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/cpts-ouest-herault.fr\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/cpts-ouest-herault.fr\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/cpts-ouest-herault.fr\\\/#organization\",\"name\":\"CPTS Ouest H\u00e9rault\",\"url\":\"https:\\\/\\\/cpts-ouest-herault.fr\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/cpts-ouest-herault.fr\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/cpts-ouest-herault.fr\\\/wp-content\\\/uploads\\\/2025\\\/03\\\/cropped-Logo-CPTS-Modifie.png\",\"contentUrl\":\"https:\\\/\\\/cpts-ouest-herault.fr\\\/wp-content\\\/uploads\\\/2025\\\/03\\\/cropped-Logo-CPTS-Modifie.png\",\"width\":175,\"height\":134,\"caption\":\"CPTS Ouest H\u00e9rault\"},\"image\":{\"@id\":\"https:\\\/\\\/cpts-ouest-herault.fr\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.linkedin.com\\\/company\\\/cpts-ouest-herault\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Formulaire - Recherche de m\u00e9decin traitant - CPTS Ouest H\u00e9rault","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/cpts-ouest-herault.fr\/index.php\/formulaire-recherche-medecin-traitant\/","og_locale":"fr_FR","og_type":"article","og_title":"Formulaire - Recherche de m\u00e9decin traitant - CPTS Ouest H\u00e9rault","og_description":"Vous \u00eates \u00e0 la recherche d\u2019un m\u00e9decin traitant sur le territoire ?Remplissez ce formulaire pour \u00eatre accompagn\u00e9 dans vos d\u00e9marches [&hellip;]","og_url":"https:\/\/cpts-ouest-herault.fr\/index.php\/formulaire-recherche-medecin-traitant\/","og_site_name":"CPTS Ouest H\u00e9rault","article_modified_time":"2026-03-19T18:05:23+00:00","twitter_card":"summary_large_image","twitter_misc":{"Dur\u00e9e de lecture estim\u00e9e":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/cpts-ouest-herault.fr\/index.php\/formulaire-recherche-medecin-traitant\/","url":"https:\/\/cpts-ouest-herault.fr\/index.php\/formulaire-recherche-medecin-traitant\/","name":"Formulaire - Recherche de m\u00e9decin traitant - CPTS Ouest H\u00e9rault","isPartOf":{"@id":"https:\/\/cpts-ouest-herault.fr\/#website"},"datePublished":"2025-04-15T11:49:19+00:00","dateModified":"2026-03-19T18:05:23+00:00","breadcrumb":{"@id":"https:\/\/cpts-ouest-herault.fr\/index.php\/formulaire-recherche-medecin-traitant\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/cpts-ouest-herault.fr\/index.php\/formulaire-recherche-medecin-traitant\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/cpts-ouest-herault.fr\/index.php\/formulaire-recherche-medecin-traitant\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Accueil","item":"https:\/\/cpts-ouest-herault.fr\/"},{"@type":"ListItem","position":2,"name":"Formulaire &#8211; Recherche de m\u00e9decin traitant"}]},{"@type":"WebSite","@id":"https:\/\/cpts-ouest-herault.fr\/#website","url":"https:\/\/cpts-ouest-herault.fr\/","name":"CPTS Ouest H\u00e9rault","description":"","publisher":{"@id":"https:\/\/cpts-ouest-herault.fr\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/cpts-ouest-herault.fr\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/cpts-ouest-herault.fr\/#organization","name":"CPTS Ouest H\u00e9rault","url":"https:\/\/cpts-ouest-herault.fr\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/cpts-ouest-herault.fr\/#\/schema\/logo\/image\/","url":"https:\/\/cpts-ouest-herault.fr\/wp-content\/uploads\/2025\/03\/cropped-Logo-CPTS-Modifie.png","contentUrl":"https:\/\/cpts-ouest-herault.fr\/wp-content\/uploads\/2025\/03\/cropped-Logo-CPTS-Modifie.png","width":175,"height":134,"caption":"CPTS Ouest H\u00e9rault"},"image":{"@id":"https:\/\/cpts-ouest-herault.fr\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.linkedin.com\/company\/cpts-ouest-herault"]}]}},"_links":{"self":[{"href":"https:\/\/cpts-ouest-herault.fr\/index.php\/wp-json\/wp\/v2\/pages\/217","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cpts-ouest-herault.fr\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cpts-ouest-herault.fr\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cpts-ouest-herault.fr\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cpts-ouest-herault.fr\/index.php\/wp-json\/wp\/v2\/comments?post=217"}],"version-history":[{"count":0,"href":"https:\/\/cpts-ouest-herault.fr\/index.php\/wp-json\/wp\/v2\/pages\/217\/revisions"}],"wp:attachment":[{"href":"https:\/\/cpts-ouest-herault.fr\/index.php\/wp-json\/wp\/v2\/media?parent=217"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}