{"id":952,"date":"2022-09-26T08:56:44","date_gmt":"2022-09-26T08:56:44","guid":{"rendered":"https:\/\/www.group-f.be\/dienstencheques\/vervanging-aanvragen\/"},"modified":"2023-01-10T10:37:03","modified_gmt":"2023-01-10T10:37:03","slug":"demandes-de-remplacement","status":"publish","type":"page","link":"https:\/\/www.group-f.be\/dienstencheques\/fr\/espace-client\/demandes-de-remplacement\/","title":{"rendered":"Demandes de remplacement"},"content":{"rendered":"\n<section class=\"block b-contact pt-40 pb-1\">\n    <div class=\"container\">\n        <div class=\"row mb-40\">\n            <div class=\"col-lg-5 col-xl-4 mb-20 mb-lg-0\">\n                <div class=\"bg-primary-light\">\n                                        <div class=\"row p-lg-40\">\n                        <div class=\"col-12\">\n                                                            <h3 class=\"h3 text-dark font-weight-bold font-uppercase mb-20\" data-aos=\"fade-up\">\n                                    Coordonn\u00e9es de contact                                <\/h3>\n                            \n                                                            <div class=\"d-flex flex-row align-items-center mb-10\" data-aos=\"fade-up\">\n                                    <i class=\"fas fa-map-marker-alt fa-lg b-contact__icon text-gray-500 mr-10\"><\/i>\n                                    <a href=\"https:\/\/www.google.com\/maps\/search\/?api=1&#038;query=Prins%20Boudewijnlaan%209%20unit%2011%202550%20Kontich\" target=\"_blank\" class=\"font-weight-normal w-100 mb-0\">\n                                        Prins Boudewijnlaan 9 unit 11<br>2550 Kontich                                    <\/a>\n                                <\/div>\n                            \n                            \n                                                            <div class=\"d-flex flex-row align-items-center mb-10\" data-aos=\"fade-up\">\n                                    <i class=\"fas fa-phone  fa-lg b-contact__icon text-gray-500 mr-10\"><\/i>\n                                    <a href=\"tel:0800 62 024\" class=\"font-weight-normal w-100 mb-0\">\n                                        0800 62 024                                    <\/a>\n                                <\/div>\n                            \n                            \n                                                            <div data-aos=\"fade-up\"><p>&nbsp;<\/p>\n<p>Vous souhaitez demander un remplacement pour votre aide m\u00e9nag\u00e8re ? Ou voulez-vous signaler quelque chose? Remplissez le formulaire.<\/p>\n<p><strong>Remarque :<\/strong> Remplir ce formulaire ne garantit pas un remplacement. Nous vous contacterons et \u00e9tudierons les possibilit\u00e9s.<\/p>\n<\/div>\n                                                    <\/div>\n                    <\/div>\n                <\/div>\n            <\/div>\n            <div class=\"col-lg-7 col-xl-8\">\n                <div class=\"bg-primary-light h-100 p-lg-40\">\n                                            <div class=\"row mb-20\">\n                            <div class=\"col-12\" data-aos=\"fade-up\">\n                                <h3 class=\"h3 text-dark font-weight-bold font-uppercase mb-20\">\n                                    Demandes de remplacement                                <\/h3>\n                            <\/div>\n                        <\/div>\n                                        <div data-aos=\"fade-up\"><script type=\"text\/javascript\">var 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gform_body'><div id='gform_fields_6' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_6_1\" class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_6_1\" ><label class='gfield_label gform-field-label' for='input_6_1'>Pr\u00e9nom<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_6_1' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_3\" class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_6_3\" ><label class='gfield_label gform-field-label' for='input_6_3'>Nom<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_6_3' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_4\" class=\"gfield gfield--type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_6_4\" ><label class='gfield_label gform-field-label' for='input_6_4'>Adresse e-mail<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_4' id='input_6_4' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_6_5\" class=\"gfield gfield--type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_6_5\" ><label class='gfield_label gform-field-label' for='input_6_5'>Num\u00e9ro de t\u00e9l\u00e9phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_5' id='input_6_5' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_8\" class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_6_8\" ><label class='gfield_label gform-field-label' for='input_6_8'>Rue<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_6_8' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_9\" class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_6_9\" ><label class='gfield_label gform-field-label' for='input_6_9'>Num\u00e9ro de la maison<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_6_9' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_11\" class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_6_11\" ><label class='gfield_label gform-field-label' for='input_6_11'>Code postal<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_6_11' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_10\" class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_6_10\" ><label class='gfield_label gform-field-label' for='input_6_10'>Ville<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_6_10' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_6_16\" class=\"gfield gfield--type-date gfield--input-type-datedropdown gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_6_16\" ><legend class='gfield_label gform-field-label' >Date pour laquelle vous souhaitez un remplacement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_6_16' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_6_16_2_container'><select name='input_16[]' id='input_6_16_2'   aria-required='true'  ><option value=''>Jour<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_6_16_1_container'><select name='input_16[]' id='input_6_16_1'   aria-required='true'  ><option value=''>Mois<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_6_16_3_container'><select name='input_16[]' id='input_6_16_3'   aria-required='true'  ><option value=''>Ann\u00e9e<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><fieldset id=\"field_6_20\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_6_20\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >\u00c0 quel moment le rempla\u00e7ant peut-il arriver ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_6_20'><div class='gchoice gchoice_6_20_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.1' type='checkbox'  value='Lundi AM'  id='choice_6_20_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_20_1' id='label_6_20_1' class='gform-field-label gform-field-label--type-inline'>Lundi AM<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_20_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.2' type='checkbox'  value='Lundi PM'  id='choice_6_20_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_20_2' id='label_6_20_2' class='gform-field-label gform-field-label--type-inline'>Lundi PM<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_20_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.3' type='checkbox'  value='Mardi AM'  id='choice_6_20_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_20_3' id='label_6_20_3' class='gform-field-label gform-field-label--type-inline'>Mardi AM<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_20_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.4' type='checkbox'  value='Mardi PM'  id='choice_6_20_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_20_4' id='label_6_20_4' class='gform-field-label gform-field-label--type-inline'>Mardi PM<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_20_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.5' type='checkbox'  value='Mercredi AM'  id='choice_6_20_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_20_5' id='label_6_20_5' class='gform-field-label gform-field-label--type-inline'>Mercredi AM<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_20_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.6' type='checkbox'  value='Mercredi PM'  id='choice_6_20_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_20_6' id='label_6_20_6' class='gform-field-label gform-field-label--type-inline'>Mercredi PM<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_20_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.7' type='checkbox'  value='Jeudi AM'  id='choice_6_20_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_20_7' id='label_6_20_7' class='gform-field-label gform-field-label--type-inline'>Jeudi AM<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_20_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.8' type='checkbox'  value='Jeudi PM'  id='choice_6_20_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_20_8' id='label_6_20_8' class='gform-field-label gform-field-label--type-inline'>Jeudi PM<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_20_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.9' type='checkbox'  value='Vendredi AM'  id='choice_6_20_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_20_9' id='label_6_20_9' class='gform-field-label gform-field-label--type-inline'>Vendredi AM<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_20_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.11' type='checkbox'  value='Vendredi PM'  id='choice_6_20_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_20_11' id='label_6_20_11' class='gform-field-label gform-field-label--type-inline'>Vendredi PM<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_20_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.12' type='checkbox'  value='Samedi AM'  id='choice_6_20_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_20_12' id='label_6_20_12' class='gform-field-label gform-field-label--type-inline'>Samedi AM<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_20_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.13' type='checkbox'  value='Samedi PM'  id='choice_6_20_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_20_13' id='label_6_20_13' class='gform-field-label gform-field-label--type-inline'>Samedi PM<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_20_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.14' type='checkbox'  value='Dimanche AM'  id='choice_6_20_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_20_14' id='label_6_20_14' class='gform-field-label gform-field-label--type-inline'>Dimanche AM<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_6_20_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.15' type='checkbox'  value='Dimanche PM'  id='choice_6_20_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_20_15' id='label_6_20_15' class='gform-field-label gform-field-label--type-inline'>Dimanche PM<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_12\" class=\"gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_6_12\" ><label class='gfield_label gform-field-label' for='input_6_12'>Bureau<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_6_12' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Antwerpen' >Antwerpen<\/option><option value='Asse' >Asse<\/option><option value='Ekeren' >Ekeren<\/option><option value='Kampenhout' 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