{"id":35425,"date":"2022-06-01T11:38:36","date_gmt":"2022-06-01T15:38:36","guid":{"rendered":"https:\/\/dormalab.com\/consentement-location\/"},"modified":"2024-11-26T20:57:06","modified_gmt":"2024-11-27T01:57:06","slug":"consentement-location","status":"publish","type":"page","link":"https:\/\/dormalab.com\/fr\/consentement-location\/","title":{"rendered":"Consentement \u00e0 la location d&rsquo;une polygraphie"},"content":{"rendered":"<p>[vc_row][vc_column css=\u00a0\u00bb.vc_custom_1584641879392{margin-top: 125px !important;}\u00a0\u00bb][vc_column_text]<!-- FORM: BODY SECTION --><\/p>\n<div class=\"wFormContainer\">\n<div class=\"wFormHeader\"><\/div>\n<style type=\"text\/css\">\n                #tfa_1,<br \/>\n                *[id^=\"tfa_1[\"] {<br \/>\n                    width: 90px !important;<br \/>\n                }<br \/>\n                #tfa_1-D,<br \/>\n                *[id^=\"tfa_1[\"][class~=\"field-container-D\"] {<br \/>\n                    width: auto !important;<br \/>\n                }<\/p>\n<p>                #tfa_872,<br \/>\n                *[id^=\"tfa_872[\"] {<br \/>\n                    width: 170px !important;<br \/>\n                }<br \/>\n                #tfa_872-D,<br \/>\n                *[id^=\"tfa_872[\"][class~=\"field-container-D\"] {<br \/>\n                    width: auto !important;<br \/>\n                }<br \/>\n            <\/style>\n<div class=\"\">\n<div id=\"5033429-WRPR\" class=\"wForm\" dir=\"ltr\">\n<div id=\"code-5033429\" class=\"codesection\"><\/div>\n<h3 id=\"5033429-T\" class=\"wFormTitle\" data-testid=\"form-title\">Consent For Rental Of\u00a0 a Home Respiratory Polygraphy Device<\/h3>\n<form id=\"5033429\" class=\" labelsLeftAligned\" role=\"form\" action=\"https:\/\/www.tfaforms.com\/api_v2\/workflow\/processor\" method=\"post\"><input id=\"tfa_1\" class=\"\" name=\"tfa_1\" type=\"hidden\" value=\"\" \/><\/p>\n<div id=\"tfa_2-D\" class=\"oneField field-container-D labelsRemoved wf-acl-hidden\" role=\"group\" aria-labelledby=\"tfa_2-L\" data-tfa-labelledby=\"-L tfa_2-L\">\n<div class=\"inputWrapper\"><span id=\"tfa_2\" class=\"choices vertical \"><span class=\"oneChoice\"><input id=\"tfa_3\" class=\"\" checked=\"checked\" name=\"tfa_3\" type=\"checkbox\" value=\"tfa_3\" data-default-value=\"true\" aria-labelledby=\"tfa_3-L\" data-tfa-labelledby=\"tfa_2-L tfa_3-L\" \/><label id=\"tfa_3-L\" class=\"label postField\" for=\"tfa_3\">Rental Consent Given<\/label><\/span><\/span><\/div>\n<\/div>\n<div id=\"tfa_4\" class=\"htmlSection\">\n<div id=\"tfa_4-HTML\" class=\"htmlContent\">\n<div>The duration of the rental for the respiratory polygraphy device is one day, then the patient must return it in\u00a0 good condition the next day to Dorma | Sleep Lab.<\/div>\n<div><\/div>\n<div>In the event of loss or damage to the equipment, the patient will have to reimburse the clinic the cost of replacing the\u00a0 equipment (value between $ 3,000 and $ 4,000)<\/div>\n<div><\/div>\n<div>The device must be returned the day after your test before 5 PM. If the device is not returned on time, $ 25.00 per day will be charged to your credit card.<\/div>\n<div><\/div>\n<div>Please leave the device at the receptionist and we will contact you by phone if the test needs to be redone.<\/div>\n<div><\/div>\n<div>Note that if we do not contact you, it means that the test is compliant. We will call you back in 3 or 4 weeks to\u00a0 make an appointment to share your results.<\/div>\n<div><\/div>\n<div>I understand and accept the rental conditions mentioned above.<\/div>\n<div><\/div>\n<\/div>\n<\/div>\n<div id=\"tfa_5-D\" class=\"oneField field-container-D \"><label id=\"tfa_5-L\" class=\"label preField reqMark\" for=\"tfa_5\">Full Name<\/label><\/p>\n<div class=\"inputWrapper\"><input id=\"tfa_5\" class=\"required\" title=\"Full Name\" name=\"tfa_5\" type=\"text\" value=\"\" aria-required=\"true\" \/><\/div>\n<\/div>\n<div id=\"tfa_872-D\" class=\"oneField field-container-D \"><label id=\"tfa_872-L\" class=\"label preField reqMark\" for=\"tfa_872\">Date and Time<\/label><\/p>\n<div class=\"inputWrapper\"><input id=\"tfa_872\" class=\"validate-datetime required\" title=\"Date and Time\" name=\"tfa_872\" type=\"text\" value=\"\" aria-required=\"true\" \/><\/div>\n<\/div>\n<div id=\"5033429-A\" class=\"actions\"><input id=\"submit_button\" class=\"primaryAction\" type=\"submit\" value=\"Submit\" data-label=\"Submit\" \/><\/div>\n<div style=\"clear: both;\"><\/div>\n<p><input id=\"tfa_dbFormId\" name=\"tfa_dbFormId\" type=\"hidden\" value=\"5033429\" \/><input id=\"tfa_dbResponseId\" name=\"tfa_dbResponseId\" type=\"hidden\" value=\"\" \/><input id=\"tfa_dbControl\" name=\"tfa_dbControl\" type=\"hidden\" value=\"0f1dd3842e427463ecdf02c886ee5dc3\" \/><input id=\"tfa_dbWorkflowSessionUuid\" name=\"tfa_dbWorkflowSessionUuid\" type=\"hidden\" value=\"\" \/><input id=\"tfa_dbVersionId\" name=\"tfa_dbVersionId\" type=\"hidden\" value=\"4\" \/><input id=\"tfa_switchedoff\" name=\"tfa_switchedoff\" type=\"hidden\" value=\"\" \/><\/p>\n<\/form>\n<\/div>\n<\/div>\n<div class=\"wFormFooter\">\n<p class=\"supportInfo\">\n<\/div>\n<p class=\"supportInfo\">\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_raw_js]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[\/vc_raw_js][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column css=\u00a0\u00bb.vc_custom_1584641879392{margin-top: 125px !important;}\u00a0\u00bb][vc_column_text] Consent For Rental Of\u00a0 a Home Respiratory Polygraphy Device Rental Consent Given The duration of the rental for the respiratory polygraphy device is one day, then the patient must return it in\u00a0 good condition the next day to Dorma | Sleep Lab. In the event of loss or damage to the &#8230; <a title=\"Consentement \u00e0 la location d&rsquo;une polygraphie\" class=\"read-more\" href=\"https:\/\/dormalab.com\/fr\/consentement-location\/\" aria-label=\"En savoir plus sur Consentement \u00e0 la location d&rsquo;une polygraphie\">Lire la suite<\/a><\/p>\n","protected":false},"author":20,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-35425","page","type-page","status-publish"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Consentement \u00e0 la location d&#039;une polygraphie - \u00c9valuez votre sommeil - Dorma Sleep Clinics<\/title>\n<meta name=\"description\" content=\"Remplissez le questionnaire m\u00e9dical et laissez un sp\u00e9cialiste du sommeil \u00e9valuer votre sommeil. 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