{"id":798,"date":"2025-12-09T20:38:25","date_gmt":"2025-12-09T20:38:25","guid":{"rendered":"https:\/\/www.aers.me\/dolce-gabbana-beauty-s-r-l\/"},"modified":"2026-06-04T08:38:39","modified_gmt":"2026-06-04T08:38:39","slug":"dolce-gabbana-beauty-s-r-l","status":"publish","type":"page","link":"https:\/\/www.aers.me\/fr\/dolce-gabbana-beauty-s-r-l\/","title":{"rendered":"Dolce &#038; Gabbana Beauty S.r.l."},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_section css=\u00a0\u00bb.vc_custom_1730189954651{padding-top: 100px !important;}\u00a0\u00bb el_class=\u00a0\u00bbbanner-section\u00a0\u00bb el_id=\u00a0\u00bbformSection\u00a0\u00bb][vc_row][vc_column]<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_6' style='display:none'><div id='gf_6' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>\u00ab\u00a0<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\u00a0\u00bb indique les champs n\u00e9cessaires<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_6' id='gform_6'  action='\/fr\/wp-json\/wp\/v2\/pages\/798#gf_6' data-formid='6' novalidate><div id='gf_page_steps_6' class='gf_page_steps'><div id='gf_step_6_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span><span class='gf_step_label'>Information des consommateurs<\/span><\/div><div id='gf_step_6_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span><span class='gf_step_label'>Informations sur le produit<\/span><\/div><div id='gf_step_6_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span><span class='gf_step_label'>Informations sur l'\u00e9v\u00e9nement<\/span><\/div><div id='gf_step_6_4' class='gf_step gf_step_pending'><span class='gf_step_number'>4<\/span><span class='gf_step_label'>Divulgation des donn\u00e9es<\/span><\/div><div id='gf_step_6_5' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>5<\/span><span class='gf_step_label'>Examiner et confirmer<\/span><\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_6_1' class='gform_page page_name_start form_page' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_6' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_6_85\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_6_85'>Courriel de notification (propri\u00e9taire)<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_85' id='input_6_85' type='email' value='csatpute@registrarcorp.com' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_6_140\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_6_140'>Adresses \u00e9lectroniques pirat\u00e9es<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_140' id='input_6_140' type='email' value='cosmetovigilance@dolcegabbana.it,mattia.pocaterra@dolcegabbana.it,alessio.vigani@dolcegabbana.it,andrea.tacchini@dolcegabbana.it' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_6_84\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_6_84'>Nom de l&#039;entreprise<\/label><div class='ginput_container ginput_container_text'><input name='input_84' id='input_6_84' type='text' value='Dolce &amp; Gabbana Beauty S.r.l.' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_124\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_6_124'>ID de l&#039;utilisateur<\/label><div class='ginput_container ginput_container_text'><input name='input_124' id='input_6_124' type='text' value='Dolce&amp;GabbanaBeautySRL' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_125\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_6_125'>Num\u00e9ro d&#039;enregistrement du CD<\/label><div class='ginput_container ginput_container_text'><input name='input_125' id='input_6_125' type='text' value='2303219' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_136\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_6_136'>Liste d\u00e9roulante<\/label><div class='ginput_container ginput_container_text'><input name='input_136' id='input_6_136' type='text' value='0' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_138\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full product_name_text field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_6_138'>Nom du produit<\/label><div class='ginput_container ginput_container_text'><input name='input_138' id='input_6_138' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_171\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full multi_product_name_text field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_6_171'>Texte du nom du produit<\/label><div class='ginput_container ginput_container_text'><input name='input_171' id='input_6_171' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_172\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full age_value field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_6_172'>\u00c2ge des clients<\/label><div class='ginput_container ginput_container_text'><input name='input_172' id='input_6_172' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_175\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Divulgation<\/h3><div class='gsection_description' id='gfield_description_6_175'>Nous avons le plaisir de vous informer que les produits que nous fabriquons et distribuons sont rigoureusement test\u00e9s et conformes au R\u00e8glement EU 1223\/2009 en vigueur pour les produits cosm\u00e9tiques ; cependant, une intol\u00e9rance \u00e0 certains des ingr\u00e9dients contenus ne peut \u00eatre exclue.<br\/>Si un effet nocif s'est produit apr\u00e8s l'application du produit cosm\u00e9tique, nous vous demandons de bien vouloir remplir le formulaire suivant, afin de pouvoir identifier les causes de l'intol\u00e9rance et de pr\u00e9venir les indispositions.<\/div><\/div><div id=\"field_6_81\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Information des consommateurs<\/h3><div class='gsection_description' id='gfield_description_6_81'><em>  Veuillez indiquer les coordonn\u00e9es de la personne qui a subi l'\u00e9v\u00e9nement ind\u00e9sirable.<\/em><\/div><\/div><div id=\"field_6_34\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full consumer-name gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_34'>Nom et 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_34' id='input_6_34' type='text' value='' class='large' maxlength='50'   placeholder='Ajouter le nom complet' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_77\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full consumer-email mw-1\/2 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_77'>Courriel<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_77' id='input_6_77' type='email' value='' class='large'   placeholder='Ajouter un courriel' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_6_39\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full consumer-phone mw-1\/2 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_39'>T\u00e9l\u00e9phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_39' id='input_6_39' type='text' value='' class='large' maxlength='25'   placeholder='0000000000' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_35\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full consumer-street-addr gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_35'>Adresse (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_35' id='input_6_35' type='text' value='' class='large' maxlength='75'   placeholder='Ajouter une adresse' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_37\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full consumer-city mw-1\/2 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_37'>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_37' id='input_6_37' type='text' value='' class='large' maxlength='40'   placeholder='S\u00e9lectionnez une ville' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_87\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full consumer-postalcode mw-1\/2 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_87'>Code postal<\/label><div class='ginput_container ginput_container_text'><input name='input_87' id='input_6_87' type='text' value='' class='large'    placeholder='00000000'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_217\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full consumer-country mw-1\/2 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_217'>Pays<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_217' id='input_6_217' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>S\u00e9lectionnez un pays<\/option><option value='Belgium' >Belgique<\/option><option value='Bulgaria' >Bulgarie<\/option><option value='Czech Republic' >R\u00e9publique tch\u00e8que<\/option><option value='Denmark' >Danemark<\/option><option value='Germany' >Allemagne<\/option><option value='Estonia' >Estonie<\/option><option value='Ireland' >Irlande<\/option><option value='Greece' >Gr\u00e8ce<\/option><option value='Spain' >Espagne<\/option><option value='France' >France<\/option><option value='Croatia' >Croatie<\/option><option value='Italy' >Italie<\/option><option value='Cyprus' >Chypre<\/option><option value='Latvia' >Lettonie<\/option><option value='Lithuania' >Lituanie<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Hungary' >Hongrie<\/option><option value='Malta' >Malte<\/option><option value='Netherlands' >Pays-Bas<\/option><option value='Austria' >Autriche<\/option><option value='Poland' >Pologne<\/option><option value='Portugal' >Portugal<\/option><option value='Romania' >Roumanie<\/option><option value='Slovenia' >Slov\u00e9nie<\/option><option value='Slovakia' >Slovaquie<\/option><option value='Finland' >Finlande<\/option><option value='Sweden' >Su\u00e8de<\/option><option value='United Kingdom' >Royaume-Uni<\/option><\/select><\/div><\/div><div id=\"field_6_159\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full d-none gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/div><div id=\"field_6_75\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full consumer-birth-datepicker mw-1\/2 gfield--show-description gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_75'>Date de naissance<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_6_75'>Veuillez saisir la date au format MM\/JJ\/AAAA.<\/div><div class='ginput_container ginput_container_date'>\n                            <input name='input_75' id='input_6_75' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='MM\/JJ\/AAAA' aria-describedby=\"input_6_75_date_format gfield_description_6_75\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_6_75_date_format' class='screen-reader-text'>MM slash JJ slash AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_6_75' class='gform_hidden' value='https:\/\/www.aers.me\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_6_115\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full consumer-gender mw-1\/2 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_115'>Genre<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_115' id='input_6_115' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>S\u00e9lectionnez<\/option><option value='Male' >Homme<\/option><option value='Female' >Femme<\/option><\/select><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_6_1' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Suivant'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_2' class='gform_page form_page page_name_products' data-js='page-field-id-1' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_2' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_6_80\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Informations sur le produit<\/h3><\/div><div id=\"field_6_134\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full product_names_dy mw-3\/4 custom-multi-select product-name gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_134'>Nom du produit<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_134' id='input_6_134' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Tapez\/S\u00e9lectionner le nom du produit<\/option><option value='5060683' >DOLCE &amp; GABBANA ALMOND SCULPT BAR - SOFT CONTOUR FACE &amp; BODY STICK <\/option><option value='4297683' >DOLCE &amp; GABBANA ANIMALIER PALETTE LIMITED EDITION MULTI-FINISH EYESHADOW &amp; FACE POWDERS<\/option><option value='4295937' >DOLCE &amp; GABBANA BERGAMOT GLOW PRIMER LASTING MAKEUP &amp; GLOW ENHANCER<\/option><option value='4646452' >DOLCE &amp; GABBANA BLUEBERRY NUTRI TINT HYDRA-GLOW &amp; FRESH SKIN TINT SPF 20 PA+++ <\/option><option value='4285168' >DOLCE &amp; GABBANA BLUEBERRY NUTRI-TINT HYDRA-GLOW &amp; FRESH SKIN TINT <\/option><option value='4628372' >DOLCE &amp; GABBANA BROW RESTYLER PENCIL 16H LASTING FILL &amp; SHAPE MICRO BROW PENCIL <\/option><option value='4841052' >DOLCE &amp; GABBANA COFFEE OIL LIP PLUMPER FLASH PLUMPING LIP OIL<\/option><option value='4938508' >DOLCE &amp; GABBANA DEVOTION - THE EAU DE PARFUM &amp; THE NEW EAU DE PARFUM POUR HOMME<\/option><option value='4545666' >DOLCE &amp; GABBANA DEVOTION BODY LOTION<\/option><option value='4146446' >DOLCE &amp; GABBANA DEVOTION EAU DE PARFUM<\/option><option value='4968041' >DOLCE &amp; GABBANA DEVOTION - THE EAU DE PARFUM &amp; THE NEW EAU DE PARFUM INTENSE<\/option><option value='4472381' >DOLCE &amp; GABBANA DEVOTION EAU DE PARFUM INTENSE<\/option><option value='4284366' >DOLCE &amp; GABBANA DEVOTION EAU DE PARFUM REFILL<\/option><option value='4167590' >DOLCE &amp; GABBANA DEVOTION LUMINIZER ILLUMINANTE VISO OIL IN POWDER LUMINIZER (00 LUCE UNIVERSALE)<\/option><option value='4167593' >DOLCE &amp; GABBANA DEVOTION MASCARA VOLUME ESTREMO VOLUME &amp; LIFT MASCARA (01 ULTRA NERO)<\/option><option value='4346215' >DOLCE &amp; GABBANA DEVOTION POUR HOMME EAU DE PARFUM<\/option><option value='4827070' >DOLCE &amp; GABBANA DEVOTION POUR HOMME PARFUM<\/option><option value='4545741' >DOLCE &amp; GABBANA DEVOTION POUR HOMME SHOWER GEL<\/option><option value='4559885&#039;' >DOLCE &amp; GABBANA DEVOTION POUR HOMME STICK DEODORANT<\/option><option value='4615484' >DOLCE &amp; GABBANA DEVOTION RICH BODY CREAM<\/option><option value='4545747' >DOLCE &amp; GABBANA DEVOTION SHOWER GEL<\/option><option value='4259512' >DOLCE &amp; GABBANA DG VIB3 EAU DE PARFUM<\/option><option value='4613511' >DOLCE &amp; GABBANA DOLCE ALCOHOL-FREE PERFUME GEL<\/option><option value='4613531' >DOLCE &amp; GABBANA DOLCE BLUE JASMINE ALCOHOL-FREE PERFUME GEL<\/option><option value='4230608' >DOLCE &amp; GABBANA DOLCE BLUE JASMINE EAU DE PARFUM<\/option><option value='4028723' >DOLCE &amp; GABBANA DOLCE EAU DE PARFUM <\/option><option value='4028727' >DOLCE &amp; GABBANA DOLCE GARDEN EAU DE PARFUM<\/option><option value='4000112' >DOLCE &amp; GABBANA DOLCE LILY EAU DE TOILETTE<\/option><option value='5173865' >DOLCE &amp; GABBANA DOLCE MAGNOLIA EAU DE PARFUM<\/option><option value='4000099' >DOLCE &amp; GABBANA DOLCE PEONY EAU DE PARFUM <\/option><option value='4028729' >DOLCE &amp; GABBANA DOLCE ROSE EAU DE TOILETTE<\/option><option value='4000107' >DOLCE &amp; GABBANA DOLCE SHINE EAU DE PARFUM<\/option><option value='4613515' >DOLCE &amp; GABBANA DOLCE VIOLET ALCOHOL-FREE PERFUME GEL<\/option><option value='3937407' >DOLCE &amp; GABBANA DOLCE VIOLET EAU DE TOILETTE<\/option><option value='4926612' >DOLCE &amp; GABBANA EVER ICON EYE PALETTE 10H MULTI-FINISH DAY TO NIGHT EYESHADOWS <\/option><option value='4559883' >DOLCE &amp; GABBANA EVERFULL HI-DEFINITION MASCARA 36H DEFINED VOLUME &amp; LENGTH MASCARA (01 TOTAL BLACK)<\/option><option value='5173877&#039;' >DOLCE &amp; GABBANA LIGHT BLUE POUR HOMME EAU DE PARFUM<\/option><option value='3960291' >DOLCE &amp; GABBANA LIGHT BLUE POUR HOMME EAU DE TOILETTE<\/option><option value='4620788' >DOLCE &amp; GABBANA LIGHT BLUE POUR HOMME SHOWER GEL<\/option><option value='4559890&#039;' >DOLCE &amp; GABBANA LIGHT BLUE POUR HOMME STICK DEODORANT<\/option><option value='3960296' >DOLCE &amp; GABBANA LIGHT BLUE SUMMER VIBES EAU DE TOILETTE<\/option><option value='3960304' >DOLCE &amp; GABBANA LIGHT BLUE SUMMER VIBES POUR HOMME EAU DE TOILETTE<\/option><option value='3937446' >DOLCE &amp; GABBANA L&#039;IMPERATRICE EAU DE TOILETTE<\/option><option value='4472413' >DOLCE &amp; GABBANA L&#039;IMPERATRICE ROYALE EAU DE TOILETTE<\/option><option value='4926597' >DOLCE &amp; GABBANA MASCULINE RE-EDITION 1999 EAU DE PARFUM<\/option><option value='4631312' >DOLCE &amp; GABBANA MEET YOUR FLAWLESS MATTE SKIN DUO<\/option><option value='4938125' >DOLCE &amp; GABBANA MEET YOUR NEW FLAWLESS SKIN HERO<\/option><option value='4285175' >DOLCE &amp; GABBANA MINT OIL LIP PLUMPER FLASH PLUMPING LIP OIL<\/option><option value='4472857' >DOLCE &amp; GABBANA MY COMFY MATTE INSTANT RICH COLOR &amp; HYDRATION LIP STYLO <\/option><option value='4968021' >DOLCE &amp; GABBANA MY DEVOTION EAU DE PARFUM INTENSE<\/option><option value='4472495' >DOLCE &amp; GABBANA MY JUICY SHEER INSTANT SHINE &amp; HYDRATION LIP STYLO<\/option><option value='4628359' >DOLCE &amp; GABBANA MY LIP OVERLINER 8H LASTING EASY GLIDE SCULPTING LIP PENCIL<\/option><option value='4879853' >DOLCE &amp; GABBANA MY NAIL GLOSS 3D GLOSSY TOP COAT<\/option><option value='4879851' >DOLCE &amp; GABBANA MY NAIL MATCH QUICK DRY LASTING NAIL LACQUER<\/option><option value='4472478' >DOLCE &amp; GABBANA MY SCULPT SATIN LASTING COLOR &amp; HYDRATION LIP STYLO <\/option><option value='4472459' >DOLCE &amp; GABBANA NAILED IT! QUICK DRY LASTING NAIL LACQUER <\/option><option value='4627614' >DOLCE &amp; GABBANA NO-PUFF CAFFEINE EYE PATCHES DEPUFFING &amp; BRIGHTENING EYE GEL PADS<\/option><option value='4627692' >DOLCE &amp; GABBANA NOURI-LIP BERRY SCRUB SMOOTHING &amp; MOISTURIZING LIP EXFOLIATOR<\/option><option value='4841043' >DOLCE &amp; GABBANA ORANGE OIL LIP PLUMPER FLASH PLUMPING LIP OIL<\/option><option value='4637232' >DOLCE &amp; GABBANA PAINT ME UP! ALL OVER MULTI-PLAY PIGMENT<\/option><option value='3937419' >DOLCE &amp; GABBANA POUR FEMME EAU DE PARFUM<\/option><option value='3960250' >DOLCE &amp; GABBANA POUR FEMME EAU DE TOILETTE<\/option><option value='3937422' >DOLCE &amp; GABBANA POUR HOMME EAU DE TOILETTE<\/option><option value='4875113' >DOLCE &amp; GABBANA PREP YOUR SKIN FOR A HEALTY GLOW<\/option><option value='4545670' >DOLCE &amp; GABBANA Q BODY LOTION<\/option><option value='3937411' >DOLCE &amp; GABBANA Q EAU DE PARFUM<\/option><option value='4230651' >DOLCE &amp; GABBANA Q EAU DE PARFUM INTENSE<\/option><option value='4284368' >DOLCE &amp; GABBANA Q EAU DE PARFUM REFILL<\/option><option value='5173825' >DOLCE &amp; GABBANA Q ELIXIR<\/option><option value='4610843' >DOLCE &amp; GABBANA Q PARFUM<\/option><option value='4472421' >DOLCE &amp; GABBANA Q REFILLABLE EAU DE PARFUM<\/option><option value='4545751' >DOLCE &amp; GABBANA Q SHOWER GEL<\/option><option value='4627611' >DOLCE &amp; GABBANA RE-BIRTH NIACINAMIDE SERUM REGENERATING &amp; SMOOTHING SERUM<\/option><option value='5234287' >DOLCE &amp; GABBANA ROSE DEW LIP BITE 24H HYDRATING GLOWY LIP TINT<\/option><option value='4397439' >DOLCE &amp; GABBANA ROSE GLOW CUSHION BRIGHTENING &amp; HYDRATING BOUNCY FOUNDATION SPF50 PA++++<\/option><option value='3937462' >DOLCE &amp; GABBANA SICILY EAU DE PARFUM<\/option><option value='4957478' >DOLCE &amp; GABBANA SICILY RE-EDITION 2003 EAU DE PARFUM<\/option><option value='4628365' >DOLCE &amp; GABBANA SLEEK KOHL GLIDER 10H LASTING INTENSE COLOR EYE PENCIL <\/option><option value='4269405' >DOLCE &amp; GABBANA THAT&#039;S MY LINE! 24H LASTING WATERPROOF EYELINER<\/option><option value='4545822' >DOLCE &amp; GABBANA THE ONE BODY LOTION<\/option><option value='3937432' >DOLCE &amp; GABBANA THE ONE EAU DE PARFUM<\/option><option value='5038455&#039;' >DOLCE &amp; GABBANA THE ONE EAU DE PARFUM INTENSE<\/option><option value='4259502' >DOLCE &amp; GABBANA THE ONE GOLD EAU DE PARFUM INTENSE <\/option><option value='4259506' >DOLCE &amp; GABBANA THE ONE GOLD POUR HOMME EAU DE PARFUM INTENSE <\/option><option value='4335695' >DOLCE &amp; GABBANA THE ONE HAIR MIST<\/option><option value='4232420' >DOLCE &amp; GABBANA THE ONE PERFUMED BODY LOTION<\/option><option value='3937433' >DOLCE &amp; GABBANA THE ONE POUR HOMME EAU DE PARFUM<\/option><option value='4210258' >DOLCE &amp; GABBANA THE ONE POUR HOMME EAU DE PARFUM INTENSE<\/option><option value='3937436' >DOLCE &amp; GABBANA THE ONE POUR HOMME EAU DE TOILETTE<\/option><option value='5038467&#039;' >DOLCE &amp; GABBANA THE ONE POUR HOMME PARFUM<\/option><option value='4232546' >DOLCE &amp; GABBANA THE ONE POUR HOMME SHOWER GEL <\/option><option value='4560843&#039;' >DOLCE &amp; GABBANA THE ONE POUR HOMME STICK DEODORANT<\/option><option value='3937443' >DOLCE &amp; GABBANA THE ONLY ONE EAU DE PARFUM<\/option><option value='3960253' >DOLCE &amp; GABBANA THE ONLY ONE EAU DE PARFUM INTENSE<\/option><option value='3960261' >DOLCE &amp; GABBANA VELVET AMBER SKIN EAU DE PARFUM<\/option><option value='4028732' >DOLCE &amp; GABBANA VELVET AMBER SUN EAU DE PARFUM<\/option><option value='3937456' >DOLCE &amp; GABBANA VELVET BLACK PATCHOULI EAU DE PARFUM<\/option><option value='3960266' >DOLCE &amp; GABBANA VELVET BLUE MUSK EAU DE PARFUM<\/option><option value='5173853' >DOLCE &amp; GABBANA VELVET BLUE MUSK SCENTED HAIR MIST<\/option><option value='5173862&#039;' >DOLCE &amp; GABBANA VELVET CRYSTAL SMOKE EAU DE PARFUM<\/option><option value='3937454' >DOLCE &amp; GABBANA VELVET DESERT OUD EAU DE PARFUM<\/option><option value='5173846' >DOLCE &amp; GABBANA VELVET DESERT OUD SCENTED HAIR MIST<\/option><option value='3937458' >DOLCE &amp; GABBANA VELVET DESIRE EAU DE PARFUM<\/option><option value='3937459' >DOLCE &amp; GABBANA VELVET EXOTIC LEATHER EAU DE PARFUM<\/option><option value='4920120' >DOLCE &amp; GABBANA VELVET HONEY SANTAL EAU DE PARFUM<\/option><option value='3960268' >DOLCE &amp; GABBANA VELVET INCENSO EAU DE PARFUM<\/option><option value='4472400' >DOLCE &amp; GABBANA VELVET INFUSION EAU DE PARFUM<\/option><option value='3937451' >DOLCE &amp; GABBANA VELVET MUGHETTO EAU DE PARFUM<\/option><option value='4920155' >DOLCE &amp; GABBANA VELVET PASSION OUD EAU DE PARFUM<\/option><option value='3960281' >DOLCE &amp; GABBANA VELVET ROSE EAU DE PARFUM<\/option><option value='3960259' >DOLCE &amp; GABBANA VELVET TENDER OUD EAU DE PARFUM<\/option><option value='3960274' >DOLCE &amp; GABBANA VELVET VETIVER EAU DE PARFUM<\/option><option value='4472402' >DOLCE &amp; GABBANA VELVET ZAFFERANO EAU DE PARFUM<\/option><option value='4735866' >DOLCE &amp; GABBANA VIOLET LIQUID BLUSH 24H HYDRATION NON-STICKY PH REACTINH<\/option><option value='4841049' >DOLCE &amp; GABBANA WATERMELON OIL LIP PLUMPER FLASH PLUMPING LIP OIL<\/option><option value='4648198' >DOLCE &amp; GABBANA YOUR ESSENTIAL LIP TRIO - MY COMFY MATTE + MY SCUPLT SATIN + MY JUICY SHEER<\/option><option value='5173797&#039;' >DOLCE &amp; GABBANA EVER-YOUTH GOLD PEPTIDES CREAM<\/option><option value='5343341&#039;' >DOLCE &amp; GABBANA NOURI-KISS PETAL LIP PATCHES - PRIMING &amp; PERFECTING LIP GEL PADS<\/option><option value='4295938' >DOLCE &amp; GABBANA EVERFULL XL MASCARA 36H EXTREME VOLUME &amp; LIFT MASCARA (01 TOTAL BLACK)<\/option><option value='4636763' >DOLCE &amp; GABBANA EVERFULL XL MASCARA 36H EXTREME VOLUME &amp; LIFT MASCARA (01 TOTAL BLACK)<\/option><option value='4559897' >DOLCE &amp; GABBANA EVERINK LINER 24H PRECISION LIQUID EYELINER (01 TOTAL BLACK)<\/option><option value='4295939' >DOLCE &amp; GABBANA EVERKISS LIQUID LIP NO TRANSFER SOFT MATTE LIQUID LIPSTICK<\/option><option value='4820168' >DOLCE &amp; GABBANA EVERLAST CONCEALER 24H WEAR CREASE-PROOF HYDRATING <\/option><option value='4374453' >DOLCE &amp; GABBANA EVERLAST FOUNDATION 24H FULL COVERAGE 3D MATTE NO TRANSFER SPF20<\/option><option value='4455074' >DOLCE &amp; GABBANA EVERLAST PRIMER 24H BLURRED MATTE PORE MINIMIZING 2X MAKEUP WEAR<\/option><option value='4295940' >DOLCE &amp; GABBANA EVERLIFT LUMINIZER OIL INFUSED SOFT-HALO POWDER (00 UNIVERSAL LIGHT)<\/option><option value='5173941' >DOLCE &amp; GABBANA EYE DARE YOU! BEYOND MULTI-FINISH EYESHADOW &amp; HIGHLIGHTER PALETTE<\/option><option value='4284393' >DOLCE &amp; GABBANA EYE DARE YOU! MULTI-FINISH EYES &amp; CHEEKS PALETTE<\/option><option value='4346849' >DOLCE &amp; GABBANA FACE&amp;EYES MATCH LASTING BRONZER &amp; EYESHADOW POWDER <\/option><option value='4696892' >DOLCE &amp; GABBANA FEFE&#039; ALCOHOL-FREE FRAGRANCE MIST FOR DOGS<\/option><option value='4316957' >DOLCE &amp; GABBANA FIG SKIN PERFECTOR SHINE CONTROL BLURRING POWDER 00 UNIVERSAL (00 UNIVERSAL)<\/option><option value='5321692' >DOLCE &amp; GABBANA FIND YOUR FLAWLESS LIP SHADE<\/option><option value='4455016' >DOLCE &amp; GABBANA GEMSTONE EYESHADOW PALETTE LIMITED EDITION MULTI-FINISH QUAD (QUARTZ HARMONY)<\/option><option value='4397441' >DOLCE &amp; GABBANA GEMSTONE LIP BALM LIMITED EDITION SPARKLING FINISH (00 DIAMOND)<\/option><option value='4397443' >DOLCE &amp; GABBANA GEMSTONE LIPSTICK LIMITED EDITION SHINE FINISH<\/option><option value='4648525' >DOLCE &amp; GABBANA GET YOUR HEALTHY GLOWY SKIN<\/option><option value='4689798' >DOLCE &amp; GABBANA GET YOUR HEALTHY GLOWY SKIN<\/option><option value='4472453' >DOLCE &amp; GABBANA GLAZELIGHTER GLOWPALESCENT ALL OVER HIGHILIGHTER (00 MULTIVERSAL)<\/option><option value='4627629' >DOLCE &amp; GABBANA GLOW-BOUNCE CERAMIDE CREAM PLUMPING &amp; REFINING MOISTURIZER<\/option><option value='5246915' >DOLCE &amp; GABBANA GLOW-REFRESH BASIL CLEANSER SERUM-TOUCH HYDRATING CLEANSER<\/option><option value='4627607' >DOLCE &amp; GABBANA HYDRA-DOSE HA BOOSTER HYDRATING &amp; BRIGHTENING ESSENCE<\/option><option value='3937429' >DOLCE &amp; GABBANA INTENSO POUR HOMME EAU DE PARFUM<\/option><option value='4839129' >DOLCE &amp; GABBANA IT\u2019S LIT! ALL OVER MICRO HIGHLIGHTER <\/option><option value='3962061' >DOLCE &amp; GABBANA K NOURISHING BEARD OIL<\/option><option value='3937414' >DOLCE &amp; GABBANA K POUR HOMME EAU DE PARFUM<\/option><option value='4230637' >DOLCE &amp; GABBANA K POUR HOMME EAU DE PARFUM INTENSE<\/option><option value='3937416' >DOLCE &amp; GABBANA K POUR HOMME EAU DE TOILETTE<\/option><option value='5173830' >DOLCE &amp; GABBANA K POUR HOMME ELIXIR<\/option><option value='4610834' >DOLCE &amp; GABBANA K POUR HOMME PARFUM<\/option><option value='4545810' >DOLCE &amp; GABBANA K POUR HOMME SHOWER GEL<\/option><option value='4559887' >DOLCE &amp; GABBANA K POUR HOMME STICK DEODORANT<\/option><option value='4000091' >DOLCE &amp; GABBANA K SHOWER GEL <\/option><option value='4609004' >DOLCE &amp; GABBANA KISS MY GLOSS! 4D GLOSS STICK &amp; LIP LINER DUO <\/option><option value='4938532' >DOLCE &amp; GABBANA LIGHT BLUE - EAU DE TOILETTE + POUR HOMME EAU DE TOILETTE<\/option><option value='5038469' >DOLCE &amp; GABBANA LIGHT BLUE BODY LOTION<\/option><option value='4627638' >DOLCE &amp; GABBANA LIGHT BLUE CAPRI IN LOVE EAU DE PARFUM<\/option><option value='5173868' >DOLCE &amp; GABBANA LIGHT BLUE EAU DE PARFUM<\/option><option value='3937468' >DOLCE &amp; GABBANA LIGHT BLUE EAU DE TOILETTE<\/option><option value='3937465' >DOLCE &amp; GABBANA LIGHT BLUE EAU INTENSE EAU DE PARFUM<\/option><option value='3937471' >DOLCE &amp; GABBANA LIGHT BLUE EAU INTENSE POUR HOMME EAU DE PARFUM<\/option><option value='4627646' >DOLCE &amp; GABBANA LIGHT BLUE POUR HOMME CAPRI IN LOVE EAU DE PARFUM<\/option><option value='5060672' >DOLCE &amp; GABBANA CHERRY GLAZE BAR 24H GLOW BLUSH STICK <\/option><option value='4719163' >DOLCE &amp; GABBANA WHAT A GEM! MULTI-WEAR PRECIOUS JEWEL STICKERS<\/option><option value='4559885' >DOLCE &amp; GABBANA DEVOTION POUR HOMME STICK DEODORANT<\/option><option value='4346832' >DOLCE &amp; GABBANA CHEEKS&amp;EYES MATCH LASTING BLUSH &amp; EYESHADOW POWDER  (ALSO REFILL)<\/option><option value='5173877' >DOLCE &amp; GABBANA LIGHT BLUE POUR HOMME EAU DE PARFUM<\/option><option value='4559890' >DOLCE &amp; GABBANA LIGHT BLUE POUR HOMME STICK DEODORANT<\/option><option value='5343341' >DOLCE &amp; GABBANA NOURI-KISS PETAL LIP PATCHES - PRIMING &amp; PERFECTING LIP GEL PADS<\/option><option value='5038455' >DOLCE &amp; GABBANA THE ONE EAU DE PARFUM INTENSE<\/option><option value='5038467' >DOLCE &amp; GABBANA THE ONE POUR HOMME PARFUM<\/option><option value='5173862' >DOLCE &amp; GABBANA VELVET CRYSTAL SMOKE EAU DE PARFUM<\/option><option value='3962045' >DOLCE &amp; GABBANA K AFTER SHAVE BALM<\/option><option value='3962041' >DOLCE &amp; GABBANA K AFTER SHAVE LOTION<\/option><option value='4232538' >DOLCE &amp; GABBANA THE ONE POUR HOMME AFTER SHAVE BALM<\/option><option value='4472437' >DOLCE &amp; GABBANA DEVOTION REFILLABLE EAU DE PARFUM<\/option><option value='4000134' >DOLCE &amp; GABBANA LIGHT BLUE REFRESHING BODY CREAM<\/option><option value='4477800' >DOLCE &amp; GABBANA LIGHT BLUE POUR HOMME REFRESHING SHOWER GEL<\/option><option value='4167591' >DOLCE &amp; GABBANA DEVOTION LIPSTICK NO TRANSFER ROSSETTO LIQUIDO IN MOUSSE<\/option><\/select><\/div><\/div><div id=\"field_6_218\" class=\"gfield gfield--type-multiselect gfield--input-type-multiselect gfield--width-full product_names_dy mw-3\/4 custom-multi-select product-name-prev gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_6_218'>Nom du produit<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_multiselect'><select multiple='multiple'  size='7' name='input_218[]' id='input_6_218' class='large gfield_select'   aria-invalid=\"false\" aria-required=\"true\" ><option value='5060683' >DOLCE &amp; GABBANA ALMOND SCULPT BAR - SOFT CONTOUR FACE &amp; BODY STICK <\/option><option value='4297683' >DOLCE &amp; GABBANA ANIMALIER PALETTE LIMITED EDITION MULTI-FINISH EYESHADOW &amp; FACE POWDERS<\/option><option value='4295937' >DOLCE &amp; GABBANA BERGAMOT GLOW PRIMER LASTING MAKEUP &amp; GLOW ENHANCER<\/option><option value='4646452' >DOLCE &amp; GABBANA BLUEBERRY NUTRI TINT HYDRA-GLOW &amp; FRESH SKIN TINT SPF 20 PA+++ <\/option><option value='4285168' >DOLCE &amp; GABBANA BLUEBERRY NUTRI-TINT HYDRA-GLOW &amp; FRESH SKIN TINT <\/option><option value='4628372' >DOLCE &amp; GABBANA BROW RESTYLER PENCIL 16H LASTING FILL &amp; SHAPE MICRO BROW PENCIL <\/option><option value='4841052' >DOLCE &amp; GABBANA COFFEE OIL LIP PLUMPER FLASH PLUMPING LIP OIL<\/option><option value='4938508' >DOLCE &amp; GABBANA DEVOTION - THE EAU DE PARFUM &amp; THE NEW EAU DE PARFUM POUR HOMME<\/option><option value='4545666' >DOLCE &amp; GABBANA DEVOTION BODY LOTION<\/option><option value='4146446' >DOLCE &amp; GABBANA DEVOTION EAU DE PARFUM<\/option><option value='4968041' >DOLCE &amp; GABBANA DEVOTION - THE EAU DE PARFUM &amp; THE NEW EAU DE PARFUM INTENSE<\/option><option value='4472381' >DOLCE &amp; GABBANA DEVOTION EAU DE PARFUM INTENSE<\/option><option value='4284366' >DOLCE &amp; GABBANA DEVOTION EAU DE PARFUM REFILL<\/option><option value='4167590' >DOLCE &amp; GABBANA DEVOTION LUMINIZER ILLUMINANTE VISO OIL IN POWDER LUMINIZER (00 LUCE UNIVERSALE)<\/option><option value='4167593' >DOLCE &amp; GABBANA DEVOTION MASCARA VOLUME ESTREMO VOLUME &amp; LIFT MASCARA (01 ULTRA NERO)<\/option><option value='4346215' >DOLCE &amp; GABBANA DEVOTION POUR HOMME EAU DE PARFUM<\/option><option value='4827070' >DOLCE &amp; GABBANA DEVOTION POUR HOMME PARFUM<\/option><option value='4545741' >DOLCE &amp; GABBANA DEVOTION POUR HOMME SHOWER GEL<\/option><option value='4559885&#039;' >DOLCE &amp; GABBANA DEVOTION POUR HOMME STICK DEODORANT<\/option><option value='4615484' >DOLCE &amp; GABBANA DEVOTION RICH BODY CREAM<\/option><option value='4545747' >DOLCE &amp; GABBANA DEVOTION SHOWER GEL<\/option><option value='4259512' >DOLCE &amp; GABBANA DG VIB3 EAU DE PARFUM<\/option><option value='4613511' >DOLCE &amp; GABBANA DOLCE ALCOHOL-FREE PERFUME GEL<\/option><option value='4613531' >DOLCE &amp; GABBANA DOLCE BLUE JASMINE ALCOHOL-FREE PERFUME GEL<\/option><option value='4230608' >DOLCE &amp; GABBANA DOLCE BLUE JASMINE EAU DE PARFUM<\/option><option value='4028723' >DOLCE &amp; GABBANA DOLCE EAU DE PARFUM <\/option><option value='4028727' >DOLCE &amp; GABBANA DOLCE GARDEN EAU DE PARFUM<\/option><option value='4000112' >DOLCE &amp; GABBANA DOLCE LILY EAU DE TOILETTE<\/option><option value='5173865' >DOLCE &amp; GABBANA DOLCE MAGNOLIA EAU DE PARFUM<\/option><option value='4000099' >DOLCE &amp; GABBANA DOLCE PEONY EAU DE PARFUM <\/option><option value='4028729' >DOLCE &amp; GABBANA DOLCE ROSE EAU DE TOILETTE<\/option><option value='4000107' >DOLCE &amp; GABBANA DOLCE SHINE EAU DE PARFUM<\/option><option value='4613515' >DOLCE &amp; GABBANA DOLCE VIOLET ALCOHOL-FREE PERFUME GEL<\/option><option value='3937407' >DOLCE &amp; GABBANA DOLCE VIOLET EAU DE TOILETTE<\/option><option value='4926612' >DOLCE &amp; GABBANA EVER ICON EYE PALETTE 10H MULTI-FINISH DAY TO NIGHT EYESHADOWS <\/option><option value='4559883' >DOLCE &amp; GABBANA EVERFULL HI-DEFINITION MASCARA 36H DEFINED VOLUME &amp; LENGTH MASCARA (01 TOTAL BLACK)<\/option><option value='5173877&#039;' >DOLCE &amp; GABBANA LIGHT BLUE POUR HOMME EAU DE PARFUM<\/option><option value='3960291' >DOLCE &amp; GABBANA LIGHT BLUE POUR HOMME EAU DE TOILETTE<\/option><option value='4620788' >DOLCE &amp; GABBANA LIGHT BLUE POUR HOMME SHOWER GEL<\/option><option value='4559890&#039;' >DOLCE &amp; GABBANA LIGHT BLUE POUR HOMME STICK DEODORANT<\/option><option value='3960296' >DOLCE &amp; GABBANA LIGHT BLUE SUMMER VIBES EAU DE TOILETTE<\/option><option value='3960304' >DOLCE &amp; GABBANA LIGHT BLUE SUMMER VIBES POUR HOMME EAU DE TOILETTE<\/option><option value='3937446' >DOLCE &amp; GABBANA L&#039;IMPERATRICE EAU DE TOILETTE<\/option><option value='4472413' >DOLCE &amp; GABBANA L&#039;IMPERATRICE ROYALE EAU DE TOILETTE<\/option><option value='4926597' >DOLCE &amp; GABBANA MASCULINE RE-EDITION 1999 EAU DE PARFUM<\/option><option value='4631312' >DOLCE &amp; GABBANA MEET YOUR FLAWLESS MATTE SKIN DUO<\/option><option value='4938125' >DOLCE &amp; GABBANA MEET YOUR NEW FLAWLESS SKIN HERO<\/option><option value='4285175' >DOLCE &amp; GABBANA MINT OIL LIP PLUMPER FLASH PLUMPING LIP OIL<\/option><option value='4472857' >DOLCE &amp; GABBANA MY COMFY MATTE INSTANT RICH COLOR &amp; HYDRATION LIP STYLO <\/option><option value='4968021' >DOLCE &amp; GABBANA MY DEVOTION EAU DE PARFUM INTENSE<\/option><option value='4472495' >DOLCE &amp; GABBANA MY JUICY SHEER INSTANT SHINE &amp; HYDRATION LIP STYLO<\/option><option value='4628359' >DOLCE &amp; GABBANA MY LIP OVERLINER 8H LASTING EASY GLIDE SCULPTING LIP PENCIL<\/option><option value='4879853' >DOLCE &amp; GABBANA MY NAIL GLOSS 3D GLOSSY TOP COAT<\/option><option value='4879851' >DOLCE &amp; GABBANA MY NAIL MATCH QUICK DRY LASTING NAIL LACQUER<\/option><option value='4472478' >DOLCE &amp; GABBANA MY SCULPT SATIN LASTING COLOR &amp; HYDRATION LIP STYLO <\/option><option value='4472459' >DOLCE &amp; GABBANA NAILED IT! QUICK DRY LASTING NAIL LACQUER <\/option><option value='4627614' >DOLCE &amp; GABBANA NO-PUFF CAFFEINE EYE PATCHES DEPUFFING &amp; BRIGHTENING EYE GEL PADS<\/option><option value='4627692' >DOLCE &amp; GABBANA NOURI-LIP BERRY SCRUB SMOOTHING &amp; MOISTURIZING LIP EXFOLIATOR<\/option><option value='4841043' >DOLCE &amp; GABBANA ORANGE OIL LIP PLUMPER FLASH PLUMPING LIP OIL<\/option><option value='4637232' >DOLCE &amp; GABBANA PAINT ME UP! ALL OVER MULTI-PLAY PIGMENT<\/option><option value='3937419' >DOLCE &amp; GABBANA POUR FEMME EAU DE PARFUM<\/option><option value='3960250' >DOLCE &amp; GABBANA POUR FEMME EAU DE TOILETTE<\/option><option value='3937422' >DOLCE &amp; GABBANA POUR HOMME EAU DE TOILETTE<\/option><option value='4875113' >DOLCE &amp; GABBANA PREP YOUR SKIN FOR A HEALTY GLOW<\/option><option value='4545670' >DOLCE &amp; GABBANA Q BODY LOTION<\/option><option value='3937411' >DOLCE &amp; GABBANA Q EAU DE PARFUM<\/option><option value='4230651' >DOLCE &amp; GABBANA Q EAU DE PARFUM INTENSE<\/option><option value='4284368' >DOLCE &amp; GABBANA Q EAU DE PARFUM REFILL<\/option><option value='5173825' >DOLCE &amp; GABBANA Q ELIXIR<\/option><option value='4610843' >DOLCE &amp; GABBANA Q PARFUM<\/option><option value='4472421' >DOLCE &amp; GABBANA Q REFILLABLE EAU DE PARFUM<\/option><option value='4545751' >DOLCE &amp; GABBANA Q SHOWER GEL<\/option><option value='4627611' >DOLCE &amp; GABBANA RE-BIRTH NIACINAMIDE SERUM REGENERATING &amp; SMOOTHING SERUM<\/option><option value='5234287' >DOLCE &amp; GABBANA ROSE DEW LIP BITE 24H HYDRATING GLOWY LIP TINT<\/option><option value='4397439' >DOLCE &amp; GABBANA ROSE GLOW CUSHION BRIGHTENING &amp; HYDRATING BOUNCY FOUNDATION SPF50 PA++++<\/option><option value='3937462' >DOLCE &amp; GABBANA SICILY EAU DE PARFUM<\/option><option value='4957478' >DOLCE &amp; GABBANA SICILY RE-EDITION 2003 EAU DE PARFUM<\/option><option value='4628365' >DOLCE &amp; GABBANA SLEEK KOHL GLIDER 10H LASTING INTENSE COLOR EYE PENCIL <\/option><option value='4269405' >DOLCE &amp; GABBANA THAT&#039;S MY LINE! 24H LASTING WATERPROOF EYELINER<\/option><option value='4545822' >DOLCE &amp; GABBANA THE ONE BODY LOTION<\/option><option value='3937432' >DOLCE &amp; GABBANA THE ONE EAU DE PARFUM<\/option><option value='5038455&#039;' >DOLCE &amp; GABBANA THE ONE EAU DE PARFUM INTENSE<\/option><option value='4259502' >DOLCE &amp; GABBANA THE ONE GOLD EAU DE PARFUM INTENSE <\/option><option value='4259506' >DOLCE &amp; GABBANA THE ONE GOLD POUR HOMME EAU DE PARFUM INTENSE <\/option><option value='4335695' >DOLCE &amp; GABBANA THE ONE HAIR MIST<\/option><option value='4232420' >DOLCE &amp; GABBANA THE ONE PERFUMED BODY LOTION<\/option><option value='3937433' >DOLCE &amp; GABBANA THE ONE POUR HOMME EAU DE PARFUM<\/option><option value='4210258' >DOLCE &amp; GABBANA THE ONE POUR HOMME EAU DE PARFUM INTENSE<\/option><option value='3937436' >DOLCE &amp; GABBANA THE ONE POUR HOMME EAU DE TOILETTE<\/option><option value='5038467&#039;' >DOLCE &amp; GABBANA THE ONE POUR HOMME PARFUM<\/option><option value='4232546' >DOLCE &amp; GABBANA THE ONE POUR HOMME SHOWER GEL <\/option><option value='4560843&#039;' >DOLCE &amp; GABBANA THE ONE POUR HOMME STICK DEODORANT<\/option><option value='3937443' >DOLCE &amp; GABBANA THE ONLY ONE EAU DE PARFUM<\/option><option value='3960253' >DOLCE &amp; GABBANA THE ONLY ONE EAU DE PARFUM INTENSE<\/option><option value='3960261' >DOLCE &amp; GABBANA VELVET AMBER SKIN EAU DE PARFUM<\/option><option value='4028732' >DOLCE &amp; GABBANA VELVET AMBER SUN EAU DE PARFUM<\/option><option value='3937456' >DOLCE &amp; GABBANA VELVET BLACK PATCHOULI EAU DE PARFUM<\/option><option value='3960266' >DOLCE &amp; GABBANA VELVET BLUE MUSK EAU DE PARFUM<\/option><option value='5173853' >DOLCE &amp; GABBANA VELVET BLUE MUSK SCENTED HAIR MIST<\/option><option value='5173862&#039;' >DOLCE &amp; GABBANA VELVET CRYSTAL SMOKE EAU DE PARFUM<\/option><option value='3937454' >DOLCE &amp; GABBANA VELVET DESERT OUD EAU DE PARFUM<\/option><option value='5173846' >DOLCE &amp; GABBANA VELVET DESERT OUD SCENTED HAIR MIST<\/option><option value='3937458' >DOLCE &amp; GABBANA VELVET DESIRE EAU DE PARFUM<\/option><option value='3937459' >DOLCE &amp; GABBANA VELVET EXOTIC LEATHER EAU DE PARFUM<\/option><option value='4920120' >DOLCE &amp; GABBANA VELVET HONEY SANTAL EAU DE PARFUM<\/option><option value='3960268' >DOLCE &amp; GABBANA VELVET INCENSO EAU DE PARFUM<\/option><option value='4472400' >DOLCE &amp; GABBANA VELVET INFUSION EAU DE PARFUM<\/option><option value='3937451' >DOLCE &amp; GABBANA VELVET MUGHETTO EAU DE PARFUM<\/option><option value='4920155' >DOLCE &amp; GABBANA VELVET PASSION OUD EAU DE PARFUM<\/option><option value='3960281' >DOLCE &amp; GABBANA VELVET ROSE EAU DE PARFUM<\/option><option value='3960259' >DOLCE &amp; GABBANA VELVET TENDER OUD EAU DE PARFUM<\/option><option value='3960274' >DOLCE &amp; GABBANA VELVET VETIVER EAU DE PARFUM<\/option><option value='4472402' >DOLCE &amp; GABBANA VELVET ZAFFERANO EAU DE PARFUM<\/option><option value='4735866' >DOLCE &amp; GABBANA VIOLET LIQUID BLUSH 24H HYDRATION NON-STICKY PH REACTINH<\/option><option value='4841049' >DOLCE &amp; GABBANA WATERMELON OIL LIP PLUMPER FLASH PLUMPING LIP OIL<\/option><option value='4648198' >DOLCE &amp; GABBANA YOUR ESSENTIAL LIP TRIO - MY COMFY MATTE + MY SCUPLT SATIN + MY JUICY SHEER<\/option><option value='5173797&#039;' >DOLCE &amp; GABBANA EVER-YOUTH GOLD PEPTIDES CREAM<\/option><option value='5343341&#039;' >DOLCE &amp; GABBANA NOURI-KISS PETAL LIP PATCHES - PRIMING &amp; PERFECTING LIP GEL PADS<\/option><option value='4295938' >DOLCE &amp; GABBANA EVERFULL XL MASCARA 36H EXTREME VOLUME &amp; LIFT MASCARA (01 TOTAL BLACK)<\/option><option value='4636763' >DOLCE &amp; GABBANA EVERFULL XL MASCARA 36H EXTREME VOLUME &amp; LIFT MASCARA (01 TOTAL BLACK)<\/option><option value='4559897' >DOLCE &amp; GABBANA EVERINK LINER 24H PRECISION LIQUID EYELINER (01 TOTAL BLACK)<\/option><option value='4295939' >DOLCE &amp; GABBANA EVERKISS LIQUID LIP NO TRANSFER SOFT MATTE LIQUID LIPSTICK<\/option><option value='4820168' >DOLCE &amp; GABBANA EVERLAST CONCEALER 24H WEAR CREASE-PROOF HYDRATING <\/option><option value='4374453' >DOLCE &amp; GABBANA EVERLAST FOUNDATION 24H FULL COVERAGE 3D MATTE NO TRANSFER SPF20<\/option><option value='4455074' >DOLCE &amp; GABBANA EVERLAST PRIMER 24H BLURRED MATTE PORE MINIMIZING 2X MAKEUP WEAR<\/option><option value='4295940' >DOLCE &amp; GABBANA EVERLIFT LUMINIZER OIL INFUSED SOFT-HALO POWDER (00 UNIVERSAL LIGHT)<\/option><option value='5173941' >DOLCE &amp; GABBANA EYE DARE YOU! BEYOND MULTI-FINISH EYESHADOW &amp; HIGHLIGHTER PALETTE<\/option><option value='4284393' >DOLCE &amp; GABBANA EYE DARE YOU! MULTI-FINISH EYES &amp; CHEEKS PALETTE<\/option><option value='4346849' >DOLCE &amp; GABBANA FACE&amp;EYES MATCH LASTING BRONZER &amp; EYESHADOW POWDER <\/option><option value='4696892' >DOLCE &amp; GABBANA FEFE&#039; ALCOHOL-FREE FRAGRANCE MIST FOR DOGS<\/option><option value='4316957' >DOLCE &amp; GABBANA FIG SKIN PERFECTOR SHINE CONTROL BLURRING POWDER 00 UNIVERSAL (00 UNIVERSAL)<\/option><option value='5321692' >DOLCE &amp; GABBANA FIND YOUR FLAWLESS LIP SHADE<\/option><option value='4455016' >DOLCE &amp; GABBANA GEMSTONE EYESHADOW PALETTE LIMITED EDITION MULTI-FINISH QUAD (QUARTZ HARMONY)<\/option><option value='4397441' >DOLCE &amp; GABBANA GEMSTONE LIP BALM LIMITED EDITION SPARKLING FINISH (00 DIAMOND)<\/option><option value='4397443' >DOLCE &amp; GABBANA GEMSTONE LIPSTICK LIMITED EDITION SHINE FINISH<\/option><option value='4648525' >DOLCE &amp; GABBANA GET YOUR HEALTHY GLOWY SKIN<\/option><option value='4689798' >DOLCE &amp; GABBANA GET YOUR HEALTHY GLOWY SKIN<\/option><option value='4472453' >DOLCE &amp; GABBANA GLAZELIGHTER GLOWPALESCENT ALL OVER HIGHILIGHTER (00 MULTIVERSAL)<\/option><option value='4627629' >DOLCE &amp; GABBANA GLOW-BOUNCE CERAMIDE CREAM PLUMPING &amp; REFINING MOISTURIZER<\/option><option value='5246915' >DOLCE &amp; GABBANA GLOW-REFRESH BASIL CLEANSER SERUM-TOUCH HYDRATING CLEANSER<\/option><option value='4627607' >DOLCE &amp; GABBANA HYDRA-DOSE HA BOOSTER HYDRATING &amp; BRIGHTENING ESSENCE<\/option><option value='3937429' >DOLCE &amp; GABBANA INTENSO POUR HOMME EAU DE PARFUM<\/option><option value='4839129' >DOLCE &amp; GABBANA IT\u2019S LIT! ALL OVER MICRO HIGHLIGHTER <\/option><option value='3962061' >DOLCE &amp; GABBANA K NOURISHING BEARD OIL<\/option><option value='3937414' >DOLCE &amp; GABBANA K POUR HOMME EAU DE PARFUM<\/option><option value='4230637' >DOLCE &amp; GABBANA K POUR HOMME EAU DE PARFUM INTENSE<\/option><option value='3937416' >DOLCE &amp; GABBANA K POUR HOMME EAU DE TOILETTE<\/option><option value='5173830' >DOLCE &amp; GABBANA K POUR HOMME ELIXIR<\/option><option value='4610834' >DOLCE &amp; GABBANA K POUR HOMME PARFUM<\/option><option value='4545810' >DOLCE &amp; GABBANA K POUR HOMME SHOWER GEL<\/option><option value='4559887' >DOLCE &amp; GABBANA K POUR HOMME STICK DEODORANT<\/option><option value='4000091' >DOLCE &amp; GABBANA K SHOWER GEL <\/option><option value='4609004' >DOLCE &amp; GABBANA KISS MY GLOSS! 4D GLOSS STICK &amp; LIP LINER DUO <\/option><option value='4938532' >DOLCE &amp; GABBANA LIGHT BLUE - EAU DE TOILETTE + POUR HOMME EAU DE TOILETTE<\/option><option value='5038469' >DOLCE &amp; GABBANA LIGHT BLUE BODY LOTION<\/option><option value='4627638' >DOLCE &amp; GABBANA LIGHT BLUE CAPRI IN LOVE EAU DE PARFUM<\/option><option value='5173868' >DOLCE &amp; GABBANA LIGHT BLUE EAU DE PARFUM<\/option><option value='3937468' >DOLCE &amp; GABBANA LIGHT BLUE EAU DE TOILETTE<\/option><option value='3937465' >DOLCE &amp; GABBANA LIGHT BLUE EAU INTENSE EAU DE PARFUM<\/option><option value='3937471' >DOLCE &amp; GABBANA LIGHT BLUE EAU INTENSE POUR HOMME EAU DE PARFUM<\/option><option value='4627646' >DOLCE &amp; GABBANA LIGHT BLUE POUR HOMME CAPRI IN LOVE EAU DE PARFUM<\/option><option value='5060672' >DOLCE &amp; GABBANA CHERRY GLAZE BAR 24H GLOW BLUSH STICK <\/option><option value='4719163' >DOLCE &amp; GABBANA WHAT A GEM! MULTI-WEAR PRECIOUS JEWEL STICKERS<\/option><option value='4559885' >DOLCE &amp; GABBANA DEVOTION POUR HOMME STICK DEODORANT<\/option><option value='4346832' >DOLCE &amp; GABBANA CHEEKS&amp;EYES MATCH LASTING BLUSH &amp; EYESHADOW POWDER  (ALSO REFILL)<\/option><option value='5173877' >DOLCE &amp; GABBANA LIGHT BLUE POUR HOMME EAU DE PARFUM<\/option><option value='4559890' >DOLCE &amp; GABBANA LIGHT BLUE POUR HOMME STICK DEODORANT<\/option><option value='5343341' >DOLCE &amp; GABBANA NOURI-KISS PETAL LIP PATCHES - PRIMING &amp; PERFECTING LIP GEL PADS<\/option><option value='5038455' >DOLCE &amp; GABBANA THE ONE EAU DE PARFUM INTENSE<\/option><option value='5038467' >DOLCE &amp; GABBANA THE ONE POUR HOMME PARFUM<\/option><option value='5173862' >DOLCE &amp; GABBANA VELVET CRYSTAL SMOKE EAU DE PARFUM<\/option><option value='3962045' >DOLCE &amp; GABBANA K AFTER SHAVE BALM<\/option><option value='3962041' >DOLCE &amp; GABBANA K AFTER SHAVE LOTION<\/option><option value='4232538' >DOLCE &amp; GABBANA THE ONE POUR HOMME AFTER SHAVE BALM<\/option><option value='4472437' >DOLCE &amp; GABBANA DEVOTION REFILLABLE EAU DE PARFUM<\/option><option value='4000134' >DOLCE &amp; GABBANA LIGHT BLUE REFRESHING BODY CREAM<\/option><option value='4477800' >DOLCE &amp; GABBANA LIGHT BLUE POUR HOMME REFRESHING SHOWER GEL<\/option><option value='4167591' >DOLCE &amp; GABBANA DEVOTION LIPSTICK NO TRANSFER ROSSETTO LIQUIDO IN MOUSSE<\/option><\/select><\/div><\/div><div id=\"field_6_177\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full brand_names_dy mw-3\/4 custom-multi-select brand-name gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_177'>Nom de la marque<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_177' id='input_6_177' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Tapez\/s\u00e9lectionnez le nom de la marque<\/option><option value='Dolce &amp; Gabbana' >Dolce &amp; Gabbana<\/option><\/select><\/div><\/div><div id=\"field_6_219\" class=\"gfield gfield--type-multiselect gfield--input-type-multiselect gfield--width-full brand_names_dy mw-3\/4 custom-multi-select brand-name-prev gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_6_219'>Nom de la marque<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_multiselect'><select multiple='multiple'  size='7' name='input_219[]' id='input_6_219' class='large gfield_select'   aria-invalid=\"false\" aria-required=\"true\" ><option value='Dolce &amp; Gabbana' >Dolce &amp; Gabbana<\/option><\/select><\/div><\/div><div id=\"field_6_126\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full batch-no mw-3\/4 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_126'>Produit N\u00b0 de lot<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_126' id='input_6_126' type='text' value='' class='large' maxlength='20'   placeholder='Ajouter le num\u00e9ro de lot du produit' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_26\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full retailer-name mw-3\/4 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_26'>Nom du magasin<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_6_26' type='text' value='' class='large' maxlength='50'   placeholder='Ajouter un nom de magasin' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_27\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full retailer-address mw-3\/4 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_27'>Adresse d&#039;achat<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_6_27' type='text' value='' class='large' maxlength='100'   placeholder='Ajouter une adresse d&#039;achat' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_29\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full retailer-city mw-1\/2 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_29'>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_29' id='input_6_29' type='text' value='' class='large' maxlength='100'   placeholder='Ajouter une ville' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_6_178\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full first-use mw-3\/4 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Premi\u00e8re utilisation ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_178'>\n\t\t\t<div class='gchoice gchoice_6_178_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_178' type='radio' value='Yes'  id='choice_6_178_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_178_0' id='label_6_178_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_178_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_178' type='radio' value='No'  id='choice_6_178_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_178_1' id='label_6_178_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_179\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full frequency-of-use mw-3\/4 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_179'>Fr\u00e9quence d&#039;utilisation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_179' id='input_6_179' type='text' value='' class='large' maxlength='20'   placeholder='Ajouter des d\u00e9tails' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_180\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half period-of-use period-of-use__start-date gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_180'>P\u00e9riode d&#039;utilisation ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_6_180'>Veuillez saisir la date au format MM\/JJ\/AAAA.<\/div><div class='ginput_container ginput_container_date'>\n                            <input name='input_180' id='input_6_180' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='Date de d\u00e9but' aria-describedby=\"input_6_180_date_format gfield_description_6_180\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_6_180_date_format' class='screen-reader-text'>MM slash JJ slash AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_6_180' class='gform_hidden' value='https:\/\/www.aers.me\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_6_181\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half period-of-use period-of-use__end-date gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_181'>P\u00e9riode d&#039;utilisation -- date de fin<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_6_181'>Veuillez saisir la date au format MM\/JJ\/AAAA.<\/div><div class='ginput_container ginput_container_date'>\n                            <input name='input_181' id='input_6_181' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='Date de fin' aria-describedby=\"input_6_181_date_format gfield_description_6_181\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_6_181_date_format' class='screen-reader-text'>MM slash JJ slash AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_6_181' class='gform_hidden' value='https:\/\/www.aers.me\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_6_109\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half first-use-date gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_6_109'>Date de la premi\u00e8re utilisation ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_6_109'><em>Veuillez saisir la date au format MM\/JJ\/AAAA.<\/em><\/div><div class='ginput_container ginput_container_text'><input name='input_109' id='input_6_109' type='text' value='' class='large'  aria-describedby=\"gfield_description_6_109\"  placeholder='MM\/JJ\/AAAA' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_110\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half last-use-date gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='input_6_110'>Date de la derni\u00e8re utilisation ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_6_110'><em>Veuillez saisir la date au format MM\/JJ\/AAAA.<\/em><\/div><div class='ginput_container ginput_container_text'><input name='input_110' id='input_6_110' type='text' value='' class='large'  aria-describedby=\"gfield_description_6_110\"  placeholder='MM\/JJ\/AAAA' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_6_182\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >L&#039;application du produit cosm\u00e9tique a-t-elle \u00e9t\u00e9 suspendue ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_182'>\n\t\t\t<div class='gchoice gchoice_6_182_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_182' type='radio' value='Yes'  id='choice_6_182_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_182_0' id='label_6_182_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_182_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_182' type='radio' value='No'  id='choice_6_182_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_182_1' id='label_6_182_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_183\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full frequency-of-use flat-field gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_183'>Jours \u00e9coul\u00e9s entre l&#039;application et l&#039;apparition des sympt\u00f4mes<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_183' id='input_6_183' type='text' value='' class='large'    placeholder='Ajouter des d\u00e9tails' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_6_184\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >La r\u00e9action s&#039;est-elle am\u00e9lior\u00e9e apr\u00e8s la suspension de l&#039;application ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_184'>\n\t\t\t<div class='gchoice gchoice_6_184_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_184' type='radio' value='Yes'  id='choice_6_184_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_184_0' id='label_6_184_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_184_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_184' type='radio' value='No'  id='choice_6_184_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_184_1' id='label_6_184_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_6_185\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Avez-vous r\u00e9appliqu\u00e9 le produit ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_185'>\n\t\t\t<div class='gchoice gchoice_6_185_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_185' type='radio' value='Yes'  id='choice_6_185_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_185_0' id='label_6_185_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_185_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_185' type='radio' value='No'  id='choice_6_185_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_185_1' id='label_6_185_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_6_186\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Les sympt\u00f4mes sont-ils r\u00e9apparus apr\u00e8s la r\u00e9application du produit cosm\u00e9tique ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_186'>\n\t\t\t<div class='gchoice gchoice_6_186_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_186' type='radio' value='Yes'  id='choice_6_186_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_186_0' id='label_6_186_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_186_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_186' type='radio' value='No'  id='choice_6_186_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_186_1' id='label_6_186_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_187\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full textarea-h-88 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_187'>Type d&#039;utilisation ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_187' id='input_6_187' class='textarea large'   maxlength='4000' placeholder='Ajoutez les d\u00e9tails ici' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_6_188\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Pendant que vous utilisiez le produit cosm\u00e9tique, avez-vous utilis\u00e9 ou pris d&#039;autres produits (tels que des m\u00e9dicaments, d&#039;autres produits \u00e0 base de plantes, des plantes m\u00e9dicinales, de l&#039;hom\u00e9opathie, des compl\u00e9ments alimentaires, d&#039;autres cosm\u00e9tiques, des produits m\u00e9nagers, des tatouages, etc...) ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_188'>\n\t\t\t<div class='gchoice gchoice_6_188_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_188' type='radio' value='Yes'  id='choice_6_188_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_188_0' id='label_6_188_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_188_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_188' type='radio' value='No'  id='choice_6_188_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_188_1' id='label_6_188_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_189\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full textarea-h-88 mt-16neg gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_189'>Si oui, veuillez pr\u00e9ciser -<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_189' id='input_6_189' class='textarea large'   maxlength='4000' placeholder='Ajoutez les d\u00e9tails ici' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_6_190\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Avez-vous d&#039;autres maladies ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_190'>\n\t\t\t<div class='gchoice gchoice_6_190_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_190' type='radio' value='Yes'  id='choice_6_190_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_190_0' id='label_6_190_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_190_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_190' type='radio' value='No'  id='choice_6_190_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_190_1' id='label_6_190_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_191\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full textarea-h-88 mt-16neg gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_191'>Si oui, veuillez pr\u00e9ciser -<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_191' id='input_6_191' class='textarea large'   maxlength='4000' placeholder='Ajoutez les d\u00e9tails ici' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_6_192\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >M\u00e9decins et informations pertinentes concernant l&#039;utilisation ant\u00e9rieure de produits cosm\u00e9tiques (par exemple, allergie, r\u00e9action ant\u00e9rieure \u00e0 l&#039;utilisation d&#039;un produit cosm\u00e9tique, etc...)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_192'>\n\t\t\t<div class='gchoice gchoice_6_192_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_192' type='radio' value='Yes'  id='choice_6_192_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_192_0' id='label_6_192_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_192_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_192' type='radio' value='No'  id='choice_6_192_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_192_1' id='label_6_192_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_193\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full textarea-h-60 mt-16neg gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_193'>Si oui, veuillez pr\u00e9ciser -<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_193' id='input_6_193' class='textarea large'   maxlength='4000' placeholder='Ajoutez les d\u00e9tails ici' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_50' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Retour'  \/> <input type='button' id='gform_next_button_6_50' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Suivant'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_3' class='gform_page form_page page_name_events' data-js='page-field-id-50' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_3' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_6_79\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Description de la r\u00e9action et conseils m\u00e9dicaux<\/h3><\/div><div id=\"field_6_194\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full mw-1\/2 gfield--show-description gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_194'>D\u00e9but de la r\u00e9action<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_194' id='input_6_194' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='MM\/JJ\/AAAA' aria-describedby=\"input_6_194_date_format gfield_description_6_194\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_6_194_date_format' class='screen-reader-text'>MM slash JJ slash AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_6_194' class='gform_hidden' value='https:\/\/www.aers.me\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><div class='gfield_description' id='gfield_description_6_194'>Veuillez saisir la date au format MM\/JJ\/AAAA.<\/div><\/div><div id=\"field_6_203\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full duration-of-reaction duration-of-reaction__label gfield_label gform-field-label gfield_html gfield_html_formatted field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div>Dur\u00e9e de la r\u00e9action :<\/div><\/div><div id=\"field_6_199\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full duration-of-reaction duration-of-reaction__hours field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_199'>Heures<\/label><div class='ginput_container ginput_container_text'><input name='input_199' id='input_6_199' type='text' value='' class='large'    placeholder='0'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_200\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full duration-of-reaction duration-of-reaction__days field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_200'>Jours<\/label><div class='ginput_container ginput_container_text'><input name='input_200' id='input_6_200' type='text' value='' class='large'    placeholder='0'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_201\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full duration-of-reaction duration-of-reaction__weeks field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_201'>Semaines<\/label><div class='ginput_container ginput_container_text'><input name='input_201' id='input_6_201' type='text' value='' class='large'    placeholder='0'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_6_195\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >La r\u00e9action est-elle toujours en cours ?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_195'>\n\t\t\t<div class='gchoice gchoice_6_195_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_195' type='radio' value='Yes'  id='choice_6_195_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_195_0' id='label_6_195_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_195_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_195' type='radio' value='No'  id='choice_6_195_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_195_1' id='label_6_195_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_6_196\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >La r\u00e9action est-elle r\u00e9solue ?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_196'>\n\t\t\t<div class='gchoice gchoice_6_196_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_196' type='radio' value='Yes'  id='choice_6_196_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_196_0' id='label_6_196_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_196_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_196' type='radio' value='No'  id='choice_6_196_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_196_1' id='label_6_196_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_197\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full mw-1\/2 flat-field gfield--show-description gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_197'>si oui, date de cessation de la r\u00e9action<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_197' id='input_6_197' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='MM\/JJ\/AAAA' aria-describedby=\"input_6_197_date_format gfield_description_6_197\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_6_197_date_format' class='screen-reader-text'>MM slash JJ slash AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_6_197' class='gform_hidden' value='https:\/\/www.aers.me\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><div class='gfield_description' id='gfield_description_6_197'>Veuillez saisir la date au format MM\/JJ\/AAAA.<\/div><\/div><div id=\"field_6_220\" class=\"gfield gfield--type-multiselect gfield--input-type-multiselect gfield--width-full flat-field mw-1\/2 custom-multi-select reaction-zone field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_220'>Zone de r\u00e9action :<\/label><div class='ginput_container ginput_container_multiselect'><select multiple='multiple'  size='7' name='input_220[]' id='input_6_220' class='large gfield_select'   aria-invalid=\"false\"  ><option value='Scalp' >Cuir chevelu<\/option><option value='Cheeks' >Joues<\/option><option value='Armpits' >Aisselles<\/option><option value='Thighs' >Cuisses<\/option><option value='Foot' >Pied<\/option><option value='Neck' >Cou<\/option><option value='Abdomen' >Abdomen<\/option><option value='Arm' >Bras<\/option><option value='Forearm' >Avant-bras<\/option><option value='Hand' >La main<\/option><option value='Front' >Partie avant du corps<\/option><option value='Outline mouth' >Contour de la bouche<\/option><option value='Torso' >Torse<\/option><option value='Legs' >Jambes<\/option><option value='Superior eyelid' >Paupi\u00e8re sup\u00e9rieure<\/option><option value='Inferior eyelid &amp; Mucous' >Paupi\u00e8re inf\u00e9rieure et muqueuse<\/option><\/select><\/div><\/div><div id=\"field_6_204\" class=\"gfield gfield--type-section gfield--input-type-section gsection mt-4 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">En cas d&#039;avis m\u00e9dical<\/h3><\/div><div id=\"field_6_207\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_207'>Nom du m\u00e9decin<\/label><div class='ginput_container ginput_container_text'><input name='input_207' id='input_6_207' type='text' value='' class='large' maxlength='50'   placeholder='Ajouter le nom du m\u00e9decin'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_208\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_208'>Adresse du m\u00e9decin<\/label><div class='ginput_container ginput_container_text'><input name='input_208' id='input_6_208' type='text' value='' class='large' maxlength='75'   placeholder='Ajouter l&#039;adresse du m\u00e9decin'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_205\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full mw-1\/2 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_205'>Courriel du m\u00e9decin<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_205' id='input_6_205' type='email' value='' class='large'   placeholder='Ajouter l&#039;adresse \u00e9lectronique du m\u00e9decin'  aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_6_206\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full mw-1\/2 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_206'>T\u00e9l\u00e9phone du m\u00e9decin<\/label><div class='ginput_container ginput_container_text'><input name='input_206' id='input_6_206' type='text' value='' class='large' maxlength='25'   placeholder='0000000000'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_15\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full textarea-h-60 field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_15'>Diagnostic m\u00e9dical et test d&#039;allergie :<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_15' id='input_6_15' class='textarea large'   maxlength='2900' placeholder='Ajoutez les d\u00e9tails ici'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_6_209\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full mw-1\/2 gfield--show-description field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_209'>Date du diagnostic m\u00e9dical<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_209' id='input_6_209' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='MM\/JJ\/AAAA' aria-describedby=\"input_6_209_date_format gfield_description_6_209\" aria-invalid=\"false\" \/>\n                            <span id='input_6_209_date_format' class='screen-reader-text'>MM slash JJ slash AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_6_209' class='gform_hidden' value='https:\/\/www.aers.me\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><div class='gfield_description' id='gfield_description_6_209'>Veuillez saisir la date au format MM\/JJ\/AAAA.<\/div><\/div><div id=\"field_6_127\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield--show-description field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_6_127'>Veuillez t\u00e9l\u00e9charger les images\/documents \u00e0 l&#039;appui ici<\/label><div class='gfield_description' id='gfield_description_6_127'>Vous pouvez t\u00e9l\u00e9charger des photos des sympt\u00f4mes<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_6_127' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_6_127&quot;,&quot;container&quot;:&quot;gform_multifile_upload_6_127&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_6_127&quot;,&quot;filelist&quot;:&quot;gform_preview_6_127&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.aers.me\\\/?gf_page=42809670bc16ccb&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.aers.me\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.aers.me\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Fichiers autoris\\u00e9s&quot;,&quot;extensions&quot;:&quot;jpg,jpeg,png,pdf,doc,docx&quot;}],&quot;max_file_size&quot;:&quot;52428800b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:6,&quot;field_id&quot;:127,&quot;_gform_file_upload_nonce_6_127&quot;:&quot;048ec7326b&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_6_127&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_6_127' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>D\u00e9posez les fichiers ici ou <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button data-label=\"Cliquez ou faites glisser le fichier dans cette zone pour le t\u00e9l\u00e9charger\" type='button' id='gform_browse_button_6_127' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_6_127 gfield_description_6_127\"  >S\u00e9lectionnez des fichiers<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_6_127'>Types de fichiers accept\u00e9s\u00a0: jpg, jpeg, png, pdf, doc, docx, Taille max. des fichiers\u00a0: 50 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_6_127'><\/ul> <div id='gform_preview_6_127' class='ginput_preview_list'><\/div><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_210' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Retour'  \/> <input type='button' id='gform_next_button_6_210' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Suivant'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_4' class='gform_page form_page page_name_review_personal_data_disclosure' data-js='page-field-id-210' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_4' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_6_211\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Divulgation de donn\u00e9es personnelles<\/h3><\/div><div id=\"field_6_212\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>Conform\u00e9ment au r\u00e8glement europ\u00e9en n\u00b0 2016\/679 \" GDPR \" et aux lois locales sur la protection de la vie priv\u00e9e, Dolce&Gabbana Beauty S.r.l. (ci-apr\u00e8s \" Contr\u00f4leur de donn\u00e9es \") vous fournit les informations suivantes concernant la collecte, l'utilisation, la divulgation ou le traitement de vos donn\u00e9es \u00e0 caract\u00e8re personnel.<\/p>\n<p><em>Le contr\u00f4leur des donn\u00e9es est Dolce&Gabbana Beauty S.r.l., situ\u00e9 \u00e0 Via Goldoni 10, 20129 Milan, Italie.<\/em><\/p>\n<h5>Finalit\u00e9 et base juridique du traitement<\/h5>\n<p>Les donn\u00e9es \u00e0 caract\u00e8re personnel seront trait\u00e9es dans le but de g\u00e9rer la communication d'informations sur la s\u00e9curit\u00e9 li\u00e9es aux <strong>activit\u00e9s de vigilance cosm\u00e9tique<\/strong>.\nLes donn\u00e9es que vous fournissez seront donc trait\u00e9es pour :<br\/>Les donn\u00e9es que vous fournissez seront donc trait\u00e9es pour :\n<\/p><ul>\n<li>Identification en temps utile des effets ind\u00e9sirables inconnus et quantification de leur fr\u00e9quence et de leur impact ;<\/li>\n<li>Vous contacter pour obtenir des informations compl\u00e9mentaires sur l'effet signal\u00e9 ;<\/li>\n<li>\u00c9valuer la relation de cause \u00e0 effet entre l'utilisation du produit cosm\u00e9tique et l'effet ind\u00e9sirable observ\u00e9 ;<\/li>\n<li>Am\u00e9liorer et\/ou mettre \u00e0 jour les informations de s\u00e9curit\u00e9 d\u00e9j\u00e0 connues ;<\/li>\n<li>Notifier ces informations \u00e0 l'autorit\u00e9 comp\u00e9tente de l'\u00c9tat membre en vertu du r\u00e8glement (CE) n\u00b0 1223\/2009, uniquement en cas d'effets ind\u00e9sirables graves affectant les consommateurs du produit cosm\u00e9tique.<\/li>\n<\/ul>\n\n<p><em>Les traitements mentionn\u00e9s ci-dessus sont n\u00e9cessaires pour remplir une obligation l\u00e9gale \u00e9tablie par la r\u00e9glementation en vigueur sur la cosm\u00e9tovigilance.<\/em><\/p>\n<h5>P\u00e9riode de conservation des donn\u00e9es<\/h5>\n<p>Les donn\u00e9es seront conserv\u00e9es pendant la dur\u00e9e n\u00e9cessaire \u00e0 l'accomplissement des obligations l\u00e9gales. En tout \u00e9tat de cause, les informations personnelles relatives \u00e0 la s\u00e9curit\u00e9\nseront conserv\u00e9es pendant une p\u00e9riode maximale de 10 ans.<br\/>\u00c0 l'expiration de la p\u00e9riode de conservation, les donn\u00e9es personnelles seront automatiquement supprim\u00e9es ou rendues anonymes de fa\u00e7on permanente\nde mani\u00e8re irr\u00e9versible. <\/p>\n<h5>Fourniture de donn\u00e9es<\/h5>\n<p>La fourniture de donn\u00e9es est n\u00e9cessaire pour atteindre l'objectif de gestion de la communication d'informations sur la s\u00e9curit\u00e9. La non-fourniture des donn\u00e9es emp\u00eachera la r\u00e9alisation des objectifs susmentionn\u00e9s mais n'affectera pas la possibilit\u00e9 d'effectuer l'achat. <\/p>\n<h5>Destinataires des donn\u00e9es \u00e0 caract\u00e8re personnel<\/h5>\n<p>\nLes donn\u00e9es peuvent \u00eatre trait\u00e9es par :\n<\/p><ul>\n<li>Dolce & Gabbana Beauty staff ;<\/li>\n<li>Les partenaires de Dolce & Gabbana Beauty qui contribuent \u00e0 la gestion des informations relatives \u00e0 la s\u00e9curit\u00e9 (par exemple, l'\u00e9valuation des accidents).<\/li>\n<\/ul>\nLes donn\u00e9es peuvent \u00e9galement \u00eatre communiqu\u00e9es \u00e0\n<ul>\n<li>les entit\u00e9s agissant en tant que responsables du traitement des donn\u00e9es, telles que les autorit\u00e9s de surveillance et de contr\u00f4le ou d'autres entit\u00e9s publiques l\u00e9galement autoris\u00e9es \u00e0 demander des donn\u00e9es, telles que les autorit\u00e9s judiciaires et\/ou de s\u00e9curit\u00e9 publique ;<\/li>\n<li>des tiers, des responsables ind\u00e9pendants du traitement des donn\u00e9es, notamment des professionnels ou des cabinets de conseil juridique ou fiscal.<\/li>\n<\/ul>\n\n<p>\nUne liste compl\u00e8te des destinataires des donn\u00e9es \u00e0 caract\u00e8re personnel peut \u00eatre demand\u00e9e en \u00e9crivant \u00e0 : <a href=\"mailto:privacy@dolcegabbana.it\">privacy@dolcegabbana.it<\/a> ou aux adresses postales\nindiqu\u00e9es dans le pr\u00e9sent avis.<\/p>\n<h5>Transfert de donn\u00e9es en dehors de l'Union europ\u00e9enne<\/h5>\n<p>Vos donn\u00e9es seront trait\u00e9es et stock\u00e9es en Italie et ne seront pas transf\u00e9r\u00e9es vers des pays non membres de l'UE.<\/p>\n<h5>Droits des personnes concern\u00e9es en vertu du GDPR<\/h5>\n<p>En vertu des lois applicables, vous pouvez \u00e0 tout moment demander des informations sur les donn\u00e9es personnelles collect\u00e9es, utilis\u00e9es ou trait\u00e9es par le contr\u00f4leur des donn\u00e9es, et demander l'acc\u00e8s \u00e0 ces donn\u00e9es personnelles, demander leur int\u00e9gration, leur correction ou leur suppression, demander la limitation du traitement et vous opposer au traitement de vos donn\u00e9es.<\/p>\nLes personnes concern\u00e9es ont le droit d'obtenir des informations suppl\u00e9mentaires concernant leurs donn\u00e9es personnelles, y compris :\n<ul class=\"list-style-roman\">\n<li>Les types de donn\u00e9es personnelles trait\u00e9es<\/li>\n<li>D\u00e9cisions prises sur la base d'un traitement automatis\u00e9<\/li>\n<li>Les crit\u00e8res utilis\u00e9s pour d\u00e9terminer la dur\u00e9e de conservation des donn\u00e9es \u00e0 caract\u00e8re personnel<\/li>\n<li>Les mesures prises pour att\u00e9nuer les risques en cas de violation des donn\u00e9es.<\/li>\n<\/ul>\n<p>Pour exercer les droits susmentionn\u00e9s et\/ou soumettre des demandes ou des plaintes concernant le traitement des donn\u00e9es \u00e0 caract\u00e8re personnel,\nvous pouvez envoyer une demande au contr\u00f4leur des donn\u00e9es en \u00e9crivant \u00e0 l'adresse \u00e9lectronique <a href=\"mailto:privacy@dolcegabbana.it\">privacy@dolcegabbana.it<\/a> ou \u00e0\naux adresses postales et aux coordonn\u00e9es indiqu\u00e9es dans le pr\u00e9sent avis.<\/p>\n<p>En outre, vous pouvez d\u00e9poser une plainte aupr\u00e8s de l'autorit\u00e9 de surveillance comp\u00e9tente.<\/p>\n<h5>D\u00e9l\u00e9gu\u00e9 \u00e0 la protection des donn\u00e9es (DPD)<\/h5>\n<p>Le d\u00e9l\u00e9gu\u00e9 \u00e0 la protection des donn\u00e9es peut \u00eatre joint \u00e0 l'adresse \u00e9lectronique suivante : <a href=\"mailto:dpo.beauty@dolcegabbana.it\">dpo.beauty@dolcegabbana.it<\/a>.<\/p><\/div><fieldset id=\"field_6_213\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Consentement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_213.1' id='input_6_213_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_6_213_1' >Je d\u00e9clare avoir re\u00e7u et lu la notice d'information concernant le traitement de mes donn\u00e9es personnelles.<span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/label><input type='hidden' name='input_213.2' value='Je d\u00e9clare avoir re\u00e7u et lu la notice d&#039;information concernant le traitement de mes donn\u00e9es personnelles.' class='gform_hidden' \/><input type='hidden' name='input_213.3' value='1' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_6_214\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half grid-col-span-4 gfield_contains_required field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_214'>Date de consentement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_214' id='input_6_214' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='S\u00e9lectionnez la date' aria-describedby=\"input_6_214_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_6_214_date_format' class='screen-reader-text'>MM slash JJ slash AAAA<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_6_214' class='gform_hidden' value='https:\/\/www.aers.me\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_6_215\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half grid-col-span-4 gfield_contains_required field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_215'>Signature\/Nom de la personne consentante<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_215' id='input_6_215' type='text' value='' class='large' maxlength='100'   placeholder='Ajouter une signature\/un nom' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_6_97' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Retour'  \/> <input type='button' id='gform_next_button_6_97' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Suivant'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_6_5' class='gform_page form_page page_name_review' data-js='page-field-id-97' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_6_5' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_6_56\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full consumer-info-review gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Information des consommateurs<\/h2><\/div><div id=\"field_6_57\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full product-info-review gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Informations sur le produit<\/h2><\/div><div id=\"field_6_55\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full event-info-review gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Informations sur l'\u00e9v\u00e9nement<\/h2><\/div><div id=\"field_6_53\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full disclosure-info-review gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>Informations sur la divulgation<\/h2><\/div><fieldset id=\"field_6_221\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full js-value-bound-to-field--213 disclosure-consent-bound-field gfield_contains_required field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Consentement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_221.1' id='input_6_221_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_6_221_1' >Je d\u00e9clare avoir re\u00e7u et lu la notice d'information concernant le traitement de mes donn\u00e9es personnelles.<span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/label><input type='hidden' name='input_221.2' value='Je d\u00e9clare avoir re\u00e7u et lu la notice d&#039;information concernant le traitement de mes donn\u00e9es personnelles.' class='gform_hidden' \/><input type='hidden' name='input_221.3' value='1' class='gform_hidden' \/><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_6' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Retour'  \/> 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