{"id":41115,"date":"2025-02-09T02:06:23","date_gmt":"2025-02-09T01:06:23","guid":{"rendered":"https:\/\/permis111.com\/?page_id=41115"},"modified":"2025-02-11T03:11:29","modified_gmt":"2025-02-11T02:11:29","slug":"register","status":"publish","type":"page","link":"https:\/\/permis111.com\/pt\/register\/","title":{"rendered":"Inscription"},"content":{"rendered":"\n<style>\n    .kivicare-modern-auth * {\n        margin: 0;\n        padding: 0;\n        box-sizing: border-box;\n    }\n    \n    .kivicare-modern-auth {\n        font-family: 'Outfit', -apple-system, BlinkMacSystemFont, 'Segoe UI', sans-serif;\n        background: #f5f5f5;\n        min-height: 60vh;\n        display: flex;\n        align-items: center;\n        justify-content: center;\n        padding: 40px 20px;\n    }\n    \n    .kivicare-register-container {\n        background: white;\n        padding: 50px 45px;\n        width: 100%;\n        max-width: 600px;\n        border-radius: 8px;\n        box-shadow: 0 2px 20px rgba(0,0,0,0.1);\n    }\n    \n    .kivicare-logo {\n        text-align: center;\n        margin-bottom: 35px;\n    }\n    \n    .kivicare-logo h1 {\n        color: #333;\n        font-size: 28px;\n        font-weight: 600;\n        margin-bottom: 10px;\n    }\n    \n    .kivicare-logo p {\n        color: #666;\n        font-size: 15px;\n        font-weight: 400;\n    }\n    \n    .kivicare-form-group {\n        margin-bottom: 22px;\n    }\n    \n    .kivicare-form-group label {\n        display: block;\n        font-weight: 600;\n        color: #333;\n        margin-bottom: 10px;\n        font-size: 14px;\n    }\n    \n    .kivicare-form-group label span {\n        color: #dc3545;\n    }\n    \n    .kivicare-form-group input,\n    .kivicare-form-group select {\n        width: 100%;\n        padding: 14px 18px;\n        border: 1px solid #e0e0e0;\n        background: #f8f9fa;\n        border-radius: 6px;\n        font-size: 15px;\n        transition: all 0.3s;\n        color: #333;\n    }\n    \n    \/* Cacher les selects natifs pendant l'initialisation *\/\n    .kivicare-form-group select {\n        opacity: 0;\n        transition: opacity 0.3s;\n    }\n    \n    .kivicare-form-group select.select2-hidden-accessible {\n        opacity: 1;\n    }\n    \n    .kivicare-form-group input:focus,\n    .kivicare-form-group select:focus {\n        outline: none;\n        border-color: #7E1710;\n        background: #fff;\n    }\n    \n    .kivicare-form-group input::placeholder {\n        color: #999;\n    }\n    \n    .kivicare-form-row {\n        display: grid;\n        grid-template-columns: 1fr 1fr;\n        gap: 15px;\n    }\n    \n    .kivicare-contact-box {\n        display: grid;\n        grid-template-columns: 180px 1fr;\n        gap: 10px;\n    }\n    \n    .kivicare-contact-box .select2-container {\n        min-width: 180px;\n    }\n    \n    .kivicare-contact-box select,\n    .kivicare-contact-box input[type=\"tel\"],\n    .kivicare-contact-box input[type=\"text\"] {\n        width: 100%;\n    }\n    \n    .kivicare-gender-group {\n        display: flex;\n        gap: 20px;\n        flex-wrap: wrap;\n    }\n    \n    .kivicare-radio-item {\n        display: flex;\n        align-items: center;\n        gap: 8px;\n    }\n    \n    .kivicare-radio-item input[type=\"radio\"] {\n        width: 18px;\n        height: 18px;\n        cursor: pointer;\n        accent-color: #7E1710;\n    }\n    \n    .kivicare-radio-item label {\n        margin: 0;\n        font-weight: 400;\n        cursor: pointer;\n    }\n    \n    .kivicare-btn-register {\n        width: 100%;\n        padding: 15px;\n        background: #7E1710;\n        color: white;\n        border: none;\n        border-radius: 6px;\n        font-size: 16px;\n        font-weight: 600;\n        cursor: pointer;\n        transition: background 0.3s;\n        display: flex;\n        align-items: center;\n        justify-content: center;\n        gap: 10px;\n        position: relative;\n        margin-top: 10px;\n    }\n    \n    .kivicare-btn-register:hover {\n        background: #5d110c;\n    }\n    \n    .kivicare-btn-register:active {\n        transform: scale(0.98);\n    }\n    \n    .kivicare-btn-register:disabled {\n        background: #ccc;\n        cursor: not-allowed;\n        opacity: 0.6;\n    }\n    \n    .kivicare-btn-register.loading {\n        pointer-events: none;\n        background: #7E1710 !important;\n        opacity: 1 !important;\n    }\n    \n    .kivicare-btn-register.loading .btn-text {\n        visibility: hidden;\n    }\n    \n    .kivicare-btn-register .spinner {\n        position: absolute;\n        left: 50%;\n        top: 50%;\n        transform: translate(-50%, -50%);\n        width: 20px;\n        height: 20px;\n        border: 3px solid rgba(255,255,255,0.3);\n        border-top-color: white;\n        border-radius: 50%;\n        animation: kivicare-spin 0.8s linear infinite;\n        display: none;\n    }\n    \n    .kivicare-btn-register.loading .spinner {\n        display: block;\n    }\n    \n    @keyframes kivicare-spin {\n        to { transform: translate(-50%, -50%) rotate(360deg); }\n    }\n    \n    .kivicare-alert {\n        padding: 14px 18px;\n        border-radius: 6px;\n        margin-bottom: 25px;\n        font-size: 14px;\n        display: none;\n    }\n    \n    .kivicare-alert.show {\n        display: flex;\n        align-items: center;\n        gap: 10px;\n    }\n    \n    .kivicare-alert i {\n        font-size: 18px;\n    }\n    \n    .kivicare-alert.alert-danger {\n        background: #f8d7da;\n        color: #721c24;\n        border: 1px solid #f5c6cb;\n    }\n    \n    .kivicare-alert.alert-danger i {\n        color: #dc3545;\n    }\n    \n    .kivicare-alert.alert-success {\n        background: #d4edda;\n        color: #155724;\n        border: 1px solid #c3e6cb;\n    }\n    \n    .kivicare-alert.alert-success i {\n        color: #28a745;\n    }\n    \n    .kivicare-alert.full-message {\n        padding: 40px 30px;\n        font-size: 16px;\n        text-align: center;\n        flex-direction: column;\n        gap: 15px;\n        margin: 0;\n        min-height: 200px;\n        justify-content: center;\n    }\n    \n    .kivicare-alert.full-message i {\n        font-size: 48px;\n    }\n    \n    .kivicare-alert.full-message span {\n        font-size: 18px;\n        line-height: 1.6;\n    }\n    \n    .kivicare-progress-container {\n        width: 100%;\n        background: rgba(0, 0, 0, 0.1);\n        border-radius: 10px;\n        height: 8px;\n        overflow: hidden;\n        margin-top: 20px;\n    }\n    \n    .kivicare-progress-bar {\n        height: 100%;\n        background: #28a745;\n        width: 0%;\n        border-radius: 10px;\n        transition: width 0.1s linear;\n    }\n    \n    .kivicare-redirect-text {\n        margin-top: 15px;\n        font-size: 14px;\n        color: #155724;\n        opacity: 0.8;\n    }\n    \n    .kivicare-custom-fields {\n        margin: 20px 0;\n    }\n    \n    .kivicare-loader {\n        text-align: center;\n        padding: 20px;\n    }\n    \n    \/* Style Select2 *\/\n    .select2-container {\n        width: 100% !important;\n    }\n    \n    .select2-container--default .select2-selection--single {\n        background: #f8f9fa !important;\n        border: 1px solid #e0e0e0 !important;\n        border-radius: 6px !important;\n        height: 48px !important;\n        padding: 0 !important;\n        display: flex !important;\n        align-items: center !important;\n    }\n    \n    .select2-container--default .select2-selection--single .select2-selection__rendered {\n        line-height: 48px !important;\n        padding-left: 18px !important;\n        padding-right: 40px !important;\n        color: #333 !important;\n        font-size: 15px !important;\n    }\n    \n    .select2-container--default .select2-selection--single .select2-selection__arrow {\n        height: 48px !important;\n        right: 10px !important;\n    }\n    \n    .select2-container--default .select2-selection--single:focus,\n    .select2-container--default.select2-container--open .select2-selection--single {\n        border-color: #7E1710 !important;\n        background: #fff !important;\n        outline: none !important;\n    }\n    \n    .select2-container--default .select2-selection--single .select2-selection__placeholder {\n        color: #999 !important;\n    }\n    \n    \/* Dropdown Select2 *\/\n    .select2-dropdown {\n        border: 1px solid #e0e0e0 !important;\n        border-radius: 6px !important;\n        box-shadow: 0 2px 10px rgba(0,0,0,0.1) !important;\n    }\n    \n    .select2-container--default .select2-results__option--highlighted[aria-selected] {\n        background-color: #7E1710 !important;\n    }\n    \n    .select2-container--default .select2-results__option[aria-selected=true] {\n        background-color: #f8f9fa !important;\n        color: #333 !important;\n    }\n    \n    @media (max-width: 768px) {\n        .kivicare-register-container {\n            padding: 35px 25px;\n        }\n        \n        .kivicare-form-row {\n            grid-template-columns: 1fr;\n        }\n        \n        .kivicare-contact-box {\n            grid-template-columns: 1fr;\n        }\n        \n        .kivicare-logo h1 {\n            font-size: 24px;\n        }\n    }\n<\/style>\n\n<div class=\"kivicare-modern-auth\" dir=''>\n    <div class=\"kivicare-register-container\">\n        <div class=\"kivicare-logo\">\n            <h1><i class=\"fas fa-user-plus\"><\/i> Inscription<\/h1>\n            <p>Cr\u00e9ez votre compte<\/p>\n        <\/div>\n        \n        <div class=\"kivicare-alert alert-danger\" id=\"kivicare-register-error\">\n            <i class=\"fas fa-exclamation-triangle\"><\/i>\n            <span id=\"kivicare-register-error-msg\"><\/span>\n        <\/div>\n        \n        <div class=\"kivicare-alert alert-success\" id=\"kivicare-register-success\">\n            <i class=\"fas fa-check-circle\"><\/i>\n            <span id=\"kivicare-register-success-msg\"><\/span>\n            <div class=\"kivicare-progress-container\" style=\"display: none;\">\n                <div class=\"kivicare-progress-bar\" id=\"kivicare-progress-bar\"><\/div>\n            <\/div>\n            <div class=\"kivicare-redirect-text\" id=\"kivicare-redirect-text\" style=\"display: none;\">\n                Redirection vers la page de connexion...\n            <\/div>\n        <\/div>\n        \n        <form id=\"kivicare-modern-register-form\" enctype=\"multipart\/form-data\">\n                        \n            <input type=\"hidden\" id=\"registerClinicId\">\n            \n            <div class=\"kivicare-form-row\">\n                <div class=\"kivicare-form-group\">\n                    <label for=\"firstName\">\n                        Pr\u00e9nom                        <span>*<\/span>\n                    <\/label>\n                    <input \n                        type=\"text\" \n                        name=\"first_name\" \n                        id=\"firstName\"\n                        placeholder=\"Votre pr\u00e9nom\"\n                        required>\n                <\/div>\n                \n                <div class=\"kivicare-form-group\">\n                    <label for=\"lastName\">\n                        Nom                        <span>*<\/span>\n                    <\/label>\n                    <input \n                        type=\"text\" \n                        name=\"last_name\" \n                        id=\"lastName\"\n                        placeholder=\"Votre nom\"\n                        required>\n                <\/div>\n            <\/div>\n            \n            <div class=\"kivicare-form-group\">\n                <label for=\"userEmail\">\n                    Email                    <span>*<\/span>\n                <\/label>\n                <input \n                    type=\"email\" \n                    name=\"user_email\" \n                    id=\"userEmail\"\n                    placeholder=\"votre@email.com\"\n                    required>\n            <\/div>\n            \n            <div class=\"kivicare-form-group\">\n                <label for=\"userContact\">\n                    Contact                    <span>*<\/span>\n                <\/label>\n                <div class=\"kivicare-contact-box\">\n                                            <select name=\"country_code\" id=\"CountryCode\">\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+93&quot;,&quot;countryCode&quot;:&quot;AF&quot;}\" >\n                                    +93 - Afghanistan                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+358&quot;,&quot;countryCode&quot;:&quot;AX&quot;}\" >\n                                    +358 - Aland Islands                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+355&quot;,&quot;countryCode&quot;:&quot;AL&quot;}\" >\n                                    +355 - Albania                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+213&quot;,&quot;countryCode&quot;:&quot;DZ&quot;}\" >\n                                    +213 - Algeria                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1684&quot;,&quot;countryCode&quot;:&quot;AS&quot;}\" >\n                                    +1684 - AmericanSamoa                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+376&quot;,&quot;countryCode&quot;:&quot;AD&quot;}\" >\n                                    +376 - Andorra                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+244&quot;,&quot;countryCode&quot;:&quot;AO&quot;}\" >\n                                    +244 - Angola                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1264&quot;,&quot;countryCode&quot;:&quot;AI&quot;}\" >\n                                    +1264 - Anguilla                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+672&quot;,&quot;countryCode&quot;:&quot;AQ&quot;}\" >\n                                    +672 - Antarctica                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1268&quot;,&quot;countryCode&quot;:&quot;AG&quot;}\" >\n                                    +1268 - Antigua and Barbuda                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+54&quot;,&quot;countryCode&quot;:&quot;AR&quot;}\" >\n                                    +54 - Argentina                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+374&quot;,&quot;countryCode&quot;:&quot;AM&quot;}\" >\n                                    +374 - Armenia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+297&quot;,&quot;countryCode&quot;:&quot;AW&quot;}\" >\n                                    +297 - Aruba                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+61&quot;,&quot;countryCode&quot;:&quot;AU&quot;}\" >\n                                    +61 - Australia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+43&quot;,&quot;countryCode&quot;:&quot;AT&quot;}\" >\n                                    +43 - Austria                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+994&quot;,&quot;countryCode&quot;:&quot;AZ&quot;}\" >\n                                    +994 - Azerbaijan                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1242&quot;,&quot;countryCode&quot;:&quot;BS&quot;}\" >\n                                    +1242 - Bahamas                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+973&quot;,&quot;countryCode&quot;:&quot;BH&quot;}\" >\n                                    +973 - Bahrain                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+880&quot;,&quot;countryCode&quot;:&quot;BD&quot;}\" >\n                                    +880 - Bangladesh                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1246&quot;,&quot;countryCode&quot;:&quot;BB&quot;}\" >\n                                    +1246 - Barbados                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+375&quot;,&quot;countryCode&quot;:&quot;BY&quot;}\" >\n                                    +375 - Belarus                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+32&quot;,&quot;countryCode&quot;:&quot;BE&quot;}\" >\n                                    +32 - Belgium                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+501&quot;,&quot;countryCode&quot;:&quot;BZ&quot;}\" >\n                                    +501 - Belize                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+229&quot;,&quot;countryCode&quot;:&quot;BJ&quot;}\" >\n                                    +229 - Benin                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1441&quot;,&quot;countryCode&quot;:&quot;BM&quot;}\" >\n                                    +1441 - Bermuda                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+975&quot;,&quot;countryCode&quot;:&quot;BT&quot;}\" >\n                                    +975 - Bhutan                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+591&quot;,&quot;countryCode&quot;:&quot;BO&quot;}\" >\n                                    +591 - Bolivia, Plurinational State of                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+387&quot;,&quot;countryCode&quot;:&quot;BA&quot;}\" >\n                                    +387 - Bosnia and Herzegovina                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+267&quot;,&quot;countryCode&quot;:&quot;BW&quot;}\" >\n                                    +267 - Botswana                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+55&quot;,&quot;countryCode&quot;:&quot;BR&quot;}\" >\n                                    +55 - Brazil                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+246&quot;,&quot;countryCode&quot;:&quot;IO&quot;}\" >\n                                    +246 - British Indian Ocean Territory                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+673&quot;,&quot;countryCode&quot;:&quot;BN&quot;}\" >\n                                    +673 - Brunei Darussalam                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+359&quot;,&quot;countryCode&quot;:&quot;BG&quot;}\" >\n                                    +359 - Bulgaria                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+226&quot;,&quot;countryCode&quot;:&quot;BF&quot;}\" >\n                                    +226 - Burkina Faso                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+257&quot;,&quot;countryCode&quot;:&quot;BI&quot;}\" >\n                                    +257 - Burundi                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+855&quot;,&quot;countryCode&quot;:&quot;KH&quot;}\" >\n                                    +855 - Cambodia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+237&quot;,&quot;countryCode&quot;:&quot;CM&quot;}\" >\n                                    +237 - Cameroon                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1&quot;,&quot;countryCode&quot;:&quot;CA&quot;}\" >\n                                    +1 - Canada                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+238&quot;,&quot;countryCode&quot;:&quot;CV&quot;}\" >\n                                    +238 - Cape Verde                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+ 345&quot;,&quot;countryCode&quot;:&quot;KY&quot;}\" >\n                                    + 345 - Cayman Islands                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+236&quot;,&quot;countryCode&quot;:&quot;CF&quot;}\" >\n                                    +236 - Central African Republic                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+235&quot;,&quot;countryCode&quot;:&quot;TD&quot;}\" >\n                                    +235 - Chad                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+56&quot;,&quot;countryCode&quot;:&quot;CL&quot;}\" >\n                                    +56 - Chile                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+86&quot;,&quot;countryCode&quot;:&quot;CN&quot;}\" >\n                                    +86 - China                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+61&quot;,&quot;countryCode&quot;:&quot;CX&quot;}\" >\n                                    +61 - Christmas Island                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+61&quot;,&quot;countryCode&quot;:&quot;CC&quot;}\" >\n                                    +61 - Cocos (Keeling) Islands                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+57&quot;,&quot;countryCode&quot;:&quot;CO&quot;}\" >\n                                    +57 - Colombia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+269&quot;,&quot;countryCode&quot;:&quot;KM&quot;}\" >\n                                    +269 - Comoros                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+242&quot;,&quot;countryCode&quot;:&quot;CG&quot;}\" >\n                                    +242 - Congo                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+243&quot;,&quot;countryCode&quot;:&quot;CD&quot;}\" >\n                                    +243 - Congo, The Democratic Republic of the Congo                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+682&quot;,&quot;countryCode&quot;:&quot;CK&quot;}\" >\n                                    +682 - Cook Islands                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+506&quot;,&quot;countryCode&quot;:&quot;CR&quot;}\" >\n                                    +506 - Costa Rica                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+225&quot;,&quot;countryCode&quot;:&quot;CI&quot;}\" >\n                                    +225 - Cote d&#039;Ivoire                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+385&quot;,&quot;countryCode&quot;:&quot;HR&quot;}\" >\n                                    +385 - Croatia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+53&quot;,&quot;countryCode&quot;:&quot;CU&quot;}\" >\n                                    +53 - Cuba                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+357&quot;,&quot;countryCode&quot;:&quot;CY&quot;}\" >\n                                    +357 - Cyprus                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+420&quot;,&quot;countryCode&quot;:&quot;CZ&quot;}\" >\n                                    +420 - Czech Republic                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+45&quot;,&quot;countryCode&quot;:&quot;DK&quot;}\" >\n                                    +45 - Denmark                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+253&quot;,&quot;countryCode&quot;:&quot;DJ&quot;}\" >\n                                    +253 - Djibouti                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1767&quot;,&quot;countryCode&quot;:&quot;DM&quot;}\" >\n                                    +1767 - Dominica                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1809&quot;,&quot;countryCode&quot;:&quot;DO&quot;}\" >\n                                    +1809 - Dominican Republic                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1829&quot;,&quot;countryCode&quot;:&quot;DO&quot;}\" >\n                                    +1829 - Dominican Republic                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1849&quot;,&quot;countryCode&quot;:&quot;DO&quot;}\" >\n                                    +1849 - Dominican Republic                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+593&quot;,&quot;countryCode&quot;:&quot;EC&quot;}\" >\n                                    +593 - Ecuador                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+20&quot;,&quot;countryCode&quot;:&quot;EG&quot;}\" >\n                                    +20 - Egypt                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+503&quot;,&quot;countryCode&quot;:&quot;SV&quot;}\" >\n                                    +503 - El Salvador                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+240&quot;,&quot;countryCode&quot;:&quot;GQ&quot;}\" >\n                                    +240 - Equatorial Guinea                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+291&quot;,&quot;countryCode&quot;:&quot;ER&quot;}\" >\n                                    +291 - Eritrea                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+372&quot;,&quot;countryCode&quot;:&quot;EE&quot;}\" >\n                                    +372 - Estonia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+251&quot;,&quot;countryCode&quot;:&quot;ET&quot;}\" >\n                                    +251 - Ethiopia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+500&quot;,&quot;countryCode&quot;:&quot;FK&quot;}\" >\n                                    +500 - Falkland Islands (Malvinas)                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+298&quot;,&quot;countryCode&quot;:&quot;FO&quot;}\" >\n                                    +298 - Faroe Islands                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+679&quot;,&quot;countryCode&quot;:&quot;FJ&quot;}\" >\n                                    +679 - Fiji                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+358&quot;,&quot;countryCode&quot;:&quot;FI&quot;}\" >\n                                    +358 - Finland                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+33&quot;,&quot;countryCode&quot;:&quot;FR&quot;}\" selected>\n                                    +33 - France                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+594&quot;,&quot;countryCode&quot;:&quot;GF&quot;}\" >\n                                    +594 - French Guiana                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+689&quot;,&quot;countryCode&quot;:&quot;PF&quot;}\" >\n                                    +689 - French Polynesia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+241&quot;,&quot;countryCode&quot;:&quot;GA&quot;}\" >\n                                    +241 - Gabon                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+220&quot;,&quot;countryCode&quot;:&quot;GM&quot;}\" >\n                                    +220 - Gambia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+995&quot;,&quot;countryCode&quot;:&quot;GE&quot;}\" >\n                                    +995 - Georgia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+49&quot;,&quot;countryCode&quot;:&quot;DE&quot;}\" >\n                                    +49 - Germany                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+233&quot;,&quot;countryCode&quot;:&quot;GH&quot;}\" >\n                                    +233 - Ghana                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+350&quot;,&quot;countryCode&quot;:&quot;GI&quot;}\" >\n                                    +350 - Gibraltar                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+30&quot;,&quot;countryCode&quot;:&quot;GR&quot;}\" >\n                                    +30 - Greece                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+299&quot;,&quot;countryCode&quot;:&quot;GL&quot;}\" >\n                                    +299 - Greenland                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1473&quot;,&quot;countryCode&quot;:&quot;GD&quot;}\" >\n                                    +1473 - Grenada                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+590&quot;,&quot;countryCode&quot;:&quot;GP&quot;}\" >\n                                    +590 - Guadeloupe                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1671&quot;,&quot;countryCode&quot;:&quot;GU&quot;}\" >\n                                    +1671 - Guam                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+502&quot;,&quot;countryCode&quot;:&quot;GT&quot;}\" >\n                                    +502 - Guatemala                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+44&quot;,&quot;countryCode&quot;:&quot;GG&quot;}\" >\n                                    +44 - Guernsey                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+224&quot;,&quot;countryCode&quot;:&quot;GN&quot;}\" >\n                                    +224 - Guinea                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+245&quot;,&quot;countryCode&quot;:&quot;GW&quot;}\" >\n                                    +245 - Guinea-Bissau                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+592&quot;,&quot;countryCode&quot;:&quot;GY&quot;}\" >\n                                    +592 - Guyana                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+509&quot;,&quot;countryCode&quot;:&quot;HT&quot;}\" >\n                                    +509 - Haiti                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+379&quot;,&quot;countryCode&quot;:&quot;VA&quot;}\" >\n                                    +379 - Holy See (Vatican City State)                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+504&quot;,&quot;countryCode&quot;:&quot;HN&quot;}\" >\n                                    +504 - Honduras                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+852&quot;,&quot;countryCode&quot;:&quot;HK&quot;}\" >\n                                    +852 - Hong Kong                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+36&quot;,&quot;countryCode&quot;:&quot;HU&quot;}\" >\n                                    +36 - Hungary                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+354&quot;,&quot;countryCode&quot;:&quot;IS&quot;}\" >\n                                    +354 - Iceland                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+91&quot;,&quot;countryCode&quot;:&quot;IN&quot;}\" >\n                                    +91 - India                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+62&quot;,&quot;countryCode&quot;:&quot;ID&quot;}\" >\n                                    +62 - Indonesia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+98&quot;,&quot;countryCode&quot;:&quot;IR&quot;}\" >\n                                    +98 - Iran, Islamic Republic of Persian Gulf                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+964&quot;,&quot;countryCode&quot;:&quot;IQ&quot;}\" >\n                                    +964 - Iraq                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+353&quot;,&quot;countryCode&quot;:&quot;IE&quot;}\" >\n                                    +353 - Ireland                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+44&quot;,&quot;countryCode&quot;:&quot;IM&quot;}\" >\n                                    +44 - Isle of Man                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+972&quot;,&quot;countryCode&quot;:&quot;IL&quot;}\" >\n                                    +972 - Israel                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+39&quot;,&quot;countryCode&quot;:&quot;IT&quot;}\" >\n                                    +39 - Italy                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1876&quot;,&quot;countryCode&quot;:&quot;JM&quot;}\" >\n                                    +1876 - Jamaica                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+81&quot;,&quot;countryCode&quot;:&quot;JP&quot;}\" >\n                                    +81 - Japan                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+44&quot;,&quot;countryCode&quot;:&quot;JE&quot;}\" >\n                                    +44 - Jersey                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+962&quot;,&quot;countryCode&quot;:&quot;JO&quot;}\" >\n                                    +962 - Jordan                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+77&quot;,&quot;countryCode&quot;:&quot;KZ&quot;}\" >\n                                    +77 - Kazakhstan                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+254&quot;,&quot;countryCode&quot;:&quot;KE&quot;}\" >\n                                    +254 - Kenya                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+686&quot;,&quot;countryCode&quot;:&quot;KI&quot;}\" >\n                                    +686 - Kiribati                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+850&quot;,&quot;countryCode&quot;:&quot;KP&quot;}\" >\n                                    +850 - Korea, Democratic People&#039;s Republic of Korea                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+82&quot;,&quot;countryCode&quot;:&quot;KR&quot;}\" >\n                                    +82 - Korea, Republic of South Korea                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+383&quot;,&quot;countryCode&quot;:&quot;XK&quot;}\" >\n                                    +383 - Kosovo                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+965&quot;,&quot;countryCode&quot;:&quot;KW&quot;}\" >\n                                    +965 - Kuwait                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+996&quot;,&quot;countryCode&quot;:&quot;KG&quot;}\" >\n                                    +996 - Kyrgyzstan                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+856&quot;,&quot;countryCode&quot;:&quot;LA&quot;}\" >\n                                    +856 - Laos                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+371&quot;,&quot;countryCode&quot;:&quot;LV&quot;}\" >\n                                    +371 - Latvia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+961&quot;,&quot;countryCode&quot;:&quot;LB&quot;}\" >\n                                    +961 - Lebanon                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+266&quot;,&quot;countryCode&quot;:&quot;LS&quot;}\" >\n                                    +266 - Lesotho                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+231&quot;,&quot;countryCode&quot;:&quot;LR&quot;}\" >\n                                    +231 - Liberia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+218&quot;,&quot;countryCode&quot;:&quot;LY&quot;}\" >\n                                    +218 - Libyan Arab Jamahiriya                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+423&quot;,&quot;countryCode&quot;:&quot;LI&quot;}\" >\n                                    +423 - Liechtenstein                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+370&quot;,&quot;countryCode&quot;:&quot;LT&quot;}\" >\n                                    +370 - Lithuania                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+352&quot;,&quot;countryCode&quot;:&quot;LU&quot;}\" >\n                                    +352 - Luxembourg                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+853&quot;,&quot;countryCode&quot;:&quot;MO&quot;}\" >\n                                    +853 - Macao                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+389&quot;,&quot;countryCode&quot;:&quot;MK&quot;}\" >\n                                    +389 - Macedonia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+261&quot;,&quot;countryCode&quot;:&quot;MG&quot;}\" >\n                                    +261 - Madagascar                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+265&quot;,&quot;countryCode&quot;:&quot;MW&quot;}\" >\n                                    +265 - Malawi                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+60&quot;,&quot;countryCode&quot;:&quot;MY&quot;}\" >\n                                    +60 - Malaysia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+960&quot;,&quot;countryCode&quot;:&quot;MV&quot;}\" >\n                                    +960 - Maldives                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+223&quot;,&quot;countryCode&quot;:&quot;ML&quot;}\" >\n                                    +223 - Mali                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+356&quot;,&quot;countryCode&quot;:&quot;MT&quot;}\" >\n                                    +356 - Malta                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+692&quot;,&quot;countryCode&quot;:&quot;MH&quot;}\" >\n                                    +692 - Marshall Islands                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+596&quot;,&quot;countryCode&quot;:&quot;MQ&quot;}\" >\n                                    +596 - Martinique                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+222&quot;,&quot;countryCode&quot;:&quot;MR&quot;}\" >\n                                    +222 - Mauritania                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+230&quot;,&quot;countryCode&quot;:&quot;MU&quot;}\" >\n                                    +230 - Mauritius                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+262&quot;,&quot;countryCode&quot;:&quot;YT&quot;}\" >\n                                    +262 - Mayotte                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+52&quot;,&quot;countryCode&quot;:&quot;MX&quot;}\" >\n                                    +52 - Mexico                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+691&quot;,&quot;countryCode&quot;:&quot;FM&quot;}\" >\n                                    +691 - Micronesia, Federated States of Micronesia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+373&quot;,&quot;countryCode&quot;:&quot;MD&quot;}\" >\n                                    +373 - Moldova                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+377&quot;,&quot;countryCode&quot;:&quot;MC&quot;}\" >\n                                    +377 - Monaco                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+976&quot;,&quot;countryCode&quot;:&quot;MN&quot;}\" >\n                                    +976 - Mongolia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+382&quot;,&quot;countryCode&quot;:&quot;ME&quot;}\" >\n                                    +382 - Montenegro                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1664&quot;,&quot;countryCode&quot;:&quot;MS&quot;}\" >\n                                    +1664 - Montserrat                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+212&quot;,&quot;countryCode&quot;:&quot;MA&quot;}\" >\n                                    +212 - Morocco                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+258&quot;,&quot;countryCode&quot;:&quot;MZ&quot;}\" >\n                                    +258 - Mozambique                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+95&quot;,&quot;countryCode&quot;:&quot;MM&quot;}\" >\n                                    +95 - Myanmar                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+264&quot;,&quot;countryCode&quot;:&quot;NA&quot;}\" >\n                                    +264 - Namibia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+674&quot;,&quot;countryCode&quot;:&quot;NR&quot;}\" >\n                                    +674 - Nauru                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+977&quot;,&quot;countryCode&quot;:&quot;NP&quot;}\" >\n                                    +977 - Nepal                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+31&quot;,&quot;countryCode&quot;:&quot;NL&quot;}\" >\n                                    +31 - Netherlands                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+599&quot;,&quot;countryCode&quot;:&quot;AN&quot;}\" >\n                                    +599 - Netherlands Antilles                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+687&quot;,&quot;countryCode&quot;:&quot;NC&quot;}\" >\n                                    +687 - New Caledonia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+64&quot;,&quot;countryCode&quot;:&quot;NZ&quot;}\" >\n                                    +64 - New Zealand                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+505&quot;,&quot;countryCode&quot;:&quot;NI&quot;}\" >\n                                    +505 - Nicaragua                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+227&quot;,&quot;countryCode&quot;:&quot;NE&quot;}\" >\n                                    +227 - Niger                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+234&quot;,&quot;countryCode&quot;:&quot;NG&quot;}\" >\n                                    +234 - Nigeria                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+683&quot;,&quot;countryCode&quot;:&quot;NU&quot;}\" >\n                                    +683 - Niue                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+672&quot;,&quot;countryCode&quot;:&quot;NF&quot;}\" >\n                                    +672 - Norfolk Island                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1670&quot;,&quot;countryCode&quot;:&quot;MP&quot;}\" >\n                                    +1670 - Northern Mariana Islands                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+47&quot;,&quot;countryCode&quot;:&quot;NO&quot;}\" >\n                                    +47 - Norway                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+968&quot;,&quot;countryCode&quot;:&quot;OM&quot;}\" >\n                                    +968 - Oman                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+92&quot;,&quot;countryCode&quot;:&quot;PK&quot;}\" >\n                                    +92 - Pakistan                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+680&quot;,&quot;countryCode&quot;:&quot;PW&quot;}\" >\n                                    +680 - Palau                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+970&quot;,&quot;countryCode&quot;:&quot;PS&quot;}\" >\n                                    +970 - Palestinian Territory, Occupied                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+507&quot;,&quot;countryCode&quot;:&quot;PA&quot;}\" >\n                                    +507 - Panama                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+675&quot;,&quot;countryCode&quot;:&quot;PG&quot;}\" >\n                                    +675 - Papua New Guinea                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+595&quot;,&quot;countryCode&quot;:&quot;PY&quot;}\" >\n                                    +595 - Paraguay                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+51&quot;,&quot;countryCode&quot;:&quot;PE&quot;}\" >\n                                    +51 - Peru                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+63&quot;,&quot;countryCode&quot;:&quot;PH&quot;}\" >\n                                    +63 - Philippines                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+872&quot;,&quot;countryCode&quot;:&quot;PN&quot;}\" >\n                                    +872 - Pitcairn                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+48&quot;,&quot;countryCode&quot;:&quot;PL&quot;}\" >\n                                    +48 - Poland                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+351&quot;,&quot;countryCode&quot;:&quot;PT&quot;}\" >\n                                    +351 - Portugal                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1939&quot;,&quot;countryCode&quot;:&quot;PR&quot;}\" >\n                                    +1939 - Puerto Rico                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+974&quot;,&quot;countryCode&quot;:&quot;QA&quot;}\" >\n                                    +974 - Qatar                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+40&quot;,&quot;countryCode&quot;:&quot;RO&quot;}\" >\n                                    +40 - Romania                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+7&quot;,&quot;countryCode&quot;:&quot;RU&quot;}\" >\n                                    +7 - Russia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+250&quot;,&quot;countryCode&quot;:&quot;RW&quot;}\" >\n                                    +250 - Rwanda                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+262&quot;,&quot;countryCode&quot;:&quot;RE&quot;}\" >\n                                    +262 - Reunion                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+590&quot;,&quot;countryCode&quot;:&quot;BL&quot;}\" >\n                                    +590 - Saint Barthelemy                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+290&quot;,&quot;countryCode&quot;:&quot;SH&quot;}\" >\n                                    +290 - Saint Helena, Ascension and Tristan Da Cunha                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1869&quot;,&quot;countryCode&quot;:&quot;KN&quot;}\" >\n                                    +1869 - Saint Kitts and Nevis                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1758&quot;,&quot;countryCode&quot;:&quot;LC&quot;}\" >\n                                    +1758 - Saint Lucia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+590&quot;,&quot;countryCode&quot;:&quot;MF&quot;}\" >\n                                    +590 - Saint Martin                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+508&quot;,&quot;countryCode&quot;:&quot;PM&quot;}\" >\n                                    +508 - Saint Pierre and Miquelon                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1784&quot;,&quot;countryCode&quot;:&quot;VC&quot;}\" >\n                                    +1784 - Saint Vincent and the Grenadines                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+685&quot;,&quot;countryCode&quot;:&quot;WS&quot;}\" >\n                                    +685 - Samoa                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+378&quot;,&quot;countryCode&quot;:&quot;SM&quot;}\" >\n                                    +378 - San Marino                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+239&quot;,&quot;countryCode&quot;:&quot;ST&quot;}\" >\n                                    +239 - Sao Tome and Principe                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+966&quot;,&quot;countryCode&quot;:&quot;SA&quot;}\" >\n                                    +966 - Saudi Arabia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+221&quot;,&quot;countryCode&quot;:&quot;SN&quot;}\" >\n                                    +221 - Senegal                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+381&quot;,&quot;countryCode&quot;:&quot;RS&quot;}\" >\n                                    +381 - Serbia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+248&quot;,&quot;countryCode&quot;:&quot;SC&quot;}\" >\n                                    +248 - Seychelles                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+232&quot;,&quot;countryCode&quot;:&quot;SL&quot;}\" >\n                                    +232 - Sierra Leone                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+65&quot;,&quot;countryCode&quot;:&quot;SG&quot;}\" >\n                                    +65 - Singapore                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+421&quot;,&quot;countryCode&quot;:&quot;SK&quot;}\" >\n                                    +421 - Slovakia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+386&quot;,&quot;countryCode&quot;:&quot;SI&quot;}\" >\n                                    +386 - Slovenia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+677&quot;,&quot;countryCode&quot;:&quot;SB&quot;}\" >\n                                    +677 - Solomon Islands                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+252&quot;,&quot;countryCode&quot;:&quot;SO&quot;}\" >\n                                    +252 - Somalia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+27&quot;,&quot;countryCode&quot;:&quot;ZA&quot;}\" >\n                                    +27 - South Africa                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+211&quot;,&quot;countryCode&quot;:&quot;SS&quot;}\" >\n                                    +211 - South Sudan                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+500&quot;,&quot;countryCode&quot;:&quot;GS&quot;}\" >\n                                    +500 - South Georgia and the South Sandwich Islands                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+34&quot;,&quot;countryCode&quot;:&quot;ES&quot;}\" >\n                                    +34 - Spain                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+94&quot;,&quot;countryCode&quot;:&quot;LK&quot;}\" >\n                                    +94 - Sri Lanka                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+249&quot;,&quot;countryCode&quot;:&quot;SD&quot;}\" >\n                                    +249 - Sudan                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+597&quot;,&quot;countryCode&quot;:&quot;SR&quot;}\" >\n                                    +597 - Suriname                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+47&quot;,&quot;countryCode&quot;:&quot;SJ&quot;}\" >\n                                    +47 - Svalbard and Jan Mayen                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+268&quot;,&quot;countryCode&quot;:&quot;SZ&quot;}\" >\n                                    +268 - Swaziland                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+46&quot;,&quot;countryCode&quot;:&quot;SE&quot;}\" >\n                                    +46 - Sweden                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+41&quot;,&quot;countryCode&quot;:&quot;CH&quot;}\" >\n                                    +41 - Switzerland                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+963&quot;,&quot;countryCode&quot;:&quot;SY&quot;}\" >\n                                    +963 - Syrian Arab Republic                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+886&quot;,&quot;countryCode&quot;:&quot;TW&quot;}\" >\n                                    +886 - Taiwan                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+992&quot;,&quot;countryCode&quot;:&quot;TJ&quot;}\" >\n                                    +992 - Tajikistan                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+255&quot;,&quot;countryCode&quot;:&quot;TZ&quot;}\" >\n                                    +255 - Tanzania, United Republic of Tanzania                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+66&quot;,&quot;countryCode&quot;:&quot;TH&quot;}\" >\n                                    +66 - Thailand                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+670&quot;,&quot;countryCode&quot;:&quot;TL&quot;}\" >\n                                    +670 - Timor-Leste                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+228&quot;,&quot;countryCode&quot;:&quot;TG&quot;}\" >\n                                    +228 - Togo                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+690&quot;,&quot;countryCode&quot;:&quot;TK&quot;}\" >\n                                    +690 - Tokelau                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+676&quot;,&quot;countryCode&quot;:&quot;TO&quot;}\" >\n                                    +676 - Tonga                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1868&quot;,&quot;countryCode&quot;:&quot;TT&quot;}\" >\n                                    +1868 - Trinidad and Tobago                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+216&quot;,&quot;countryCode&quot;:&quot;TN&quot;}\" >\n                                    +216 - Tunisia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+90&quot;,&quot;countryCode&quot;:&quot;TR&quot;}\" >\n                                    +90 - Turkey                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+993&quot;,&quot;countryCode&quot;:&quot;TM&quot;}\" >\n                                    +993 - Turkmenistan                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1649&quot;,&quot;countryCode&quot;:&quot;TC&quot;}\" >\n                                    +1649 - Turks and Caicos Islands                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+688&quot;,&quot;countryCode&quot;:&quot;TV&quot;}\" >\n                                    +688 - Tuvalu                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+256&quot;,&quot;countryCode&quot;:&quot;UG&quot;}\" >\n                                    +256 - Uganda                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+380&quot;,&quot;countryCode&quot;:&quot;UA&quot;}\" >\n                                    +380 - Ukraine                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+971&quot;,&quot;countryCode&quot;:&quot;AE&quot;}\" >\n                                    +971 - United Arab Emirates                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+44&quot;,&quot;countryCode&quot;:&quot;GB&quot;}\" >\n                                    +44 - United Kingdom                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1&quot;,&quot;countryCode&quot;:&quot;US&quot;}\" >\n                                    +1 - United States                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+598&quot;,&quot;countryCode&quot;:&quot;UY&quot;}\" >\n                                    +598 - Uruguay                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+998&quot;,&quot;countryCode&quot;:&quot;UZ&quot;}\" >\n                                    +998 - Uzbekistan                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+678&quot;,&quot;countryCode&quot;:&quot;VU&quot;}\" >\n                                    +678 - Vanuatu                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+58&quot;,&quot;countryCode&quot;:&quot;VE&quot;}\" >\n                                    +58 - Venezuela, Bolivarian Republic of Venezuela                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+84&quot;,&quot;countryCode&quot;:&quot;VN&quot;}\" >\n                                    +84 - Vietnam                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1284&quot;,&quot;countryCode&quot;:&quot;VG&quot;}\" >\n                                    +1284 - Virgin Islands, British                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+1340&quot;,&quot;countryCode&quot;:&quot;VI&quot;}\" >\n                                    +1340 - Virgin Islands, U.S.                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+681&quot;,&quot;countryCode&quot;:&quot;WF&quot;}\" >\n                                    +681 - Wallis and Futuna                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+967&quot;,&quot;countryCode&quot;:&quot;YE&quot;}\" >\n                                    +967 - Yemen                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+260&quot;,&quot;countryCode&quot;:&quot;ZM&quot;}\" >\n                                    +260 - Zambia                                <\/option>\n                                                            <option value=\"{&quot;countryCallingCode&quot;:&quot;+263&quot;,&quot;countryCode&quot;:&quot;ZW&quot;}\" >\n                                    +263 - Zimbabwe                                <\/option>\n                                                    <\/select>\n                                        \n                    <input type=\"tel\" name=\"mobile_number\" id=\"userContact\" placeholder=\"06 12 34 56 78\" required>\n                <\/div>\n            <\/div>\n            \n            <div class=\"kivicare-form-group\">\n                <label for=\"Usergender\">\n                    Genre                    <span>*<\/span>\n                <\/label>\n                <div class=\"kivicare-gender-group\">\n                    <div class=\"kivicare-radio-item\">\n                        <input type=\"radio\" id=\"male\" name=\"gender\" value=\"male\" required>\n                        <label for=\"male\">Homme<\/label>\n                    <\/div>\n                    <div class=\"kivicare-radio-item\">\n                        <input type=\"radio\" id=\"female\" name=\"gender\" value=\"female\">\n                        <label for=\"female\">Femme<\/label>\n                    <\/div>\n                    <div class=\"kivicare-radio-item\" id=\"otherGenderOption\">\n                        <input type=\"radio\" id=\"other\" name=\"gender\" value=\"other\">\n                        <label for=\"other\">Autre<\/label>\n                    <\/div>\n                <\/div>\n            <\/div>\n            \n                            <div class=\"kivicare-form-group\">\n                    <label for=\"userRole\">\n                        Type de compte                        <span>*<\/span>\n                    <\/label>\n                    <select name=\"user_role\" id=\"userRole\" required>\n                                                    <option value=\"kiviCare_doctor\">\n                                Bioth\u00e9rapeute                            <\/option>\n                                            <\/select>\n                <\/div>\n                        \n                            <div class=\"kivicare-form-group\">\n                    <label for=\"userClinic\">\n                        S\u00e9lectionner une clinique                        <span>*<\/span>\n                    <\/label>\n                    <select name=\"user_clinic\" id=\"userClinic\" required>\n                                                    <option value=\"1\"  selected='selected'>\n                                Permis111                            <\/option>\n                                            <\/select>\n                <\/div>\n                        \n            <div id=\"kcCustomFieldsList\" class=\"kivicare-custom-fields\"><\/div>\n            \n            <button type=\"submit\" class=\"kivicare-btn-register\" id=\"kivicare-btn-register\">\n                <span class=\"btn-text\">\n                    <i class=\"fas fa-user-plus\"><\/i> \n                    S&#039;inscrire                <\/span>\n                <span class=\"spinner\"><\/span>\n            <\/button>\n        <\/form>\n    <\/div>\n<\/div>\n\n<script>\n(function($) {\n    'use strict';\n    \n    \/\/ Attendre que tout soit charg\u00e9\n    function initializeSelect2() {\n        \/\/ S'assurer que Select2 est charg\u00e9\n        if (typeof $.fn.select2 === 'undefined') {\n            setTimeout(initializeSelect2, 100);\n            return;\n        }\n        \n        \/\/ Initialiser Select2 avec options\n        if ($('#CountryCode').length) {\n            $('#CountryCode').select2({\n                width: '100%',\n                placeholder: 'S\u00e9lectionner...',\n                allowClear: false\n            });\n        }\n        \n        if ($('#userRole').length) {\n            $('#userRole').select2({ \n                minimumResultsForSearch: Infinity,\n                width: '100%',\n                placeholder: 'S\u00e9lectionner un type de compte'\n            });\n        }\n        \n        if ($('#userClinic').length) {\n            $('#userClinic').select2({ \n                minimumResultsForSearch: Infinity,\n                width: '100%',\n                placeholder: 'S\u00e9lectionner une clinique'\n            });\n        }\n    }\n    \n    document.addEventListener('readystatechange', event => {\n        if (event.target.readyState === \"complete\") {\n            \/\/ Petit d\u00e9lai pour s'assurer que Select2 est charg\u00e9\n            setTimeout(function() {\n                initializeSelect2();\n                \n                \/\/ Appeler apr\u00e8s l'initialisation de Select2\n                setTimeout(function() {\n                    if($('#userRole').val()){\n                        kcGetRegisterPageCustomField($('#userRole').val());\n                    }\n                    \n                    if (document.getElementById('CountryCode') !== null) {\n                        getCountryCodeData();\n                    }\n                    \n                    getUserRegistrationFormData();\n                }, 200);\n            }, 300);\n            \n                    }\n    });\n    \n        \n    function kivicareShowError(message) {\n        const errorDiv = $('#kivicare-register-error');\n        const errorMsg = $('#kivicare-register-error-msg');\n        const successDiv = $('#kivicare-register-success');\n        \n        errorMsg.text(message);\n        errorDiv.addClass('show');\n        successDiv.removeClass('show');\n    }\n    \n    function kivicareShowSuccess(message) {\n        const successDiv = $('#kivicare-register-success');\n        const successMsg = $('#kivicare-register-success-msg');\n        const errorDiv = $('#kivicare-register-error');\n        \n        successMsg.text(message);\n        successDiv.addClass('show');\n        errorDiv.removeClass('show');\n    }\n    \n    const post = (route, data = {}, frontEnd = false, headers = {}) => {\n        window.ajaxurl = 'https:\/\/permis111.com\/wp-admin\/admin-ajax.php';\n        window.nonce = '0abae89a41';\n        \n        let url = window.ajaxurl + '?action=ajax_post';\n        \n        if (data.append !== undefined) {\n            data.append('route_name', route);\n            data.append('_ajax_nonce', window.nonce);\n        } else {\n            data.route_name = route;\n            data._ajax_nonce = window.nonce;\n        }\n        \n        return new Promise((resolve, reject) => {\n            axios.post(url, data, headers)\n                .then((response) => {\n                    if (response.data.status_code !== undefined && response.data.status_code === 403) {\n                        kivicareShowError('Route not found');\n                    }\n                    resolve(response);\n                })\n                .catch((error) => {\n                    reject(error);\n                    kivicareShowError('Internal server error');\n                });\n        });\n    };\n    \n    const get = (route, data, frontEnd = false) => {\n        data._ajax_nonce = '911ea2f24c';\n        let url = 'https:\/\/permis111.com\/wp-admin\/admin-ajax.php';\n        url = url + '?action=ajax_get&route_name=' + route;\n        \n        return new Promise((resolve, reject) => {\n            axios.get(url, {params: data})\n                .then((response) => {\n                    if (response.data.status_code !== undefined && response.data.status_code === 403) {\n                        kivicareShowError('Route not found');\n                    }\n                    resolve(response);\n                })\n                .catch((error) => {\n                    reject(error);\n                    kivicareShowError('Internal server error');\n                });\n        });\n    };\n    \n    $(document).on('submit', '#kivicare-modern-register-form', function(event) {\n        event.preventDefault();\n        \n        $('#kcCustomFieldsList .kivicare-required').prop('required', true);\n        $.each($('#kcCustomFieldsList').find(':input:checkbox').parent().parent(), function(key, value) {\n            let cbx_group = $(value).find(':input:checkbox');\n            if (cbx_group.is(\":checked\")) {\n                cbx_group.prop('required', false);\n            }\n        });\n        \n        const btnRegister = $('#kivicare-btn-register');\n        btnRegister.addClass('loading');\n        \n        var result = {};\n        $.each($(this).find(':input').serializeArray(), function() {\n            result[this.name] = this.value;\n        });\n        \n        var custom_fields = kivicareCustomFieldsData('kcCustomFieldsList');\n        const registerData = {...result, ...{custom_fields}};\n        \n        let formData = new FormData(this);\n        $.each(registerData, function(key, value) {\n            if (typeof(value) === 'object') {\n                value = JSON.stringify(value);\n            }\n            formData.append(key, value);\n        });\n        \n        post('register_new_user', formData, true)\n            .then((response) => {\n                btnRegister.removeClass('loading');\n                \n                                \n                if (response.data.status !== undefined && response.data.status === true) {\n                    \/\/ Masquer le formulaire et le logo\n                    $('#kivicare-modern-register-form').hide();\n                    $('.kivicare-logo').hide();\n                    $('#kivicare-register-error').hide();\n                    \n                    \/\/ Afficher le message retourn\u00e9 par le serveur (qui contient l'info sur la validation)\n                    kivicareShowSuccess(response.data.message);\n                    \n                    \/\/ Ajouter la classe pour afficher le message en plein \u00e9cran\n                    $('#kivicare-register-success').addClass('full-message');\n                    \n                    \/\/ Afficher la barre de progression et le texte de redirection\n                    $('.kivicare-progress-container').show();\n                    $('#kivicare-redirect-text').show();\n                    \n                    \/\/ Scroll vers le haut pour afficher le message\n                    $('html, body').animate({\n                        scrollTop: $('.kivicare-register-container').offset().top - 20\n                    }, 500);\n                    \n                    \/\/ Animer la barre de progression\n                    let progress = 0;\n                    const totalTime = 5000; \/\/ 5 secondes\n                    const interval = 30; \/\/ Mise \u00e0 jour toutes les 30ms\n                    const increment = (interval \/ totalTime) * 100;\n                    \n                    const progressInterval = setInterval(() => {\n                        progress += increment;\n                        if (progress >= 100) {\n                            progress = 100;\n                            clearInterval(progressInterval);\n                        }\n                        $('#kivicare-progress-bar').css('width', progress + '%');\n                    }, interval);\n                    \n                    \/\/ Rediriger vers permis-login.php apr\u00e8s l'animation\n                    setTimeout(() => {\n                        window.location.href = 'https:\/\/permis111.com\/permis-login.php';\n                    }, totalTime);\n                } else {\n                    kivicareShowError(response.data.message || 'Erreur lors de l\\&#039;inscription');\n                    \n                    \/\/ Scroll vers le haut pour afficher le message d'erreur\n                    $('html, body').animate({\n                        scrollTop: $('.kivicare-register-container').offset().top - 20\n                    }, 500);\n                }\n            })\n            .catch((error) => {\n                btnRegister.removeClass('loading');\n                \n                                \n                kivicareShowError('Erreur de connexion au serveur');\n                \n                \/\/ Scroll vers le haut pour afficher le message d'erreur\n                $('html, body').animate({\n                    scrollTop: $('.kivicare-register-container').offset().top - 20\n                }, 500);\n                \n                console.log(error);\n            });\n    });\n    \n    $(document).on('change', '#userRole', function(event) {\n        kcGetRegisterPageCustomField(this.value);\n    });\n    \n    function kcGetRegisterPageCustomField(type) {\n        let customFieldEle = document.getElementById('kcCustomFieldsList');\n        customFieldEle.innerHTML = '<div class=\"kivicare-loader\"><i class=\"fas fa-spinner fa-spin\"><\/i> Chargement...<\/div>';\n        \n        get('get_appointment_custom_field', {user_role: type}, true)\n            .then((res) => {\n                customFieldEle.innerHTML = '';\n                if(res.data.status !== undefined && res.data.status){\n                    customFieldEle.innerHTML = res.data.data;\n                    $('#kcCustomFieldsList').find('.appointment_widget_multiselect').each(function() {\n                        $(this).select2({\n                            placeholder: $(this).attr('placeholder'),\n                            allowClear: true\n                        });\n                    });\n                }\n            })\n            .catch((error) => {\n                customFieldEle.innerHTML = '';\n                console.log(error);\n            });\n    }\n    \n    function getCountryCodeData() {\n        get('get_country_code_settings_data', {})\n            .then((response) => {\n                if (response.data.status !== undefined && response.data.status === true) {\n                    var valueString = '{\"countryCallingCode\":\"+' + response.data.data.country_calling_code + '\",\"countryCode\":\"' + response.data.data.country_code + '\"}';\n                    $('#CountryCode').val(valueString).trigger('change');\n                }\n            })\n            .catch((error) => {\n                console.log(error);\n            });\n    }\n    \n    function getUserRegistrationFormData() {\n        get('get_user_registration_form_settings_data', {})\n            .then((response) => {\n                if (response.data.status !== undefined && response.data.status === true) {\n                    let userRegistrationFormSettingData = response.data.data.userRegistrationFormSettingData;\n                    if (userRegistrationFormSettingData === 'on') {\n                        $('#otherGenderOption').show();\n                    } else {\n                        $('#otherGenderOption').hide();\n                    }\n                }\n            })\n            .catch((error) => {\n                console.log(error);\n            });\n    }\n    \n    function kivicareCustomFieldsData(ele) {\n        var custom_fields = {};\n        $.each($('#'+ele).find('select, textarea, :input:not(:checkbox)').serializeArray(), function() {\n            custom_fields[this.name] = this.value;\n        });\n        var temp = [];\n        var temp2 = '';\n        $.each($('#'+ele).find(':input:checkbox').serializeArray(), function(key, value) {\n            if(temp2 !== value.name){\n                temp = [];\n            }\n            temp.push(value.value);\n            custom_fields[value.name] = temp;\n            temp2 = value.name;\n        });\n        $('#'+ele).find('.appointment_widget_multiselect').each(function() {\n            custom_fields[$(this).attr('name')] = $(this).val().map((index) => {\n                return {'id': index, 'text': index};\n            });\n        });\n        return custom_fields;\n    }\n    \n})(jQuery);\n<\/script>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-41115","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/permis111.com\/pt\/wp-json\/wp\/v2\/pages\/41115","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/permis111.com\/pt\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/permis111.com\/pt\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/permis111.com\/pt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/permis111.com\/pt\/wp-json\/wp\/v2\/comments?post=41115"}],"version-history":[{"count":3,"href":"https:\/\/permis111.com\/pt\/wp-json\/wp\/v2\/pages\/41115\/revisions"}],"predecessor-version":[{"id":41325,"href":"https:\/\/permis111.com\/pt\/wp-json\/wp\/v2\/pages\/41115\/revisions\/41325"}],"wp:attachment":[{"href":"https:\/\/permis111.com\/pt\/wp-json\/wp\/v2\/media?parent=41115"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}