{"id":1304,"date":"2026-08-13T13:11:07","date_gmt":"2026-08-13T17:11:07","guid":{"rendered":"https:\/\/ddm-chg.com\/?page_id=1304"},"modified":"2026-09-23T11:04:23","modified_gmt":"2026-09-23T15:04:23","slug":"formulaire-de-declaration-de-comportements-non-ethiques","status":"publish","type":"page","link":"https:\/\/ddm-chg.com\/en\/formulaire-de-declaration-de-comportements-non-ethiques\/","title":{"rendered":"Formulaire de d\u00e9claration de comportements non \u00e9thiques"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_3' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Formulaire de d\u00e9claration de comportements non \u00e9thiques<\/h2>\n                            <p class='gform_description'>Signalement d'une situation de comportements non \u00e9thiques.<\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_3'  action='\/en\/wp-json\/wp\/v2\/pages\/1304' data-formid='3' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_3' class='gform_fields top_label form_sublabel_above description_above validation_above' data-column-layout='fill'><div id=\"field_3_68\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\"><label id='gfield_label_3_68' class='gfield_label gform-field-label' for='input_3_68'><span class='gform-field-label__text'>URL<\/span><\/label><div class='gfield_description' id='gfield_description_3_68'>This field is for validation purposes and should be left unchanged.<\/div><div class='ginput_container'><input name='input_68' id='input_3_68' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_3_51\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"e6648c0e\" data-field-span=\"12\"><h3>1. Informations sur le [la] d\u00e9clarant[e]<\/h3><\/div><div id=\"field_3_9\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"1b9959cc\" data-field-span=\"12\"><label id='gfield_label_3_9' class='gfield_label gform-field-label' for='input_3_9'><span class='gform-field-label__text'>Identit\u00e9<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_9' id='input_3_9' class='large gfield_select'     aria-invalid=\"false\" ><option value='Je consens \u00e0 ce que mon identit\u00e9 soit divulgu\u00e9e dans le traitement de ma d\u00e9claration' >Je consens \u00e0 ce que mon identit\u00e9 soit divulgu\u00e9e dans le traitement de ma d\u00e9claration<\/option><option value='Je souhaite que mon identit\u00e9 demeure confidentielle' >Je souhaite que mon identit\u00e9 demeure confidentielle<\/option><option value='Je souhaite faire une d\u00e9claration anonyme' >Je souhaite faire une d\u00e9claration anonyme<\/option><\/select><\/div><\/div><fieldset id=\"field_3_55\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"4ad34754\" data-field-span=\"12\"><legend id='gfield_label_3_55' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Nom complet du d\u00e9clarant<\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_3_55'>\n                            \n                            <span id='input_3_55_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_3_55_3' id='input_3_55_3_label' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_55.3' id='input_3_55_3' value=''   aria-required='false'     aria-labelledby=\"input_3_55_3_label gfield_label_3_55\"\/>\n                                                <\/span>\n                            \n                            <span id='input_3_55_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_3_55_6' id='input_3_55_6_label' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_55.6' id='input_3_55_6' value=''   aria-required='false'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_3_4\" class=\"gfield gfield--type-post_custom_field gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"fbadcb9d\" data-field-span=\"12\"><label id='gfield_label_3_4' class='gfield_label gform-field-label' for='input_3_4'><span class='gform-field-label__text'>Poste\/fonction<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_3_4' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_5\" class=\"gfield gfield--type-post_custom_field gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"f5ef112d\" data-field-span=\"12\"><label id='gfield_label_3_5' class='gfield_label gform-field-label' for='input_3_5'><span class='gform-field-label__text'>Service\/d\u00e9partement<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_3_5' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_7\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"d7f66c8a\" data-field-span=\"12\"><label id='gfield_label_3_7' class='gfield_label gform-field-label' for='input_3_7'><span class='gform-field-label__text'>Adresse courriel<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_7' id='input_3_7' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_3_8\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-formatted gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"f25ff0c4\" data-field-span=\"12\"><legend id='gfield_label_3_8' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>T\u00e9l\u00e9phone<\/span><\/legend><div class='ginput_container ginput_container_phone'>\n\t\t\t<div class=\"gform-phone\">\n\t\t\t\t<div class=\"gform-phone__input-wrapper\">\n\t\t\t\t\t<span class=\"ginput_country-selector_container\">\n\t\t\t\t\t\t<label for='country_selector_button_8' id='country_selector_button_8_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n\t\t\t\t\t\t<button type=\"button\" id=\"country_selector_button_8\" class=\"gform-phone__country-selector gform-theme-button gform-theme-button--tertiary\" aria-haspopup=\"listbox\" aria-expanded=\"false\" aria-controls=\"gform_phone_dropdown_6adae3e046618\" aria-label=\"Select country\" >\n\t\t\t\t\t\t\t<span class=\"gform-phone__flag-icon gform-phone__flag-icon--ca\"><\/span>\n\t\t\t\t\t\t\t<span class=\"gform-phone__dial-code\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t\t\t\t\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<span class=\"ginput_phone_container\">\n\t\t\t\t\t\t<label for='input_3_8_visible' id='input_3_8_visible_label' class='gform-field-label gform-field-label--type-sub '>Num\u00e9ro de t\u00e9l\u00e9phone<\/label>\n\t\t\t\t\t\t<input type=\"tel\" class=\"gform-phone__input\" id=\"input_3_8_visible\" name=\"\" autocomplete=\"tel\" value=\"\"    aria-invalid=\"false\"  >\n\t\t\t\t\t\t\n\t\t\t\t\t<\/span>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"gform-phone__dropdown gform-phone__dropdown--hidden\" role=\"listbox\" id=\"gform_phone_dropdown_6adae3e046618\" tabindex=\"-1\">\n\t\t\t\t\t<div class=\"gform-phone__search-wrapper\">\n\t\t\t\t\t\t<input type=\"text\" class=\"gform-phone__search\" placeholder=\"Search countries\" aria-label=\"Search for a country\" aria-controls=\"gform_phone_dropdown_6adae3e046618_list\">\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<ul class=\"gform-phone__country-list gform-ul-reset\" id=\"gform_phone_dropdown_6adae3e046618_list\" role=\"listbox\" aria-label=\"Country list\">\n\t\t\t\t\t\t<!-- Country items will be populated by JavaScript -->\n\t\t\t\t\t<\/ul>\n\t\t\t\t\t<div class=\"gform-phone__aria-live-search-status\" aria-live=\"polite\" aria-atomic=\"true\" style=\"position: absolute; width: 1px; height: 1px; margin: -1px; border: 0; padding: 0; overflow: hidden; clip: rect(0, 0, 0, 0); clip-path: inset(50%); white-space: nowrap;\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"gform-phone__aria-live\" aria-live=\"polite\" aria-atomic=\"true\" style=\"position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0 0 0 0); clip-path: inset(50%); border: 0; white-space: nowrap;\"><\/div>\n\t\t\t<\/div><input name='input_8' id='input_3_8' type='hidden' value='' class='large' data-phone-format='formatted' data-default-country='ca' data-show-country-code='false'  aria-invalid=\"false\" \/><\/div><\/fieldset><div id=\"field_3_59\" class=\"gfield gfield--type-section gfield--input-type-section gsection no-spacing field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"ba7eddc9\" data-field-span=\"12\"><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_3_52\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full no-spacing gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"98e61d0f\" data-field-span=\"12\"><h3>2. Informations sur la situation<\/h3><\/div><fieldset id=\"field_3_50\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"1c6bfb1a\" data-field-span=\"12\"><legend id='gfield_label_3_50' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Date de l&#039;\u00e9v\u00e9nement<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_3_50' class='ginput_container ginput_complex gform-grid-row'>\n                                        <div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_3_50_3_container'>\n                                            <label for='input_3_50_3' id='input_3_50_3_label' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                                            <input type='number' maxlength='4' name='input_50[]' id='input_3_50_3' value=''   aria-required='true'   aria-labelledby=\"input_3_50_3_label gfield_label_3_50\"  placeholder='YYYY' min='1920' max='2027' step='1'\/>\n                                        <\/div><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_3_50_1_container'>\n                                            <label for='input_3_50_1' id='input_3_50_1_label' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Month<\/label>\n                                            <input type='number' maxlength='2' name='input_50[]' id='input_3_50_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_3_50_2_container'>\n                                            <label for='input_3_50_2' id='input_3_50_2_label' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Day<\/label>\n                                            <input type='number' maxlength='2' name='input_50[]' id='input_3_50_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                       <\/div>\n                                    <\/div><\/fieldset><div id=\"field_3_18\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"5ec9ad4d\" data-field-span=\"12\"><label id='gfield_label_3_18' class='gfield_label gform-field-label' for='input_3_18'><span class='gform-field-label__text'>Lieu de l&#039;\u00e9v\u00e9nement<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_3_18' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_20\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"a64bbee3\" data-field-span=\"12\"><label id='gfield_label_3_20' class='gfield_label gform-field-label' for='input_3_20'><span class='gform-field-label__text'>Personne(s) impliqu\u00e9e(s)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_20' id='input_3_20' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_3_22\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"3aef44dc\" data-field-span=\"12\"><label id='gfield_label_3_22' class='gfield_label gform-field-label' for='input_3_22'><span class='gform-field-label__text'>Description des faits<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_3_22'>D\u00e9crire de mani\u00e8re factuelle et d\u00e9taill\u00e9e ce qui s\u2019est produit.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_22' id='input_3_22' class='textarea small'  aria-describedby=\"gfield_description_3_22\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_3_26\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"e211e1a4\" data-field-span=\"12\"><legend id='gfield_label_3_26' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Nature du comportement non \u00e9thique<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_3_26'>S\u00e9lectionner tous les choix qui s'appliquent \u00e0 la situation d\u00e9crite.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_26'><div class='gchoice gchoice_3_26_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.1' type='checkbox'  value='Conflit d\u2019int\u00e9r\u00eats'  id='choice_3_26_1'   aria-describedby=\"gfield_description_3_26\" aria-labelledby=\"label_3_26_1 gfield_label_3_26\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_3_26_1' id='label_3_26_1' class='gform-field-label gform-field-label--type-inline'>Conflit d\u2019int\u00e9r\u00eats<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_26_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.2' type='checkbox'  value='Fraude ou malversation'  id='choice_3_26_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_26_2' id='label_3_26_2' class='gform-field-label gform-field-label--type-inline'>Fraude ou malversation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_26_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.3' type='checkbox'  value='Harc\u00e8lement (psychologique ou sexuel)'  id='choice_3_26_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_26_3' id='label_3_26_3' class='gform-field-label gform-field-label--type-inline'>Harc\u00e8lement (psychologique ou sexuel)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_26_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.4' type='checkbox'  value='Non-respect des politiques internes'  id='choice_3_26_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_26_4' id='label_3_26_4' class='gform-field-label gform-field-label--type-inline'>Non-respect des politiques internes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_26_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.5' type='checkbox'  value='Manquement \u00e0 la s\u00e9curit\u00e9'  id='choice_3_26_5'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_26_5' id='label_3_26_5' class='gform-field-label gform-field-label--type-inline'>Manquement \u00e0 la s\u00e9curit\u00e9<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_26_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_26.6' type='checkbox'  value='Autre'  id='choice_3_26_6'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_26_6' id='label_3_26_6' class='gform-field-label gform-field-label--type-inline'>Autre<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_60\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"678df722\" data-field-span=\"12\"><label id='gfield_label_3_60' class='gfield_label gform-field-label' for='input_3_60'><span class='gform-field-label__text'>Pr\u00e9ciser.<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_60' id='input_3_60' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_3_27\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"6c5f6a46\" data-field-span=\"12\"><legend id='gfield_label_3_27' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Preuves ou \u00e9l\u00e9ments \u00e0 l&#039;appui<\/span><\/legend><div class='gfield_description' id='gfield_description_3_27'>Indiquer le(s) type(s) d'\u00e9l\u00e9ments de preuve. Ces \u00e9l\u00e9ments peuvent \u00eatre transmis avec ce formulaire. Dans le cas contraire, ceux-ci pourront vous \u00eatre demand\u00e9s lors du traitement de la d\u00e9claration. S'il s'agit de t\u00e9moins, veuillez remplir la section Coordonn\u00e9es des t\u00e9moins.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_27'><div class='gchoice gchoice_3_27_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.1' type='checkbox'  value='Courriels'  id='choice_3_27_1'   aria-describedby=\"gfield_description_3_27\" aria-labelledby=\"label_3_27_1 gfield_label_3_27\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_3_27_1' id='label_3_27_1' class='gform-field-label gform-field-label--type-inline'>Courriels<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_27_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.3' type='checkbox'  value='Rapports'  id='choice_3_27_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_27_2' id='label_3_27_2' class='gform-field-label gform-field-label--type-inline'>Rapports<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_27_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.4' type='checkbox'  value='Photos'  id='choice_3_27_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_27_3' id='label_3_27_3' class='gform-field-label gform-field-label--type-inline'>Photos<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_27_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.2' type='checkbox'  value='T\u00e9moins'  id='choice_3_27_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_27_4' id='label_3_27_4' class='gform-field-label gform-field-label--type-inline'>T\u00e9moins<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_27_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.5' type='checkbox'  value='Autre'  id='choice_3_27_5'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_27_5' id='label_3_27_5' class='gform-field-label gform-field-label--type-inline'>Autre<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_61\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"44dc5cfc\" data-field-span=\"12\"><label id='gfield_label_3_61' class='gfield_label gform-field-label' for='input_3_61'><span class='gform-field-label__text'>Pr\u00e9ciser.<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_61' id='input_3_61' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_29\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"95cc8f79\" data-field-span=\"12\"><label id='gfield_label_3_29' class='gfield_label gform-field-label' for='gform_browse_button_3_29'><span class='gform-field-label__text'>Documents \u00e0 l&#039;appui<\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_3_29' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_3_29&quot;,&quot;container&quot;:&quot;gform_multifile_upload_3_29&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_3_29&quot;,&quot;filelist&quot;:&quot;gform_preview_3_29&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/ddm-chg.com\\\/?gf_page=dbdb7459fe436b8&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/ddm-chg.com\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/ddm-chg.com\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;jpg,gif,png,pdf&quot;}],&quot;max_file_size&quot;:&quot;536870912b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:3,&quot;field_id&quot;:29,&quot;_gform_file_upload_nonce_3_29&quot;:&quot;c82518d022&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;5&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_3_29&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_3_29' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_3_29' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_3_29\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_3_29'>Accepted file types: jpg, gif, png, pdf, Max. file size: 512 MB, Max. files: 5.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_3_29'><\/ul> <div id='gform_preview_3_29' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_3_30\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"f39e8f36\" data-field-span=\"12\"><legend id='gfield_label_3_30' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Coordonn\u00e9es des t\u00e9moins<\/span><\/legend><div class='gfield_description' id='gfield_description_3_30'>Indiquer le nom et les coordonn\u00e9es dont vous disposez pour chacun des t\u00e9moins.<\/div><div class='ginput_container ginput_container_list ginput_list '><div class='gfield_list gfield_list_container'><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_30_cell1 gform-grid-col' ><input aria-invalid='false'  aria-describedby=\"gfield_description_3_30\" aria-labelledby=\"gfield_label_3_30\" data-aria-label-template='Coordonn\u00e9es des t\u00e9moins, Row {0}' type='text' name='input_30[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 10)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 10)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><div id=\"field_3_34\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"18430641\" data-field-span=\"12\"><label id='gfield_label_3_34' class='gfield_label gform-field-label' for='input_3_34'><span class='gform-field-label__text'>Commentaires<\/span><\/label><div class='gfield_description' id='gfield_description_3_34'>Veuillez indiquer toute information compl\u00e9mentaire.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_34' id='input_3_34' class='textarea small'  aria-describedby=\"gfield_description_3_34\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_3_57\" class=\"gfield gfield--type-section gfield--input-type-section gsection no-spacing field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"c9671942\" data-field-span=\"12\"><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_3_53\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full no-spacing gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"934b0aec\" data-field-span=\"12\"><h3>3. Suivi de la situation et impacts<\/h3><\/div><div id=\"field_3_32\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"5830671e\" data-field-span=\"12\"><label id='gfield_label_3_32' class='gfield_label gform-field-label' for='input_3_32'><span class='gform-field-label__text'>Actions d\u00e9j\u00e0 entreprises<\/span><\/label><div class='gfield_description' id='gfield_description_3_32'>Avez-vous d\u00e9j\u00e0 signal\u00e9 la situation? \u00c0 qui? Quelles mesures ont \u00e9t\u00e9 prises?<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_32' id='input_3_32' class='textarea small'  aria-describedby=\"gfield_description_3_32\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_3_33\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"0076fc51\" data-field-span=\"12\"><legend id='gfield_label_3_33' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>R\u00e9percussions ou risques observ\u00e9s<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_33'><div class='gchoice gchoice_3_33_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.1' type='checkbox'  value='Financier'  id='choice_3_33_1'    aria-labelledby=\"label_3_33_1 gfield_label_3_33\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_3_33_1' id='label_3_33_1' class='gform-field-label gform-field-label--type-inline'>Financier<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_33_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.2' type='checkbox'  value='R\u00e9putation de l\u2019entreprise'  id='choice_3_33_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_33_2' id='label_3_33_2' class='gform-field-label gform-field-label--type-inline'>R\u00e9putation de l\u2019entreprise<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_33_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.3' type='checkbox'  value='Climat de travail'  id='choice_3_33_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_33_3' id='label_3_33_3' class='gform-field-label gform-field-label--type-inline'>Climat de travail<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_33_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.5' type='checkbox'  value='Sant\u00e9 et s\u00e9curit\u00e9'  id='choice_3_33_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_33_4' id='label_3_33_4' class='gform-field-label gform-field-label--type-inline'>Sant\u00e9 et s\u00e9curit\u00e9<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_33_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.4' type='checkbox'  value='L\u00e9gal\/conformit\u00e9'  id='choice_3_33_5'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_33_5' id='label_3_33_5' class='gform-field-label gform-field-label--type-inline'>L\u00e9gal\/conformit\u00e9<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_33_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.6' type='checkbox'  value='Autre'  id='choice_3_33_6'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_33_6' id='label_3_33_6' class='gform-field-label gform-field-label--type-inline'>Autre<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_67\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"2a71ec3b\" data-field-span=\"12\"><label id='gfield_label_3_67' class='gfield_label gform-field-label' for='input_3_67'><span class='gform-field-label__text'>Pr\u00e9ciser.<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_67' id='input_3_67' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_37\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"8750e9e9\" data-field-span=\"12\"><label id='gfield_label_3_37' class='gfield_label gform-field-label' for='input_3_37'><span class='gform-field-label__text'>Attentes ou recommandations<\/span><\/label><div class='gfield_description' id='gfield_description_3_37'>Indiquez si vous souhaitez qu\u2019une action particuli\u00e8re soit prise.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_37' id='input_3_37' class='textarea small'  aria-describedby=\"gfield_description_3_37\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_3_58\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"20dc5c74\" data-field-span=\"12\"><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_3_54\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"b1ee22ec\" data-field-span=\"12\"><h3>D\u00e9claration et signature<\/h3><\/div><fieldset id=\"field_3_46\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"15424a5e\" data-field-span=\"12\"><legend id='gfield_label_3_46' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Nom complet du d\u00e9clarant<\/span><\/legend><div class='gfield_description' id='gfield_description_3_46'>Si vous d\u00e9sirez faire une d\u00e9claration anonyme, veuillez ne pas indiquer vos pr\u00e9nom et nom. Vous devez tout de m\u00eame dater ce formulaire et consentir \u00e0 transmettre les informations.<\/div><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_3_46'>\n                            \n                            <span id='input_3_46_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_3_46_3' id='input_3_46_3_label' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_46.3' id='input_3_46_3' value=''   aria-required='false'     aria-describedby=\"gfield_description_3_46\" aria-labelledby=\"input_3_46_3_label gfield_label_3_46\"\/>\n                                                <\/span>\n                            \n                            <span id='input_3_46_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_3_46_6' id='input_3_46_6_label' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_46.6' id='input_3_46_6' value=''   aria-required='false'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_3_39\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_above gfield_visibility_visible\" data-group-id=\"d2b8ecda\" data-field-span=\"12\"><legend id='gfield_label_3_39' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Date de signature<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_3_39' class='ginput_container ginput_complex gform-grid-row'>\n                                        <div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_3_39_3_container'>\n                                            <label for='input_3_39_3' id='input_3_39_3_label' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                                            <input type='number' maxlength='4' name='input_39[]' id='input_3_39_3' value=''   aria-required='true'   aria-labelledby=\"input_3_39_3_label gfield_label_3_39\"  placeholder='YYYY' min='1920' max='2027' step='1'\/>\n                                        <\/div><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' 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