{"id":6406,"date":"2025-01-10T11:55:29","date_gmt":"2025-01-10T10:55:29","guid":{"rendered":"https:\/\/www.lyceecharlescoulomb.fr\/site\/?p=6406"},"modified":"2026-01-27T09:00:12","modified_gmt":"2026-01-27T08:00:12","slug":"formulaire-signalements-risques","status":"publish","type":"post","link":"https:\/\/www.lyceecharlescoulomb.fr\/site\/?p=6406","title":{"rendered":"Formulaire Signalements Risques"},"content":{"rendered":"\n\n\n<div id=\"envoi-message\" style=\"display:none;\">\n    \u23f3 Envoi du signalement en cours\u2026  \n    Merci de patienter et de ne pas recharger la page.\n<\/div>\n\n<h2>Signalement d\u2019un risque ou incident (DUERP)<\/h2>\n    <ul >\n    <li class=\"info-obligatoire\">Les champs marqu\u00e9s d\u2019un <span class=\"obligatoire\">*<\/span> sont obligatoires.<\/li>\n    <li class=\"info-obligatoire\">Le signalement peut \u00eatre effectu\u00e9 de mani\u00e8re anonyme.<\/li>\n    <li class=\"info-obligatoire\">Vous ne recevrez pas de mail de confirmation, m\u00eame si vous avez rempli le champ Email<\/li>\n<\/ul>\n\n\n<form action=\"https:\/\/www.lyceecharlescoulomb.fr\/site\/wp-admin\/admin-post.php\"\n      method=\"post\"\n      enctype=\"multipart\/form-data\"\n      id=\"duerp-form\">\n\n    <input type=\"hidden\" name=\"action\" value=\"duerp_submit\">\n    <input type=\"hidden\" name=\"redirect_to\" value=\"https:\/\/www.lyceecharlescoulomb.fr\/site\/?p=6406\">\n    <input type=\"hidden\" id=\"duerp_nonce\" name=\"duerp_nonce\" value=\"8f9c9e13d0\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/site\/index.php?rest_route=%2Fwp%2Fv2%2Fposts%2F6406\" \/>\n    <!-- Honeypot -->\n    <div class=\"honeypot\">\n        <input type=\"text\" name=\"website\" tabindex=\"-1\" autocomplete=\"off\">\n    <\/div>\n\n    <fieldset class=\"bloc-anonyme\">\n        <legend>Identit\u00e9 du d\u00e9clarant<\/legend>\n\n        <label>\n            <input type=\"checkbox\" name=\"anonyme\" value=\"1\" id=\"duerp-anonyme\">\n            Effectuer un signalement <strong>anonyme<\/strong>\n        <\/label>\n\n        <div id=\"identite-fields\">\n            <label>Nom<\/label>\n            <input type=\"text\" name=\"nom\" maxlength=\"100\">\n\n            <label>Pr\u00e9nom<\/label>\n            <input type=\"text\" name=\"prenom\" maxlength=\"100\">\n        <\/div>\n    <\/fieldset>\n\n    <label>Email (facultatif)<\/label>\n    <input type=\"email\" name=\"email_declarant\" maxlength=\"255\">\n\n    <label>\n        Date du signalement <span class=\"obligatoire\">*<\/span>\n    <\/label>\n    <input type=\"date\" name=\"date_incident\" required value=\"2026-04-14\">\n\n    <label>\n        Lieu <span class=\"obligatoire\">*<\/span>\n    <\/label>\n    <input type=\"text\" name=\"lieu\" maxlength=\"255\" required>\n\n    <label>\n        Risque(s) <span class=\"obligatoire\">*<\/span>\n    <\/label>\n    <select name=\"id_risques[]\" multiple required size=\"12\">\n                    <option value=\"1\">\n                Activit\u00e9 physique, postures et port de charges            <\/option>\n                    <option value=\"4\">\n                Ambiances thermiques            <\/option>\n                    <option value=\"16\">\n                Autres risques (charge nerveuse, risques psychosociaux, agressions, \u2026)            <\/option>\n                    <option value=\"3\">\n                Bruit            <\/option>\n                    <option value=\"8\">\n                Chute de hauteur            <\/option>\n                    <option value=\"7\">\n                Chute de plain pied            <\/option>\n                    <option value=\"13\">\n                Circulation interne            <\/option>\n                    <option value=\"5\">\n                \u00c9clairage            <\/option>\n                    <option value=\"9\">\n                Electricit\u00e9            <\/option>\n                    <option value=\"10\">\n                Equipements de travail            <\/option>\n                    <option value=\"12\">\n                Incendie, explosion            <\/option>\n                    <option value=\"15\">\n                Intervention d\u2019une entreprise            <\/option>\n                    <option value=\"14\">\n                Manque d\u2019hygi\u00e8ne            <\/option>\n                    <option value=\"2\">\n                Produits, aux \u00e9missions et d\u00e9chets            <\/option>\n                    <option value=\"6\">\n                Rayonnements (\u00e9lectromagn\u00e9tiques, ionisants)            <\/option>\n                    <option value=\"11\">\n                Utilisation d\u2019\u00e9cran            <\/option>\n            <\/select>\n\n    <p class=\"help\">\n        Maintenez Ctrl (ou Cmd sur Mac) pour s\u00e9lectionner plusieurs risques.\n    <\/p>\n\n    <label>\n        Description <span class=\"obligatoire\">*<\/span>\n    <\/label>\n    <textarea name=\"description\" rows=\"6\" required><\/textarea>\n\n    <label class=\"aide\">\n        Vous pouvez joindre jusqu\u2019\u00e0 4 photos (JPG ou PNG, 2 Mo max par fichier).<br>\n    <\/label>\n    <input type=\"file\" name=\"photos[]\" accept=\"image\/jpeg,image\/png\" multiple>\n\n    <p class=\"info-envoi\">\n        \u26a0\ufe0f L\u2019envoi peut prendre quelques secondes si des photos sont jointes.\n    <\/p>\n\n    <button type=\"submit\">Envoyer le signalement<\/button>\n<\/form>\n\n<script>\ndocument.addEventListener('DOMContentLoaded', function () {\n\n    const form = document.getElementById('duerp-form');\n    const checkbox = document.getElementById('duerp-anonyme');\n    const identite = document.getElementById('identite-fields');\n    const envoiMsg = document.getElementById('envoi-message');\n    const maxSize  = 2 * 1024 * 1024;\n\n    function toggleIdentite() {\n        identite.style.display = checkbox.checked ? 'none' : 'block';\n        if (checkbox.checked) {\n            identite.querySelectorAll('input').forEach(i => i.value = '');\n        }\n    }\n\n    toggleIdentite();\n    checkbox.addEventListener('change', toggleIdentite);\n\n    form.addEventListener('submit', function (e) {\n\n        if (!form.checkValidity()) {\n            form.reportValidity();\n            e.preventDefault();\n            return;\n        }\n\n        const files = form.querySelector('input[type=\"file\"]').files;\n        for (const f of files) {\n            if (f.size > maxSize) {\n                alert('Chaque fichier doit faire moins de 2 Mo.');\n                e.preventDefault();\n                return;\n            }\n        }\n\n        envoiMsg.style.display = 'block';\n        form.querySelector('button[type=\"submit\"]').disabled = true;\n    });\n\n});\n<\/script>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ocean_post_layout":"","ocean_both_sidebars_style":"","ocean_both_sidebars_content_width":0,"ocean_both_sidebars_sidebars_width":0,"ocean_sidebar":"0","ocean_second_sidebar":"0","ocean_disable_margins":"enable","ocean_add_body_class":"","ocean_shortcode_before_top_bar":"","ocean_shortcode_after_top_bar":"","ocean_shortcode_before_header":"","ocean_shortcode_after_header":"","ocean_has_shortcode":"","ocean_shortcode_after_title":"","ocean_shortcode_before_footer_widgets":"","ocean_shortcode_after_footer_widgets":"","ocean_shortcode_before_footer_bottom":"","ocean_shortcode_after_footer_bottom":"","ocean_display_top_bar":"default","ocean_display_header":"default","ocean_header_style":"","ocean_center_header_left_menu":"0","ocean_custom_header_template":"0","ocean_custom_logo":0,"ocean_custom_retina_logo":0,"ocean_custom_logo_max_width":0,"ocean_custom_logo_tablet_max_width":0,"ocean_custom_logo_mobile_max_width":0,"ocean_custom_logo_max_height":0,"ocean_custom_logo_tablet_max_height":0,"ocean_custom_logo_mobile_max_height":0,"ocean_header_custom_menu":"0","ocean_menu_typo_font_family":"0","ocean_menu_typo_font_subset":"","ocean_menu_typo_font_size":0,"ocean_menu_typo_font_size_tablet":0,"ocean_menu_typo_font_size_mobile":0,"ocean_menu_typo_font_size_unit":"px","ocean_menu_typo_font_weight":"","ocean_menu_typo_font_weight_tablet":"","ocean_menu_typo_font_weight_mobile":"","ocean_menu_typo_transform":"","ocean_menu_typo_transform_tablet":"","ocean_menu_typo_transform_mobile":"","ocean_menu_typo_line_height":0,"ocean_menu_typo_line_height_tablet":0,"ocean_menu_typo_line_height_mobile":0,"ocean_menu_typo_line_height_unit":"","ocean_menu_typo_spacing":0,"ocean_menu_typo_spacing_tablet":0,"ocean_menu_typo_spacing_mobile":0,"ocean_menu_typo_spacing_unit":"","ocean_menu_link_color":"","ocean_menu_link_color_hover":"","ocean_menu_link_color_active":"","ocean_menu_link_background":"","ocean_menu_link_hover_background":"","ocean_menu_link_active_background":"","ocean_menu_social_links_bg":"","ocean_menu_social_hover_links_bg":"","ocean_menu_social_links_color":"","ocean_menu_social_hover_links_color":"","ocean_disable_title":"default","ocean_disable_heading":"default","ocean_post_title":"","ocean_post_subheading":"","ocean_post_title_style":"","ocean_post_title_background_color":"","ocean_post_title_background":0,"ocean_post_title_bg_image_position":"","ocean_post_title_bg_image_attachment":"","ocean_post_title_bg_image_repeat":"","ocean_post_title_bg_image_size":"","ocean_post_title_height":0,"ocean_post_title_bg_overlay":0.5,"ocean_post_title_bg_overlay_color":"","ocean_disable_breadcrumbs":"default","ocean_breadcrumbs_color":"","ocean_breadcrumbs_separator_color":"","ocean_breadcrumbs_links_color":"","ocean_breadcrumbs_links_hover_color":"","ocean_display_footer_widgets":"default","ocean_display_footer_bottom":"default","ocean_custom_footer_template":"0","ocean_post_oembed":"","ocean_post_self_hosted_media":"","ocean_post_video_embed":"","ocean_link_format":"","ocean_link_format_target":"self","ocean_quote_format":"","ocean_quote_format_link":"post","ocean_gallery_link_images":"on","ocean_gallery_id":[],"footnotes":""},"categories":[1],"tags":[],"class_list":["post-6406","post","type-post","status-publish","format-standard","hentry","category-non-classe","entry"],"_links":{"self":[{"href":"https:\/\/www.lyceecharlescoulomb.fr\/site\/index.php?rest_route=\/wp\/v2\/posts\/6406","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.lyceecharlescoulomb.fr\/site\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.lyceecharlescoulomb.fr\/site\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.lyceecharlescoulomb.fr\/site\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lyceecharlescoulomb.fr\/site\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=6406"}],"version-history":[{"count":1,"href":"https:\/\/www.lyceecharlescoulomb.fr\/site\/index.php?rest_route=\/wp\/v2\/posts\/6406\/revisions"}],"predecessor-version":[{"id":6407,"href":"https:\/\/www.lyceecharlescoulomb.fr\/site\/index.php?rest_route=\/wp\/v2\/posts\/6406\/revisions\/6407"}],"wp:attachment":[{"href":"https:\/\/www.lyceecharlescoulomb.fr\/site\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=6406"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.lyceecharlescoulomb.fr\/site\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=6406"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.lyceecharlescoulomb.fr\/site\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=6406"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}