{"id":67,"date":"2026-06-21T19:14:49","date_gmt":"2026-06-21T19:14:49","guid":{"rendered":"https:\/\/nouveau.taxis-conventionnes-cpam-idf.fr\/?page_id=67"},"modified":"2026-06-21T19:18:46","modified_gmt":"2026-06-21T19:18:46","slug":"reservation-de-transport-conventionne-cpam","status":"publish","type":"page","link":"https:\/\/nouveau.taxis-conventionnes-cpam-idf.fr\/index.php\/reservation-de-transport-conventionne-cpam\/","title":{"rendered":"R\u00e9servation de transport conventionn\u00e9 CPAM"},"content":{"rendered":"\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f66-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"66\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/67#wpcf7-f66-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"66\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f66-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<h3>Coordonn\u00e9es du patient\n<\/h3>\n<p>Nom et pr\u00e9nom *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"nom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Ex : Jean Dupont\" value=\"\" type=\"text\" name=\"nom\" \/><\/span>\n<\/p>\n<p>T\u00e9l\u00e9phone *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"telephone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Ex : 06 12 34 56 78\" value=\"\" type=\"tel\" name=\"telephone\" \/><\/span>\n<\/p>\n<p>Adresse e-mail\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-text wpcf7-validates-as-email\" aria-invalid=\"false\" placeholder=\"Ex : patient@email.fr\" value=\"\" type=\"email\" name=\"email\" \/><\/span>\n<\/p>\n<h3>Votre rendez-vous m\u00e9dical\n<\/h3>\n<p>Date du transport *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"date-transport\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-transport\" \/><\/span>\n<\/p>\n<p>Heure du rendez-vous m\u00e9dical *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"heure-rdv\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Ex : 14h30\" value=\"\" type=\"text\" name=\"heure-rdv\" \/><\/span>\n<\/p>\n<p>\u00c9tablissement de soins *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"etablissement-soins\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Ex : Institut Curie, Avicenne, Gustave Roussy...\" value=\"\" type=\"text\" name=\"etablissement-soins\" \/><\/span>\n<\/p>\n<p>Type de rendez-vous *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"type-rdv\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"type-rdv\"><option value=\"Consultation\">Consultation<\/option><option value=\"Hospitalisation\">Hospitalisation<\/option><option value=\"Chimioth\u00e9rapie\">Chimioth\u00e9rapie<\/option><option value=\"Radioth\u00e9rapie\">Radioth\u00e9rapie<\/option><option value=\"Dialyse\">Dialyse<\/option><option value=\"R\u00e9\u00e9ducation\">R\u00e9\u00e9ducation<\/option><option value=\"Examen m\u00e9dical\">Examen m\u00e9dical<\/option><option value=\"Autre\">Autre<\/option><\/select><\/span>\n<\/p>\n<h3>Votre trajet\n<\/h3>\n<p>Adresse de d\u00e9part *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"adresse-depart\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Adresse compl\u00e8te de prise en charge\" value=\"\" type=\"text\" name=\"adresse-depart\" \/><\/span>\n<\/p>\n<p>Adresse d'arriv\u00e9e *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"adresse-arrivee\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Adresse compl\u00e8te ou \u00e9tablissement d&#039;arriv\u00e9e\" value=\"\" type=\"text\" name=\"adresse-arrivee\" \/><\/span>\n<\/p>\n<p>Le trajet d\u00e9passe-t-il 150 km ?\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"trajet-150km\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"trajet-150km\"><option value=\"Non\">Non<\/option><option value=\"Oui\">Oui<\/option><option value=\"Je ne sais pas\">Je ne sais pas<\/option><\/select><\/span>\n<\/p>\n<h3>Prise en charge CPAM\n<\/h3>\n<p>Avez-vous un bon de transport prescrit par votre m\u00e9decin ? *\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"bon-transport\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"bon-transport\"><option value=\"Oui\">Oui<\/option><option value=\"Non\">Non<\/option><option value=\"En cours d&#039;obtention\">En cours d&#039;obtention<\/option><option value=\"Je ne sais pas\">Je ne sais pas<\/option><\/select><\/span>\n<\/p>\n<p><small>Si vous ne disposez pas encore d\u2019un bon de transport, nous pouvons vous informer sur les d\u00e9marches \u00e0 effectuer. L\u2019absence de bon de transport ne garantit pas la prise en charge par l\u2019Assurance Maladie.<\/small>\n<\/p>\n<p>Situation du patient\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"situation\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"situation[]\" value=\"ALD (Affection Longue Dur\u00e9e)\" \/><span class=\"wpcf7-list-item-label\">ALD (Affection Longue Dur\u00e9e)<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"situation[]\" value=\"Invalidit\u00e9\" \/><span class=\"wpcf7-list-item-label\">Invalidit\u00e9<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"situation[]\" value=\"Grossesse de plus de 6 mois\" \/><span class=\"wpcf7-list-item-label\">Grossesse de plus de 6 mois<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"situation[]\" value=\"Accident du travail \/ maladie professionnelle\" \/><span class=\"wpcf7-list-item-label\">Accident du travail \/ maladie professionnelle<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"situation[]\" value=\"Aucune de ces situations\" \/><span class=\"wpcf7-list-item-label\">Aucune de ces situations<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<h3>Informations compl\u00e9mentaires\n<\/h3>\n<p>Message\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Pr\u00e9cisez toute information utile : accompagnant, fauteuil pliant, retour pr\u00e9vu, besoin d\u2019aide pour marcher, horaires particuliers...\" name=\"message\"><\/textarea><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"rgpd\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"rgpd\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">J\u2019accepte que mes informations soient utilis\u00e9es uniquement pour traiter ma demande de transport.<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"R\u00e9server mon transport\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\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-67","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/nouveau.taxis-conventionnes-cpam-idf.fr\/index.php\/wp-json\/wp\/v2\/pages\/67","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nouveau.taxis-conventionnes-cpam-idf.fr\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/nouveau.taxis-conventionnes-cpam-idf.fr\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/nouveau.taxis-conventionnes-cpam-idf.fr\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/nouveau.taxis-conventionnes-cpam-idf.fr\/index.php\/wp-json\/wp\/v2\/comments?post=67"}],"version-history":[{"count":2,"href":"https:\/\/nouveau.taxis-conventionnes-cpam-idf.fr\/index.php\/wp-json\/wp\/v2\/pages\/67\/revisions"}],"predecessor-version":[{"id":69,"href":"https:\/\/nouveau.taxis-conventionnes-cpam-idf.fr\/index.php\/wp-json\/wp\/v2\/pages\/67\/revisions\/69"}],"wp:attachment":[{"href":"https:\/\/nouveau.taxis-conventionnes-cpam-idf.fr\/index.php\/wp-json\/wp\/v2\/media?parent=67"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}