<!– Modal Structure –>
<div id=”rendezvousModal” style=”display:none; position:fixed; top:0; left:0; width:100%; height:100%; background-color: rgba(0,0,0,0.6); z-index:1000; justify-content:center; align-items:center;”>
<div style=”background:white; padding:30px; border-radius:10px; max-width:500px; width:90%; position:relative;”>
<span id=”closeModalBtn” style=”position:absolute; top:10px; right:15px; cursor:pointer; font-size:20px;”>×</span>
<h2 style=”color:#b4a7d6; margin-bottom:20px;”>Prise de rendez-vous</h2>
<form action=”mailto:[email protected]” method=”post” enctype=”text/plain”>
<label>Nom complet :</label><br>
<input type=”text” name=”Nom” required style=”width:100%; padding:10px; margin-bottom:10px;”><br>
<label>Email :</label><br>
<input type=”email” name=”Email” required style=”width:100%; padding:10px; margin-bottom:10px;”><br>
<label>Téléphone :</label><br>
<input type=”tel” name=”Téléphone” required style=”width:100%; padding:10px; margin-bottom:10px;”><br>
<label>Raison de la visite :</label><br>
<select name=”Raison” required style=”width:100%; padding:10px; margin-bottom:10px;”>
<option value=”Consultation générale”>Consultation générale</option>
<option value=”Détartrage / nettoyage”>Détartrage / nettoyage</option>
<option value=”Urgence dentaire”>Urgence dentaire</option>
<option value=”Blanchiment”>Blanchiment</option>
<option value=”Implant / prothèse”>Implant / prothèse</option>
<option value=”Autre”>Autre</option>
</select><br>
<label>Message :</label><br>
<textarea name=”Message” rows=”4″ style=”width:100%; padding:10px; margin-bottom:15px;”></textarea><br>
<input type=”submit” value=”Envoyer” style=”background-color:#b4a7d6; color:white; border:none; padding:10px 20px; border-radius:5px; cursor:pointer;”>
</form>
</div>
</div>
