<div class="flex">
<div class='itm row' >[text* your-name placeholder "Nom, prénom*"]</div>  </br>
<div class='itm row'>[text* your-email placeholder "E-mail*"]</div> </div></br>
<div class="flex">
<div class='itm row' >[text* telephone placeholder "Téléphone*"]</div> </br>
<div class='itm row'>[text* adresse placeholder "Adresse*"]</div> </div></br>
<div class='itm row' >[text* rendezvous class:datefield placeholder "Date de visite souhaitée"]</div></div>
</br>
<div class="bt">[submit "Envoyer"]</div>