www.cephadex.com Open in urlscan Pro
35.173.69.207  Public Scan

Form analysis
2 forms found in the DOM

<form id="subscribe">
  <div class="row justify-content-center">
    <div class="col-md-6">
      <div class="form-floating mb-3">
        <input type="text" class="form-control" name="first-name" id="first-name" placeholder="First Name" required="">
        <label for="first-name">First Name</label>
      </div>
    </div>
    <div class="col-md-6">
      <div class="form-floating mb-3">
        <input type="text" class="form-control" name="last-name" id="last-name" placeholder="Last Name" required="">
        <label for="last-name">Last Name</label>
      </div>
    </div>
  </div>
  <div class="row justify-content-center">
    <div class="col-md-8 col-lg-6">
      <div class="form-floating mb-3">
        <input type="email" class="form-control" name="email" id="email" placeholder="Email Address" required="">
        <label for="email">Email Address</label>
      </div>
    </div>
  </div>
  <div class="row justify-content-center">
    <div class="col-md-8 col-lg-6">
      <button type="submit" class="btn btn-primary w-100 py-3 rounded-pill">Subscribe</button>
    </div>
  </div>
</form>

POST /feedback

<form id="feedback-form" method="POST" action="/feedback">
  <input id="csrf_token" name="csrf_token" type="hidden" value="ImViNjIzZGIyNDFmOWYzNGRmZTgzZWUzODNjMDJjMWIzNDU0MWNjZjci.ZG7rGg.7hcdbWeKJ9L7tTi-94amiO2fipg">
  <!-- Name input-->
  <div class="form-floating mb-3">
    <input class="form-control" id="name" name="name" placeholder="Name" required="required" type="text" value="">
    <label for="name">Name</label>
  </div>
  <!-- Email address input-->
  <div class="form-floating mb-3">
    <input class="form-control" id="email" name="email" placeholder="Email" required="required" type="text" value="">
    <label for="email">Email</label>
  </div>
  <!-- Feedback type input-->
  <div class="form-floating mb-3">
    <select class="form-control" id="type_feedback" name="type_feedback" required="required">
      <option value=""></option>
      <option value="general">General Feedback</option>
      <option value="bug">Bug Report</option>
      <option value="feature">Feature Request</option>
    </select>
    <label for="type_feedback">Feedback Type</label>
  </div>
  <!-- Message input-->
  <div class="form-floating mb-3">
    <textarea class="form-control" id="message" name="message" placeholder="Message" required="required" style="height: 10rem"></textarea>
    <label for="message">Message</label>
  </div>
  <!-- Submit button-->
  <div class="d-grid"><button class="btn btn-primary rounded-pill btn-lg" id="submitButton" type="submit">Submit</button></div>
</form>

Text Content

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