enroll.wondrhealth.com
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34.238.48.40
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Submitted URL: https://click.hello.wondrhealth.com/?qs=fc735a93fcfb7e0f342587884be6a809d8792a4a046efc3915366c3b1d85cce92fc48764930d9f87e6c4eead9d7a...
Effective URL: https://enroll.wondrhealth.com/enroll.html?s=BCBSIL&e=emilio.escobedo@apci.org&sfmc_id=84709863&utm_source=sfmc&utm_term=bottom...
Submission: On October 25 via api from RU — Scanned from US
Effective URL: https://enroll.wondrhealth.com/enroll.html?s=BCBSIL&e=emilio.escobedo@apci.org&sfmc_id=84709863&utm_source=sfmc&utm_term=bottom...
Submission: On October 25 via api from RU — Scanned from US
Form analysis
2 forms found in the DOM<form data-v-0fb2b967="" novalidate="novalidate" class="form-floating-labels fl-form">
<div data-v-0fb2b967="" class="d-flex justify-content-center card-form">
<div data-v-0fb2b967="" style="width: 100%; max-width: 300px;">
<div data-v-0fb2b967="" class="form-group centered-input" style="margin-bottom: 44px;">
<div data-v-0fb2b967="">
<div class="fl-wrap fl-wrap-input"><label data-v-0fb2b967="" for="field_email" class="fl-label">Email Address</label><input data-v-0fb2b967="" type="email" id="field_email" data-placeholder="Email Address" placeholder="Email Address"
aria-describedby="Email" tabindex="1" data-contentful="user_email" class="form-control form-control-lg text-center fl-input"></div><!----><!---->
</div>
</div>
<p data-v-0fb2b967=""><button data-v-0fb2b967="" type="submit" tabindex="3" data-contentful="body:button_next" class="btn btn-primary-light shadow btn-block">Next</button></p>
<p data-v-0fb2b967="" class="mt-4"></p>
<div data-v-0fb2b967="" class="d-flex justify-content-center">
<div class="S9gUrf-YoZ4jf" style="position: relative;">
<div></div><iframe src="https://accounts.google.com/gsi/button?client_id=405820707410-ohpetmo3uiaqva1bpfc33h1rnrsh3p4h.apps.googleusercontent.com&iframe_id=gsi_191997_309793&as=bqAgGNs72GeDd%2BF1H5PXeA"
allow="identity-credentials-get" id="gsi_191997_309793" title="Sign in with Google Button" style="display: block; position: relative; top: 0px; left: 0px; height: 44px; width: 202px; border: 0px; margin: -2px -10px;"></iframe>
</div>
</div>
</div>
</div>
</form>
POST
<form method="post" novalidate="novalidate" class="js-waitlist-form form-floating-labels fl-form">
<div class="d-flex justify-content-center card-form">
<div style="width: 100%; max-width: 300px;">
<div class="form-group">
<div><span class="form-text small text-danger">
<div class="fl-wrap fl-wrap-input"><label for="first_name" class="fl-label">First Name</label><input type="text" id="first_name" name="first_name" placeholder="First Name" aria-label="First Name" data-placeholder="First Name"
data-contentful="modal:waitlist:first_name" class="form-control form-control-lg fl-input"></div><span></span>
</span></div>
</div>
<div class="form-group">
<div><span class="form-text small text-danger">
<div class="fl-wrap fl-wrap-input fl-is-required"><label for="last_name" class="fl-label">Last Name</label><input type="text" id="last_name" name="last_name" placeholder="Last Name" aria-label="Last Name" required="required"
data-placeholder="Last Name" data-contentful="modal:waitlist:last_name" class="form-control form-control-lg fl-input"></div><span></span>
</span></div>
</div>
<div class="form-group">
<div><span class="form-text small text-danger">
<div class="fl-wrap fl-wrap-input fl-is-required"><label for="user_email" class="fl-label">Email</label><input type="text" id="user_email" name="user_email" placeholder="Email" aria-label="Email" required="required"
data-placeholder="Email" data-contentful="modal:waitlist:email_address" class="form-control form-control-lg fl-input"></div><span></span>
</span></div>
</div><input type="hidden" name="C_Corporate_Clients_item_id" id="C_Corporate_Clients_item_id" value="' . (int)$corpClientRow['item_id'] . '"><input type="hidden" name="code2" id="code2" value="' .$code2. '">
<p><button type="submit" data-contentful="body:button_join_waitlist" class="btn btn-block shadow text-spacing-4 btn-primary-light" disabled="disabled">Join the Waitlist</button></p>
<p><button type="button" data-dismiss="modal" data-contentful="body:button_cancel" class="btn btn-block btn-no-shadow text-spacing-4 btn-white"> Cancel </button></p>
</div>
</div>
</form>
Text Content
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