bupa-mkt-prod1-t.adobe-campaign.com Open in urlscan Pro
54.220.175.161  Public Scan

Form analysis
1 forms found in the DOM

POST

<form id="mainForm" method="post" novalidate="">
  <div class="form-group"><label for="userEmail">Email Address:</label>
    <div><input name="email" class="input-email" id="userEmail" type="text" readonly="readonly" placeholder="Your email address" value="" data-nl-bindto="xpath" data-nl-label="Email" data-nl-xpath="@email" autocomplete="off">
      <!-- onblur="validateEmail(this);" onchange="validateEmail(this);"-->
      <p class="errorMsg" id="emailError"></p>
    </div>
  </div>
  <div class="form-group">
    <p>I am happy to receive marketing about Bupa products and services via email:</p>
  </div>
  <div class="form-group">
    <p class="errorMsg" id="radioErroMsg"></p>
    <div class="radio-group"><label class="radio-wrapper"><label class="radio-wrapper"> <input name="optradio" onchange="radioValid()" type="radio" value="yes" id="2b56b772-eda0-4e2f-8c7f-19da07817f11"><span class="checkmark yes"> <span
              class="dot"></span> </span></label></label> <label class="radio-wrapper"> <input name="optradio" onchange="radioValid()" type="radio" value="no" id="91a40c37-0b24-478f-a7a7-3b6a1628b7b3"> <span class="checkmark no"> <span
            class="dot"></span> </span> </label></div>
    <input name="txt_Preference" id="txt_Preference" type="hidden" value=""> <input name="txt_Preference" id="txt_Preference" type="hidden" value=""> <input name="txt_Response" id="txt_Response" type="hidden" value="">
  </div>
  <div class="form-group">
    <div class="terms">
      <p>Please see <a href="https://www.bupa.co.uk/privacy" target="_blank"> www.bupa.co.uk/privacy</a> for more information about how we collect, use and protect your data.</p>
    </div>
    <input class="btn-submit" id="btnSubmit" onclick="submitMe()" type="button" value="Submit">
  </div>
  <input name="ctx" type="hidden"><input name="userAction" type="hidden"><input name="transition" type="hidden">
</form>

Text Content

Email Address:



I am happy to receive marketing about Bupa products and services via email:



Please see www.bupa.co.uk/privacy for more information about how we collect, use
and protect your data.



www.bupa.co.uk