patientonlineportal.com Open in urlscan Pro
38.105.243.29  Public Scan

Form analysis
1 forms found in the DOM

POST /idp/account/signin?ReturnUrl=%2fidp%2fissue%2fwsfed%3fwa%3dwsignin1.0%26wtrealm%3dhttps%253a%252f%252fpatientonlineportal.com%252f%26wctx%3drm%253d0%2526id%253dpassive%2526ru%253d%25252f%26wct%3d2023-01-03T14%253a34%253a19Z%26wreply%3dhttps%253a%252f%252fpatientonlineportal.com%252f&wa=wsignin1.0&wtrealm=https%3a%2f%2fpatientonlineportal.com%2f&wctx=rm%3d0%26id%3dpassive%26ru%3d%252f&wct=2023-01-03T14%3a34%3a19Z&wreply=https%3a%2f%2fpatientonlineportal.com%2f

<form
  action="/idp/account/signin?ReturnUrl=%2fidp%2fissue%2fwsfed%3fwa%3dwsignin1.0%26wtrealm%3dhttps%253a%252f%252fpatientonlineportal.com%252f%26wctx%3drm%253d0%2526id%253dpassive%2526ru%253d%25252f%26wct%3d2023-01-03T14%253a34%253a19Z%26wreply%3dhttps%253a%252f%252fpatientonlineportal.com%252f&amp;wa=wsignin1.0&amp;wtrealm=https%3a%2f%2fpatientonlineportal.com%2f&amp;wctx=rm%3d0%26id%3dpassive%26ru%3d%252f&amp;wct=2023-01-03T14%3a34%3a19Z&amp;wreply=https%3a%2f%2fpatientonlineportal.com%2f"
  method="post"><input name="__RequestVerificationToken" type="hidden" value="RHZe8_XNoyxuCabT6-YdxRUXbvuXBCBCXuWWNGXf9gdK8FhnHaZCB-9nNs34w7FSpDWslKV5oB6iBXeVA31jEVQ-1hXj3R0okrG5_hmVquU1">
  <div class="form-group">
    <label class="form-label" for="UserName">User name</label>
    <input autocapitalize="off" autocorrect="off" class="form-control" data-val="true" data-val-required="The User name field is required." id="UserName" name="UserName" type="text" value="">
    <span class="field-validation-valid" data-valmsg-for="UserName" data-valmsg-replace="true"></span>
  </div>
  <div class="form-group">
    <label class="form-label" for="Password">Password</label>
    <input autocomplete="off" class="form-control" data-val="true" data-val-required="The Password field is required." id="Password" name="Password" type="password">
    <span class="field-validation-valid" data-valmsg-for="Password" data-valmsg-replace="true"></span>
  </div>
  <div class="form-group">
    <a href="https://patientonlineportal.com/home/forgotpassword">Forgot Password?</a>
    <a class="pull-right" href="/admin">Portal Admin Login</a>
  </div>
  <div class="checkbox">
    <input class="checkbox" data-val="true" data-val-required="The Remember me? field is required." id="EnableSSO" name="EnableSSO" style="margin-left: 0px;" type="checkbox" value="true"><input name="EnableSSO" type="hidden" value="false">
    <label for="EnableSSO">Remember me?</label>
  </div>
  <p>&nbsp;</p>
  <div class="btn-group">
    <button type="submit" class="btn btn-primary">Sign In</button>
  </div>
</form>

Text Content

PATIENT PORTAL LOGIN

Login
User name
Password
Forgot Password? Portal Admin Login
Remember me?

 

Sign In