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www.elevatehealth.net Open in urlscan Pro
104.22.42.233  Public Scan

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Submitted URL: https://www2.caehealthcare.com/
Effective URL: https://www.elevatehealth.net/
Submission: On December 11 via api from US — Scanned from DE

Form analysis 5 forms found in the DOM

POST https://elevatehealth.net/

<form class="flex justify-between items-center" id="lowSearchFormMobile" method="post" action="https://elevatehealth.net/">
  <div class="hiddenFields">
    <input type="hidden" name="params" value="eyJyZXN1bHRfcGFnZSI6Ilwvc2VhcmNoLXJlc3VsdHNcLyJ9">
    <input type="hidden" name="ACT" value="47">
    <input type="hidden" name="site_id" value="1">
    <input type="hidden" name="csrf_token" value="e78adbe55231e2eafa22fd5d54853ec435884bb3">
  </div>
  <input type="text" class="w-full h-10 p-0 text-3xl border-0 mobileSearchInput placeholder:text-slate-300 placeholder:text-lg focus:border-0 focus:ring-0" name="keywords" placeholder="Enter your search keywords" aria-label="keywords">
  <button type="submit" role="button" tabindex="0" aria-label="Button: clickable image">
    <svg width="26" height="26" viewBox="0 0 26 26" fill="none" xmlns="http://www.w3.org/2000/svg">
      <path
        d="M16.2 0.200195C10.8 0.200195 6.5 4.5002 6.5 9.8002C6.5 12.1002 7.3 14.2002 8.7 15.9002L0 24.4002L1.4 25.8002L10.1 17.4002C11.8 18.8002 13.9 19.6002 16.3 19.6002C21.7 19.6002 26 15.3002 26 10.0002C25.9 4.6002 21.6 0.200195 16.2 0.200195ZM16.2 17.6002C11.9 17.6002 8.3 14.1002 8.3 9.8002C8.3 5.5002 11.8 2.0002 16.2 2.0002C20.6 2.0002 24.1 5.5002 24.1 9.8002C24.1 14.1002 20.5 17.6002 16.2 17.6002Z"
        fill="#212640"></path>
    </svg>
  </button>
</form>

POST https://elevatehealth.net/

<form class="new-search-desktop flex items-center" id="lowSearchForm" method="post" action="https://elevatehealth.net/">
  <div class="hiddenFields">
    <input type="hidden" name="params" value="eyJyZXN1bHRfcGFnZSI6Ilwvc2VhcmNoLXJlc3VsdHNcLyJ9">
    <input type="hidden" name="ACT" value="47">
    <input type="hidden" name="site_id" value="1">
    <input type="hidden" name="csrf_token" value="e78adbe55231e2eafa22fd5d54853ec435884bb3">
  </div>
  <div class="search-icon-desktop">
    <svg class="h-6" viewBox="0 0 16 17" fill="none" xmlns="http://www.w3.org/2000/svg">
      <path class="fill-green" fill-rule="evenodd" clip-rule="evenodd"
        d="M6.89098 1.83759C4.10007 1.83759 1.83759 4.10007 1.83759 6.89098C1.83759 9.68188 4.10007 11.9444 6.89098 11.9444C9.68188 11.9444 11.9444 9.68188 11.9444 6.89098C11.9444 4.10007 9.68188 1.83759 6.89098 1.83759ZM0 6.89098C0 3.0852 3.0852 0 6.89098 0C10.6968 0 13.782 3.0852 13.782 6.89098C13.782 10.6968 10.6968 13.782 6.89098 13.782C3.0852 13.782 0 10.6968 0 6.89098Z">
      </path>
      <path class="fill-green" fill-rule="evenodd" clip-rule="evenodd" d="M11.9455 10.6462L16.0013 14.7019L14.7019 16.0013L10.6462 11.9455L11.9455 10.6462Z" fill="#2969F2"></path>
    </svg>
  </div>
  <input type="text" class="border-0 placeholder:text-slate-300 focus:border-0 focus:ring-0 w-80" maxlength="256" name="keywords" aria-label="keywords" data-name="Search" placeholder="Enter your search keywords and press enter" id="keywords">
  <input type="submit" value="Submit" class="hidden">
</form>

POST https://elevatehealth.net/

<form method="post" action="https://elevatehealth.net/">
  <div class="hiddenFields">
    <input type="hidden" name="ACT" value="15">
    <input type="hidden" name="RET" value="https://elevatehealth.net">
    <input type="hidden" name="site_id" value="1">
    <input type="hidden" name="csrf_token" value="e78adbe55231e2eafa22fd5d54853ec435884bb3">
  </div>
  <div class="flex flex-col gap-6 mt-12">
    <div class="flex flex-col ">
      <label class="block mb-2 font-semibold">Email Address</label>
      <div class="relative">
        <input type="txt" name="username" data-name="username" class="w-full py-2 bg-white border rounded px-9 border-dkGrey placeholder:font-normal" placeholder="">
        <svg class="absolute z-10 top-3.5 left-3.5" width="14" height="12" viewBox="0 0 14 12" fill="none">
          <path
            d="M1 3.3335L6.26 6.84016C6.47911 6.98635 6.7366 7.06436 7 7.06436C7.2634 7.06436 7.52089 6.98635 7.74 6.84016L13 3.3335M2.33333 10.6668H11.6667C12.0203 10.6668 12.3594 10.5264 12.6095 10.2763C12.8595 10.0263 13 9.68712 13 9.3335V2.66683C13 2.31321 12.8595 1.97407 12.6095 1.72402C12.3594 1.47397 12.0203 1.3335 11.6667 1.3335H2.33333C1.97971 1.3335 1.64057 1.47397 1.39052 1.72402C1.14048 1.97407 1 2.31321 1 2.66683V9.3335C1 9.68712 1.14048 10.0263 1.39052 10.2763C1.64057 10.5264 1.97971 10.6668 2.33333 10.6668Z"
            stroke="#898B8C" stroke-width="2" stroke-linecap="round" stroke-linejoin="round"></path>
        </svg>
      </div>
    </div>
    <div class="relative flex flex-col" x-data="{ show: true }">
      <label class="mb-2 font-semibold">Password</label>
      <div class="relative">
        <input type="password" name="password" data-name="password" :type="show ? 'password' : 'text'" class="w-full py-2 bg-white border rounded px-9 border-dkGrey placeholder:font-normal" placeholder="">
        <a href="#" @click="forgotPass = !forgotPass" class="block pt-2 text-sm font-semibold text-accent">Forgot Password?</a>
        <svg class="absolute z-10 top-3 left-3" width="16" height="16" viewBox="0 0 16 16" fill="none">
          <path
            d="M8.00008 10V11.3333M4.00008 14H12.0001C12.3537 14 12.6928 13.8595 12.9429 13.6095C13.1929 13.3594 13.3334 13.0203 13.3334 12.6667V8.66667C13.3334 8.31304 13.1929 7.97391 12.9429 7.72386C12.6928 7.47381 12.3537 7.33333 12.0001 7.33333H4.00008C3.64646 7.33333 3.30732 7.47381 3.05727 7.72386C2.80722 7.97391 2.66675 8.31304 2.66675 8.66667V12.6667C2.66675 13.0203 2.80722 13.3594 3.05727 13.6095C3.30732 13.8595 3.64646 14 4.00008 14ZM10.6667 7.33333V4.66667C10.6667 3.95942 10.3858 3.28115 9.8857 2.78105C9.3856 2.28095 8.70733 2 8.00008 2C7.29284 2 6.61456 2.28095 6.11446 2.78105C5.61437 3.28115 5.33341 3.95942 5.33341 4.66667V7.33333H10.6667Z"
            stroke="#898B8C" stroke-width="2" stroke-linecap="round" stroke-linejoin="round"></path>
        </svg>
        <!-- Password Reveal -->
        <div class="absolute right-0 flex items-center pr-3 top-3.5">
          <svg class="h-4 text-gray-700 block" fill="none" @click="show = !show" :class="{'hidden': !show, 'block':show }" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 576 512">
            <path fill="currentColor"
              d="M572.52 241.4C518.29 135.59 410.93 64 288 64S57.68 135.64 3.48 241.41a32.35 32.35 0 0 0 0 29.19C57.71 376.41 165.07 448 288 448s230.32-71.64 284.52-177.41a32.35 32.35 0 0 0 0-29.19zM288 400a144 144 0 1 1 144-144 143.93 143.93 0 0 1-144 144zm0-240a95.31 95.31 0 0 0-25.31 3.79 47.85 47.85 0 0 1-66.9 66.9A95.78 95.78 0 1 0 288 160z">
            </path>
          </svg>
          <svg class="h-4 text-gray-700 hidden" fill="none" @click="show = !show" :class="{'block': !show, 'hidden':show }" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 640 512">
            <path fill="currentColor"
              d="M320 400c-75.85 0-137.25-58.71-142.9-133.11L72.2 185.82c-13.79 17.3-26.48 35.59-36.72 55.59a32.35 32.35 0 0 0 0 29.19C89.71 376.41 197.07 448 320 448c26.91 0 52.87-4 77.89-10.46L346 397.39a144.13 144.13 0 0 1-26 2.61zm313.82 58.1l-110.55-85.44a331.25 331.25 0 0 0 81.25-102.07 32.35 32.35 0 0 0 0-29.19C550.29 135.59 442.93 64 320 64a308.15 308.15 0 0 0-147.32 37.7L45.46 3.37A16 16 0 0 0 23 6.18L3.37 31.45A16 16 0 0 0 6.18 53.9l588.36 454.73a16 16 0 0 0 22.46-2.81l19.64-25.27a16 16 0 0 0-2.82-22.45zm-183.72-142l-39.3-30.38A94.75 94.75 0 0 0 416 256a94.76 94.76 0 0 0-121.31-92.21A47.65 47.65 0 0 1 304 192a46.64 46.64 0 0 1-1.54 10l-73.61-56.89A142.31 142.31 0 0 1 320 112a143.92 143.92 0 0 1 144 144c0 21.63-5.29 41.79-13.9 60.11z">
            </path>
          </svg>
        </div>
      </div>
    </div>
    <button type="submit" class="flex group justify-between items-center gap-2.5 px-6 py-3 font-bold text-sm text-center transition-colors border-2 border-transparent rounded-md text-dkBlue bg-brBlue hover:border-green hover:bg-transparent">
      <span>Sign In</span>
      <svg width="16" height="8" viewBox="0 0 16 8" fill="none" xmlns="http://www.w3.org/2000/svg">
        <path class="fill-dkBlue" fill-rule="evenodd" clip-rule="evenodd"
          d="M15.3185 4.4714L12.2204 7.80474C11.9785 8.06509 11.5862 8.06509 11.3442 7.80474C11.1208 7.56442 11.1036 7.18626 11.2926 6.92473L11.3442 6.86193L13.3846 4.66667L0.628759 4.66667V3.33333L13.3846 3.33333L11.3442 1.13807C11.1208 0.897749 11.1036 0.519595 11.2926 0.258067L11.3442 0.195262C11.5675 -0.0450605 11.919 -0.0635469 12.1621 0.139803L12.2204 0.195262L15.3185 3.5286C15.5605 3.78894 15.5605 4.21105 15.3185 4.4714Z">
        </path>
      </svg>
    </button>
  </div>
</form>

POST https://elevatehealth.net/

<form method="post" action="https://elevatehealth.net/">
  <div class="hiddenFields">
    <input type="hidden" name="ACT" value="17">
    <input type="hidden" name="RET" value="https://elevatehealth.net/passreset">
    <input type="hidden" name="P"
      value="OIQymN5ZEsVcBv2Gekzf8DSy6RqLVQPNkNLhOxrlWshYj2i0T81zwhzIiIkm2rjdQ7PMM+MvqJuqup7w1V+eNDIow8p+uXeGtcdqaYocUbWU4wO+On+BeyvZBYswfFhLfHD/nR5C80viGn/vogKx5sYaOEcd0OaB4B9g1CTaX8Tkf4BcAP2yQpoObkh7Ri0UXujLTXg4aTP+vHn0Gs+Akw==">
    <input type="hidden" name="site_id" value="1">
    <input type="hidden" name="csrf_token" value="e78adbe55231e2eafa22fd5d54853ec435884bb3">
  </div>
  <div class="flex flex-col gap-6 mt-12">
    <div class="flex flex-col ">
      <label class="block mb-2 font-semibold">Email Address</label>
      <div class="relative">
        <input type="email" name="email" class="w-full py-2 bg-white border rounded px-9 border-dkGrey placeholder:font-normal" placeholder="Enter your email address here">
        <svg class="absolute z-10 top-3.5 left-3.5" width="14" height="12" viewBox="0 0 14 12" fill="none">
          <path
            d="M1 3.3335L6.26 6.84016C6.47911 6.98635 6.7366 7.06436 7 7.06436C7.2634 7.06436 7.52089 6.98635 7.74 6.84016L13 3.3335M2.33333 10.6668H11.6667C12.0203 10.6668 12.3594 10.5264 12.6095 10.2763C12.8595 10.0263 13 9.68712 13 9.3335V2.66683C13 2.31321 12.8595 1.97407 12.6095 1.72402C12.3594 1.47397 12.0203 1.3335 11.6667 1.3335H2.33333C1.97971 1.3335 1.64057 1.47397 1.39052 1.72402C1.14048 1.97407 1 2.31321 1 2.66683V9.3335C1 9.68712 1.14048 10.0263 1.39052 10.2763C1.64057 10.5264 1.97971 10.6668 2.33333 10.6668Z"
            stroke="#898B8C" stroke-width="2" stroke-linecap="round" stroke-linejoin="round"></path>
        </svg>
      </div>
    </div>
    <button type="submit" class="flex group justify-between items-center gap-2.5 px-6 py-3 font-bold text-sm text-center transition-colors border-2 border-transparent rounded-md text-dkBlue bg-brBlue hover:border-green hover:bg-transparent">
      <span>Reset Password</span>
      <svg width="16" height="8" viewBox="0 0 16 8" fill="none" xmlns="http://www.w3.org/2000/svg">
        <path class="fill-dkBlue" fill-rule="evenodd" clip-rule="evenodd"
          d="M15.3185 4.4714L12.2204 7.80474C11.9785 8.06509 11.5862 8.06509 11.3442 7.80474C11.1208 7.56442 11.1036 7.18626 11.2926 6.92473L11.3442 6.86193L13.3846 4.66667L0.628759 4.66667V3.33333L13.3846 3.33333L11.3442 1.13807C11.1208 0.897749 11.1036 0.519595 11.2926 0.258067L11.3442 0.195262C11.5675 -0.0450605 11.919 -0.0635469 12.1621 0.139803L12.2204 0.195262L15.3185 3.5286C15.5605 3.78894 15.5605 4.21105 15.3185 4.4714Z">
        </path>
      </svg>
    </button>
  </div>
</form>

POST https://elevatehealth.net/?ACT=118&entry=457

<form action="https://elevatehealth.net/?ACT=118&amp;entry=457" class="md:grid md:grid-cols-4 gap-6 px-2" method="POST">
  <input type="hidden" name="spambot" value="livewebsite">
  <input type="hidden" name="success_location" value="https://elevatehealth.net/success">
  <input type="hidden" name="error_location" value="https://elevatehealth.net">
  <input type="hidden" name="product" value="">
  <input type="hidden" name="utm_source" id="utm_source" value="">
  <input type="hidden" name="utm_medium" id="utm_medium" value="">
  <input type="hidden" name="utm_campaign" id="utm_campaign" value="">
  <input type="hidden" name="utm_term" id="utm_term" value="">
  <input type="hidden" name="utm_content" id="utm_content" value="">
  <fieldset class="col-span-2">
    <label class="flex text-gray-900 text-base leading-relaxed mb-2 mt-4 md:mt-0" for="first_name">First name *</label>
    <input class="w-full bg-paleGrey border border-ltGrey rounded placeholder:text-dkGrey px-4 py-3" type="text" name="fname" id="" placeholder="First name" required="">
  </fieldset>
  <fieldset class="col-span-2">
    <label class="flex text-gray-900 text-base leading-relaxed mb-2 mt-4 md:mt-0" for="last_name">Last name *</label>
    <input class="w-full bg-paleGrey border border-ltGrey rounded placeholder:text-dkGrey px-4 py-3" type="text" name="lname" id="" required="" placeholder="Last name">
  </fieldset>
  <fieldset class="col-span-2">
    <label class="flex text-gray-900 text-base leading-relaxed mb-2 mt-4 md:mt-0" for="first_name">Email *</label>
    <input class="w-full bg-paleGrey border border-ltGrey rounded placeholder:text-dkGrey px-4 py-3" type="email" name="email" id="" required="" placeholder="Email">
  </fieldset>
  <fieldset class="col-span-2">
    <label class="flex text-gray-900 text-base leading-relaxed mb-2 mt-4 md:mt-0" for="first_name">Company / Institution Name</label>
    <input class="w-full bg-paleGrey border border-ltGrey rounded placeholder:text-dkGrey px-4 py-3" type="text" name="institution" id="" placeholder="Company / Institution Name">
  </fieldset>
  <fieldset class="col-span-2">
    <label class="flex text-gray-900 text-base leading-relaxed mb-2 mt-4 md:mt-0" for="first_name">Campus</label>
    <input class="w-full bg-paleGrey border border-ltGrey rounded placeholder:text-dkGrey px-4 py-3" type="text" name="campus" id="" placeholder="Campus">
  </fieldset>
  <fieldset class="col-span-2">
    <label class="flex text-gray-900 text-base leading-relaxed mb-2 mt-4 md:mt-0" for="first_name">Job title</label>
    <input class="w-full bg-paleGrey border border-ltGrey rounded placeholder:text-dkGrey px-4 py-3" type="text" name="job_title" id="" placeholder="Job title">
  </fieldset>
  <fieldset class="col-span-4">
    <label class="flex text-gray-900 text-base leading-relaxed mb-2 mt-4 md:mt-0" for="first_name">Phone</label>
    <input class="w-full bg-paleGrey border border-ltGrey rounded placeholder:text-dkGrey px-4 py-3" type="text" name="phone" id="" placeholder="Phone">
  </fieldset>
  <fieldset class="col-span-2">
    <label class="flex text-gray-900 text-base leading-relaxed mb-2 mt-4 md:mt-0" for="first_name">Select country *</label>
    <select class="w-full bg-paleGrey border border-ltGrey rounded placeholder:text-dkGrey px-4 py-3 focus:border-green focus:ring-green" name="country" id="">
      <option value="">-</option>
      <option value="United States">United States</option>
      <option value="Canada">Canada</option>
      <option value="Afghanistan">Afghanistan</option>
      <option value="Albania">Albania</option>
      <option value="Algeria">Algeria</option>
      <option value="Andorra">Andorra</option>
      <option value="Angola">Angola</option>
      <option value="Anguilla">Anguilla</option>
      <option value="Antarctica">Antarctica</option>
      <option value="Antigua and Barbuda">Antigua and Barbuda</option>
      <option value="Argentina">Argentina</option>
      <option value="Armenia">Armenia</option>
      <option value="Aruba">Aruba</option>
      <option value="Australia">Australia</option>
      <option value="Austria">Austria</option>
      <option value="Azerbaijan">Azerbaijan</option>
      <option value="Bahamas">Bahamas</option>
      <option value="Bahrain">Bahrain</option>
      <option value="Bangladesh">Bangladesh</option>
      <option value="Barbados">Barbados</option>
      <option value="Belgium">Belgium</option>
      <option value="Belize">Belize</option>
      <option value="Benin">Benin</option>
      <option value="Bermuda">Bermuda</option>
      <option value="Bhutan">Bhutan</option>
      <option value="Bolivia, Plurinational State of">Bolivia, Plurinational State of</option>
      <option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
      <option value="Botswana">Botswana</option>
      <option value="Brazil">Brazil</option>
      <option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
      <option value="Brunei Darussalam">Brunei Darussalam</option>
      <option value="Bulgaria">Bulgaria</option>
      <option value="Burkina Faso">Burkina Faso</option>
      <option value="Burundi">Burundi</option>
      <option value="Cambodia">Cambodia</option>
      <option value="Cameroon">Cameroon</option>
      <option value="Cape Verde">Cape Verde</option>
      <option value="Cayman Islands">Cayman Islands</option>
      <option value="Central African Republic">Central African Republic</option>
      <option value="Chad">Chad</option>
      <option value="Chile">Chile</option>
      <option value="China">China</option>
      <option value="Christmas Island">Christmas Island</option>
      <option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
      <option value="Colombia">Colombia</option>
      <option value="Comoros">Comoros</option>
      <option value="Congo">Congo</option>
      <option value="Cook Islands">Cook Islands</option>
      <option value="Costa Rica">Costa Rica</option>
      <option value="Cote d'Ivoire">Cote d'Ivoire</option>
      <option value="Croatia">Croatia</option>
      <option value="Curaçao">Curaçao</option>
      <option value="Cyprus">Cyprus</option>
      <option value="Czech Republic">Czech Republic</option>
      <option value="Denmark">Denmark</option>
      <option value="Djibouti">Djibouti</option>
      <option value="Dominica">Dominica</option>
      <option value="Dominican Republic">Dominican Republic</option>
      <option value="Ecuador">Ecuador</option>
      <option value="Egypt">Egypt</option>
      <option value="El Salvador">El Salvador</option>
      <option value="Equatorial Guinea">Equatorial Guinea</option>
      <option value="Eritrea">Eritrea</option>
      <option value="Estonia">Estonia</option>
      <option value="Ethiopia">Ethiopia</option>
      <option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
      <option value="Faroe Islands">Faroe Islands</option>
      <option value="Fiji">Fiji</option>
      <option value="Finland">Finland</option>
      <option value="France">France</option>
      <option value="French Guiana">French Guiana</option>
      <option value="French Polynesia">French Polynesia</option>
      <option value="French Southern Territories">French Southern Territories</option>
      <option value="Gabon">Gabon</option>
      <option value="Gambia">Gambia</option>
      <option value="Georgia">Georgia</option>
      <option value="Germany">Germany</option>
      <option value="Ghana">Ghana</option>
      <option value="Gibraltar">Gibraltar</option>
      <option value="Greece">Greece</option>
      <option value="Greenland">Greenland</option>
      <option value="Grenada">Grenada</option>
      <option value="Guadeloupe">Guadeloupe</option>
      <option value="Guatemala">Guatemala</option>
      <option value="Guernsey">Guernsey</option>
      <option value="Guinea">Guinea</option>
      <option value="Guinea-Bissau">Guinea-Bissau</option>
      <option value="Guyana">Guyana</option>
      <option value="Haiti">Haiti</option>
      <option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
      <option value="Honduras">Honduras</option>
      <option value="Hungary">Hungary</option>
      <option value="Iceland">Iceland</option>
      <option value="India">India</option>
      <option value="Indonesia">Indonesia</option>
      <option value="Iraq">Iraq</option>
      <option value="Ireland">Ireland</option>
      <option value="Isle of Man">Isle of Man</option>
      <option value="Israel">Israel</option>
      <option value="Italy">Italy</option>
      <option value="Jamaica">Jamaica</option>
      <option value="Japan">Japan</option>
      <option value="Jersey">Jersey</option>
      <option value="Jordan">Jordan</option>
      <option value="Kazakhstan">Kazakhstan</option>
      <option value="Kenya">Kenya</option>
      <option value="Kiribati">Kiribati</option>
      <option value="Korea, Republic of">Korea, Republic of</option>
      <option value="Kuwait">Kuwait</option>
      <option value="Kyrgyzstan">Kyrgyzstan</option>
      <option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
      <option value="Latvia">Latvia</option>
      <option value="Lebanon">Lebanon</option>
      <option value="Lesotho">Lesotho</option>
      <option value="Liberia">Liberia</option>
      <option value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option>
      <option value="Liechtenstein">Liechtenstein</option>
      <option value="Lithuania">Lithuania</option>
      <option value="Luxembourg">Luxembourg</option>
      <option value="Macao">Macao</option>
      <option value="Macedonia, the former Yugoslav Republic of">Macedonia, the former Yugoslav Republic of</option>
      <option value="Madagascar">Madagascar</option>
      <option value="Malawi">Malawi</option>
      <option value="Malaysia">Malaysia</option>
      <option value="Maldives">Maldives</option>
      <option value="Mali">Mali</option>
      <option value="Malta">Malta</option>
      <option value="Martinique">Martinique</option>
      <option value="Mauritania">Mauritania</option>
      <option value="Mauritius">Mauritius</option>
      <option value="Mayotte">Mayotte</option>
      <option value="Mexico">Mexico</option>
      <option value="Moldova, Republic of">Moldova, Republic of</option>
      <option value="Monaco">Monaco</option>
      <option value="Mongolia">Mongolia</option>
      <option value="Montenegro">Montenegro</option>
      <option value="Montserrat">Montserrat</option>
      <option value="Morocco">Morocco</option>
      <option value="Mozambique">Mozambique</option>
      <option value="Myanmar">Myanmar</option>
      <option value="Namibia">Namibia</option>
      <option value="Nauru">Nauru</option>
      <option value="Nepal">Nepal</option>
      <option value="Netherlands">Netherlands</option>
      <option value="New Caledonia">New Caledonia</option>
      <option value="New Zealand">New Zealand</option>
      <option value="Nicaragua">Nicaragua</option>
      <option value="Niger">Niger</option>
      <option value="Nigeria">Nigeria</option>
      <option value="Niue">Niue</option>
      <option value="Norfolk Island">Norfolk Island</option>
      <option value="Norway">Norway</option>
      <option value="Oman">Oman</option>
      <option value="Pakistan">Pakistan</option>
      <option value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</option>
      <option value="Panama">Panama</option>
      <option value="Papua New Guinea">Papua New Guinea</option>
      <option value="Paraguay">Paraguay</option>
      <option value="Peru">Peru</option>
      <option value="Philippines">Philippines</option>
      <option value="Pitcairn">Pitcairn</option>
      <option value="Poland">Poland</option>
      <option value="Portugal">Portugal</option>
      <option value="Qatar">Qatar</option>
      <option value="Reunion">Reunion</option>
      <option value="Romania">Romania</option>
      <option value="Rwanda">Rwanda</option>
      <option value="Saint Barthélemy">Saint Barthélemy</option>
      <option value="Saint Helena, Ascension and Tristan da Cunha">Saint Helena, Ascension and Tristan da Cunha</option>
      <option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
      <option value="Saint Lucia">Saint Lucia</option>
      <option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
      <option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
      <option value="Samoa">Samoa</option>
      <option value="San Marino">San Marino</option>
      <option value="Sao Tome and Principe">Sao Tome and Principe</option>
      <option value="Saudi Arabia">Saudi Arabia</option>
      <option value="Senegal">Senegal</option>
      <option value="Serbia">Serbia</option>
      <option value="Seychelles">Seychelles</option>
      <option value="Sierra Leone">Sierra Leone</option>
      <option value="Singapore">Singapore</option>
      <option value="Slovakia">Slovakia</option>
      <option value="Slovenia">Slovenia</option>
      <option value="Solomon Islands">Solomon Islands</option>
      <option value="Somalia">Somalia</option>
      <option value="South Africa">South Africa</option>
      <option value="Spain">Spain</option>
      <option value="Sri Lanka">Sri Lanka</option>
      <option value="Suriname">Suriname</option>
      <option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
      <option value="Sweden">Sweden</option>
      <option value="Switzerland">Switzerland</option>
      <option value="Taiwan">Taiwan</option>
      <option value="Tajikistan">Tajikistan</option>
      <option value="Tanzania, United Republic of">Tanzania, United Republic of</option>
      <option value="Thailand">Thailand</option>
      <option value="Timor-Leste">Timor-Leste</option>
      <option value="Togo">Togo</option>
      <option value="Tokelau">Tokelau</option>
      <option value="Tonga">Tonga</option>
      <option value="Trinidad and Tobago">Trinidad and Tobago</option>
      <option value="Tunisia">Tunisia</option>
      <option value="Turkey">Turkey</option>
      <option value="Turkmenistan">Turkmenistan</option>
      <option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
      <option value="Tuvalu">Tuvalu</option>
      <option value="Uganda">Uganda</option>
      <option value="Ukraine">Ukraine</option>
      <option value="United Arab Emirates">United Arab Emirates</option>
      <option value="United Kingdom">United Kingdom</option>
      <option value="Uruguay">Uruguay</option>
      <option value="Uzbekistan">Uzbekistan</option>
      <option value="Vanuatu">Vanuatu</option>
      <option value="Venezuela, Bolivarian Republic of">Venezuela, Bolivarian Republic of</option>
      <option value="Viet Nam">Viet Nam</option>
      <option value="Virgin Islands, British">Virgin Islands, British</option>
      <option value="Wallis and Futuna">Wallis and Futuna</option>
      <option value="Western Sahara">Western Sahara</option>
      <option value="Yemen">Yemen</option>
      <option value="Zambia">Zambia</option>
      <option value="Zimbabwe">Zimbabwe</option>
    </select>
  </fieldset>
  <fieldset class="col-span-2" style="display:none">
    <label class="flex text-gray-900 text-base leading-relaxed mb-2 mt-4 md:mt-0" for="first_name">Select state or province *</label>
    <select class="w-full bg-paleGrey border border-ltGrey rounded placeholder:text-dkGrey px-4 py-3" name="state">
    </select>
  </fieldset>
  <h4 class="col-span-4 text-lg md:text-[1.25rem] font-semibold mb-6 mt-2">Products of interest:</h4>
  <fieldset class="col-span-4 grid md:grid-cols-4 gap-6 gap-y-6 mb-6">
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox741" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="Apollo" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox741" class="font-medium text-dkblue">Apollo</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox742" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="Ares" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox742" class="font-medium text-dkblue">Ares</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox743" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="Aria" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox743" class="font-medium text-dkblue">Aria</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox744" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="Blue Phantom" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox744" class="font-medium text-dkblue">Blue Phantom</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox745" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="CathLabVR" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox745" class="font-medium text-dkblue">CathLabVR</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox746" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="HPS" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox746" class="font-medium text-dkblue">HPS</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox747" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="ICCU" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox747" class="font-medium text-dkblue">ICCU</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox748" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="Juno" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox748" class="font-medium text-dkblue">Juno</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox750" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="Learning Modules" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox750" class="font-medium text-dkblue">Learning Modules</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox749" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="LearningSpace" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox749" class="font-medium text-dkblue">LearningSpace</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox752" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="Lucina" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox752" class="font-medium text-dkblue">Lucina</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox753" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="Luna" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox753" class="font-medium text-dkblue">Luna</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox754" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="Maestro Embody" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox754" class="font-medium text-dkblue">Maestro Embody</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox755" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="Maestro Evolve" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox755" class="font-medium text-dkblue">Maestro Evolve</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox756" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="Medicor" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox756" class="font-medium text-dkblue">Medicor</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox757" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="SimEquip" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox757" class="font-medium text-dkblue">SimEquip</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox751" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="SMART Manikin" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox751" class="font-medium text-dkblue">SMART Manikin</label>
      </div>
    </div>
    <div class="relative flex items-start">
      <div class="flex h-6 items-center">
        <input id="checkbox758" data-field="product" aria-describedby="comments-description" name="" type="checkbox" value="Vimedix" class="h-4 w-4 rounded border-gray-300 text-green focus:ring-green">
      </div>
      <div class="ml-3 text-sm leading-6">
        <label for="checkbox758" class="font-medium text-dkblue">Vimedix</label>
      </div>
    </div>
  </fieldset>
  <fieldset class="col-span-2">
    <label class="flex text-gray-900 text-base leading-relaxed mb-2 mt-4 md:mt-0" for="first_name">Simulator serial number</label>
    <input class="w-full bg-paleGrey border border-ltGrey rounded placeholder:text-dkGrey px-4 py-3" type="text" name="serial_num" id="" placeholder="Simulator serial number">
  </fieldset>
  <fieldset class="col-span-4">
    <label class="flex text-gray-900 text-base leading-relaxed mb-2 mt-4 md:mt-0" for="first_name">Your message</label>
    <textarea class="w-full bg-paleGrey border border-ltGrey rounded placeholder:text-dkGrey px-4 py-3 focus:border-green focus:ring-green" name="comments" id="" cols="30" rows="10" placeholder=""></textarea>
  </fieldset>
  <fieldset class="col-span-4">
    <div class="cf-turnstile" data-sitekey="0x4AAAAAAA0ZijOlugcuYaHh">
      <div><input type="hidden" name="cf-turnstile-response" id="cf-chl-widget-9i6we_response"></div>
    </div>
  </fieldset>
  <button type="submit" class="flex group justify-center items-center gap-2.5 px-6 py-3 font-bold text-sm text-center transition-colors border-2 border-transparent rounded-md text-green bg-dkBlue hover:text-dkBlue hover:border-green hover:bg-white">
    <span>Submit</span>
  </button>
</form>

Text Content

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Elevate Healthcare


REIMAGINING HEALTHCARE EDUCATION AND REVOLUTIONIZING LEARNING WITH CUTTING-EDGE
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Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia
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of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea,
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Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao
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Mali Malta Martinique Mauritania Mauritius Mayotte Mexico Moldova, Republic of
Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru
Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk
Island Norway Oman Pakistan Palestinian Territory, Occupied Panama Papua New
Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Qatar Reunion Romania
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and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines
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Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa
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PRODUCTS OF INTEREST:

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