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cignahealthcare.co.uk Open in urlscan Pro
108.138.17.26  Public Scan

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Submitted URL: http://cignahealthcare.co.uk/
Effective URL: https://cignahealthcare.co.uk/
Submission: On June 07 via manual from GB — Scanned from GB

Form analysis 1 forms found in the DOM

<form class="bg-white rounded px-4 text-dark py-4" id="hero-json-form" data-jsonform-tree="[object Object]" can_known="0">
  <div><input type="hidden" id="jsonform-1-elt-from_email" name="from_email" value="cigna_landing@canddi.com"><input type="hidden" id="jsonform-1-elt-to_email" name="to_email" value="enquiries@cignahealthcare.co.uk"><input type="hidden"
      id="jsonform-1-elt-original_email" name="original_email" value="">
    <div class="row text-left">
      <div class="col-sm-12 col-md-12 col-lg-6 mb-3">
        <div class="form-group jsonform-error-fname"><label for="jsonform-1-elt-fname">First Name</label>
          <div class="controls"><input type="text" class="form-control" name="fname" value="" id="jsonform-1-elt-fname" aria-label="First Name" placeholder="First Name"><span class="help-block jsonform-errortext" style="display:none;"></span></div>
        </div>
      </div>
      <div class="col-sm-12 col-md-12 col-lg-6 mb-3">
        <div class="form-group jsonform-error-lname"><label for="jsonform-1-elt-lname">Surname</label>
          <div class="controls"><input type="text" class="form-control" name="lname" value="" id="jsonform-1-elt-lname" aria-label="Surname" placeholder="Surname"><span class="help-block jsonform-errortext" style="display:none;"></span></div>
        </div>
      </div>
    </div>
    <div class="row text-left">
      <div class="col-sm-12 col-md-12 col-lg-6 mb-3">
        <div class="form-group jsonform-error-cname"><label for="jsonform-1-elt-cname">Company Name</label>
          <div class="controls"><input type="text" class="form-control" name="cname" value="" id="jsonform-1-elt-cname" aria-label="Company Name" placeholder="Company Name"><span class="help-block jsonform-errortext" style="display:none;"></span>
          </div>
        </div>
      </div>
      <div class="col-sm-12 col-md-12 col-lg-6 mb-3">
        <div class="form-group jsonform-error-telno"><label for="jsonform-1-elt-telno">Telephone Number</label>
          <div class="controls"><input type="tel" class="form-control" name="telno" value="" id="jsonform-1-elt-telno" aria-label="Telephone Number" placeholder="Telephone Number"><span class="help-block jsonform-errortext"
              style="display:none;"></span></div>
        </div>
      </div>
    </div>
    <div class="form-group jsonform-error-email text-left"><label for="jsonform-1-elt-email">Email Address</label>
      <div class="controls"><input type="email" class="form-control" name="email" value="" id="jsonform-1-elt-email" aria-label="Email Address" placeholder="Email Address"><span class="help-block jsonform-errortext" style="display:none;"></span>
      </div>
    </div> <button type="button" id="jsonform-1-elt-counter-2" class="btn btn-default btn btn-primary btn-lg button-shadow button-wide-mobile text-white">Get more information</button>
  </div>
  <div class="form-check p-0 my-3">
    <label class="form-check-label sm-font-small">
      <input type="checkbox"> Please tick here if you're <b>not</b> the named person on this form, to confirm that you have their consent to use this data </label>
  </div>
</form>

Text Content

Thank you for your enquiry, a member of our team will be in contact with you
shortly.

First Name

Surname

Company Name

Telephone Number

Email Address

Get more information
Please tick here if you're not the named person on this form, to confirm that
you have their consent to use this data
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