www.recoveryoutcomes.net Open in urlscan Pro
137.135.129.175  Public Scan

Form analysis
3 forms found in the DOM

POST /Account/Login?ReturnUrl=%2F

<form action="/Account/Login?ReturnUrl=%2F" autocomplete="false" class="form-horizontal" id="login" method="post" role="form" novalidate="novalidate"><input name="__RequestVerificationToken" type="hidden"
    value="8QQqkcCFfm-RrlIbOV-GOP1kwD1I41wPmbiMnnakNLle6L0N3TRi7aRFlWyetXbBSnalkwRFQPkKcSGdU5etyGIgMKc1"> <input type="text" id="UserName" name="UserName" placeholder="UserName" required="" autofocus="">
  <span class="field-validation-valid text-danger mt-5" data-valmsg-for="UserName" data-valmsg-replace="true"></span> <input type="password" name="Password" class="password" placeholder="Password" autocomplete="new-password"
    onkeypress="capLock(event)" required="">
  <span id="caps-warning" style="display:none">Caps Lock</span>
  <span class="field-validation-valid text-danger mt-5" data-valmsg-for="Password" data-valmsg-replace="true"></span> <button id="formSubmitButton" type="submit" class="btn btn-lg btn-primary btn-block mt-20">Log in</button>
  <div>
    <input data-val="true" data-val-required="The Remember me field is required." id="RememberMe" name="RememberMe" type="checkbox" value="true"><input name="RememberMe" type="hidden" value="false">&nbsp; <label for="RememberMe"
      style="margin-top:5px;">Remember me</label>
  </div>
  <div class="mt-10">
    <a href="/Account/ForgotPassword">Forgot password</a>
  </div>
  <button id="passwordless-login" onclick="loginPasswordless(event)" type="button" class="btn btn-default" title="Biometric login"><img src="/Images/fingerprint.svg" width="50" title="Biometric Login"> </button>
</form>

<form>
  <input class="form-control" id="patientNoteId" value="0" type="hidden">
  <div class="form-group">
    <label for="patientNoteTextArea">Note</label>
    <textarea class="form-control" id="patientNoteTextArea" rows="3"></textarea>
  </div>
  <div class="form-check">
    <label class="form-check-label"><input id="patientNoteImportant" type="checkbox" class="form-check-input"> Important</label>
    <label class="form-check-label"><input id="patientNotePrivate" type="checkbox" class="form-check-input"> Private</label>
  </div>
</form>

<form>
  <input class="form-control" id="nurseNoteId" value="0" type="hidden">
  <div class="form-group">
    <label for="nurseNoteTextArea">Note</label>
    <textarea class="form-control" id="nurseNoteTextArea" rows="4"></textarea>
  </div>
</form>

Text Content

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  Remember me
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© 2016. OutcomesIT (Pty) Ltd. All rights reserved





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MODAL TITLE



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PATIENT NOTE

Note
Important Private
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NURSE INSTRUCTION

Note
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NO YES