go.nexthealthtechnologies.com Open in urlscan Pro
52.54.96.194  Public Scan

Form analysis
1 forms found in the DOM

POST https://go.nexthealthtechnologies.com/l/884923/2021-04-29/mhf2d

<form accept-charset="UTF-8" method="post" action="https://go.nexthealthtechnologies.com/l/884923/2021-04-29/mhf2d" class="form" id="pardot-form">
  <style type="text/css">
    form.form p label {
      float: none;
      text-align: left;
      line-height: 1em;
      width: auto;
    }

    form.form p.submit {
      margin-left: 5px;
    }

    form.form p.no-label {
      margin-left: 50px;
    }

    form.form span.value {
      margin-left: 0px;
    }

    form.form p span.description {
      margin-left: 0px;
    }

    form.form p.required label,
    form.form span.required label {
      background-position: top left;
      background: none;
      padding-left: 0px;
    }
  </style>
  <p class="form-field  email pd-text required required-custom    ">
    <label class="field-label" for="Emailpi_Email">Business Email *</label>
    <input type="text" name="Emailpi_Email" id="Emailpi_Email" value="" class="text" size="30" maxlength="255" onchange="" onfocus="piAjax.loadEmailIndicator(this, 25589, 'https://go.nexthealthtechnologies.com/images/indicator2.gif');">
  </p>
  <div id="error_for_Emailpi_Email" style="display:none"></div>
  <p class="form-field  Email_Opt_In pd-checkbox   no-label  ">
    <span class="value"><span><input type="checkbox" name="884923_25591pi_884923_25591_141565" id="884923_25591pi_884923_25591_141565" value="141565" onchange=""><label class="inline" for="884923_25591pi_884923_25591_141565">Yes, I would like to
          receive emails from NextHealth Technologies.</label></span></span>
  </p>
  <div id="error_for_884923_25591pi_884923_25591" style="display:none"></div>
  <p style="position:absolute; width:190px; left:-9999px; top: -9999px;visibility:hidden;">
    <label for="pi_extra_field">Comments</label>
    <input type="text" name="pi_extra_field" id="pi_extra_field">
  </p>
  <!-- forces IE5-8 to correctly submit UTF8 content  -->
  <input name="_utf8" type="hidden" value="☃">
  <p class="submit">
    <input type="submit" accesskey="s" class="buttonelic helping-habit alignleft" value="DOWNLOAD CASE STUDY">
  </p>
  <script type="text/javascript">
    //<![CDATA[
    var anchors = document.getElementsByTagName("a");
    for (var i = 0; i < anchors.length; i++) {
      var anchor = anchors[i];
      if (anchor.getAttribute("href") && !anchor.getAttribute("target")) {
        anchor.target = "_top";
      }
    }
    //]]>
  </script>
  <input type="hidden" name="hiddenDependentFields" id="hiddenDependentFields" value="">
</form>

Text Content

Business Email *



Yes, I would like to receive emails from NextHealth Technologies.



Comments