proassurance.velscope.com
Open in
urlscan Pro
159.89.239.137
Public Scan
URL:
https://proassurance.velscope.com/
Submission: On June 04 via automatic, source certstream-suspicious — Scanned from DE
Submission: On June 04 via automatic, source certstream-suspicious — Scanned from DE
Form analysis 1 forms found in the DOM
<form class="vbout_drag vbtb-HForm01" novalidate="" id="x9a3c5dda-5e85-fdfd-312d-b26794316ed6" enctype="multipart/form-data" data-vbtlpblkfrm="yes">
<div class="vbfs-form">
<div class="vbfs-rows">
<div class="vbfs-row ">
<div class="vbfs-field vbfs-input vbfs-text"><input type="text" data-name="fullname" name="vbout_EmbedForm[field][436870]" id="custom-436870_vbfvid1" value="" class="vfb-text required" placeholder="Full Name *"></div>
</div>
<div class="vbfs-row ">
<div class="vbfs-field vbfs-input vbfs-email"><input type="email" data-name="email" name="vbout_EmbedForm[field][436873]" id="custom-436873_vbfvid2" value="" class="vfb-text required validate-email" placeholder="Email Address *"></div>
</div>
<div class="vbfs-row ">
<div class="vbfs-field vbfs-input vbfs-phone"><input type="tel" data-name="phone" name="vbout_EmbedForm[field][436874]" id="custom-436874_vbfvid3" value="" class="vfb-text required validate-phone" placeholder="Phone Number *"></div>
</div>
<div class="vbfs-row" style="display: none;">
<div class="vbfs-field vbfs-input vbfs-text"><input type="text" name="vbout_EmbedForm[field][0]" placeholder="Middle Name" tabindex="-1" id="x9a3c5dda-5e85-fdfd-312d-b26794316ed6_vbfvid4"></div>
</div>
<div class="vbfs-row ">
<div class="vbfs-field vbfs-input vbfs-text"><input type="text" data-name="company-name" name="vbout_EmbedForm[field][436894]" id="custom-436894_vbfvid5" value="" class="vfb-text required" placeholder="Your Company *"></div>
</div>
<div class="vbfs-row ">
<div class="vbfs-field vbfs-input vbfs-text"><input type="text" data-name="zipcode" name="vbout_EmbedForm[field][436881]" id="custom-436881_vbfvid6" value="" class="vfb-text required" placeholder="Zip Code *"></div>
</div>
<div class="vbfs-row">
<div class="vbfs-label">
<span style="font-family: 'ProximaNova Regular';">
<font style="font-size: 12px; color: rgb(255, 255, 255);"><label class="title" for="custom-917974" style="">
<font style="color: rgb(255, 255, 255);">Consent for marketing. Check all that apply.<span class="required-asterisk" style="">*</span></font>
</label>
</font>
</span>
</div>
<div class="vbfs-field vbfs-checkbox"><span style="font-family: 'ProximaNova Regular';">
<font style="font-size: 12px; color: rgb(255, 255, 255);"><input type="checkbox" data-name="field-917974" name="vbout_EmbedForm[field][917974][gdpr]" id="custom-917974-gdpr_vbfvid7" value="yes"
class="vfb-gdpr vfb-checkbox requiredOption"><label for="custom-917974-gdpr_vbfvid7" class="vbfs-choice" style="padding: 0 0 0 5px">
<font style="color: rgb(255, 255, 255);">You agree to our
<a href="https://velscope.com/privacy-policy/?utm_medium=Landing+Page&utm_campaign=USI&utm_content=entertowin&utm_source=hekadoc&utm_term=freevelscope">Terms</a> and
<a href="https://velscope.com/privacy-policy/?utm_medium=Landing+Page&utm_campaign=USI&utm_content=entertowin&utm_source=hekadoc&utm_term=freevelscope">Privacy Policy</a>.</font>
</label></font>
</span></div>
<div class="vbfs-field vbfs-checkbox"><span style="font-family: 'ProximaNova Regular';">
<font style="font-size: 12px; color: rgb(255, 255, 255);"><input type="checkbox" data-name="field-917974" name="vbout_EmbedForm[field][917974][newsletter]" id="custom-917974-newsletter_vbfvid8" value="yes"
class="vfb-gdpr vfb-checkbox requiredOption"><label for="custom-917974-newsletter_vbfvid8" class="vbfs-choice" style="padding: 0 0 0 5px">
<font style="color: rgb(255, 255, 255);">Yes, enter me to win</font>
</label></font>
</span></div>
<div class="vbfs-field vbfs-checkbox"><span style="font-family: 'ProximaNova Regular';">
<font style="font-size: 12px; color: rgb(255, 255, 255);"><input type="checkbox" data-name="field-917974" name="vbout_EmbedForm[field][917974][f9179742640]" id="custom-917974-f9179742640_vbfvid9" value="yes"
class="vfb-gdpr vfb-checkbox"><label for="custom-917974-f9179742640_vbfvid9" class="vbfs-choice" style="padding: 0 0 0 5px">
<font style="color: rgb(255, 255, 255);">I currently use the VELscope</font>
</label></font>
</span></div>
<div class="vbfs-field vbfs-checkbox"><span style="font-family: 'ProximaNova Regular';">
<font style="font-size: 12px; color: rgb(255, 255, 255);"><input type="checkbox" data-name="field-917974" name="vbout_EmbedForm[field][917974][f9179748791]" id="custom-917974-f9179748791_vbfvid10" value="yes"
class="vfb-gdpr vfb-checkbox"><label for="custom-917974-f9179748791_vbfvid10" class="vbfs-choice" style="padding: 0 0 0 5px">
<font style="color: rgb(255, 255, 255);">I use a different adjunctive device</font>
</label></font>
</span></div>
<div class="vbfs-field vbfs-checkbox"><span style="font-family: 'ProximaNova Regular';">
<font style="font-size: 12px; color: rgb(255, 255, 255);"><input type="checkbox" data-name="field-917974" name="vbout_EmbedForm[field][917974][f9179742511]" id="custom-917974-f9179742511_vbfvid11" value="yes" class="vfb-gdpr vfb-checkbox"
style=""><label for="custom-917974-f9179742511_vbfvid11" class="vbfs-choice" style="padding: 0px 0px 0px 5px;">
<font style="color: rgb(255, 255, 255);">I do not use an adjunctive device</font>
</label></font>
</span></div>
<div class="vfb-gdpr-disclaimer"><span style="font-family: 'ProximaNova Regular';">
<font style="color: rgb(255, 255, 255); font-size: 12px;">You are about to authorize VELscope to contact you for the purpose indicated on the selected options. You are in control of your data and can unsubscribe from our lists using our
self opt-out option or by emailing our support directly at VELscope.</font>
</span></div>
</div>
</div>
<div class="vbfs-buttons">
<div class="vbfs-submit">
<input type="submit" class="vbf-submit" value="Book My Demo Now"
style="width: 255px;height: 52.9972px;line-height: 53px;padding-top: 0px;padding-right: 0px;padding-bottom: 0px;padding-left: 0px;margin-top: 10px;margin-right: 0px;margin-bottom: 0px;margin-left: 0px;background-image: none;background-color: #8dc63f;background-repeat: repeat;border-top-left-radius: 5px;border-top-right-radius: 5px;border-bottom-left-radius: 5px;border-bottom-right-radius: 5px;border-top: 0px none rgb(255, 255, 255);border-bottom: 0px none rgb(255, 255, 255);border-left: 0px none rgb(255, 255, 255);border-right: 0px none rgb(255, 255, 255);"
id="x9a3c5dda-5e85-fdfd-312d-b26794316ed6_vbfvid12">
</div>
</div>
</div>
</form>Text Content
SPONSORED BY AWARD-WINNING ORAL SCREENING AND IMAGING TECHNOLOGY THE VELSCOPE VALUE BUNDLE INCLUDES: * VELSCOPE VX SYSTEM * IPOD PHOTO SYSTEM * VELSCOPE VX DISPOSABLES * POINT-OF-SALE PACKAGE * VIDEO TRAINING MODULES 2024 VELSCOPE SWEEPSTAKES! Consent for marketing. Check all that apply.* You agree to our Terms and Privacy Policy. Yes, enter me to win I currently use the VELscope I use a different adjunctive device I do not use an adjunctive device You are about to authorize VELscope to contact you for the purpose indicated on the selected options. You are in control of your data and can unsubscribe from our lists using our self opt-out option or by emailing our support directly at VELscope. WHY THE VELSCOPE? The VELscope Vx is the market-leader in fluorescence screening for visualizing oral abnormalities, including oral cancer. Similar systems claim to deliver the same tissue visualization technology but only the VELscope is backed by dozens of independent clinical research studies. Proprietary blue LED and optical filtering technologies Backed by over a decade of clinical research The most awarded system for tissue fluorescence visualization Used in over 20,000 practices in 23 countries worldwide ©2024 LED DENTAL INC. ALL RIGHTS RESERVED. THE 2024 VELSCOPE SWEEPSTAKES RUNS FROM JANUARY 1 TO DECEMBER 31, 2024. NO PURCHASE NECESSARY. OPEN TO PRACTICING DENTAL PROFESSIONALS RESIDING IN THE US AND CANADA. ONE PRIZE OF A VELSCOPE VALUE BUNDLE WILL BE AWARDED. BY PARTICIPATING IN THE 2024 VELSCOPE SWEEPSTAKES, ENTRANTS EXPRESS INTEREST IN THE VELSCOPE VX ENHANCED ORAL ASSESSMENT SYSTEM AND ACKNOWLEDGE THAT PROVIDED INFORMATION MAY BE USED FOR SWEEPSTAKES COMMUNICATION AND OTHER PURPOSES, INCLUDING SALES CALLS. ENTRANTS ARE NOT OBLIGATED TO AGREE TO A SALES PRESENTATION. ADDITIONAL TERMS AND CONDITIONS MAY APPLY. VOID IN ARIZONA, VERMONT, QUEBEC, AND WHERE PROHIBITED.