forms.riskconsole.com
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Submitted URL: http://www.ventivtech.com/engage
Effective URL: https://forms.riskconsole.com/PerfectForms/PresentationServer/Form.aspx/Play/30AAggMl?f=30AAggMl
Submission: On September 06 via manual from US — Scanned from DE
Effective URL: https://forms.riskconsole.com/PerfectForms/PresentationServer/Form.aspx/Play/30AAggMl?f=30AAggMl
Submission: On September 06 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
<form id="PF_21" class="form" style="height: 1100px; width: 1280px; border-color: rgb(231, 245, 255); border-width: 12px; border-style: solid; display: block; left: 148px; top: 13px;">
<div id="PF_16Container" class="PageContainer" style="z-index:0;left:0px;top:0px;">
<div id="PF_16" name="PF_16" class="page" style="width: 1280px; height: 1100px; background-color: rgb(255, 255, 255); display: block;">
<img id="PF_39" title="" src="/PerfectForms/PresentationServer/ImageAspectRatioHandler.ashx?id=U29KZ2djZ0FnQUFnVUF3SSYyNTQmODcmYm90aCY2NjMmOTAuMA==" class="picture" role="presentation" alt=""
style="z-index: 2; left: 52px; top: 25px; width: 254px; height: 87px; display: block;">
<div id="PF_40" rel="False" class="mediumheading text" style="z-index: 3; font-family: Calibri; font-size: 24px; font-style: normal; left: 547px; top: 40px; height: 32px; width: 181px; font-weight: bold !important; display: block;"> Case Entry
Form </div><button aria-label="Next" title="Next" rel="#E7F5FF," id="PF_1" class="button" onclick="return false;"
style="width: 58px; height: 31px; z-index: 4; font-family: Calibri; font-size: 20px; font-style: normal; left: 1142px; top: 78px; border-width: 0px; background-color: transparent; border-style: none; overflow: hidden; text-overflow: ellipsis; white-space: nowrap; position: absolute; font-weight: bold !important; display: block;">Next
</button>
<div id="PF_41" class="horizontalseparator" style="z-index: 5; left: 25px; top: 124px; width: 1223px; height: 2px; background-color: rgb(0, 0, 0); display: block;">
</div>
<div id="PF_42" rel="False" class="largeheading text" style="z-index: 6; font-family: Calibri; font-size: 24px; font-style: normal; left: 121px; top: 134px; height: 32px; width: 181px; font-weight: bold !important; display: block;"> Welcome
</div>
<div id="PF_43" rel="False" class="typetext text text"
style="z-index: 7; color: rgb(0, 0, 0); font-family: Calibri; font-size: 16px; font-style: normal; left: 124px; top: 167px; height: 241px; width: 815px; font-weight: normal !important; display: block;"> The following pages present a series of
questions you will answer in regards to any issues you are seeing within the RiskConsole, SafetyLogic or iVOS systems. Each page will have navigation buttons at the top that will guide you through the form. Clicking the Submit button will
submit your Case to the Ventiv staff.<br><br>If this is a system down emergency, please contact us at Ventiv Support:<br>For US: Contact your Client Delivery Lead<br>For Europe: +44 (0) 203 817 7400<br>For Hong Kong: +852 5804
9837 For Singapore: 800 101 3668 <br>For Philippines 1800 1110 2465<br>For Australia: 1800 251 774 or +61 (02) 8669 7222<br>
</div>
<div id="PF_44" rel="False" class="typetext text text"
style="z-index: 12; color: rgb(0, 0, 0); font-family: Calibri; font-size: 16px; font-style: normal; left: 123px; top: 415px; height: 21px; width: 94px; font-weight: bold !important; display: block;"> Your Name </div><span><input id="PF_2"
name="PF_2" type="text" maxlength="90" value="" class="textinput" onclick="return false;"
style="font-family: Calibri; font-size: 16px; font-style: normal; z-index: 886; border-color: rgb(255, 0, 0); left: 123px; top: 450px; height: 21px; line-height: 21px; width: 647px; font-weight: normal !important; display: block;"><label
id="PF_2label" class="offscreen" for="PF_2">No description</label></span><span><input id="PF_45" name="PF_45" type="text" maxlength="99" value="" class="textinput" onclick="return false;"
style="z-index: 9999; border-color: rgb(255, 0, 0); left: 125px; top: 525px; display: block;"><label id="PF_45label" class="offscreen" for="PF_45">No description</label></span><span><input id="PF_3" name="PF_3" type="text" maxlength="50"
value="" class="textinput" onclick="return false;" validtext="validate[custom[email]]"
style="font-family: Calibri; font-size: 16px; font-style: normal; z-index: 9999; border-color: rgb(255, 0, 0); left: 125px; top: 600px; height: 21px; line-height: 21px; width: 372px; font-weight: normal !important; display: block;"
data-validation-engine="undefinedvalidate[custom[email]]"><label id="PF_3label" class="offscreen" for="PF_3">No description</label></span>
<div id="PF_46" rel="False" class="typetext text text"
style="z-index: 891; color: rgb(0, 0, 0); font-family: Calibri; font-size: 16px; font-style: normal; left: 125px; top: 649px; height: 21px; width: 272px; font-weight: bold !important; display: block;"> Best phone number to contact you </div>
<span><input id="PF_4" name="PF_4" type="text" maxlength="30" value="" class="textinput" onclick="return false;"
style="font-family: Calibri; font-size: 16px; font-style: normal; z-index: 1765; border-color: rgb(255, 0, 0); left: 125px; top: 689px; height: 21px; line-height: 21px; width: 294px; font-weight: normal !important; display: block;"><label
id="PF_4label" class="offscreen" for="PF_4">No description</label></span>
<div id="PF_47" rel="False" class="typetext text text"
style="z-index: 9999; color: rgb(0, 0, 0); font-family: Calibri; font-size: 16px; font-style: normal; left: 125px; top: 562px; height: 21px; width: 184px; font-weight: bold !important; display: block;"> Your Email Address </div>
<div id="PF_48" rel="False" class="typetext text text"
style="z-index: 9999; color: rgb(0, 0, 0); font-family: Calibri; font-size: 16px; font-style: normal; left: 102px; top: 382px; height: 21px; width: 257px; font-weight: bold !important; display: block;"> ** Red box denotes a required field
</div><button aria-label="Next" title="Next" rel="#E7F5FF," id="PF_49" class="button" onclick="return false;"
style="width: 58px; height: 31px; z-index: 9999; font-family: Calibri; font-size: 20px; font-style: normal; left: 1132px; top: 734px; border-width: 0px; background-color: transparent; border-style: none; overflow: hidden; text-overflow: ellipsis; white-space: nowrap; position: absolute; font-weight: bold !important; display: block;">Next
</button><button aria-label="Submit" title="Submit" rel="#E7F5FF," id="PF_6" class="button hidden" onclick="return false;"
style="width: 85px; height: 31px; z-index: 9999; font-family: Calibri; font-size: 20px; font-style: normal; left: 1142px; top: 78px; border-width: 0px; background-color: transparent; border-style: none; overflow: hidden; text-overflow: ellipsis; white-space: nowrap; position: absolute; font-weight: bold !important; display: none;">Submit
</button><button aria-label="Submit" title="Submit" rel="#E7F5FF," id="PF_50" class="button hidden" onclick="return false;"
style="width: 85px; height: 31px; z-index: 9999; font-family: Calibri; font-size: 20px; font-style: normal; left: 1132px; top: 734px; border-width: 0px; background-color: transparent; border-style: none; overflow: hidden; text-overflow: ellipsis; white-space: nowrap; position: absolute; font-weight: bold !important; display: none;">Submit
</button>
<div id="PF_51" rel="False" class="typetext text text"
style="z-index: 9999; color: rgb(0, 0, 0); font-family: Calibri; font-size: 16px; font-style: normal; left: 125px; top: 499px; height: 22px; width: 108px; font-weight: bold !important; display: block;"> Company Name </div>
</div>
</div>
</form>Text Content
Case Entry Form Next Welcome The following pages present a series of questions you will answer in regards to any issues you are seeing within the RiskConsole, SafetyLogic or iVOS systems. Each page will have navigation buttons at the top that will guide you through the form. Clicking the Submit button will submit your Case to the Ventiv staff. If this is a system down emergency, please contact us at Ventiv Support: For US: Contact your Client Delivery Lead For Europe: +44 (0) 203 817 7400 For Hong Kong: +852 5804 9837 For Singapore: 800 101 3668 For Philippines 1800 1110 2465 For Australia: 1800 251 774 or +61 (02) 8669 7222 Your Name No descriptionNo descriptionNo description Best phone number to contact you No description Your Email Address ** Red box denotes a required field Next Submit Submit Company Name Loading hide Opening form...