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69.167.171.19  Public Scan

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Submitted URL: https://electroacupunctureinstitute.com.electro-acupuncturemedicine.com/
Effective URL: https://electroacupunctureinstitute.com/
Submission: On March 25 via api from US — Scanned from US

Form analysis 1 forms found in the DOM

POST https://eam.activehosted.com/proc.php

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  <div class="_form-content">
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      <div class="_form-title">Get notified when we go live!</div>
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      <div class="_html-code">
        <p>Enter your details below to get updated when the Electro Acupuncture Institute goes live.</p>
      </div>
    </div>
    <div class="_form_element _x90774016 _inline-style ">
      <label for="fullname" class="_form-label">Full Name</label>
      <div class="_field-wrapper">
        <input type="text" id="fullname" name="fullname" placeholder="Type your name" data-name="fullname">
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    <div class="_form_element _x37947374 _inline-style ">
      <label for="email" class="_form-label">Email*</label>
      <div class="_field-wrapper">
        <input type="text" id="email" name="email" placeholder="Type your email" required="" data-name="email">
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    <div class="_button-wrapper _inline-style"><button id="_form_176_submit" class="_submit" type="submit">Yes Please Keep Me Informed</button></div>
    <div class="_clear-element"></div>
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  <div class="_form-thank-you" style="display:none;"></div>
</form>

Text Content

Coming Soon

The Electro Acupuncture Institute

Get notified when we go live!

Enter your details below to get updated when the Electro Acupuncture Institute
goes live.

Full Name

Email*

Yes Please Keep Me Informed