seamusmedical.com Open in urlscan Pro
2606:4700:3033::ac43:91fc  Public Scan

Form analysis
1 forms found in the DOM

Name: form-162628 — POST

<form id="form-162628" name="form-162628" method="post" onsubmit="return validateName()">
  <div class="text-editor editor-border-text diva page-popup-width" style="clear:both">
    <style>
      .page-popup-width {
        width: 100%;
      }

      .button-save-text {
        color: ;
        padding: 3px 10px;
        margin: 5px 0;
        text-align: center;
        font-size: 18px;
        border-radius: 5px;
      }

      .visually-hidden {
        position: absolute;
        width: 1px;
        height: 1px;
        margin: -1px;
        padding: 0;
        overflow: hidden;
        clip: rect(0, 0, 0, 0);
        border: 0;
      }

      @media screen and (max-width: 600px) {
        .page-popup-width {}
    </style>
    <!-- TEXT here -->
    <label class="visually-hidden" for="Full Name" style="font-size:.001px">Full Name:</label>
    <input class="page-popup-input" placeholder="Full Name" type="text" name="lead_contact" value="" required="" pattern="[A-Za-z\s.]{1,}">
  </div>
  <div class="text-editor editor-border-text diva page-popup-width" style="clear:both">
    <style>
      .page-popup-width {
        width: 100%;
      }

      .button-save-text {
        color: ;
        padding: 3px 10px;
        margin: 5px 0;
        text-align: center;
        font-size: 18px;
        border-radius: 5px;
      }

      .visually-hidden {
        position: absolute;
        width: 1px;
        height: 1px;
        margin: -1px;
        padding: 0;
        overflow: hidden;
        clip: rect(0, 0, 0, 0);
        border: 0;
      }

      @media screen and (max-width: 600px) {
        .page-popup-width {}
    </style>
    <!-- TEXT here -->
    <label class="visually-hidden" for="Email Address" style="font-size:.001px">Email Address:</label>
    <input class="page-popup-input" placeholder="Email Address" type="email" name="lead_email" value="">
  </div>
  <input class="popup-input" type="hidden" name="page_group_id" id="page_group_id" value="1175">
  <input type="hidden" value="13440" name="assembly_id">
  <input type="hidden" value="11617" name="account_id">
  <input type="hidden" value="13440&amp;ac=11617&amp;a=13440&amp;r1=99151&amp;r2=42729&amp;r3=49377&amp;r4=43367" name="page">
  <div class="clear"></div>
  <script>
    function validateName() {
      var nameInput = document.getElementById('name');
      var regex = /^[A-Za-z\s.]+$/; // Regex pattern for letters, space, and period
      if (!regex.test(nameInput.value)) {
        alert('Please enter a valid name.');
        return false;
      }
      return true;
    }
  </script>
  <!-- BUTTON HERE -->
  <div class="clear"></div>
  <div class="button-editor editor-border-button diva " id="locate_section_rows_162628">
    <div style="display: flex; position:relative; justify-content: center; clear: both">
      <button class="sub-content-638518 changing_font-contentheaders-638518" style="list-style-type: none" "="">Submit</button>
           </div>
              <!--- BUTTON close ---></div>
                 
      <script>
          document.addEventListener('DOMContentLoaded', function() {
    const $form = document.getElementById('form-162628')
    
    if (!$form) {
        return
    }
    $form.addEventListener('submit', function(event) {
        document.getElementById('myoptinmodal').style.display = 'flex'; // Show optinmodal
    });
});
   
  /* window.onload = function() {
    document.getElementById('form-162628').addEventListener('submit', function(event) {
        document.getElementById('myoptinmodal').style.display = 'flex'; // Show optinmodal
    });
};*/
       
</script>
           
<script src=" https://ajax.googleapis.com/ajax/libs/jquery/3.5.1/jquery.min.js"></script>
        <script>
          function saveText(id) {
            var newText = $('.changing_font-contentheaders-' + id).text();
            $.ajax({
              type: 'POST',
              url: 'saveText.asp',
              data: {
                id: id,
                text: newText
              },
              success: function(response) {
                console.log('Text updated successfully.');
              },
              error: function() {
                alert('Failed to update text.');
              }
            });
          }
        </script>
        <br><br>
</form>

Text Content

HEADLINE -- PACKED FULL OF EXCITING, COMPELLING BENEFITS TO ATTRACT YOUR
VISITORS!


ELABORATE ON THE BENEFITS OF READING THIS LETTER AND CREATE URGENCY SO YOUR
VISITORS MUST READ IT TODAY!

CONTACT US AT:

(800) 555-1212






H3 SECTION HEADLINE GOES HERE

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor.

Full Name:
Email Address:


Submit





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