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www.patientchannel.co.uk.62354073.uk Open in urlscan Pro
2602:faa9:4002:610:a0cd:f134:a4f2:7585  Public Scan

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URL: https://www.patientchannel.co.uk.62354073.uk/
Submission: On July 18 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

<form class="getin_form wow fadeInUp" data-wow-delay="400ms" onsubmit="return false;" style="visibility: hidden; animation-delay: 400ms; animation-name: none;">
  <div class="row">
    <div class="col-sm-12" id="result"></div>
    <div class="col-md-6 col-sm-6">
      <div class="form-group bottom35">
        <input class="form-control" type="text" placeholder="First Name:" required="" id="first_name" name="first_name">
      </div>
    </div>
    <div class="col-md-6 col-sm-6">
      <div class="form-group bottom35">
        <input class="form-control" type="text" placeholder="Last Name:" required="" id="last_name" name="last_name">
      </div>
    </div>
    <div class="col-md-6 col-sm-6">
      <div class="form-group bottom35">
        <input class="form-control" type="email" placeholder="Email:" required="" id="email" name="email">
      </div>
    </div>
    <div class="col-md-6 col-sm-6">
      <div class="form-group bottom35">
        <input class="form-control" type="tel" placeholder="Phone:" id="phone" name="phone">
      </div>
    </div>
    <div class="col-md-12 col-sm-12">
      <div class="form-group bottom35">
        <textarea class="form-control" placeholder="Message" id="message" name="message"></textarea>
      </div>
    </div>
    <div class="col-sm-12">
      <button type="submit" class="button btnprimary" id="submit_btn">Send Message</button>
    </div>
  </div>
</form>

Text Content

 * Home

 * contact

 * Home
 * contact

© 2020-24 RadioComapny.Net

   
   


 * WELCOME TO
   
   
   THE PATIENT CHANNEL
   
   
   MUSIC AND MORE FOR YOU
   
   24 HOURS A DAY





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CONTACT THE PATIENT CHANNEL

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OUR EMAIL

Email: studio@patientchannel.uk

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 * https://ice.dab1.uk:8443/dab1

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