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www.mypatientvisit.com Open in urlscan Pro
40.70.26.92  Public Scan

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Submitted URL: http://www.mypatientvisit.com/
Effective URL: https://www.mypatientvisit.com/
Submission: On December 05 via manual from IN — Scanned from DE

Form analysis 1 forms found in the DOM

Name: loginForm — 

<form _ngcontent-cca-c128="" novalidate="" role="form" name="loginForm" ng-reflect-form="[object Object]" class="ng-untouched ng-pristine ng-invalid">
  <div _ngcontent-cca-c128="" fxlayout="row" fxlayout.lt-sm="column" ng-reflect-fx-layout="row" ng-reflect-fx-layout.lt-sm="column" style="flex-direction: row; box-sizing: border-box; display: flex;">
    <div _ngcontent-cca-c128="" fxflex="65%" fxflex.lt-sm="100%" fxlayout="column" fxlayoutgap="0.5%" class="login-section-left" ng-reflect-fx-layout="column" ng-reflect-fx-flex="65%" ng-reflect-fx-flex.lt-sm="100%" ng-reflect-fx-layout-gap="0.5%"
      style="flex-direction: column; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 65%;">
      <div _ngcontent-cca-c128="" fxlayout="row" ng-reflect-fx-layout="row" style="margin-bottom: 0.5%; flex-direction: row; box-sizing: border-box; display: flex;">
        <h2 _ngcontent-cca-c128="">WELCOME, PLEASE LOG IN</h2>
      </div>
      <div _ngcontent-cca-c128="" fxlayout="row" ng-reflect-fx-layout="row" style="margin-bottom: 0.5%; flex-direction: row; box-sizing: border-box; display: flex;">
        <p _ngcontent-cca-c128="" class="welcome-subheader">Log in with the information you used when you registered.</p>
      </div>
      <div _ngcontent-cca-c128="" fxlayout="row" ng-reflect-fx-layout="row" style="margin-bottom: 0.5%; flex-direction: row; box-sizing: border-box; display: flex;"><!--bindings={}--></div>
      <div _ngcontent-cca-c128="" fxlayout="row" ng-reflect-fx-layout="row" style="margin-bottom: 0.5%; flex-direction: row; box-sizing: border-box; display: flex;"><mat-form-field _ngcontent-cca-c128="" appearance="outline" fxflex="65%"
          fxflex.lt-sm="100%"
          class="mat-form-field username ng-tns-c112-0 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-outline mat-form-field-can-float ng-untouched ng-pristine ng-invalid mat-form-field-should-float mat-focused"
          ng-reflect-appearance="outline" ng-reflect-fx-flex="65%" ng-reflect-fx-flex.lt-sm="100%" style="flex: 1 1 100%; box-sizing: border-box; max-width: 65%;">
          <div class="mat-form-field-wrapper ng-tns-c112-0">
            <div class="mat-form-field-flex ng-tns-c112-0">
              <div class="mat-form-field-outline ng-tns-c112-0 ng-star-inserted">
                <div class="mat-form-field-outline-start ng-tns-c112-0"></div>
                <div class="mat-form-field-outline-gap ng-tns-c112-0"></div>
                <div class="mat-form-field-outline-end ng-tns-c112-0"></div>
              </div>
              <div class="mat-form-field-outline mat-form-field-outline-thick ng-tns-c112-0 ng-star-inserted">
                <div class="mat-form-field-outline-start ng-tns-c112-0"></div>
                <div class="mat-form-field-outline-gap ng-tns-c112-0"></div>
                <div class="mat-form-field-outline-end ng-tns-c112-0"></div>
              </div><!--ng-container--><!--bindings={
  "ng-reflect-ng-if": "true"
}-->
              <div class="mat-form-field-prefix ng-tns-c112-0 ng-star-inserted"><mat-icon _ngcontent-cca-c128="" role="img" matprefix="" class="mat-icon notranslate material-icons mat-icon-no-color ng-tns-c112-0" aria-hidden="true"
                  data-mat-icon-type="font">person_outline</mat-icon></div><!--bindings={
  "ng-reflect-ng-if": "1"
}-->
              <div class="mat-form-field-infix ng-tns-c112-0"><input _ngcontent-cca-c128="" matinput="" formcontrolname="username" id="username" name="username" data-qa="username" type="text" required="" autofocus=""
                  class="mat-input-element mat-form-field-autofill-control login-input ng-tns-c112-0 ng-untouched ng-pristine ng-invalid cdk-text-field-autofill-monitored" ng-reflect-id="username" ng-reflect-type="text" ng-reflect-required=""
                  ng-reflect-name="username" ng-reflect-placeholder="Enter Username" placeholder="Enter Username" data-placeholder="Enter Username" aria-invalid="false" aria-required="true"><span class="mat-form-field-label-wrapper ng-tns-c112-0"><!--bindings={
  "ng-reflect-ng-if": "false"
}--></span></div><!--bindings={
  "ng-reflect-ng-if": "0"
}-->
            </div><!--bindings={
  "ng-reflect-ng-if": "false"
}-->
            <div class="mat-form-field-subscript-wrapper ng-tns-c112-0" ng-reflect-ng-switch="hint"><!--bindings={
  "ng-reflect-ng-switch-case": "error"
}-->
              <div class="mat-form-field-hint-wrapper ng-tns-c112-0 ng-trigger ng-trigger-transitionMessages ng-star-inserted" style="opacity: 1; transform: translateY(0%);"><!--bindings={
  "ng-reflect-ng-if": ""
}-->
                <div class="mat-form-field-hint-spacer ng-tns-c112-0"></div>
              </div><!--bindings={
  "ng-reflect-ng-switch-case": "hint"
}-->
            </div>
          </div>
        </mat-form-field></div>
      <div _ngcontent-cca-c128="" fxlayout="row" ng-reflect-fx-layout="row" style="margin-bottom: 0.5%; flex-direction: row; box-sizing: border-box; display: flex;"><mat-form-field _ngcontent-cca-c128="" appearance="outline" fxflex="65%"
          fxflex.lt-sm="100%" class="mat-form-field password ng-tns-c112-1 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-outline mat-form-field-can-float ng-untouched ng-pristine ng-invalid" ng-reflect-appearance="outline"
          ng-reflect-fx-flex="65%" ng-reflect-fx-flex.lt-sm="100%" style="flex: 1 1 100%; box-sizing: border-box; max-width: 65%;">
          <div class="mat-form-field-wrapper ng-tns-c112-1">
            <div class="mat-form-field-flex ng-tns-c112-1">
              <div class="mat-form-field-outline ng-tns-c112-1 ng-star-inserted">
                <div class="mat-form-field-outline-start ng-tns-c112-1"></div>
                <div class="mat-form-field-outline-gap ng-tns-c112-1"></div>
                <div class="mat-form-field-outline-end ng-tns-c112-1"></div>
              </div>
              <div class="mat-form-field-outline mat-form-field-outline-thick ng-tns-c112-1 ng-star-inserted">
                <div class="mat-form-field-outline-start ng-tns-c112-1"></div>
                <div class="mat-form-field-outline-gap ng-tns-c112-1"></div>
                <div class="mat-form-field-outline-end ng-tns-c112-1"></div>
              </div><!--ng-container--><!--bindings={
  "ng-reflect-ng-if": "true"
}-->
              <div class="mat-form-field-prefix ng-tns-c112-1 ng-star-inserted"><mat-icon _ngcontent-cca-c128="" role="img" matprefix="" class="mat-icon notranslate material-icons mat-icon-no-color ng-tns-c112-1" aria-hidden="true"
                  data-mat-icon-type="font">vpn_key</mat-icon></div><!--bindings={
  "ng-reflect-ng-if": "1"
}-->
              <div class="mat-form-field-infix ng-tns-c112-1"><input _ngcontent-cca-c128="" matinput="" formcontrolname="password" id="password" name="password" data-qa="password" type="password" required="" autocomplete="off"
                  class="mat-input-element mat-form-field-autofill-control login-input ng-tns-c112-1 ng-untouched ng-pristine ng-invalid cdk-text-field-autofill-monitored" ng-reflect-id="password" ng-reflect-type="password" ng-reflect-required=""
                  ng-reflect-name="password" ng-reflect-placeholder="Password" placeholder="Password" data-placeholder="Password" aria-invalid="false" aria-required="true"><span class="mat-form-field-label-wrapper ng-tns-c112-1"><!--bindings={
  "ng-reflect-ng-if": "false"
}--></span></div><!--bindings={
  "ng-reflect-ng-if": "0"
}-->
            </div><!--bindings={
  "ng-reflect-ng-if": "false"
}-->
            <div class="mat-form-field-subscript-wrapper ng-tns-c112-1" ng-reflect-ng-switch="hint"><!--bindings={
  "ng-reflect-ng-switch-case": "error"
}-->
              <div class="mat-form-field-hint-wrapper ng-tns-c112-1 ng-trigger ng-trigger-transitionMessages ng-star-inserted" style="opacity: 1; transform: translateY(0%);"><!--bindings={
  "ng-reflect-ng-if": ""
}-->
                <div class="mat-form-field-hint-spacer ng-tns-c112-1"></div>
              </div><!--bindings={
  "ng-reflect-ng-switch-case": "hint"
}-->
            </div>
          </div>
        </mat-form-field></div>
      <div _ngcontent-cca-c128="" fxlayout="row" ng-reflect-fx-layout="row" style="margin-bottom: 0.5%; flex-direction: row; box-sizing: border-box; display: flex;">
        <div _ngcontent-cca-c128=""><mat-checkbox _ngcontent-cca-c128="" name="rememberMe" formcontrolname="rememberMe" data-qa="rememberMe" class="mat-checkbox rememberMe mat-accent ng-untouched ng-pristine ng-valid" ng-reflect-name="rememberMe"
            id="mat-checkbox-1"><label class="mat-checkbox-layout" for="mat-checkbox-1-input">
              <div class="mat-checkbox-inner-container"><input type="checkbox" class="mat-checkbox-input cdk-visually-hidden" id="mat-checkbox-1-input" tabindex="0" name="rememberMe" aria-checked="false">
                <div matripple="" class="mat-ripple mat-checkbox-ripple mat-focus-indicator" ng-reflect-trigger="[object HTMLLabelElement]" ng-reflect-disabled="false" ng-reflect-radius="20" ng-reflect-centered="true"
                  ng-reflect-animation="[object Object]">
                  <div class="mat-ripple-element mat-checkbox-persistent-ripple"></div>
                </div>
                <div class="mat-checkbox-frame"></div>
                <div class="mat-checkbox-background"><svg version="1.1" focusable="false" viewBox="0 0 24 24" xml:space="preserve" class="mat-checkbox-checkmark">
                    <path fill="none" stroke="white" d="M4.1,12.7 9,17.6 20.3,6.3" class="mat-checkbox-checkmark-path"></path>
                  </svg>
                  <div class="mat-checkbox-mixedmark"></div>
                </div>
              </div><span class="mat-checkbox-label"><span style="display: none;">&nbsp;</span> Remember Me </span>
            </label></mat-checkbox></div>
      </div>
      <div _ngcontent-cca-c128="" fxlayout="row" ng-reflect-fx-layout="row" style="margin-bottom: 0.5%; flex-direction: row; box-sizing: border-box; display: flex;">
        <hr _ngcontent-cca-c128="" fxflex="65%" fxflex.lt-sm="100%" ng-reflect-fx-flex="65%" ng-reflect-fx-flex.lt-sm="100%" style="flex: 1 1 100%; box-sizing: border-box; max-width: 65%;">
      </div><!--bindings={
  "ng-reflect-ng-if": null
}-->
      <div _ngcontent-cca-c128="" fxlayout="row" ng-reflect-fx-layout="row" style="margin-bottom: 0.5%; flex-direction: row; box-sizing: border-box; display: flex;"><button _ngcontent-cca-c128="" fxflex="65%" fxflex.lt-sm="100%" mat-raised-button=""
          data-qa="login-btn" class="btn-primary login-btn" ng-reflect-fx-flex="65%" ng-reflect-fx-flex.lt-sm="100%" style="flex: 1 1 100%; box-sizing: border-box; max-width: 65%;">Login</button><!--bindings={}--></div>
      <div _ngcontent-cca-c128="" fxlayout="row" ng-reflect-fx-layout="row" style="flex-direction: row; box-sizing: border-box; display: flex;"><a _ngcontent-cca-c128="" data-qa="forgot-your-password" class="need-help">Need help with your login?</a>
      </div>
    </div>
    <div _ngcontent-cca-c128="" fxflex="35%" fxflex.lt-sm="100%" fxlayout="column" fxlayoutgap="7%" class="login-section-right" ng-reflect-fx-layout="column" ng-reflect-fx-flex="35%" ng-reflect-fx-flex.lt-sm="100%" ng-reflect-fx-layout-gap="7%"
      style="flex-direction: column; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 35%;">
      <div _ngcontent-cca-c128="" fxlayout="row" ng-reflect-fx-layout="row" style="margin-bottom: 7%; flex-direction: row; box-sizing: border-box; display: flex;">
        <h2 _ngcontent-cca-c128="">DON'T HAVE AN ACCOUNT?</h2>
      </div>
      <div _ngcontent-cca-c128="" fxlayout="row" ng-reflect-fx-layout="row" style="margin-bottom: 7%; flex-direction: row; box-sizing: border-box; display: flex;"><button _ngcontent-cca-c128="" fxflex="100%" data-qa="register-btn"
          mat-raised-button="" ng-reflect-fx-flex="100%" style="flex: 1 1 100%; box-sizing: border-box; max-width: 100%;">Create an account</button></div>
      <div _ngcontent-cca-c128="" fxlayout="row" ng-reflect-fx-layout="row" style="margin-bottom: 7%; flex-direction: row; box-sizing: border-box; display: flex;">
        <h2 _ngcontent-cca-c128="">WANT TO PAY A BILL?</h2>
      </div>
      <div _ngcontent-cca-c128="" fxlayout="row" ng-reflect-fx-layout="row" style="margin-bottom: 7%; flex-direction: row; box-sizing: border-box; display: flex;"><button _ngcontent-cca-c128="" fxflex="100%" data-qa="express-pay-btn"
          mat-raised-button="" ng-reflect-fx-flex="100%" style="flex: 1 1 100%; box-sizing: border-box; max-width: 100%;">Bill Pay</button></div><!--bindings={}--><!--bindings={}--><span _ngcontent-cca-c128="" fxshow="true" fxshow.lt-sm="false"
        fxflex="1 1 auto" ng-reflect-fx-flex="1 1 auto" ng-reflect-fx-show="true" ng-reflect-fx-show.lt-sm="false" style="margin-bottom: 7%; flex: 1 1 auto; box-sizing: border-box;"></span>
      <div _ngcontent-cca-c128="" fxlayout="row" ng-reflect-fx-layout="row" style="margin-bottom: 7%; flex-direction: row; box-sizing: border-box; display: flex;">
        <hr _ngcontent-cca-c128="" fxflex="1 1 auto" ng-reflect-fx-flex="1 1 auto" style="flex: 1 1 auto; box-sizing: border-box;">
      </div>
      <div _ngcontent-cca-c128="" fxlayout="row" ng-reflect-fx-layout="row" style="flex-direction: row; box-sizing: border-box; display: flex;">
        <h6 _ngcontent-cca-c128="" fxflex="100%" class="contact-practice" ng-reflect-fx-flex="100%" style="flex: 1 1 100%; box-sizing: border-box; max-width: 100%;">Or please contact your practice for access to the portal.</h6>
      </div>
    </div>
  </div>
</form>

Text Content

WELCOME, PLEASE LOG IN

Log in with the information you used when you registered.


person_outline


vpn_key



  Remember Me

--------------------------------------------------------------------------------

Login
Need help with your login?


DON'T HAVE AN ACCOUNT?

Create an account


WANT TO PAY A BILL?

Bill Pay

--------------------------------------------------------------------------------

OR PLEASE CONTACT YOUR PRACTICE FOR ACCESS TO THE PORTAL.