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URL: https://www.accucare-inc.com/product/cpapmax-pillow-contour-products-cpap-bipap-supplies
Submission: On June 19 via manual from SV — Scanned from NL

Form analysis 4 forms found in the DOM

Name: Search — GET /search

<form name="Search" id="Search" action="/search" method="get" autocomplete="off">
  <input type="search" placeholder="Search Site" id="searchfield" class="searchField" name="q" aria-label="Site Search">
  <input type="submit" value="Search" class="button button-secondary">
</form>

Name: productForm-250 — POST 

<form method="post" id="productForm-250" name="productForm-250">
  <input type="hidden" name="actionRun" id="actionRun" value="addToCart">
  <input type="hidden" name="hidAddPosition" id="hidAddPosition" value="product">
  <input type="hidden" name="hidProdId" id="hidProdId" value="250">
  <input type="hidden" name="hidCatId" id="hidCatId" value="55">
  <input type="hidden" name="hidButtonClick" id="hidButtonClick" value="">
  <div class="product-pricing">
    <ul class="clearfix list-style-none add-cart">
      <li class="pricing">
        <!-- DISPLAY PRICE -->
      </li>
      <li class="add-to-cart relative">
        <a class="button button-primary" href="/product-order-request?pid=250">Product Order Request</a>
      </li>
    </ul>
  </div><!-- eof product-pricing -->
</form>

Name: ReviewForm — POST /modules/ecommerce/process.php

<form id="reviewForm" method="post" name="ReviewForm" action="/modules/ecommerce/process.php">
  <input type="hidden" name="actionRun" id="actionRun" value="createReview">
  <input type="hidden" name="hidProdId" id="hidProdId" value="250">
  <h3>Create Customer Review</h3>
  <fieldset>
    <legend class="readeronly">Customer Review Rating</legend>
    <p style="margin-bottom: 20px;">
      <label class="required">Please enter your rating for this product:</label>
      <span class="star-rating-control"></span>
    </p>
    <div class="rating-cancel"><a href="#" title="Internal Link to Cancel Rating"><span class="d-none">Cancel Rating</span></a></div>
    <div aria-label="1 Star Rating" class="star-rating rater-0 star star-rating-applied star-rating-live"><a href="#" title="1 Star Rating">1</a></div>
    <div aria-label="2 Star Rating" class="star-rating rater-0 star star-rating-applied star-rating-live"><a href="#" title="2 Star Rating">2</a></div>
    <div aria-label="3 Star Rating" class="star-rating rater-0 star star-rating-applied star-rating-live"><a href="#" title="3 Star Rating">3</a></div>
    <div aria-label="4 Star Rating" class="star-rating rater-0 star star-rating-applied star-rating-live"><a href="#" title="4 Star Rating">4</a></div>
    <div aria-label="5 Star Rating" class="star-rating rater-0 star star-rating-applied star-rating-live"><a href="#" title="5 Star Rating">5</a></div><input name="Rating" type="radio" title="1 Star Rating" class="star star-rating-applied" value="1"
      required="required" data-parsley-errors-container="#rating-error-container" data-parsley-required-message="Select a rating!" style="display: none;">
    <input name="Rating" type="radio" title="2 Star Rating" class="star star-rating-applied" value="2" required="required" data-parsley-errors-container="#rating-error-container" data-parsley-required-message="Select a rating!"
      style="display: none;">
    <input name="Rating" type="radio" title="3 Star Rating" class="star star-rating-applied" value="3" required="required" data-parsley-errors-container="#rating-error-container" data-parsley-required-message="Select a rating!"
      style="display: none;">
    <input name="Rating" type="radio" title="4 Star Rating" class="star star-rating-applied" value="4" required="required" data-parsley-errors-container="#rating-error-container" data-parsley-required-message="Select a rating!"
      style="display: none;">
    <input name="Rating" type="radio" title="5 Star Rating" class="star star-rating-applied" value="5" required="required" data-parsley-errors-container="#rating-error-container" data-parsley-required-message="Select a rating!"
      style="display: none;">
    <p></p>
  </fieldset>
  <ul style="display: none;" class="parsley-errors-list filled" id="parsley-id-110">
    <li class="parsley-required">Select a rating.</li>
  </ul>
  <p><label for="reviewer" class="required">Full Name:</label>
    <input type="text" name="reviewer" id="reviewer" value="" style="width: 600px" required="required" data-parsley-required-message="Enter a full name.">
  </p>
  <p><label for="TitleTextBox" class="required">Please enter a title for your review:</label><input type="text" name="Title" id="TitleTextBox" value="" style="width: 600px" required="required" data-parsley-required-message="Enter a review title.">
  </p>
  <p><label for="Body" class="required">Please write your review below:</label><textarea style="width: 600px; height: 200px" id="Body" name="Body" required="required" data-parsley-required-message="Enter your review."></textarea></p>
  <p><label for="recommend"><input name="recommend" id="recommend" type="checkbox" value="Yes"> I would recommend this product to family and friends.</label></p>
  <input type="submit" value="Submit Review" title="Add to Cart" class="addToCartBtn button silver" id="ReviewSubmitButton">
</form>

Name: Search — GET /search

<form name="Search" id="mobileSearch" action="/search" method="get" autocomplete="off">
  <input type="search" id="mobileSearchfield" class="searchField" name="q" aria-label="Site Search" placeholder="Search">
  <input type="submit" class="searchSubmit hide" value="Search">
</form>

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CPAPMAX PILLOW

HomeCatalogSleep TherapyCPAPmax Pillow

From Contour Products

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❮ ❯





Maximize your CPAP Therapy experience with our next generation CPAPmax
Pillow!-Experience a cooler sleep experience - reduce heat and
perspiration-Includes a removable 3/4" foam layer so you control your pillow
thickness-I  View more

 * 
 * Product Order Request

 * In Stock

 * Details
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Maximize your CPAP Therapy experience with our next generation CPAPmax Pillow!

-Experience a cooler sleep experience - reduce heat and perspiration
-Includes a removable 3/4" foam layer so you control your pillow thickness
-Innovative 2 in 1 design lets you choose a plush memory foam surface, or flip
pillow over for traditional fiberfill feel
-Provides superior support and comfort while working with your CPAP Therapy
-Teether designed right into the pillow cover to prevent your hose from moving
around at night





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