www.prnpt.com
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199.96.6.152
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Submitted URL: https://cxg6v04.na1.hubspotlinks.com/Ctc/LY+113/cXg6V04/VX0HVC7g0rCbW76cH9N3Tq5lYW6WXg815pNRtgMpKrmj3qn9gW8wLKSR6lZ3pZW6-RSFM6trZxgW5...
Effective URL: https://www.prnpt.com/partnerships/employers?utm_campaign=Ergo%20Re-Engagement%20-%20Colleen%20-%20Q4.2024&utm_medium=...
Submission: On December 21 via api from AE — Scanned from DE
Effective URL: https://www.prnpt.com/partnerships/employers?utm_campaign=Ergo%20Re-Engagement%20-%20Colleen%20-%20Q4.2024&utm_medium=...
Submission: On December 21 via api from AE — Scanned from DE
Form analysis 1 forms found in the DOM
POST ./employers?utm_campaign=Ergo+Re-Engagement+-+Colleen+-+Q4.2024&utm_medium=email&_hsenc=p2ANqtz--l-qfa8q6Rqh5w3P8ZFmI3iVI8eTu2ISczQSFvOrZoeP3OtTNEvNEa6T_WWpx8pM9xRqFPlGbrLePfD9SH_YJI8_SR8xrUBctGHuc-gvSbjeRZS_o&_hsmi=339401485&utm_content=339401485&utm_source=hs_email
<form method="post"
action="./employers?utm_campaign=Ergo+Re-Engagement+-+Colleen+-+Q4.2024&utm_medium=email&_hsenc=p2ANqtz--l-qfa8q6Rqh5w3P8ZFmI3iVI8eTu2ISczQSFvOrZoeP3OtTNEvNEa6T_WWpx8pM9xRqFPlGbrLePfD9SH_YJI8_SR8xrUBctGHuc-gvSbjeRZS_o&_hsmi=339401485&utm_content=339401485&utm_source=hs_email"
onsubmit="javascript:return WebForm_OnSubmit();" id="form1" enctype="multipart/form-data">
<div class="aspNetHidden">
<input type="hidden" name="__EVENTTARGET" id="__EVENTTARGET" value="">
<input type="hidden" name="__EVENTARGUMENT" id="__EVENTARGUMENT" value="">
<input type="hidden" name="__LASTFOCUS" id="__LASTFOCUS" value="">
<input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE"
value="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<h2 class="underline align-center"> Building a Safe and Healthy Workplace </h2>
<p class="p1 align-center"> Take the first step towards substantial reductions in costly workers' compensation claims and an overall increase in company productivity and employee satisfaction. PRN's Ergonomics team can assess your company's
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<h2 class="underline align-center"> How a Fortune 500 Tech Company Benefits from PRN's Client-First Approach </h2>
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<p> PRN offers a unique and customizable service model. This model was unlike anything that competitors could offer. PRN's service model lends itself to a client-first approach; focused less on asking the client to fit into a predetermined
framework and more on working with the client to create solutions together. Others have been unsuccessful in providing this model as they are more focused on having us fit into their model or "buy" their program. Others focus more on
sales than solutions. </p>
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<cite>Operational manager of EHS for a fortune 500 technology company</cite>
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<h2> Pathways with Purpose </h2>
<p> PRN's clinical pathway follows a comprehensive treatment and reporting experience for employers and employees, with the goal of lessening health care costs and improving the material impact on employee productivity. </p>
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<h2> Want to learn more? Get in touch with us! </h2>
<p> For nearly three decades, PRN has been developing, testing, deploying, and improving ergonomics programs for companies. Our goal is to eliminate any chance of work-related injuries while creating a safe and ideal workspace for each of
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<span id="ctl14_rptPageParts_rptSections_0_rptFields_0_rxText_1" class="error-msg" style="display:none;">This field needs to be a valid value</span>
<span id="ctl14_rptPageParts_rptSections_0_rptFields_0_cvText_1" class="error-msg" style="display:none;"></span>
</div>
<input type="hidden" name="ctl00$ctl14$rptPageParts$ctl00$rptSections$ctl00$rptFields$ctl02$hdnFieldID" id="ctl14_rptPageParts_rptSections_0_rptFields_0_hdnFieldID_2" value="73">
<div id="ctl14_rptPageParts_rptSections_0_rptFields_0_pnlTextFieldBlock_2" class=" sm-full md-half required" data-fieldid="73" data-sectionid="10" data-formid="10" data-fieldtype="text">
<label for="ctl14_rptPageParts_rptSections_0_rptFields_0_txtTextField_2" id="ctl14_rptPageParts_rptSections_0_rptFields_0_lblTextFieldLabel_2">Company</label>
<input name="ctl00$ctl14$rptPageParts$ctl00$rptSections$ctl00$rptFields$ctl02$txtTextField" type="text" id="ctl14_rptPageParts_rptSections_0_rptFields_0_txtTextField_2" data-label="Company">
<span id="ctl14_rptPageParts_rptSections_0_rptFields_0_rfText_2" class="error-msg" style="display:none;">This field is required</span>
<span id="ctl14_rptPageParts_rptSections_0_rptFields_0_rxText_2" class="error-msg" style="display:none;">This field needs to be a valid value</span>
<span id="ctl14_rptPageParts_rptSections_0_rptFields_0_cvText_2" class="error-msg" style="display:none;"></span>
</div>
<input type="hidden" name="ctl00$ctl14$rptPageParts$ctl00$rptSections$ctl00$rptFields$ctl03$hdnFieldID" id="ctl14_rptPageParts_rptSections_0_rptFields_0_hdnFieldID_3" value="74">
<div id="ctl14_rptPageParts_rptSections_0_rptFields_0_pnlTextFieldBlock_3" class=" sm-full md-half required" data-fieldid="74" data-sectionid="10" data-formid="10" data-fieldtype="text">
<label for="ctl14_rptPageParts_rptSections_0_rptFields_0_txtTextField_3" id="ctl14_rptPageParts_rptSections_0_rptFields_0_lblTextFieldLabel_3">Title</label>
<input name="ctl00$ctl14$rptPageParts$ctl00$rptSections$ctl00$rptFields$ctl03$txtTextField" type="text" id="ctl14_rptPageParts_rptSections_0_rptFields_0_txtTextField_3" data-label="Title">
<span id="ctl14_rptPageParts_rptSections_0_rptFields_0_rfText_3" class="error-msg" style="display:none;">This field is required</span>
<span id="ctl14_rptPageParts_rptSections_0_rptFields_0_rxText_3" class="error-msg" style="display:none;">This field needs to be a valid value</span>
<span id="ctl14_rptPageParts_rptSections_0_rptFields_0_cvText_3" class="error-msg" style="display:none;"></span>
</div>
<input type="hidden" name="ctl00$ctl14$rptPageParts$ctl00$rptSections$ctl00$rptFields$ctl04$hdnFieldID" id="ctl14_rptPageParts_rptSections_0_rptFields_0_hdnFieldID_4" value="75">
<div id="ctl14_rptPageParts_rptSections_0_rptFields_0_pnlTextFieldBlock_4" class=" sm-full md-half required" data-fieldid="75" data-sectionid="10" data-formid="10" data-fieldtype="text">
<label for="ctl14_rptPageParts_rptSections_0_rptFields_0_txtTextField_4" id="ctl14_rptPageParts_rptSections_0_rptFields_0_lblTextFieldLabel_4">Email</label>
<input name="ctl00$ctl14$rptPageParts$ctl00$rptSections$ctl00$rptFields$ctl04$txtTextField" type="text" id="ctl14_rptPageParts_rptSections_0_rptFields_0_txtTextField_4" data-label="Email">
<span id="ctl14_rptPageParts_rptSections_0_rptFields_0_rfText_4" class="error-msg" style="display:none;">This field is required</span>
<span id="ctl14_rptPageParts_rptSections_0_rptFields_0_rxText_4" class="error-msg" style="display:none;">This field needs to be a valid value</span>
<span id="ctl14_rptPageParts_rptSections_0_rptFields_0_cvText_4" class="error-msg" style="display:none;"></span>
</div>
<input type="hidden" name="ctl00$ctl14$rptPageParts$ctl00$rptSections$ctl00$rptFields$ctl05$hdnFieldID" id="ctl14_rptPageParts_rptSections_0_rptFields_0_hdnFieldID_5" value="76">
<div id="ctl14_rptPageParts_rptSections_0_rptFields_0_pnlTextFieldBlock_5" class=" sm-full md-half required" data-fieldid="76" data-sectionid="10" data-formid="10" data-fieldtype="text">
<label for="ctl14_rptPageParts_rptSections_0_rptFields_0_txtTextField_5" id="ctl14_rptPageParts_rptSections_0_rptFields_0_lblTextFieldLabel_5">Phone</label>
<input name="ctl00$ctl14$rptPageParts$ctl00$rptSections$ctl00$rptFields$ctl05$txtTextField" type="text" id="ctl14_rptPageParts_rptSections_0_rptFields_0_txtTextField_5" data-label="Phone">
<span id="ctl14_rptPageParts_rptSections_0_rptFields_0_rfText_5" class="error-msg" style="display:none;">This field is required</span>
<span id="ctl14_rptPageParts_rptSections_0_rptFields_0_rxText_5" class="error-msg" style="display:none;">This field needs to be a valid value</span>
<span id="ctl14_rptPageParts_rptSections_0_rptFields_0_cvText_5" class="error-msg" style="display:none;"></span>
</div>
<input type="hidden" name="ctl00$ctl14$rptPageParts$ctl00$rptSections$ctl00$rptFields$ctl06$hdnFieldID" id="ctl14_rptPageParts_rptSections_0_rptFields_0_hdnFieldID_6" value="77">
<div id="ctl14_rptPageParts_rptSections_0_rptFields_0_pnlDropdownFieldBlock_6" class=" sm-half md-half lg-half required" data-fieldid="77" data-sectionid="10" data-formid="10" data-fieldtype="select">
<label for="ctl00_ctl14_rptPageParts_ctl00_rptSections_ctl00_rptFields_ctl06_ddlDropDownField" id="ctl14_rptPageParts_rptSections_0_rptFields_0_lblDropdownBoxLabel_6">Choose a Program</label>
<select name="ctl00$ctl14$rptPageParts$ctl00$rptSections$ctl00$rptFields$ctl06$ddlDropDownField"
onchange="javascript:setTimeout('__doPostBack(\'ctl00$ctl14$rptPageParts$ctl00$rptSections$ctl00$rptFields$ctl06$ddlDropDownField\',\'\')', 0)"
id="ctl00_ctl14_rptPageParts_ctl00_rptSections_ctl00_rptFields_ctl06_ddlDropDownField" data-label="Choose a Program">
<option selected="selected" value="Ergonomics">Ergonomics</option>
<option value="Trainings & Assessments">Trainings & Assessments</option>
<option value="Work Conditioning">Work Conditioning</option>
<option value="MSK Solutions">MSK Solutions</option>
<option value="Workers' Compensation">Workers' Compensation</option>
</select>
<span id="ctl14_rptPageParts_rptSections_0_rptFields_0_rfDropDown_6" class="error-msg" style="display:none;">This field is required</span>
</div>
<input type="hidden" name="ctl00$ctl14$rptPageParts$ctl00$rptSections$ctl00$rptFields$ctl07$hdnFieldID" id="ctl14_rptPageParts_rptSections_0_rptFields_0_hdnFieldID_7" value="-1">
<div id="ctl14_rptPageParts_rptSections_0_pnlFBHP_0" class="fb-hp-pnl">
<input name="ctl00$ctl14$rptPageParts$ctl00$rptSections$ctl00$txtFBHP" type="text" id="ctl14_rptPageParts_rptSections_0_txtFBHP_0" class="fb-hp-i"
tbcontroltovalidate="ctl00$ctl14$rptPageParts$ctl00$rptSections$ctl00$txtFBHP">
<span id="ctl14_rptPageParts_rptSections_0_cvFBHP_0" class="fb-hp-val" tbcontroltovalidate="ctl00$ctl14$rptPageParts$ctl00$rptSections$ctl00$txtFBHP" style="visibility:hidden;">Nice try spambot</span>
</div>
</fieldset>
</div>
</div>
</div>
<div class="form-footer">
</div>
<div id="ctl14_pnlCaptcha" class="form-builder-captcha">
<div id="ctl14_recaptcha" class="g-recaptcha" style="display: inline-block;" data-sitekey="6LcRspobAAAAALL-eQIsAliMtbOt_H8Wb0mp04on" data-callback="unHideValidationMessage_ctl14">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-f96b0z6l24n5" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LcRspobAAAAALL-eQIsAliMtbOt_H8Wb0mp04on&co=aHR0cHM6Ly93d3cucHJucHQuY29tOjQ0Mw..&hl=de&v=zIriijn3uj5Vpknvt_LnfNbF&size=normal&cb=ub0ucq3s535m"></iframe>
</div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
<span id="ctl14_rfRecapcha" class="required error-msg recapcha-error" display="Dynamic" style="display: inline-block; margin-bottom: 20px; margin-left: 15px;"></span>
</div>
</div>
</div>
<div id="ctl14_pnlPageControls" class="form-builder-submit-controls">
<input type="hidden" name="ctl00$ctl14$hdnRecaptcha" id="ctl14_hdnRecaptcha" value="ctl14_recaptcha">
<input type="hidden" name="ctl00$ctl14$hdnRfCaptcha" id="ctl14_hdnRfCaptcha" value="ctl14_rfRecapcha">
<span class="status">
</span>
<input type="submit" name="ctl00$ctl14$btnSubmit" value="Submit" onclick="return Validate_ctl14();" id="ctl14_btnSubmit" class="btn btn-primary submit formbuilder-form">
<input type="hidden" name="ctl00$ctl14$hdnRecipientToken" id="hdnRecipientToken">
</div>
</div>
<div id="ctl14_pnlSaveProgress" class="form-builder-progress">
</div>
</div>
<script type="text/javascript">
const fbPrm1ctl14 = Sys.WebForms.PageRequestManager.getInstance();
fbPrm1ctl14.add_endRequest(function(sender, args) {
pageLoadctl14();
});
var myRecapchaFormIndexctl14;
// CHECKBOX CLIENT SIDE VALIDATION
function CheckBoxRequired_ClientValidate_ctl14(sender, e) {
var inputBox = sender.previousSibling.previousSibling.previousSibling.previousSibling; //hacky way to grab the checkbox for validation.
if (inputBox != null) {
e.IsValid = inputBox.checked;
} else {
e.IsValid = true;
}
}
// CHECKBOXLIST CLIENT SIDE VALIDATION
function CheckBoxListRequired_ClientValidate_ctl14(sender, e) {
//this gets the ul element of li elements that each contain a checkbox
let inputBoxesUl = sender.previousSibling.previousSibling;
e.IsValid = false;
for (const li of inputBoxesUl.children) {
let currentCheckboxInput = li.firstElementChild;
if (currentCheckboxInput.checked) {
e.IsValid = true;
break;
}
}
}
// RECAPCHA UNHIDE VALIDATION MESSAGE
function unHideValidationMessage_ctl14() {
var recapchaRequiredMessage = $('#ctl14_rfRecapcha');
recapchaRequiredMessage.html('');
}
// CLIENT SIDE VALIDATION
function Validate_ctl14() {
console.log("validating form..");
var isClientRecapchaValid = true;
// RECAPCHA CLIENT SIDE VALIDATION FIRST. MUST SHOW ALL ERROR MESSAGES. CUSTOM VALIDATOR DOES NOT WORK
var recapchaIsDefined = $('#ctl14_recaptcha');
if (recapchaIsDefined.length) {
var response = grecaptcha.getResponse(myRecapchaFormIndexctl14);
if (response.length == 0) {
// Try modal validation
var myModalRecapchaID = sessionStorage.getItem("modalRecaptchaIDctl14");
if (myModalRecapchaID) response = grecaptcha.getResponse(myModalRecapchaID);
}
if (response.length == 0) {
var recapchaRequiredMessage = $('#ctl14_rfRecapcha');
recapchaRequiredMessage.html('This field is required');
isClientRecapchaValid = false;
}
}
window.scrollTo = function() {}
var isValid = Page_ClientValidate('8b80efce-a153-43ac-8431-6c782881a8d1'); // use validation group
if (!isValid || !isClientRecapchaValid) {
ScrollToForm_ctl14();
} else {
return true;
}
Page_BlockSubmit = false;
return false;
}
//Check for spammers
function Validate_HP_ctl14(sender, args) {
//console.log("validating honeypot..");
try {
const hp_input = sender.parentNode.querySelector("input[id*='txtFBHP']");
//console.log(sender);
//console.log(sender.parentNode);
//console.log(hp_input);
if (hp_input != null && hp_input) {
if (hp_input.value.length > 0) {
args.IsValid = false;
}
} else {
args.IsValid = true;
}
} catch (e) {
console.log(e);
}
//alert("validating honeypot!");
}
function pageLoadctl14() {
setupRecapchactl14();
}
// EXPLICITLY INITIALIZE RECAPTCHA IF NOT IN MODAL
function onloadCallbackctl14() {
setupRecapchactl14();
}
function setupRecapchactl14() {
var jq = jQuery.noConflict();
var recaptchaModal = jq('#ctl14_recaptcha')
var sitekey = recaptchaModal.data('sitekey');
if (recaptchaModal.parents('.modal').length) {
// Set Site Key and PanelID to initialize later
sessionStorage.setItem("reCaptchaClientIDctl14", 'ctl14_recaptcha');
sessionStorage.setItem("reCaptchaSiteID", sitekey);
} else {
if (recaptchaModal.length) {
console.log("reinitializing recapcha ctl14");
myRecapchaFormIndexctl14 = grecaptcha.render('ctl14_recaptcha', {
'sitekey': sitekey
});
}
}
};
// EXPLICITLY INITIALIZE RECAPTCHA IF NOT IN MODAL
function ScrollToForm_ctl14() {
var formThankYouPanel = document.getElementById('ctl14_pnlEmailComplete');
console.log("Thanks " + formThankYouPanel);
if (formThankYouPanel != null) {
formThankYouPanel.scrollIntoView({
behavior: 'smooth'
});
} else {
//console.log("Update " + formUpdatePanel);
//formUpdatePanel.scrollIntoView({ behavior: 'smooth' });
}
}
var scrollPosition = 0;
window.addEventListener("scroll", setScrollPos);
function setScrollPos() {
scrollPosition = window.pageYOffset || document.documentElement.scrollTop;
}
function SetScrollEvent() {
scrollPosition = 0;
}
</script>
<script>
// RECAPCHA WITHIN MODAL TRIGGERS. RENDERS AFTER MODAL LOAD. CURRENTLY CAN"T LOAD MULTIPLE TIMES
var myModalLinks = document.getElementsByClassName('open-modal');
for (var i = 0; i < myModalLinks.length; i++) {
let myModalID = myModalLinks[i].href.substring(1); //remove the #
var containsAModal = modalContainsARecapcha(myModalID);
myModalLinks[i].addEventListener('mouseup', function() {
var ClientID = sessionStorage.getItem("reCaptchaClientIDctl14");
var RecSiteID = sessionStorage.getItem("reCaptchaSiteID");
setTimeout(function() {
var recaptchaModal = sessionStorage.getItem("modalRecaptchaIDctl14");
console.log(recaptchaModal);
console.log(window.recaptchaLoaded);
if (window.recaptchaLoaded != true) {
var reCaptchaID = grecaptcha.render(ClientID, {
'sitekey': RecSiteID,
});
window.recaptchaLoaded = true;
sessionStorage.setItem("modalRecaptchaIDctl14", reCaptchaID);
} else {
if (recaptchaModal != null && containsAModal == true) {
alert("Could not load the reCAPTCHA, please reload the page.");
}
}
}, 100);
});
}
function modalContainsARecapcha(modalID) {
var myModal = document.getElementById(modalID);
if (myModal) {
var myModalRecapchaContainer = myModal.getElementsByClassName("form-builder-captcha");
if (myModalRecapchaContainer.length > 0) {
return true;
}
}
return false;
}
</script>
<p></p>
<h2></h2>
</article>
</div>
<div class="floating-schedule-cta">
<span class="icon calendar-icon"></span> <a href="/general-schedule-an-appointment/" style="text-decoration: none; color:white;">Request an Appointment</a>
</div>
</main>
<footer>
<div class="footer-left">
<p>Copyright © 2024, PRN. All Rights Reserved</p>
<p><a href="/privacy/">Privacy Policy</a> / <a href="/terms-and-conditions/">Terms of Use</a> / <a target="_blank" title="PRN Media Relations" href="mailto:media@prnpt.com" rel="noopener">Media Inquiries</a> /
<a href="/about/cigna-mrf/">Cigna MRF</a> / <a href="/privacy-request/">Do Not Sell My Personal Info</a><a href="/terms-and-conditions/"></a></p>
</div>
<div class="footer-right">
<p></p>
<div class="social-nav">
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</ul>
</div>
<p></p>
</div>
</footer>
<script type="text/javascript">
//<![CDATA[
var Page_ValidationSummaries = new Array(document.getElementById("ctl14_val1"));
var Page_Validators = new Array(document.getElementById("ctl14_rptPageParts_rptSections_0_rptFields_0_rfText_0"), document.getElementById("ctl14_rptPageParts_rptSections_0_rptFields_0_rxText_0"), document.getElementById(
"ctl14_rptPageParts_rptSections_0_rptFields_0_cvText_0"), document.getElementById("ctl14_rptPageParts_rptSections_0_rptFields_0_rfText_1"), document.getElementById("ctl14_rptPageParts_rptSections_0_rptFields_0_rxText_1"), document
.getElementById("ctl14_rptPageParts_rptSections_0_rptFields_0_cvText_1"), document.getElementById("ctl14_rptPageParts_rptSections_0_rptFields_0_rfText_2"), document.getElementById("ctl14_rptPageParts_rptSections_0_rptFields_0_rxText_2"),
document.getElementById("ctl14_rptPageParts_rptSections_0_rptFields_0_cvText_2"), document.getElementById("ctl14_rptPageParts_rptSections_0_rptFields_0_rfText_3"), document.getElementById(
"ctl14_rptPageParts_rptSections_0_rptFields_0_rxText_3"), document.getElementById("ctl14_rptPageParts_rptSections_0_rptFields_0_cvText_3"), document.getElementById("ctl14_rptPageParts_rptSections_0_rptFields_0_rfText_4"), document
.getElementById("ctl14_rptPageParts_rptSections_0_rptFields_0_rxText_4"), document.getElementById("ctl14_rptPageParts_rptSections_0_rptFields_0_cvText_4"), document.getElementById("ctl14_rptPageParts_rptSections_0_rptFields_0_rfText_5"),
document.getElementById("ctl14_rptPageParts_rptSections_0_rptFields_0_rxText_5"), document.getElementById("ctl14_rptPageParts_rptSections_0_rptFields_0_cvText_5"), document.getElementById(
"ctl14_rptPageParts_rptSections_0_rptFields_0_rfDropDown_6"), document.getElementById("ctl14_rptPageParts_rptSections_0_cvFBHP_0"));
//]]>
</script>
<script type="text/javascript">
//<![CDATA[
var ctl14_val1 = document.all ? document.all["ctl14_val1"] : document.getElementById("ctl14_val1");
ctl14_val1.validationGroup = "8b80efce-a153-43ac-8431-6c782881a8d1";
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ctl14_rptPageParts_rptSections_0_rptFields_0_rfText_0.display = "Dynamic";
ctl14_rptPageParts_rptSections_0_rptFields_0_rfText_0.validationGroup = "8b80efce-a153-43ac-8431-6c782881a8d1";
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ctl14_rptPageParts_rptSections_0_rptFields_0_rxText_0.enabled = "False";
ctl14_rptPageParts_rptSections_0_rptFields_0_rxText_0.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid";
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ctl14_rptPageParts_rptSections_0_rptFields_0_cvText_0.enabled = "False";
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