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www.daytwo.com Open in urlscan Pro
34.133.226.254  Public Scan

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Submitted URL: http://www.daytwo.com/quiktrip
Effective URL: https://www.daytwo.com/quiktrip/
Submission: On March 27 via manual from US — Scanned from DE

Form analysis 2 forms found in the DOM

POST https://daytwo.my.salesforce-sites.com/forms/apex/MultiPartEndpoint?encoding=UTF-8

<form action="https://daytwo.my.salesforce-sites.com/forms/apex/MultiPartEndpoint?encoding=UTF-8" enctype="multipart/form-data" id="form1" method="post" target="ffIframe">
  <input id="userTimeZone" type="hidden" value="0">
  <input id="txtObjId" type="hidden" value="">
  <input id="txtHtmlId" type="hidden" value="">
  <input id="formHtml" type="hidden">
  <input id="txtSessionID" type="hidden" value="">
  <input class="ignore-submit" id="txtSubmittedData" type="hidden" value="">
  <input id="multipageEnabled" type="hidden" value="false">
  <input id="googleCaptchaEnabled" type="hidden" value="false">
  <input id="breadcrumbEnabled" type="hidden" value="false">
  <input id="breadcrumbNumbered" type="hidden" value="false">
  <input id="breadcrumbPrefix" type="hidden" value="">
  <input id="submitMessage" type="hidden" value="">
  <input id="submitUrl" type="hidden" value="">
  <input id="submitBtnText" type="hidden" value="Next ➤">
  <input id="prevBtnText" type="hidden" value="Previous">
  <input id="nextBtnText" type="hidden" value="Next">
  <input id="pageValType" type="hidden" value="form">
  <input id="txtUserContentId" type="hidden" value="">
  <input id="hasCustomCSS" type="hidden" value="true">
  <input id="isCurrentForm" type="hidden" value="false">
  <input id="isDraft" type="hidden" value="false">
  <input id="saveForLaterEnabled" type="hidden" value="false">
  <input id="saveBtnText" type="hidden" value="Save">
  <input id="discardBtnText" type="hidden" value="Discard">
  <input id="draftSaved" type="hidden" value="false">
  <input id="draftEmail" type="hidden">
  <input id="paymentType" type="hidden" value="">
  <input class="ignore-submit" id="ruleFieldsMap" type="hidden" value="">
  <input class="ignore-submit" id="relatedFieldsMapJSON" type="hidden" value="">
  <input class="ignore-submit" id="staticPrefillParams" type="hidden" value="{&quot;Lead.Employer__c&quot;:&quot;0011v00002NI1hLAAT&quot;}">
  <input id="formName" type="hidden" value="">
  <input id="formId" type="hidden" value="a3k7U000000kH8tQAE">
  <input id="prefillObj" type="hidden" value="">
  <input id="accessToken" type="hidden" value="fdp4AaQDDiUbSWcR/jS5gJ7KW37savvwY2ER9ZZIvTgajZewl5A4txQ1P9bYczyIQpxDcdu23wD8g3CCnOvHuhW3+jfnlyUU4HmjLvrd7chlZbBJJ5hDwV55Ihjz4T6lxgjz+sfX6ro9acPuYXpzOmIkwFz/QWmaZF7XyYdMJZE=">
  <input id="dateFormat" type="hidden" value="mm/dd/yy">
  <input id="todayDate" type="hidden" value="Mon Mar 27 00:00:00 GMT 2023">
  <input id="userLocal" type="hidden" value="en_US">
  <input id="jsCode" type="hidden" value="FF_OnBeforeSave = function() {
     let lastName = document.getElementById(&amp;#39;Lead.LastName&amp;#39;);
     if (lastName) {
          lastName.value = lastName.value.trim();
     }
     return true;
}

function FF_OnAfterRender() {
    // set attributes for html field
    fs(&amp;#39;#Lead\\.MobilePhone&amp;#39;).attr(&amp;#39;pattern&amp;#39;, &amp;#39;[0-9]{10}&amp;#39;);
    fs(&amp;#39;#Lead\\.MobilePhone&amp;#39;).attr(&amp;#39;minlength&amp;#39;, &amp;#39;10&amp;#39;);
    fs(&amp;#39;#Lead\\.MobilePhone&amp;#39;).attr(&amp;#39;maxlength&amp;#39;, &amp;#39;10&amp;#39;);

    //call function to validate field input
    fs(&amp;#39;#Lead\\.MobilePhone&amp;#39;).change(function() {
        validateField();
    });
    return true;
}

function validateField() {
    var re = new RegExp(&amp;quot;[0-9]{10}&amp;quot;);
    //display alert window and focus on field if input does not meet reg ex criteria
    if (!re.test(fs(&amp;#39;#Lead\\.MobilePhone&amp;#39;).val())) {
        alert(&amp;#39;Please enter just numbers without spaces or characters&amp;#39;);
        fs(&amp;#39;#Lead\\.MobilePhone&amp;#39;).focus();
    }
}


function FF_OnAfterSave() {
    // Update base_url to the url the values should be appended to
    var baseUrl = &amp;#39;https://calendly.com/d/cg4-3j6-vr9/daytwo-enrollment-call&amp;#39;;
    // Update Parameter to match the corresponding parameter
    // name desired in the URL
    // Update Field_to_Append to match the API Name
    // of the field whose value should be appended
    var fieldsToAppend = {
        &amp;#39;email&amp;#39;: &amp;#39;Lead.Email&amp;#39;,
        &amp;#39;first_name&amp;#39;: &amp;#39;Lead.FirstName&amp;#39;,
        &amp;#39;last_name&amp;#39;: &amp;#39;Lead.LastName&amp;#39;
        }
   
    var fieldArray = [];
    for(const p in fieldsToAppend) {
        if (fieldsToAppend.hasOwnProperty(p)) {
            var f = document.getElementById(fieldsToAppend[p]);
            if (f) {
                fieldArray.push(p + &amp;#39;=&amp;#39; + encodeURIComponent(f.value));
            }
        }
    }

    var redirectUrl = baseUrl + (baseUrl.indexOf(&amp;#39;?&amp;#39;) !== -1 ? &amp;#39;&amp;amp;&amp;#39; : &amp;#39;?&amp;#39;) + fieldArray.join(&amp;#39;&amp;amp;&amp;#39;);

    location.href = redirectUrl;
}">
  <input id="ipAddress" type="hidden" value="81.95.5.38">
  <input id="recaptchaSiteKey" type="hidden" value="6Lc18EwUAAAAAOB_uHmFppxqGckUWnMwK0h3fsdp">
  <input id="submitRules" type="hidden">
  <input id="hfFileServiceEndpoint" name="hfFileServiceEndpoint" type="hidden" value="https://sfapi.formstack.io">
  <input id="hfFileServiceApiKey" name="hfFileServiceApiKey" type="hidden" value="8fc5982e-6eca-4d73-a3ff-997902b163b0-20212151122">
  <input id="fsListFileUploadedJSON" name="fsListFileUploadedJSON" type="hidden" value="[]">
  <input id="CommunityInstanceURL" type="hidden" value="">
  <input id="CommunitySessioID" type="hidden" value="">
  <input id="CommunityUserId" type="hidden" value="">
  <input id="CommunityUserType" type="hidden" value="">
  <input id="CommunityViewMode" type="hidden" value="">
  <input id="comPrefillDataset" type="hidden" value="">
  <input id="comPrefillObj" type="hidden">
  <div id="dvBannerHTML" runat="server">
    <div id="j_id0:j_id13" class="ff-form-main">
      <div id="ffOverlay"></div>
      <div id="ffPage6439" class="ff-page-row page-1" data-pagetitle="Page title">
        <div class="ff-group-row group-0" id="ffSection0">
          <div class="ff-item-row">
            <div class="ff-col-1 ff-section-col"><label class="ff-section-header" id="sectionLabel0">Getting started is simple</label></div>
          </div>
          <div class="ff-item-row" style="display: none;">
            <div class="ff-col-1 ff-label-col"><label vatt="REFERENCE" for="inputLead.OwnerId" class="ff-label" id="lblLeadOwnerId">Owner</label></div>
            <div class="ff-col-2 ff-field-col"><input type="hidden" id="Lead.OwnerId" vatt="REFERENCE" value="0057U000000ML3QQAW" data-vatt="REFERENCE"><input type="textbox" id="inputLead.OwnerId" title="Lookup" placeholder=""
                name="inputLead.OwnerId" class="ff-input-type ff-type-text lookup-link" readonly="readonly" vatt="REFERENCE" value="Adria Heimburger" data-lobj="Group,User" data-robj="" data-display-format="" data-relationship-name="Owner"
                data-requiredmessage="required" data-isupsert="false" data-ishidden="true" data-vatt="REFERENCE"></div>
          </div>
          <div class="ff-item-row" style="display: none;">
            <div class="ff-col-1 ff-label-col"><label vatt="DATE" for="Lead.Enrollment_Form_Date__c" class="ff-label" id="lblLeadEnrollment_Form_Date__c">Enrollment Form Date</label></div>
            <div class="ff-col-2 ff-field-col"><input type="textbox" id="Lead.Enrollment_Form_Date__c" placeholder="" aria-placeholder="" name="Lead.Enrollment_Form_Date__c" vatt="DATE" class="ff-input-type ff-type-text hasDatepicker"
                data-maxlengthmessage="Maximum 10 characters" maxlength="10" data-validatefieldtype="date" value="{{TDAY()}}" data-requiredmessage="required" data-isupsert="false" data-ishidden="true" data-vatt="DATE"></div>
          </div>
          <div class="ff-item-row" style="display: none;">
            <div class="ff-col-1 ff-label-col"><label vatt="REFERENCE" for="inputLead.Employer__c" class="ff-label" id="lblLeadEmployer__c">Employer</label></div>
            <div class="ff-col-2 ff-field-col"><input type="hidden" id="Lead.Employer__c" vatt="REFERENCE" data-vatt="REFERENCE" value="0011v00002NI1hLAAT"><input type="textbox" id="inputLead.Employer__c" title="Lookup" placeholder=""
                name="inputLead.Employer__c" class="ff-input-type ff-type-text lookup-link" readonly="readonly" vatt="REFERENCE" value="" data-lobj="Account" data-robj="" data-display-format="" data-relationship-name="Employer__r"
                data-requiredmessage="required" data-isupsert="true" data-ishidden="true" data-vatt="REFERENCE"></div>
          </div>
          <div class="ff-item-row" style="display: none;">
            <div class="ff-col-1 ff-label-col"><label vatt="REFERENCE" for="inputLead.RecordTypeId" class="ff-label" id="lblLeadRecordTypeId">Record Type</label></div>
            <div class="ff-col-2 ff-field-col"><input type="hidden" id="Lead.RecordTypeId" vatt="REFERENCE" value="0127U00000006DuQAI" data-vatt="REFERENCE"><input type="textbox" id="inputLead.RecordTypeId" title="Lookup" placeholder=""
                name="inputLead.RecordTypeId" class="ff-input-type ff-type-text lookup-link" readonly="readonly" vatt="REFERENCE" value="Member Lead" data-lobj="RecordType" data-robj="Lead" data-display-format="" data-relationship-name="RecordType"
                data-requiredmessage="required" data-isupsert="false" data-ishidden="true" data-vatt="REFERENCE"></div>
          </div>
          <div class="ff-item-row">
            <div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Lead.FirstName" class="ff-label" id="lblLeadFirstName">First Name</label><span class="requiredSpan ff-required-mark">*</span></div>
            <div class="ff-col-2 ff-field-col"><input type="textbox" id="Lead.FirstName" placeholder="As it appears on ID" aria-placeholder="As it appears on ID" name="Lead.FirstName" vatt="STRING" class="ff-input-type ff-type-text"
                data-maxlengthmessage="Maximum 40 characters" maxlength="40" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="false"
                data-vatt="STRING"></div>
          </div>
          <div class="ff-item-row">
            <div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Lead.LastName" class="ff-label" id="lblLeadLastName">Last Name</label><span class="requiredSpan ff-required-mark">*</span></div>
            <div class="ff-col-2 ff-field-col"><input type="textbox" id="Lead.LastName" placeholder="" aria-placeholder="" name="Lead.LastName" vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 80 characters"
                maxlength="80" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="true" data-ishidden="false" data-vatt="STRING"></div>
          </div>
          <div class="ff-item-row">
            <div class="ff-col-1 ff-label-col"><label vatt="EMAIL" for="Lead.Email" class="ff-label" id="lblLeadEmail">Email</label><span class="requiredSpan ff-required-mark">*</span></div>
            <div class="ff-col-2 ff-field-col"><input type="textbox" id="Lead.Email" placeholder="" aria-placeholder="" name="Lead.Email" vatt="EMAIL" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 80 characters" maxlength="80"
                data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="false" data-vatt="EMAIL"></div>
          </div>
          <div class="ff-item-row">
            <div class="ff-col-1 ff-label-col"><label vatt="PHONE" for="Lead.MobilePhone" class="ff-label" id="lblLeadMobilePhone">Mobile Phone</label><span class="requiredSpan ff-required-mark">*</span></div>
            <div class="ff-col-2 ff-field-col"><input type="textbox" id="Lead.MobilePhone" placeholder="Enter only numbers" aria-placeholder="Enter only numbers" name="Lead.MobilePhone" vatt="PHONE" class="ff-input-type ff-type-text"
                data-maxlengthmessage="Maximum 40 characters" maxlength="10" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="false" data-vatt="PHONE"
                pattern="[0-9]{10}" minlength="10"></div>
          </div>
          <div class="ff-item-row">
            <div class="ff-col-1 ff-label-col"><label vatt="DATE" for="Lead.Birthdate__c" class="ff-label" id="lblLeadBirthdate__c">Birthdate</label><span class="requiredSpan ff-required-mark">*</span></div>
            <div class="ff-col-2 ff-field-col"><input type="textbox" id="Lead.Birthdate__c" placeholder="" aria-placeholder="" name="Lead.Birthdate__c" vatt="DATE" class="ff-input-type ff-type-text hasDatepicker"
                data-maxlengthmessage="Maximum 10 characters" maxlength="10" data-validatefieldtype="date" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="true" data-ishidden="false"
                data-vatt="DATE"></div>
          </div>
          <div class="ff-item-row fw-row">
            <div class="ff-col-1 ff-label-col"><label id="GENERALTEXT494" class="ff-label ff-general-text-label" vatt="STRING" data-ishidden="false">I agree to DayTwo’s
                <a href="https://www.daytwo.com/legal/terms-of-service" target="_blank">Terms of Use</a> and <a href="https://www.daytwo.com/legal/privacy-policy" target="_blank">Privacy Policy</a>. You may receive follow up emails and text messages
                about this program.</label></div>
          </div>
          <div class="ff-item-row" style="display: none;">
            <div class="ff-col-1 ff-label-col"><label vatt="PICKLIST" for="Lead.Status" class="ff-label" id="lblLeadStatus">Status</label></div>
            <div class="ff-col-2 ff-field-col"><select name="Lead.Status" id="Lead.Status" vatt="PICKLIST" class="ff-select-type ff-singlepicklist" data-flexcontrol="" data-list-of-dependent-fields="Lead_Acquisition_Status_Detail__c"
                data-requiredmessage="required" data-isupsert="false" data-ishidden="true" disabled="disabled" data-vatt="PICKLIST" fs-dp-listener="true">
                <option value="">--select an item--</option>
                <option value="Disqualified">Disqualified </option>
                <option value="Nurture">Nurture </option>
                <option value="Known">Known </option>
                <option value="Engaged">Engaged </option>
                <option value="SGL">SGL </option>
                <option value="MQL">MQL </option>
                <option value="Meeting Scheduled">Meeting Scheduled </option>
                <option value="Meeting Held">Meeting Held </option>
                <option value="Qualified">SAL </option>
                <option value="New">New </option>
                <option value="Intake Screening" selected="selected">Intake Screening </option>
                <option value="Waitlist">Waitlist </option>
                <option value="A1C Validation">A1C Validation </option>
                <option value="Enrollment Approved">Enrollment Approved </option>
                <option value="Closed-Ineligible">Closed-Ineligible </option>
                <option value="Closed-Enrolled">Closed-Enrolled </option>
              </select></div>
          </div>
        </div>
      </div>
      <div class="ff-footer-group">
        <div class="ff-item-row ff-footer-row">
          <div class="ff-submit-btn">
            <div class="footnoteDiv"><span class="requiredSpan  ff-footnote ff-required-mark">*</span><label class="ff-footnote-label ff-label">- required</label></div>
            <div class="btnDiv"><input type="button" class="sectionHeader ff-btn-submit" id="btnsubmit" value="Next ➤" data-btnmessage="" data-btnurl=""></div>
          </div>
        </div>
      </div>
    </div>
  </div>
  <iframe id="ffIframe" name="ffIframe" style="display:none"></iframe>
  <div id="dialog">
  </div>
  <div id="ffLookupDialog" style="overflow:hidden">
  </div>
  <input id="selectedId" type="hidden">
</form>

<form id="mktoForm_1390" class="mktoForm" style="display: none;"></form>

Text Content

SMALL CHANGES.
BIG RESULTS.

DayTwo Makes it easy.

Now, you can live with diabetes, without restrictive diets:



Know your blood sugar response before the first bite



Eat what you love – with small tweaks

Getting started is simple
Owner

Enrollment Form Date

Employer

Record Type

First Name*

Last Name*

Email*

Mobile Phone*

Birthdate*

I agree to DayTwo’s Terms of Use and Privacy Policy. You may receive follow up
emails and text messages about this program.
Status
--select an item--Disqualified Nurture Known Engaged SGL MQL Meeting Scheduled
Meeting Held SAL New Intake Screening Waitlist A1C Validation Enrollment
Approved Closed-Ineligible Closed-Enrolled
*- required







MEMBERS EXPERIENCE LIFE-CHANGING RESULTS:



Weight loss

Lower A1C

More energy

Improved mood




HOW WILL DAYTWO EMPOWER YOU?



Personalized Recommendations

Your gut microbiome profile and blood test results are a guide to tailoring your
individual plan.

Easy-to-use App

Use the app to see how you respond to any food or food combination, so you’ll
know the best foods to eat.

1:1 Support

Registered dietitians and health guides are available to help you create lasting
change.



*QuikTrip benefits will cover ALL program costs for eligible members enrolled in
the QuikTrip HMO Health Plan for the first six months. After that, if you wish
to continue, the applicable deductible and copay will apply.

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