www.medbridgeeducation.com
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Submitted URL: http://www.medbridgeeducation.com/password/set_password/?code=A2868B7BEF1D149965E29C7531D3819E0CCBFAE8EC8089442BDC85FA0AAE1766&ema...
Effective URL: https://www.medbridgeeducation.com/home/information?code=0536307C
Submission: On January 24 via manual from US — Scanned from DE
Effective URL: https://www.medbridgeeducation.com/home/information?code=0536307C
Submission: On January 24 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
POST /home/update_student_information
<form class="card" id="information-form" method="POST" action="/home/update_student_information" novalidate="novalidate" data-hs-cf-bound="true">
<div style="display: none">
<input type="hidden" name="X-CSRF-Token" class="form-control " id="X-CSRF-Token" value="0dfc7ae6f049f9e32ee4b1a5e63e569b">
</div>
<div class="card-header">
<p class="title">License information</p>
<p class="m-t-4 subheading grey-text">Tell us more about yourself. We'll use this information to ensure your CEUs are accurately recorded.</p>
</div>
<div class="card-content p-t-1">
<div class="form-group"><label class="control-label" for="discipline">What is your primary discipline?</label><select name="student[discipline_id]" id="discipline" class="form-control ">
<option value="2">Certified Athletic Trainer</option>
<option value="22">Case Manager</option>
<option value="18">Home Health Aide</option>
<option value="15">Long Term Care Administrator</option>
<option value="14">Nurse</option>
<option value="19">Nursing Assistant (CNA)</option>
<option value="3" selected="selected">Occupational Therapist</option>
<option value="5">Occupational Therapy Assistant</option>
<option value="1">Physical Therapist</option>
<option value="4">Physical Therapist Assistant</option>
<option value="20">Registered Dietitian</option>
<option value="17">Respiratory Therapist</option>
<option value="16">Social Worker</option>
<option value="11">Speech-Language Pathologist</option>
<option value="12">Strength & Conditioning Specialist</option>
<option value="21">Therapeutic Recreation Specialist</option>
<option value="6">Other (Non-Accredited)</option>
</select></div>
</div>
<div class="card-content p-t-4">
<div class="form-group"><label class="control-label" for="state">What state is your primary license in?</label><select name="student[stateid]" id="state" class="form-control ">
<option value="" disabled="" selected="" style="display:none;">Choose state for primary license</option>
<optgroup label="United States">
<option value="1">Alabama</option>
<option value="2">Alaska</option>
<option value="3">Arizona</option>
<option value="4">Arkansas</option>
<option value="5">California</option>
<option value="6">Colorado</option>
<option value="7">Connecticut</option>
<option value="8">Delaware</option>
<option value="9">District of Columbia</option>
<option value="10">Florida</option>
<option value="11">Georgia</option>
<option value="12">Hawaii</option>
<option value="13">Idaho</option>
<option value="14">Illinois</option>
<option value="15">Indiana</option>
<option value="16">Iowa</option>
<option value="17">Kansas</option>
<option value="18">Kentucky</option>
<option value="19">Louisiana</option>
<option value="20">Maine</option>
<option value="21">Maryland</option>
<option value="22">Massachusetts</option>
<option value="23">Michigan</option>
<option value="24">Minnesota</option>
<option value="25">Mississippi</option>
<option value="26">Missouri</option>
<option value="27">Montana</option>
<option value="28">Nebraska</option>
<option value="29">Nevada</option>
<option value="30">New Hampshire</option>
<option value="31">New Jersey</option>
<option value="32">New Mexico</option>
<option value="33">New York</option>
<option value="34">North Carolina</option>
<option value="35">North Dakota</option>
<option value="36">Ohio</option>
<option value="37">Oklahoma</option>
<option value="38">Oregon</option>
<option value="39">Pennsylvania</option>
<option value="82">Puerto Rico</option>
<option value="40">Rhode Island</option>
<option value="41">South Carolina</option>
<option value="42">South Dakota</option>
<option value="43">Tennessee</option>
<option value="44">Texas</option>
<option value="45">Utah</option>
<option value="46">Vermont</option>
<option value="47">Virginia</option>
<option value="49">Washington</option>
<option value="48">West Virginia</option>
<option value="50">Wisconsin</option>
<option value="51">Wyoming</option>
</optgroup>
<optgroup label="Canada">
<option value="67">Alberta</option>
<option value="64">British Columbia</option>
<option value="63">Manitoba</option>
<option value="62">New Brunswick</option>
<option value="68">Newfoundland and Labrador</option>
<option value="61">Nova Scotia</option>
<option value="59">Ontario</option>
<option value="65">Prince Edward Island</option>
<option value="60">Quebec</option>
<option value="66">Saskatchewan</option>
</optgroup>
<optgroup label="Australia">
<option value="70">Australian Capital Territory</option>
<option value="71">Jervis Bay Territory</option>
<option value="72">New South Wales</option>
<option value="73">Northern Territory</option>
<option value="74">Queensland</option>
<option value="75">South Australia</option>
<option value="76">Tasmania</option>
<option value="77">Victoria</option>
<option value="69">Western Australia</option>
</optgroup>
<optgroup label="Bahrain">
<option value="81">Bahrain</option>
</optgroup>
<optgroup label="Other">
<option value="79">Other</option>
</optgroup>
<optgroup label="Qatar">
<option value="80">Qatar</option>
</optgroup>
<optgroup label="United Kingdom">
<option value="78">United Kingdom</option>
</optgroup>
</select></div>
</div>
<div class="card-content p-t-10">
<p class="title p-b-2">Create a password</p>
<div class="input-field m-b-4">
<input name="student[password]" id="password" type="password" class="custom-validate" data-test="password" required="">
<label for="student[password]">Create a new password</label>
<span for="password" id="password-error" class="error helper">
</span>
</div>
<div class="input-field m-b-4">
<input name="student[confirm-password]" id="confirm-password" type="password" class="custom-validate" data-test="confirm-password" required="">
<label for="student[confirm-password]">Confirm password</label>
</div>
<div class="row password-hints col-xs-12">
<div class="col-md-6 p-l-0"> Must include: <ul>
<li class="p-t-1 p-l-2 "> 8 characters </li>
<li class="p-t-1 p-l-2 "> 1 uppercase letter </li>
<li class="p-t-1 p-l-2 "> 1 lowercase letter </li>
<li class="p-t-1 p-l-2 "> 1 number </li>
<li class="p-t-1 p-l-2 "> 1 special character (excluding %) </li>
</ul>
</div>
<div class="col-md-6 must-exclude p-l-0"> Must exclude: <ul>
<li class="p-t-1 p-l-2 "> Commonly used passwords (e.g., password) </li>
<li class="p-t-1 p-l-2 "> Previously used passwords </li>
</ul>
</div>
</div>
<script>
/*
* Clears password errors for the password field
*/
function clearPasswordHintErrors() {
$('.password-hints li').each(function() {
$(this).removeClass('has-error');
});
}
</script>
</div>
<input type="hidden" name="code" class="form-control " id="code" value="0536307C">
<div class="card-content m-t-6">
<input ng-model="CA.acceptTerms" class="filled-in" type="checkbox" name="terms" id="terms" required="" data-test="terms">
<label class="m-t-6" for="terms">I have read and agree to MedBridge's <a href="/about/termsofuse" target="_blank">terms of use.</a></label>
</div>
<div class="card-content m-t-6 m-b-5">
<div class="col-sm-6 offset-sm-3">
<input type="submit" class="btn btn-flat btn-primary w-100 btn-block" data-test="activate-account" value="Activate Account">
</div>
</div>
</form>Text Content
SESSION ABOUT TO EXPIRE Due to inactivity, you will be signed out in 30 minutes. Do you want to stay signed in? Sign out Stay signed in MedBridge Education & Training * Continuing Education * Live Webinars * Certification Prep * Certificate Programs * Compliance * Microlearning Patient Engagement * Home Exercise Programs * Patient Education More * Orthopedic Exam Tests * Manual Therapy Techniques help * supervisor_account Ashton Anderson Signed In Under OU Health (Silver Lite) * Dashboard * Notifications * Sign Out Activate your MedBridge account License information Tell us more about yourself. We'll use this information to ensure your CEUs are accurately recorded. What is your primary discipline?Certified Athletic TrainerCase ManagerHome Health AideLong Term Care AdministratorNurseNursing Assistant (CNA)Occupational TherapistOccupational Therapy AssistantPhysical TherapistPhysical Therapist AssistantRegistered DietitianRespiratory TherapistSocial WorkerSpeech-Language PathologistStrength & Conditioning SpecialistTherapeutic Recreation SpecialistOther (Non-Accredited) What state is your primary license in?Choose state for primary licenseAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanAustralian Capital TerritoryJervis Bay TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern AustraliaBahrainOtherQatarUnited Kingdom Create a password Create a new password Confirm password Must include: * 8 characters * 1 uppercase letter * 1 lowercase letter * 1 number * 1 special character (excluding %) Must exclude: * Commonly used passwords (e.g., password) * Previously used passwords I have read and agree to MedBridge's terms of use.