thesuraniclinic.simplespa.com Open in urlscan Pro
212.227.10.33  Public Scan

Submitted URL: http://thesuraniclinic.simplespa.com/
Effective URL: https://thesuraniclinic.simplespa.com/
Submission: On July 19 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

<form class="form-horizontal" role="form" data-toggle="validator" id="frmcontact" novalidate="true">
  <fieldset>
    <div class="form-group no-gutter">
      <label for="apptcname" class="col-lg col-md control-label" data-l10n-id="name">Name</label>
      <div class="col-lg-12 col-md-12 col-lg col-md no-gutter" style="padding-left:2px;">
        <div class="col-sm-12 no-gutter">
          <input id="apptcname" class="form-control" type="hidden">
          <div class="input-group" style="width:100%;">
            <input style="font-size:16px;" type="text" class="form-control" name="apptcname_first" aria-label="First Name" id="apptcname_first" placeholder="First Name (required)" autocomplete="off" autocorrect="off" autocapitalize="off"
              spellcheck="false" required="">
            <span class="input-group-addon" style="width:4px;"></span>
            <input style="font-size:16px;" type="text" class="form-control" name="apptcname_last" aria-label="Last Name" id="apptcname_last" placeholder="Last Name" autocomplete="off" autocorrect="off" autocapitalize="off" spellcheck="false">
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    </div>
    <div class="form-group no-gutter">
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        <div class="row">
          <div class="col-lg-6 col-md-6 no-gutter">
            <label for="apptcmobile" class="col-lg col-md col-sm control-label no-gutter"><span data-l10n-id="mobile">Handy</span></label>
            <input style="font-size:16px;" id="apptcmobile" name="mobile" type="tel" class="form-control" aria-label="Mobile" placeholder="Mobile # (required)" autocomplete="off" autocorrect="off" autocapitalize="off" spellcheck="false" required="">
          </div>
          <div class="col-lg-6 col-md-6 no-gutter">
            <label for="apptcemail" class="col-lg col-md col-sm control-label no-gutter"><span data-l10n-id="email">Email</span></label>
            <input style="font-size:16px;" id="apptcemail" name="email" class="form-control" type="email" aria-label="Email" placeholder="Email (required)" autocomplete="off" autocorrect="off" autocapitalize="off" spellcheck="false" required="">
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        </div>
      </div>
    </div>
    <div class="form-group no-gutter" id="apptcaddress-row">
      <label for="apptcstreet" class="col-lg col-md control-label" data-l10n-id="address">Adresse</label>
      <div class="col-lg-12 col-md-12 col-lg col-md no-gutter" style="padding-left:2px;">
        <div class="col-lg-12 no-gutter">
          <div class="">
            <input style="font-size:16px;" id="apptcstreet" type="text" class="form-control" aria-label="Street" placeholder="Street" autocomplete="off" autocorrect="off" autocapitalize="off" spellcheck="false">
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        </div>
        <div class="col-lg-12 no-gutter">
          <div class="input-group" style="width:100%;">
            <input style="font-size:16px;" id="apptccity" type="text" class="form-control" aria-label="City" placeholder="City" autocomplete="off" autocorrect="off" autocapitalize="off" spellcheck="false">
            <span class="input-group-addon" style="width:4px;"></span>
            <input style="font-size:16px;" id="apptcstate" class="form-control" type="text" aria-label="State" placeholder="State" autocomplete="off" autocorrect="off" autocapitalize="off" spellcheck="false">
            <span class="input-group-addon" style="width:4px;"></span>
            <input style="font-size:16px;" id="apptczip" class="form-control" type="text" aria-label="Zip" placeholder="Zip" autocomplete="off" autocorrect="off" autocapitalize="off" spellcheck="false">
          </div>
        </div>
      </div>
    </div>
    <div class="form-group no-gutter" id="apptcbday-row" style="display:none;">
      <label for="apptcstreet" class="col-lg col-md control-label" data-l10n-id="Birthday">Birthday</label>
      <div class="col-lg-12 col-md-12 col-lg col-md no-gutter" style="padding-left:2px;">
        <div class="col-xs-12 no-gutter">
          <div class="input-group" style="width:100%;">
            <input style="font-size:16px;" type="text" class="form-control" name="bday" id="customer_bday" placeholder="Birthday" readonly="true">
            <div class="input-group-prepend"><span class="input-group-text"><i class="fa fa-calendar" aria-hidden="true"></i></span></div>
            <input style="font-size:16px;" type="number" class="form-control" min="1900" max="2050" name="bday-year" id="customer_bday-year" placeholder="Year">
          </div>
        </div>
      </div>
      <input type="hidden" name="bday-month" id="customer_bday-month">
      <input type="hidden" name="bday-day" id="customer_bday-day">
    </div>
    <div class="form-group no-gutter" id="apptcgender-row" style="display:none;">
      <label for="apptcstreet" class="col-lg col-md control-label" data-l10n-id="gender">Geschlecht</label>
      <div class="col-lg-12 col-md-12 col-lg col-md no-gutter" style="padding-left:2px;">
        <label class="radio-inline">
          <input type="radio" name="customer_gender" value="1">
          <i class="fa fa-female" aria-hidden="true"></i> <span data-l10n-id="female">Weiblich</span>
        </label> &nbsp; <label class="radio-inline">
          <input type="radio" name="customer_gender" value="2">
          <i class="fa fa-male" aria-hidden="true"></i> <span data-l10n-id="male">Männlich</span>
        </label> &nbsp; <label class="radio-inline">
          <input type="radio" name="customer_gender" id="customer_gender" value="0">
          <i class="fa fa-genderless" aria-hidden="true"></i> <span data-l10n-id="none">none</span>
        </label>
      </div>
    </div>
    <div class="form-group no-gutter" id="apptnotes_row">
      <label for="apptnotes" class="col-lg col-md control-label" data-l10n-id="comments" id="lbl_comments">Beschreibung</label>
      <div class="col-lg-12 col-md-12 col-lg col-md no-gutter" style="padding-left:2px;">
        <div class="col-lg-12 no-gutter">
          <textarea style="font-size:16px;" id="apptnotes" rows="3" class="form-control" placeholder="anything you would like us to know about your appointment"></textarea>
        </div>
      </div>
    </div>
    <div class="form-group">
      <div class="col-lg-12">
        <div class="checkbox">
          <label>
            <input type="checkbox" id="obk-consent" name="edit-reminder-sms" value="1" checked="" disabled=""> <i><span>By submitting this form, you agree to receive appointment notifications from The Surani Clinic</span></i>
          </label>
        </div>
      </div>
    </div>
    <div class="form-group no-gutter" id="apptgc_row" style="display:none;">
      <div class="col-lg-12 col-md-12 col-lg col-md no-gutter" style="padding-left:2px;">
        <div class="col-lg-12">
          <div class="input-group" id="gcard-srch-appt">
            <input id="appt-giftcertificate" class="form-control form-control-sm input-sm" type="text" placeholder="Enter Code" autocomplete="off" autocorrect="off" autocapitalize="off" spellcheck="false" style="font-size:16px;">
            <span class="input-group-btn input-group-append">
              <button class="btn btn-default btn-dark" type="button" id="apply-giftcertificate"><i class="fa fa-certificate"></i>&nbsp; <span data-l10n-id="apply">Übernehmen</span></button>
            </span>
          </div>
          <span class="help-block" id="apply_giftcertificate_help"></span>
        </div>
      </div>
    </div>
    <input id="addclientid" type="hidden">
    <input id="addgcno" type="hidden">
    <button type="button" class="btn btn-link btn-xs pull-left" id="add-apptgc-button" style=""><span data-l10n-id="haveagiftcertificate">Haben Sie einen Geschenkgutschein</span>?</button>
    <button type="submit" class="btn btn-default btn-dark pull-right disabled" id="dialog-confirm-button"><span data-l10n-id="confirm">Bestätigen</span></button>
  </fieldset>
</form>

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Terminmanagement-Software von SimpleSpa

 *  Online-Buchung
 *  Produkte kaufen
 *  Geschenkkarten kaufen
 *  Bewertungen

THE SURANI CLINIC

1675 Bayview Ave
Toronto, Ontario M4G 3C1
Canada
4165100100
info@suraniclinic.com

Wegbeschreibung




 * Start
 * Service
 * Mitarbeiter
 * Datum
 * Meine Info
 * Bestätigen



Schritt 1 von 6




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AUSWÄHLEN SERVICE




AUSWÄHLEN MITARBEITER




AUSWÄHLEN DATUM/ZEIT



Freitag, Juli 19, 2024


Erstes verfügbares Datum


«July
2024»SuMoTuWeThFrSa301234567891011121314151617181920212223242526272829303112345678910TodayClear

«2024»JanFebMarAprMayJunJulAugSepOctNovDecTodayClear

«2020-2029»201920202021202220232024202520262027202820292030TodayClear

«2000-2090»199020002010202020302040205020602070208020902100TodayClear

«2000-2900»190020002100220023002400250026002700280029003000TodayClear

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GEBEN SIE IHRE INFORMATIONEN EIN



Name

Handy
Email
Adresse

Birthday

Geschlecht
Weiblich   Männlich   none
Beschreibung

By submitting this form, you agree to receive appointment notifications from The
Surani Clinic
  Übernehmen
Haben Sie einen Geschenkgutschein? Bestätigen


BESTÄTIGEN SIE IHREN TERMIN



Datum:
...
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Mitarbeiter:
...
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Kosten:
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Dauer:
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--------------------------------------------------------------------------------

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...
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Termin Notizen:
...

BITTE BESTÄTIGEN SIE, DASS DIE TERMININFORMATIONEN KORREKT SIND ...

Thank you for booking with us. The balance of the payment will be processed on
the day of the appointment at the Surani Clinic. The booking fee of 20% is non
refundable. 



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GESCHÄFTSZEITEN

 * Mo.CLOSED
 * Di.10:00AM - 7:00PM
 * Mi.10:00AM - 4:00PM
 * Do.10:00AM - 6:00PM
 * Fr.10:00AM - 3:00PM
 * Sa.10:00AM - 2:00PM
 * So.CLOSED

THE SURANI CLINIC

1675 Bayview Ave
Toronto, Ontario M4G 3C1
Canada
4165100100
info@suraniclinic.com

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BUSINESS HOURS

 * Mo.CLOSED
 * Di.10:00AM - 7:00PM
 * Mi.10:00AM - 4:00PM
 * Do.10:00AM - 6:00PM
 * Fr.10:00AM - 3:00PM
 * Sa.10:00AM - 2:00PM
 * So.CLOSED

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