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member.asktia.com Open in urlscan Pro
34.215.63.191  Public Scan

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Submitted URL: https://link.mail.asktia.com/ls/click?upn=u001.HzUeJGxxzWF6yFL3vL-2BLEl6XpOXl8mHXgqKz6h36VeNSbmc65ToiP2xPItlNm43VR3OnssjMMM8c...
Effective URL: https://member.asktia.com/widget/?widgetStep=phone-login&lid=fm2d3fb1vayj&utm_source=email&utm_medium=Tia_ACQ_Membership-P...
Submission: On September 20 via api from US — Scanned from DE

Form analysis 6 forms found in the DOM

<form data-testid="signup-widget-treatment-test" class="css-lgbo0i">
  <p class="css-1ne77n">Let's get started</p><input name="phoneNum" inputmode="tel" placeholder="Phone" errormessage="Please enter a valid phone number" data-testid="signup-widget-phoneNum" required="" class="css-12nn79y">
  <div class="css-jcdegt">
    <div class="css-lgbo0i"><button class="css-142x2xd" disabled="">Next</button></div>
  </div>
</form>

<form id="validate-sms" onsubmit="return false">
  <p> <span style="position: absolute; left: 20px"><a class="backlink" href="#" onclick="showJoinScreen(); return false;"><img src="/assets/svg/arrow-left-black-new.svg">BACK</a></span>Step 1 of 4</p>
  <p><b>Verification</b></p>
  <div class="row">
    <div class="column narrow-cell"><input class="auto-advance" id="signup-code-1" type="text" maxlength="1" name="signup-code-1" pattern="[0-9]*" required="required"></div>
    <div class="column narrow-cell"><input class="auto-advance" id="signup-code-2" type="text" maxlength="1" name="signup-code-2" pattern="[0-9]*" required="required"></div>
    <div class="column narrow-cell"><input class="auto-advance" id="signup-code-3" type="text" maxlength="1" name="signup-code-3" pattern="[0-9]*" required="required"></div>
    <div class="column narrow-cell"><input class="auto-advance" id="signup-code-4" type="text" maxlength="1" name="signup-code-4" pattern="[0-9]*" required="required"></div>
    <div class="column narrow-cell"><input class="auto-advance" id="signup-code-5" type="text" maxlength="1" name="signup-code-5" pattern="[0-9]*" required="required"></div>
    <div class="column narrow-cell"><input class="auto-advance" id="signup-code-6" type="text" maxlength="1" name="signup-code-6" pattern="[0-9]*" required="required"></div>
  </div>
  <div class="row"><button class="button conditional-submit active" onclick="advanceJoinForm(1); return false">Back</button></div>
</form>

<form id="your-insurance" onsubmit="return false" autocomplete="off">
  <div class="modal" id="camera-modal" style="display: none">
    <div class="content-large" id="file-modal-1">
      <div class="close" onclick="hideModal('#camera-modal', stopVideo()); return false;">×</div>
      <h1>Send us images of your insurance card</h1>
      <div class="file-upload-mask">
        <div class="row">
          <div class="column left"><a class="button">Card Front</a></div>
          <div class="column right">
            <p id="image-name-1"><em>No image</em></p>
          </div>
        </div><input type="file" id="front-upload" name="front" accept="image/*">
      </div>
      <div class="file-upload-mask">
        <div class="row">
          <div class="column left"><a class="button">Card Back</a></div>
          <div class="column right">
            <p id="image-name-2"><em>No image</em></p>
          </div>
        </div><input type="file" id="back-upload" name="back" accept="image/*">
      </div>
      <p><a class="button conditional-submit" id="upload-button-1" style="margin-top: 30px;" onclick="saveImages(this, &quot;member-signup&quot;); return false">Upload</a></p>
    </div>
  </div><input id="signup-insurance-issuer-id" type="hidden" name="signup-insurance-issuer-id">
  <p> <span style="position: absolute; left: 20px"><a class="backlink" href="#" onclick="showJoinScreen(); return false;"><img src="/assets/svg/arrow-left-black-new.svg">BACK</a></span>Step 2 of 4</p>
  <p><b>Insurance</b></p>
  <div class="row"><input class="search" id="signup-insurance-issuer" type="text" name="signup-insurance-issuer" data-typeahead="payer" placeholder="Insurance company (e.g. United)" required="required"></div>
  <div class="row"><input id="signup-insurance-member-id" type="text" name="signup-insurance-member-id" placeholder="Member ID" required="required"></div>
  <p class="sub-section">Your name</p>
  <div class="row">
    <div class="column left"><input id="signup-insurance-member-given-name" type="text" name="signup-insurance-member-given-name" placeholder="First name" required="required"></div>
    <div class="column right"><input id="signup-insurance-member-family-name" type="text" name="signup-insurance-member-family-name" placeholder="Last name" required="required"></div>
  </div>
  <p class="sub-section">Your date of birth</p>
  <div class="row"><input onchange="handleDateInputColor(this);" id="signup-insurance-member-date-of-birth" type="date" name="signup-insurance-member-date-of-birth" placeholder="Date of birth" title="Date of birth" required="required"></div>
  <div class="row" id="insurance-planholder">
    <p class="sub-section">Plan holder’s name</p>
    <div class="row">
      <div class="column left"><input id="signup-insurance-planholder-given-name" type="text" name="signup-insurance-planholder-given-name" placeholder="First name" required="required"></div>
      <div class="column right"><input id="signup-insurance-planholder-family-name" type="text" name="signup-insurance-planholder-family-name" placeholder="Last name" required="required"></div>
    </div>
    <p class="sub-section">Plan holder’s date of birth</p>
    <div class="row"><input onchange="handleDateInputColor(this);" id="signup-insurance-planholder-date-of-birth" type="date" name="signup-insurance-planholder-date-of-birth" placeholder="Date of birth" title="Date of birth" required="required">
    </div>
  </div>
  <div class="row" id="signup-insurance-checkbox-container">
    <div><input id="signup-insurance-dependent" type="checkbox" name="signup-insurance-dependent"><label for="signup-insurance-dependent">I'm a dependent</label></div>
    <div><input id="signup-insurance-plan-none" type="checkbox" name="signup-insurance-plan-none" value="1"><label for="signup-insurance-plan-none">I don't have insurance</label></div>
    <div><input id="signup-insurance-plan-skip" type="checkbox" name="signup-insurance-plan-skip" value="1"><label for="signup-insurance-plan-skip">Skip for now</label></div>
  </div>
  <div class="alpha-bg padded" id="signup-insurance-text"></div>
  <div id="signup-insurance-checking-coverage">
    <div class="circle">
      <div class="spinner pie"></div>
      <div class="filler pie"></div>
      <div class="mask"></div>
      <div class="static"></div><img src="/images/insurance-checking-loader.svg">
    </div>
    <div class="text">Checking Coverage</div>
  </div>
  <div class="row"><button class="button conditional-submit" id="insurance-check-coverage-btn" onclick="checkInsuranceCoverage(); return false">Check Coverage</button></div>
  <div class="row"><button class="button conditional-submit hidden" id="insurance-check-next-btn" onclick="insuranceNextButtonOnClick(); return false">Next</button></div>
  <p class="alpha-bg padded" style="margin: 30px 0 20px; font-size: 16px">Insurance questions?<br><a href="#" onclick="showFileModal(); return false;">Send us a photo of your card!</a></p>
</form>

<form id="choose-your-plan" onsubmit="return false">
  <p><span
      style="position: absolute; left: 20px"><a class="backlink" href="#" onclick="window.amplitudeExperiment === 'treatment' ? showJoinScreen() : showInsurancePanel(); return false;"><img src="/assets/svg/arrow-left-black-new.svg">BACK</a></span>Step
    3 of 4</p>
  <p><b>Membership</b></p>
  <div class="perks-container">
    <p>Access to virtual &amp; in-person appointments</p>
    <p>Your own Care Coordinator to help with RX refills, insurance, referrals &amp; more</p>
    <p>Unlimited messaging with your providers</p>
  </div>
  <p>Choose your plan:</p>
  <div class="row" id="pricing-plans" style="align-items: flex-start">
    <div class="column left">
      <input id="radio2" type="radio" name="plan" value="2" onclick="showPlan(this);" checked="" )="">
      <label class="pricing" for="radio2">
        <span class="cadence">annual</span>
        <span class="title">
          <sup>$</sup>
          <span>150</span>
        </span>
        <span class="frequency">per year</span>
      </label>
    </div>
    <div class="column right">
      <input id="radio15" type="radio" name="plan" value="15" onclick="showPlan(this);" checked="/">
      <label class="pricing" for="radio15">
        <span class="cadence">monthly</span>
        <span class="title">
          <sup>$</sup>
          <span>20</span>
        </span>
        <span class="frequency">Initiation Fee</span>
        <span class="light">+$20/mo next month</span>
      </label>
    </div>
  </div>
  <div class="row" id="fm-promo-link"><a onclick="togglePromoBlock()">Have a promo or referral code?</a></div>
  <div class="row" id="fm-promo">
    <div class="column major"><input id="signup-promo" type="text" name="signup-promo" placeholder="Promo code">
      <div id="promo-success-btn">&nbsp;</div>
      <div id="promo-error-btn">&nbsp;</div>
    </div>
    <div class="column minor"><button class="button conditional-submit inline" id="btn-signup-promo" onclick="applyPromo(); return false">Apply</button></div>
  </div>
  <div class="row"><button class="button conditional-submit active" id="plan-btn" style="margin-top: 40px" onclick="savePricingPlan(); return false">Next</button></div>
  <div class="row" style="justify-content: space-around">
    <p>Tia's membership fee does not cover services</p>
  </div>
</form>

POST /api/v1/account/process-card

<form id="payment" novalidate="novalidate" action="/api/v1/account/process-card" method="post">
  <p><span
      style="position: absolute; left: 20px"><a class="backlink" href="#" onclick="window.amplitudeExperiment === 'treatment' ? showJoinScreen() : showPricingPanel(); return false;"><img src="/assets/svg/arrow-left-black-new.svg">BACK</a></span>Step
    4 of 4</p>
  <p><b>Payment</b></p>
  <div class="row" id="selectedPayment"></div>
  <p style="margin-top: 30px">Enter your card details:</p>
  <div class="row">
    <div id="card-container" style="width: 100%"></div>
  </div>
  <div class="row"><button class="button conditional-submit final button-credit-card" id="sq-creditcard" onclick="tE('Payment widget - 3, credit card', cwMixpanelProps); requestNewCardNonce(event); return false;">Join now<span>*$150 Annual
        Membership</span></button></div>
  <div class="row">
    <p style="max-width: 320px; margin: 10px auto; font-size: 12px;">By purchasing you agree to recurring payments to the card saved on file. </p>
  </div><input id="card-nonce" type="hidden" name="nonce"><input id="stripe-record" type="hidden" name="stripe-record"><input id="is-apple-pay" type="hidden" name="is-apple-pay"><input id="postal-code" type="hidden" name="postal-code"><input id="tr"
    type="hidden">
</form>

<form id="welcome" onsubmit="return false"><img src="/assets/svg/sparkly-woman.svg" style="height: 260px; margin: 30px auto;">
  <div class="row"><a class="button conditional-submit active" id="finish-btn" onclick="scheduleAppointment();" style="color: #fff">Get started</a></div>
</form>

Text Content

Loading
Contact Info
Phone Verification
Check Insurance
Checkout

Let's get started

Next
Selecting 'Next' means you agree to our Terms of Use & Privacy Policy and to
receive text messages and emails from Tia.Message and data rates may apply. Text
STOP to opt out.Questions?Call (646) 650-5337
Loading

BACKStep 1 of 4

Verification


Back
Loading
×


SEND US IMAGES OF YOUR INSURANCE CARD

Card Front

No image

Card Back

No image

Upload

BACKStep 2 of 4

Insurance




Your name



Your date of birth



Plan holder’s name



Plan holder’s date of birth


I'm a dependent
I don't have insurance
Skip for now

Checking Coverage
Check Coverage
Next

Insurance questions?
Send us a photo of your card!

Loading

BACKStep 3 of 4

Membership

Access to virtual & in-person appointments

Your own Care Coordinator to help with RX refills, insurance, referrals & more

Unlimited messaging with your providers

Choose your plan:

annual $ 150 per year
monthly $ 20 Initiation Fee +$20/mo next month
Have a promo or referral code?
 
 
Apply
Next

Tia's membership fee does not cover services

Loading

BACKStep 4 of 4

Payment



Enter your card details:


Join now*$150 Annual Membership

By purchasing you agree to recurring payments to the card saved on file.

Get started
Learn More about Tia

annual $ 150 per year monthly $ 20 Initiation Fee +$20/mo next month


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