www.essentiamychart.org
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Submitted URL: https://www.essentiamychart.org/mychart/s/2GEZHXP7ELRTC2UCCN7ARMUBDQ/NoAcctLogin
Effective URL: https://www.essentiamychart.org/MyChart/Authentication/SecondaryValidation
Submission: On January 12 via manual from US — Scanned from US
Effective URL: https://www.essentiamychart.org/MyChart/Authentication/SecondaryValidation
Submission: On January 12 via manual from US — Scanned from US
Form analysis 1 forms found in the DOM
<form id="two-factor-wrapper-form" autocomplete="off">
<div class="grid padded">
<div class="row">
<div class="col-12">
<h1 id="twoFactorHeader" class="alignCenter">Verify Your Identity</h1>
</div>
</div>
<div class="grid compact" id="demographicsGrid">
<div class="row">
<div class="col-12 alignCenter">
<h2>Personal Information</h2>
</div>
</div>
<div class="row" id="demographics-desc-wrapper">
<div class="col-12 alignCenter"><span id="demographics-desc" class="alignCenter">Confirm information for Scott </span><a class="logoutLink" href="/MyChart/Home/Logout?skipabandoncurrent=1"> or use a username and password.</a></div>
</div>
<div id="demographics">
<div class="row">
<div class="col-12">
<div class="required alignCenter">Indicates a required field.</div>
</div>
</div>
<div id="dobEntry" class="col-12 alignCenter">
<div class="ghostInput"><label class="required ellipsisOverflow" for="DateOfBirth">Date of Birth</label><input id="DateOfBirth" name="DateOfBirth" class="required demographics-entry" inputmode="numeric" autocomplete="bday" value=""
data-validation-settings="{"required":true,"isDate":true,"maxDate":"2023-01-12","format":true}" placeholder="MM/DD/YYYY" aria-describedby="DateOfBirth_message" aria-required="true"
data-invalid="true" data-fieldhistory="[""]" data-fieldhistoryptr="1">
<div class="clearlabel" id="DateOfBirth_autoformatted" aria-live="polite"></div>
</div>
<div id="DateOfBirth_message" data-message-display-for="DateOfBirth" aria-live="polite" aria-atomic="true"></div>
</div>
<div id="zipEntry" class="col-12 alignCenter">
<div class="ghostInput"><label class="required ellipsisOverflow" for="ZipCode">ZIP Code</label><input id="ZipCode" name="ZipCode" class="required demographics-entry" autocomplete="postal-code" value=""
data-validation-settings="{"required":true}" aria-describedby="ZipCode_message" aria-required="true" data-invalid="true"></div>
<div id="ZipCode_message" data-message-display-for="ZipCode" aria-live="polite" aria-atomic="true"></div>
</div>
<div class="row">
<div class="col-12">
<div id="demographics-mismatch-error" aria-live="assertive" class="hidden alert alignCenter"><img src="/MyChart/en-US/images/error_circle.png" class="yield" alt=""><span id="demographics-mismatch-error-text">The information you entered
does not match our records.</span></div>
</div>
</div>
</div>
</div>
<div class="grid compact">
<div class="row">
<div class="col-12 alignCenter">
<h2>Two-Step Verification</h2>
</div>
</div>
<div class="row">
<div class="col-12 alignStart">
<div id="code-sent-desc" class="alignCenter">We've sent a security code to your email on file.</div>
<div id="two-factor-learn-more"><button type="button" class="button tertiary neutral centerButton" id="learnMore" style="padding-bottom: 1rem;">Learn more</button></div>
</div>
</div>
<div class="row">
<div id="codeDirections" class="col-12 alignCenter">Enter your code below to continue.</div>
</div>
<div class="row">
<div id="twofactorform" class="col-12 alignCenter">
<div class="ghostInput"><label class="biglabel required" for="twofactorcode">Enter Code</label><input id="twofactorcode" name="twofactorcode" class="required" inputmode="numeric" maxlength="12" value=""
data-validation-settings="{"required":true,"isNumericString":true}" aria-describedby="twofactorcode_message" aria-required="true" data-invalid="true"></div>
<div id="twofactorcode_message" data-message-display-for="twofactorcode" aria-live="assertive"></div>
</div>
</div>
<div class="row">
<div id="submitButtonContainer" class="col-12 alignCenter"><span><button type="submit" class="button primary positive disabled" id="submitSecondaryValidation" data-disable-if-invalid="true" disabled=""
title="Verify button. At least one required item is missing a valid response. Please check the form." aria-label="Verify button. At least one required item is missing a valid response. Please check the form."><img class="btnImg null"
aria-hidden="true" src="/MyChart/en-US/images/authentication/wp_authenticate_code_icon.png">Verify</button></span></div>
</div>
<div id="twofactorresend" class="col-12 alignCenter">
<div id="resend-code-header">Didn't receive the code?</div><button type="button" class="button tertiary neutral centerButton" id="resendCode">Resend code</button>
</div>
</div>
</div>
</form>Text Content
Error: Please enable JavaScript in your browser before using this site. VERIFY YOUR IDENTITY PERSONAL INFORMATION Confirm information for Scott or use a username and password. Indicates a required field. Date of Birth ZIP Code The information you entered does not match our records. TWO-STEP VERIFICATION We've sent a security code to your email on file. Learn more Enter your code below to continue. Enter Code Verify Didn't receive the code? Resend code Default ThemeMyChart® licensed from Epic Systems Corporation, © 1999 - 2023. Loading...