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URL: https://www.medme2.john-weston.com/
Submission: On October 08 via api from US — Scanned from PL

Form analysis 1 forms found in the DOM

POST /

<form id="form-contact" class="form" method="post" action="/">
  <fieldset class="form__wrapper">
    <div class="form__inner">
      <div class="form__content">
        <div class="form__field-container">
          <label class="form-field">
            <div class="form-field__wrapper">
              <div class="form-field__inner">
                <input class="form-field__core" name="name" type="text" placeholder="Imię">
              </div>
            </div>
          </label>
        </div>
        <div class="form__field-container">
          <label class="form-field">
            <div class="form-field__wrapper">
              <div class="form-field__inner">
                <input class="form-field__core" name="surname" type="text" placeholder="Nazwisko">
              </div>
            </div>
          </label>
        </div>
        <div class="form__field-container">
          <label class="form-field">
            <div class="form-field__wrapper">
              <div class="form-field__inner">
                <input class="form-field__core" name="email" type="text" placeholder="E-mail">
              </div>
            </div>
          </label>
        </div>
        <div class="form__field-container">
          <label class="form-field">
            <div class="form-field__wrapper">
              <div class="form-field__inner">
                <input class="form-field__core" name="phone" type="text" placeholder="Nr telefonu">
              </div>
            </div>
          </label>
        </div>
        <div class="form__bottom-row">
          <div class="button-container-with-contents">
            <div class="button-container-with-contents__container">
              <div class="button-container-with-contents__contents-container">
                <div class="single-checkbox">
                  <div class="single-checkbox__wrapper">
                    <div class="single-checkbox__inner">
                      <div class="single-checkbox__field-container">
                        <label class="choice-field">
                          <input type="checkbox" name="conditions" value="1">
                          <div class="choice-field__wrapper">
                            <div class="choice-field__inner"></div>
                          </div>
                          <div class="single-checkbox__description">
                            <p> Wyrażam zgodę na przetwarzanie danych osobowych przez firmę Medme.pl <a class="ajax-overlayer-button" href="https://www.medme.pl/informacje/polityka-prywatnosci" target="_blank">(Polityka prywatności)</a>. </p>
                          </div>
                        </label>
                      </div>
                    </div>
                  </div>
                </div>
                <div class="single-checkbox">
                  <div class="single-checkbox__wrapper">
                    <div class="single-checkbox__inner">
                      <div class="single-checkbox__field-container">
                        <label class="choice-field">
                          <input type="checkbox" name="conditions" value="1">
                          <div class="choice-field__wrapper">
                            <div class="choice-field__inner"></div>
                          </div>
                          <div class="single-checkbox__description">
                            <p> Wyrażam zgodę na otrzymywanie materiałów promocyjnych i newsletterów. </p>
                          </div>
                        </label>
                      </div>
                    </div>
                  </div>
                </div>
              </div>
              <div class="button-container-with-contents__button-container">
                <div class="button-wrapper">
                  <button class="button" type="submit">
                    <div class="button__wrapper">
                      <div class="button__inner"> Zapisz się </div>
                    </div>
                  </button>
                  <div class="button-wrapper__spinner form__spinner">
                    <div class="wrapper">
                      <div>
                        <div class="spinner">
                          <i class="fa fa-circle-notch fa-spin" aria-hidden="true"></i>
                        </div>
                      </div>
                    </div>
                  </div>
                </div>
              </div>
            </div>
          </div>
        </div>
        <div class="form__info-container">
          <div class="form__info-wrapper">
            <div class="form__info">
              <div class="failure"> Proszę wypełnić wszystkie pola </div>
            </div>
          </div>
        </div>
      </div>
    </div>
  </fieldset>
</form>

Text Content

MedMe.pl
Zapisz się na webinar


PRZECHOROWANIE,
CZY ZASZCZEPIENIE?

KIEDY MAMY WYŻSZĄ ODPORNOŚĆ
W PRZYPADKU COVID-19?

 * 3.03.2021
 * 10:00

LIVE
DR N. MED.
Sylwester Piaskowski
Ekspert ds. COVID-19 z przychodni Dimedic.pl


ZAPISZ SIĘ NA WEBINAR

Ante facilisi ultrices lacinia senectus pulvinar. Odio amet maecenas aliquam
dolor fusce.

Wyrażam zgodę na przetwarzanie danych osobowych przez firmę Medme.pl (Polityka
prywatności).

Wyrażam zgodę na otrzymywanie materiałów promocyjnych i newsletterów.

Zapisz się

Proszę wypełnić wszystkie pola
 * MedMe.pl
 * * 
   * 
 * Polityka prywatności
 * Copyright © 2021 Pharma Partner Sp. z o. o.


200 @ app_master_index
HTTP status 200 OK
Controller MasterController :: index
Route name app_master_index
Has session no
Stateless Check no
171 ms
Total time 171 ms
Initialization time 103 ms
8.0 MiB
Peak memory usage 8.0 MiB
PHP memory limit 512 MiB
1
1 AJAX request (Clear)

# Profile Method Type Status URL Time
1n/aPOSTxhr200https://www.google-analytics.com/j/collect?v=1&_v=j101&a=1535356481&t=pageview&_s=1&dl=https%3A%2F%2Fwww.medme2.john-weston.com%2F&ul=pl-pl&de=UTF-8&dt=WEBINAR%20-%20Przechorowanie%2C%20czy%20zaszczepienie%3F%20Kiedy%20mamy%20wy%C5%BCsz%C4%85%20odporno%C5%9B%C4%87%20w%20przypadku%20COVID-19%3F&sd=24-bit&sr=1600x1200&vp=1600x1200&je=0&_u=YEBAAUABAAAAACAAI~&jid=780207554&gjid=1177039206&cid=1700847777.1728386507&tid=UA-25943686-7&_gid=509250469.1728386507&_r=1&gtm=457e4a20za200&gcd=13l3l3l2l1l1&dma_cps=syphamo&dma=1&tag_exp=101529665~101671035~101747727&jsscut=1&npa=1&z=55373170351ms

5 in 0.87 ms
Cache Calls 5
Total time 0.87 ms
Cache hits 4 / 5 (80%)
Cache writes 0
anon.
Logged in as anon.
Authenticated Yes
Token class AnonymousToken
Firewall name main
2 ms
Render Time 2 ms
Template Calls 5
Block Calls 2
Macro Calls 0
5.2.3
Profiler token 17302e
Environment dev
Debug enabled
PHP version 7.4.33   View phpinfo()
PHP Extensions xdebug ✗ APCu ✗ OPcache ✓
PHP SAPI litespeed
Resources Read Symfony 5.2.3 Docs
Help Symfony Support Channels