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34.193.160.203  Public Scan

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Submitted URL: http://dc7c29-survey.artax.nl/mrIWeb/mrIWeb.dll?I.Project=DIMRED&i.user1=DF2684&i.user2=3&id=0&nid=1017
Effective URL: https://www.amgsurvey.com/websurvey/CC23-1328EMSCS/cgi-bin/ciwweb.pl?studyname=CC231328EMSCS&nid=1017&hid_pagenum=1&hid_li...
Submission: On October 30 via api from SA — Scanned from NL

Form analysis 1 forms found in the DOM

Name: mainform — POST ciwweb.pl?hid_s=Av8AANFqgNAePNwoVKbNfuhBGLswAAAA4Ua26SYK6hBinvlS3Hcpl-BcuegoCuQdZpbhSt12NIv9KcPiLQ3vGmzjgC2rEjSL

<form name="mainform" onsubmit="SSI_SubmitMe(); return false;" method="post" action="ciwweb.pl?hid_s=Av8AANFqgNAePNwoVKbNfuhBGLswAAAA4Ua26SYK6hBinvlS3Hcpl-BcuegoCuQdZpbhSt12NIv9KcPiLQ3vGmzjgC2rEjSL">
  <div class="page" id="page" role="main">
    <input type="hidden" name="hid_backup" value="CC231328EMSCS,457,698668684,2,1">
    <input type="hidden" name="hid_studyname" value="CC231328EMSCS">
    <input type="hidden" name="hid_respnum" value="457,698668684">
    <input type="hidden" name="hid_s" id="hid_s" value="Av8AANFqgNAePNwoVKbNfuhBGLswAAAA4Ua26SYK6hBinvlS3Hcpl-BcuegoCuQdZpbhSt12NIv9KcPiLQ3vGmzjgC2rEjSL">
    <input type="hidden" id="hid_pagenum" name="hid_pagenum" value="2">
    <input type="hidden" name="hid_javascript" value="0">
    <input type="hidden" name="hid_previous" value="0">
    <input type="hidden" id="hid_screenwidth" name="hid_screenwidth" value="1600">
    <div class="page_header font_primary_color">
      <div class="header_logo"><img src="/websurvey/CC23-1328EMSCS/graphics/AMG_logo_new.jpg"></div>
      <div class="header_text">Next Gen Monitors/Defibrillators Study</div>
    </div>
    <div id="error_box" class="page_error error_messages HideElement" role="alert"></div>
    <div id="alert_dialog" class="dialog"></div>
    <div class="question select" id="CountryQ_div">
      <div class="question_body indent">
        <div class="question_text">Country:</div>
        <div class="response_body" role="radiogroup">
          <div class="response_column" valign="top" align="left">
            <div class="clickable response_row">
              <div class="input_cell option_column">
                <div id="CountryQ_1_graphical" class="graphical_select radiobox" role="radio" aria-checked="false" aria-labelledby="CountryQ_1_label" tabindex="0">
                  <svg class="radio_svg" width="22" height="22" viewBox="0 0 22 22" fill="none">
                    <circle class="stroke_primary_color" cx="11" cy="11" r="10.5" stroke="#808080"></circle>
                    <circle class="fill_primary_color" cx="11" cy="11" r="7" fill="#808080"></circle>
                  </svg>
                </div><input name="CountryQ" value="1" type="radio" id="CountryQ_1" class="HideElement">
              </div>
              <div class="option_cell option_column">
                <div class="options"><label for="CountryQ_1" id="CountryQ_1_label">Australia</label></div>
              </div>
            </div>
            <div class="clickable response_row">
              <div class="input_cell option_column">
                <div id="CountryQ_2_graphical" class="graphical_select radiobox" role="radio" aria-checked="false" aria-labelledby="CountryQ_2_label" tabindex="0">
                  <svg class="radio_svg" width="22" height="22" viewBox="0 0 22 22" fill="none">
                    <circle class="stroke_primary_color" cx="11" cy="11" r="10.5" stroke="#808080"></circle>
                    <circle class="fill_primary_color" cx="11" cy="11" r="7" fill="#808080"></circle>
                  </svg>
                </div><input name="CountryQ" value="2" type="radio" id="CountryQ_2" class="HideElement">
              </div>
              <div class="option_cell option_column">
                <div class="options"><label for="CountryQ_2" id="CountryQ_2_label">Canada</label></div>
              </div>
            </div>
            <div class="clickable response_row">
              <div class="input_cell option_column">
                <div id="CountryQ_3_graphical" class="graphical_select radiobox" role="radio" aria-checked="false" aria-labelledby="CountryQ_3_label" tabindex="0">
                  <svg class="radio_svg" width="22" height="22" viewBox="0 0 22 22" fill="none">
                    <circle class="stroke_primary_color" cx="11" cy="11" r="10.5" stroke="#808080"></circle>
                    <circle class="fill_primary_color" cx="11" cy="11" r="7" fill="#808080"></circle>
                  </svg>
                </div><input name="CountryQ" value="3" type="radio" id="CountryQ_3" class="HideElement">
              </div>
              <div class="option_cell option_column">
                <div class="options"><label for="CountryQ_3" id="CountryQ_3_label">Germany</label></div>
              </div>
            </div>
            <div class="clickable response_row">
              <div class="input_cell option_column">
                <div id="CountryQ_4_graphical" class="graphical_select radiobox" role="radio" aria-checked="false" aria-labelledby="CountryQ_4_label" tabindex="0">
                  <svg class="radio_svg" width="22" height="22" viewBox="0 0 22 22" fill="none">
                    <circle class="stroke_primary_color" cx="11" cy="11" r="10.5" stroke="#808080"></circle>
                    <circle class="fill_primary_color" cx="11" cy="11" r="7" fill="#808080"></circle>
                  </svg>
                </div><input name="CountryQ" value="4" type="radio" id="CountryQ_4" class="HideElement">
              </div>
              <div class="option_cell option_column">
                <div class="options"><label for="CountryQ_4" id="CountryQ_4_label">Saudi Arabia</label></div>
              </div>
            </div>
            <div class="clickable response_row">
              <div class="input_cell option_column">
                <div id="CountryQ_5_graphical" class="graphical_select radiobox" role="radio" aria-checked="false" aria-labelledby="CountryQ_5_label" tabindex="0">
                  <svg class="radio_svg" width="22" height="22" viewBox="0 0 22 22" fill="none">
                    <circle class="stroke_primary_color" cx="11" cy="11" r="10.5" stroke="#808080"></circle>
                    <circle class="fill_primary_color" cx="11" cy="11" r="7" fill="#808080"></circle>
                  </svg>
                </div><input name="CountryQ" value="5" type="radio" id="CountryQ_5" class="HideElement">
              </div>
              <div class="option_cell option_column">
                <div class="options"><label for="CountryQ_5" id="CountryQ_5_label">United Kingdom</label></div>
              </div>
            </div>
            <div class="clickable response_row">
              <div class="input_cell option_column">
                <div id="CountryQ_6_graphical" class="graphical_select radiobox" role="radio" aria-checked="false" aria-labelledby="CountryQ_6_label" tabindex="0">
                  <svg class="radio_svg" width="22" height="22" viewBox="0 0 22 22" fill="none">
                    <circle class="stroke_primary_color" cx="11" cy="11" r="10.5" stroke="#808080"></circle>
                    <circle class="fill_primary_color" cx="11" cy="11" r="7" fill="#808080"></circle>
                  </svg>
                </div><input name="CountryQ" value="6" type="radio" id="CountryQ_6" class="HideElement">
              </div>
              <div class="option_cell option_column">
                <div class="options"><label for="CountryQ_6" id="CountryQ_6_label">United States</label></div>
              </div>
            </div>
          </div>
        </div>
        <input type="hidden" name="hid_list_CountryQ" value="1,2,3,4,5,6">
      </div>
    </div>
    <input type="hidden" name="hid_q_CountryQ" value="CountryQ">
    <input type="hidden" name="hid_prev_CountryQ" value="2,CountryQ,2,6cc596fbcda54130454396b600f17bad">
    <script type="text/javascript">
      var GlobalQuestHash = 0;
      var strGlobalError_missing = "[%ERRTEXT()%]<FONT SIZE=4>  Please answer the question and click the right arrow to continue.<\/FONT>";
      var strGlobalError_page_error = "An error has occurred on this page.  Please fix this error and try again.";
      var blnGlobalCommaForDecimal = false;

      function SSI_Verify() {
        SSI_InitializeErrors();
        SSI_RadCheck("CountryQ", "CountryQ", "", 1, true);
        SSI_RemoveErrors();
        return SSI_ShowErrors();
      }
    </script>
    <input type="hidden" name="hid_pagetime" value="1698668520">
    <div class="submit_div">
      <div id="next_button" role="button" class="navigation_button graphical_next_button" tabindex="0"><svg width="112" height="36" viewBox="0 0 112 36" fill="none" xmlns="http://www.w3.org/2000/svg">
          <rect class="fill_primary_color next_svg_rect" width="112" height="36" rx="4" fill="#2796C6"></rect>
          <path fill-rule="evenodd" clip-rule="evenodd"
            d="M71.6783 17.7395C72.1072 18.1355 72.1072 18.8132 71.6783 19.2091L63.1519 27.0796C62.7461 27.4542 62.1134 27.4289 61.7388 27.0231L60.3823 25.5535C60.0077 25.1477 60.033 24.515 60.4388 24.1404L64.4104 20.4743L42.5257 20.4743C41.9734 20.4743 41.5257 20.0266 41.5257 19.4743L41.5257 17.4743C41.5257 16.922 41.9734 16.4743 42.5257 16.4743L64.4104 16.4743L60.4388 12.8083C60.033 12.4336 60.0077 11.801 60.3823 11.3952L61.7388 9.92556C62.1134 9.51974 62.7461 9.49443 63.1519 9.86904L71.6783 17.7395Z"
            fill="white"></path>
        </svg>
      </div>
    </div>
    <div class="progress_bar">
      <table class="progress_bar_table">
        <tbody>
          <tr>
            <td class="left_cell">0%</td>
            <td class="middle_cell">
              <div class="progress_bar_outer">
                <div class="progress_bar_inner background_primary_color" style="width: 28%">
                  <p class="sr-only">28%</p>
                </div>
              </div>
            </td>
            <td class="right_cell">100%</td>
          </tr>
        </tbody>
      </table>
    </div>
    <div class="page_footer"> Prepared by: AMG Research </div>
    <script type="text/javascript">
      function SSI_Initialize() {
        SSI_PageInitialize();
        SSI_InitializeErrors();
        SSI_SubmitInitialize();
        GlobalGraphicalSelect = true;
        SSI_ClickableInitialize(true);
        SSI_List_EventSetup("CountryQ_*", [1, 2, 3, 4, 5, 6], []);
        SSI_SetupToolTips();
      }
      GlobalDocumentReadyArray.push(function() {
        SSI_Initialize();
      })
    </script>
  </div>
</form>

Text Content

Next Gen Monitors/Defibrillators Study


Country:
Australia
Canada
Germany
Saudi Arabia
United Kingdom
United States


0%

28%

100%

Prepared by: AMG Research