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192.124.249.67  Public Scan

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Submitted URL: https://t.e2ma.net/click/k25o0g/4ppzqcjh/kyqimp
Effective URL: https://www.regionalskinlaser.com/specials/
Submission: On July 22 via api from US — Scanned from DE

Form analysis 2 forms found in the DOM

POST /specials/

<form method="post" class="seaforms seaform-129" id="seaform-129" action="/specials/" enctype="multipart/form-data" encoding="multipart/form-data" data-form-id="129" novalidate="novalidate"> <input type="hidden" name="sf[sfname]"
    value="footer-contact">
  <input type="hidden" name="sf[_sfnonce]" value="52f7542585">
  <input type="hidden" name="sf[http_referrer]" value="/specials/">
  <div class="stopyenoh robotic">
    <label for="stopyenoh-input-129" class="">do or do not , there is no try</label>
    <input id="stopyenoh-input-129" class="" type="text" name="thefaxnumber9tX4bPz" value="" tabindex="-1" autocomplete="off">
    <label for="stopyenoh-checkbox-129">check that box</label>
    <input id="stopyenoh-checkbox-129" class="" type="checkbox" name="contact_by_fax" value="1" tabindex="-1" autocomplete="off">
  </div> <!-- .stopyenoh -->
  <div class="field-required type-singlelinetext field-5 field-wrap"><label for="first-name-5">First Name</label> <input type="text" id="first-name-5" name="sf[first-name-5]" value="" class="text-inputtype" required="" placeholder="First Name"
      data-placeholder-text="First Name" aria-required="true">
  </div>
  <div class="field-required type-singlelinetext field-18 field-wrap"><label for="last-name-18">Last Name</label> <input type="text" id="last-name-18" name="sf[last-name-18]" value="" class="text-inputtype" required="" placeholder="Last Name"
      data-placeholder-text="Last Name" aria-required="true">
  </div>
  <div class="field-required type-singlelinetext field-6 field-wrap"><label for="email-6">Email</label> <input type="email" id="email-6" name="sf[email-6]" value="" class="email-inputtype" required="" placeholder="Email" data-placeholder-text="Email"
      aria-required="true">
  </div>
  <div class="field-required type-singlelinetext field-7 field-wrap"><label for="phone-7">Phone</label> <input type="text" id="phone-7" name="sf[phone-7]" value="" class="text-inputtype" required="" placeholder="Phone" data-placeholder-text="Phone"
      aria-required="true">
  </div>
  <div class="field-required type-selectbox field-27 field-wrap"><label for="preferred-location-27">Preferred Location</label> <select name="sf[preferred-location-27]" class="" id="preferred-location-27" required="" aria-required="true">
      <option selected="selected" value="0:" disabled="">Preferred Location</option>
      <option value="1:acajas@regionalplasticsurgery.com" acajas@regionalplasticsurgery.com="">Richardson</option>
      <option value="2:acajas@regionalplasticsurgery.com" acajas@regionalplasticsurgery.com="">Sherman</option>
      <option value="3:lsaucier@regionalplasticsurgery.com" lsaucier@regionalplasticsurgery.com="">Rockwall</option>
    </select>
  </div>
  <div class="type-textarea field-9 field-wrap"><label for="message-9">Message</label> <textarea name="sf[message-9]" id="message-9" cols="30" rows="10" placeholder="Message" data-placeholder-text="Message"></textarea>
  </div>
  <div class="disclaimer type-text field-11 field-wrap">
    <p>Communications through our website or via email are not encrypted and are not necessarily secure. Use of the internet or email is for your convenience only, and by using them, you assume the risk of unauthorized use.</p>
  </div>
  <div class="type-submitbutton field-wrap">
    <input id="62dafac696e13" class="seaformsButton submit-btn" type="submit" name="form-submits" value="Send" disabled="disabled">
  </div>
  <div style="color:red;display:none;" class="ajaxfail--response--message"></div>
</form>

POST /specials/

<form method="post" class="seaforms seaform-76" id="seaform-76" action="/specials/" enctype="multipart/form-data" encoding="multipart/form-data" data-form-id="76" novalidate="novalidate"> <input type="hidden" name="sf[sfname]" value="sticky-contact">
  <input type="hidden" name="sf[_sfnonce]" value="52f7542585">
  <input type="hidden" name="sf[http_referrer]" value="/specials/">
  <div class="stopyenoh robotic">
    <label for="stopyenoh-input-76" class="">do or do not , there is no try</label>
    <input id="stopyenoh-input-76" class="" type="text" name="thefaxnumber9tX4bPz" value="" tabindex="-1" autocomplete="off">
    <label for="stopyenoh-checkbox-76">check that box</label>
    <input id="stopyenoh-checkbox-76" class="" type="checkbox" name="contact_by_fax" value="1" tabindex="-1" autocomplete="off">
  </div> <!-- .stopyenoh -->
  <div class="type-checkbox field-19 field-wrap"><label for="yes-id-like-to-know-about-events-and-special-offers-by-e-mail-19">Yes, I'd like to know about events and special offers by e-mail</label> <input type="checkbox"
      name="sf[yes-id-like-to-know-about-events-and-special-offers-by-e-mail-19]" id="yes-id-like-to-know-about-events-and-special-offers-by-e-mail-19" value="true">
  </div>
  <div class="field-required type-singlelinetext field-1 field-wrap"><label for="name-1">Name</label> <input type="text" id="name-1" name="sf[name-1]" value="" class="text-inputtype" required="" placeholder="Name" data-placeholder-text="Name"
      aria-required="true">
  </div>
  <div class="field-required type-singlelinetext field-2 field-wrap"><label for="email-2">Email</label> <input type="email" id="email-2" name="sf[email-2]" value="" class="email-inputtype" required="" placeholder="Email" data-placeholder-text="Email"
      aria-required="true">
  </div>
  <div class="field-required type-singlelinetext field-3 field-wrap"><label for="phone-3">Phone</label> <input type="tel" id="phone-3" name="sf[phone-3]" value="" class="tel-inputtype" required="" placeholder="Phone" data-placeholder-text="Phone"
      aria-required="true">
  </div>
  <div class="field-required type-selectbox field-31 field-wrap"><label for="preferred-location-31">Preferred Location</label> <select name="sf[preferred-location-31]" class="" id="preferred-location-31" required="" aria-required="true">
      <option selected="selected" value="0:" disabled="">Preferred Location</option>
      <option value="1:acajas@regionalplasticsurgery.com" acajas@regionalplasticsurgery.com="">Richardson</option>
      <option value="2:acajas@regionalplasticsurgery.com" acajas@regionalplasticsurgery.com="">Sherman</option>
      <option value="3:lsaucier@regionalplasticsurgery.com" lsaucier@regionalplasticsurgery.com="">Rockwall</option>
    </select>
  </div>
  <div class="type-singlelinetext field-4 field-wrap"><label for="message-4">Message</label> <input type="text" id="message-4" name="sf[message-4]" value="" class="text-inputtype" placeholder="Message" data-placeholder-text="Message">
  </div>
  <div class="type-submitbutton field-wrap">
    <input id="62dafac69a871" class="seaformsButton submit-btn" type="submit" name="form-submits" value="Send" disabled="disabled">
  </div>
  <div style="color:red;display:none;" class="ajaxfail--response--message"></div>
</form>

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Richardson/Sherman: (972) 470-5012 Rockwall: (214) 535-9623

 * Home
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Regional Skin & Laser Center


SPECIALS





 

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Locations
   
 * Richardson:
   3201 E President George Bush Hwy, Suite #105
   Richardson, TX 75082
   
   
 * Sherman:
   1111 E Sara Swamy Dr
   Sherman, TX 75090
   
   
 * Rockwall:
   1407 Ridge Rd, Suite #101
   Rockwall, TX 75087
   

Contact Us Today!
do or do not , there is no try check that box
First Name
Last Name
Email
Phone
Preferred Location Preferred Location Richardson Sherman Rockwall
Message

Communications through our website or via email are not encrypted and are not
necessarily secure. Use of the internet or email is for your convenience only,
and by using them, you assume the risk of unauthorized use.



   
 * Richardson:
   3201 E President George Bush Hwy, Suite #105
   Richardson, TX 75082
   (972) 470-5012
   
   
 * Sherman:
   1111 E Sara Swamy Dr
   Sherman, TX 75090
   (972) 470-5012
   
   
 * Rockwall:
   1407 Ridge Rd, Suite #101
   Rockwall, TX 75087
   (214) 535-9623
   

 * Home
 * About Us
   * Specials
 * Services
   * Cosmetic Services
   * Skin & Laser Treatments
     * Skin Rejuvenation & Laser Treatments
     * AcuPulse™
     * FemTouch™
     * Fraxel®
     * Intense Pulsed Light (IPL) Photofacial
     * Laser Hair Removal
     * SkinPen®
     * IPL Photofacial
     * Dermaplaning
   * Injectables & Dermal Fillers
     * Injectables & Dermal Fillers Overview
     * BOTOX® Cosmetic
     * Dysport®
     * Jeuveau™
     * JUVÉDERM®
     * Restylane®
     * RADIESSE®
     * Sculptra Aesthetic®
     * KYBELLA®
     * SELPHYL® PRFM
     * QWO® Cellulite Treatment
   * Customized Facials
     * Facials Overview
     * Signature Facial
     * Deluxe Facial
     * Platinum Facial
     * HydraFacial™
     * Signature HydraFacial™
     * Deluxe HydraFacial™
     * Platinum HydraFacial™
   * Chemical Peels
     * Chemical Peels Overview
     * Glycolic / Lactic Peel
     * Salicylic / Mandelic Peel
     * VI Peel®
     * Smoothing Body Peel
     * ZO® 3-Step Peel
 * Skin Care Products
 * Video Gallery
 * Blog
 * Patient Portal
 * Contact

Copyright © 2022 Regional Skin and Laser Center. All rights reserved | Privacy
Policy | Sitemap | Accessibility Statement
Medical Website Design by Rosemont Media

*Stock model images are used throughout this website and are for illustrative
purposes only. All before-and-after photos and patient testimonials on our site
are from actual patients, and have been published with permission. Individual
results may vary.
Request a Consultation
do or do not , there is no try check that box
Yes, I'd like to know about events and special offers by e-mail
Name
Email
Phone
Preferred Location Preferred Location Richardson Sherman Rockwall
Message


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