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108.157.4.82  Public Scan

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URL: https://www.surveymonkey.com/r/XX27ZBG
Submission: On February 11 via api from AU — Scanned from DE

Form analysis 1 forms found in the DOM

Name: surveyForm — POST 

<form name="surveyForm" action="" method="post" enctype="multipart/form-data" novalidate="" data-survey-page-form="">
  <div class="questions clearfix">
    <div class="question-click-shield" tabindex="-1" style="height: 297px; width: 896px; display: none;"></div>
    <div class="question-row clearfix" tabindex="-1">
      <div data-question-type="demographic_international" data-rq-question-type="contact" class="question-container
    
    ">
        <div id="question-field-751515059" data-qnumber="1" data-qdispnumber="1" data-question-id="751515059" class=" question-demographic question-demographic-int qn question international question-required">
          <h3 class="screenreader-only">Question Title</h3>
          <div class="text-input-group question-fieldset question-legend">
            <h4 id="question-title-751515059" class=" question-title-container ">
              <span class="required-asterisk notranslate"> * </span>
              <span class="question-number notranslate"> 1<span class="question-dot">.</span>
              </span>
              <span class="user-generated notranslate  
                "> Contact information</span>
            </h4>
            <div class="question-body clearfix notranslate ">
              <div class="text-input-container clearfix">
                <label for="751515059_4945141680" class="question-body-font-theme answer-label question-demographic-label user-generated " style="width:25%;"> Name </label>
                <input id="751515059_4945141680" name="751515059_4945141680" type="text" class="text medium" size="30" aria-required="true" data-sm-open-single="" maxlength="20000">
              </div>
              <div class="text-input-container clearfix">
                <label for="751515059_4945141681" class="question-body-font-theme answer-label question-demographic-label user-generated " style="width:25%;"> Company </label>
                <input id="751515059_4945141681" name="751515059_4945141681" type="text" class="text medium" size="30" aria-required="true" data-sm-open-single="" maxlength="20000">
              </div>
              <div class="text-input-container clearfix">
                <label for="751515059_4945141684" class="question-body-font-theme answer-label question-demographic-label user-generated " style="width:25%;"> City/Town </label>
                <input id="751515059_4945141684" name="751515059_4945141684" type="text" class="text medium" size="15" aria-required="true" data-sm-open-single="" maxlength="20000">
              </div>
              <div class="text-input-container clearfix">
                <label for="751515059_4945141686" class="question-body-font-theme answer-label question-demographic-label user-generated " style="width:25%;"> Country </label>
                <input id="751515059_4945141686" name="751515059_4945141686" type="text" class="text medium" size="15" aria-required="true" data-sm-open-single="" maxlength="20000">
              </div>
              <div class="text-input-container clearfix">
                <label for="751515059_4945141687" class="question-body-font-theme answer-label question-demographic-label user-generated " style="width:25%;"> Linkedin or Social media link </label>
                <input id="751515059_4945141687" name="751515059_4945141687" type="text" class="text medium" size="15" aria-required="true" data-sm-open-single="" maxlength="20000">
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              <div class="text-input-container clearfix">
                <label for="751515059_4945141688" class="question-body-font-theme answer-label question-demographic-label user-generated " style="width:25%;"> Email Address </label>
                <input id="751515059_4945141688" name="751515059_4945141688" type="email" class="text medium" size="30" aria-required="true" data-sm-open-single="" maxlength="20000">
              </div>
              <div class="text-input-container clearfix">
                <label for="751515059_4945141689" class="question-body-font-theme answer-label question-demographic-label user-generated " style="width:25%;"> Phone Number </label>
                <input id="751515059_4945141689" name="751515059_4945141689" type="tel" class="text medium" size="30" aria-required="true" data-sm-open-single="" maxlength="20000">
              </div>
            </div>
          </div>
        </div>
      </div>
      <button id="751515059-ok" class="new-button ok-button user-generated notranslate hide" type="submit"> OK </button>
    </div>
    <div class="question-click-shield" tabindex="-1" style="height: 213px; width: 896px;"></div>
    <div class="question-row clearfix overlay
                   " tabindex="-1">
      <div data-question-type="single_choice_vertical_two_col" data-rq-question-type="single_choice_vertical_two_col" class="question-container
    
    ">
        <div id="question-field-760371379" data-qnumber="2" data-qdispnumber="2" data-question-id="760371379" class=" question-single-choice-radio qn question vertical_two_col question-required">
          <h3 class="screenreader-only">Question Title</h3>
          <fieldset class=" question-fieldset" data-radio-button-group="">
            <legend class="question-legend">
              <h4 id="question-title-760371379" class="
                     question-title-container ">
                <span class="required-asterisk notranslate"> * </span>
                <span class="question-number notranslate"> 2<span class="question-dot">.</span>
                </span>
                <span class="user-generated notranslate  
                "> Which role/job title best describes you?</span>
              </h4>
            </legend>
            <div class="question-body clearfix notranslate ">
              <div class="answer-option-col
                            answer-option-col-2">
                <div class="answer-option-cell">
                  <div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-760371379">
                    <input id="760371379_5031856403" aria-labelledby="760371379_5031856403_label" name="760371379" type="radio" role="radio" class="radio-button-input " value="5031856403" aria-checked="false">
                    <label data-sm-radio-button-label="" id="760371379_5031856403_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="760371379_5031856403">
                      <span class="radio-button-display ">
                      </span>
                      <span class="radio-button-label-text question-body-font-theme user-generated "> Payer </span>
                    </label>
                  </div>
                </div>
                <div class="answer-option-cell">
                  <div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-760371379">
                    <input id="760371379_5031856404" aria-labelledby="760371379_5031856404_label" name="760371379" type="radio" role="radio" class="radio-button-input " value="5031856404" aria-checked="false">
                    <label data-sm-radio-button-label="" id="760371379_5031856404_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="760371379_5031856404">
                      <span class="radio-button-display ">
                      </span>
                      <span class="radio-button-label-text question-body-font-theme user-generated "> General practitioner (GP) </span>
                    </label>
                  </div>
                </div>
                <div class="answer-option-cell">
                  <div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-760371379">
                    <input id="760371379_5031856405" aria-labelledby="760371379_5031856405_label" name="760371379" type="radio" role="radio" class="radio-button-input " value="5031856405" aria-checked="false">
                    <label data-sm-radio-button-label="" id="760371379_5031856405_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="760371379_5031856405">
                      <span class="radio-button-display ">
                      </span>
                      <span class="radio-button-label-text question-body-font-theme user-generated "> Diabetologist/Endocrinologist </span>
                    </label>
                  </div>
                </div>
              </div>
              <div class="answer-option-col
                            answer-option-col-2">
                <div class="answer-option-cell">
                  <div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-760371379">
                    <input id="760371379_5031856406" aria-labelledby="760371379_5031856406_label" name="760371379" type="radio" role="radio" class="radio-button-input " value="5031856406" aria-checked="false">
                    <label data-sm-radio-button-label="" id="760371379_5031856406_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="760371379_5031856406">
                      <span class="radio-button-display ">
                      </span>
                      <span class="radio-button-label-text question-body-font-theme user-generated "> Diabetes specialist nurse </span>
                    </label>
                  </div>
                </div>
                <div class="answer-option-cell">
                  <div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-760371379">
                    <input id="760371379_5031856407" aria-labelledby="760371379_5031856407_label" name="760371379" type="radio" role="radio" class="radio-button-input " value="5031856407" aria-checked="false">
                    <label data-sm-radio-button-label="" id="760371379_5031856407_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="760371379_5031856407">
                      <span class="radio-button-display ">
                      </span>
                      <span class="radio-button-label-text question-body-font-theme user-generated "> Diabetes specialist educator </span>
                    </label>
                  </div>
                </div>
              </div>
              <div class="other-answer-container other-answer-option-container">
                <div data-sm-radio-button="" class="radio-button-container " aria-labelledby="question-title-760371379">
                  <input id="760371379_5031856408" aria-labelledby="760371379_5031856408_label" name="760371379" type="radio" role="radio" class="radio-button-input " value="5031856408" aria-checked="false" data-other-answer="">
                  <label data-sm-radio-button-label="" id="760371379_5031856408_label" class="answer-label radio-button-label no-touch touch-sensitive clearfix" for="760371379_5031856408">
                    <span class="radio-button-display ">
                    </span>
                    <span class="radio-button-label-text question-body-font-theme user-generated "> Other (please specify) </span>
                  </label>
                </div>
                <input id="760371379_other" name="760371379_other" type="text" class="text other-answer-text" maxlength="20000" size="50" aria-label="Other (please specify)" data-other-text="">
              </div>
            </div>
          </fieldset>
        </div>
      </div>
      <button id="760371379-ok" class="new-button ok-button user-generated notranslate hide" type="submit"> OK </button>
    </div>
  </div>
  <div class="survey-submit-actions center-text clearfix">
    <button type="submit" data-submit-page-button="" class="btn small next-button survey-page-button user-generated notranslate"> NEXT </button>
  </div>
  <input type="hidden" id="survey_data" name="survey_data"
    value="4FoTYerhlqpl9PSGmuD5IVIm_2BE5n_2F1IltluBh9joX3nzqewNjSsoxnpYlsAEfY9XckO_2Buu9p5Zr8RVtkalLWo0FK6OeI3OaZXdtC_2Bvg1SxcYGGG8yET8A8RSFXaXbcMr99qaSxaZgjrzs2_2FRUsiGzxPhFkdXNa0Wcv_2BssG2r3q5_2BiVRnA1qvG8XJa8521UPiPEhtW9PkXWNAHvS9AL7s1YKFx19zrV_2FsARN2J6qXzGOhWkpIxQwRkJRURKyOYHag30dGNkheBVPk_2F3t3BHDtG4Cm0JvOASGOr9_2FmGxVUjsrOGJE7TQCA5UMpypKjv3Rbm6jy50IP7pbJdlj6wvlT5Xf_2FmB9gnQBv76R1xckm1YrsU_2BTc_2FDA4M4tamvVoeE3KzPy3mRiW4s9dz3NF43TTZ_2FzUMmpK5pPSIaug_2B5cWKbpFv3uQitKDkgcgCIZr7fk5DS44ElFMgYl4379pJccQDbrTv7A_2F4qvHQhaOBu_2BJ9LVvGuYGYfNdGGfxMxhOpn5NdrSe9QtcH9sbex7TIwteQnrWmVPQ653WDEvbYJUsz4sIfvOqbLX58Wu0Evt2omxT">
  <input type="hidden" data-response-quality="" id="response_quality_data" name="response_quality_data" value="{}">
  <input type="hidden" id="is_previous" name="is_previous" value="false">
  <input type="hidden" id="disable_survey_buttons_on_submit" name="disable_survey_buttons_on_submit" value="">
</form>

Text Content

HEALTHCARE PROFESSIONALS STUDY IN TAIWAN AND AUSTRALIA





QUESTION TITLE

* 1. CONTACT INFORMATION

Name
Company
City/Town
Country
Linkedin or Social media link
Email Address
Phone Number
OK



QUESTION TITLE

* 2. WHICH ROLE/JOB TITLE BEST DESCRIBES YOU?

Payer
General practitioner (GP)
Diabetologist/Endocrinologist
Diabetes specialist nurse
Diabetes specialist educator
Other (please specify)
OK
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