www.organroxx.com Open in urlscan Pro
37.97.169.60  Public Scan

Form analysis
1 forms found in the DOM

POST /website_form/

<form action="/website_form/" method="post" data-model_name="crm.lead" data-success_page="/contactus-thank-you" class="s_website_form container-fluid mt32" enctype="multipart/form-data" data-editable-form="false">
  <div class="form-group row form-field o_website_form_required_custom">
    <label class="col-lg-3 col-md-4 col-form-label" for="contact_name">Naam</label>
    <div class="col-lg-7 col-md-8">
      <input type="text" class="form-control o_website_form_input" name="contact_name" required="" value="">
    </div>
  </div>
  <div class="form-group row form-field">
    <label class="col-lg-3 col-md-4 col-form-label" for="phone">Telefoon</label>
    <div class="col-lg-7 col-md-8">
      <input type="text" class="form-control o_website_form_input" name="phone" value="">
    </div>
  </div>
  <div class="form-group row form-field o_website_form_required_custom">
    <label class="col-lg-3 col-md-4 col-form-label" for="email_from">Email</label>
    <div class="col-lg-7 col-md-8">
      <input type="text" class="form-control o_website_form_input" name="email_from" required="" value="">
    </div>
  </div>
  <div class="form-group row form-field o_website_form_required">
    <label class="col-lg-3 col-md-4 col-form-label" for="name">Subject</label>
    <div class="col-lg-7 col-md-8">
      <input type="text" class="form-control o_website_form_input" name="name" required="" value="">
    </div>
  </div>
  <div class="form-group row form-field o_website_form_required_custom">
    <label class="col-lg-3 col-md-4 col-form-label" for="description">Your question</label>
    <div class="col-lg-7 col-md-8">
      <textarea class="form-control o_website_form_input" name="description" required=""></textarea>
    </div>
  </div>
  <div class="form-group row">
    <div class="offset-lg-3 offset-md-4 col-md-8 col-lg-7">
      <a href="#" role="button" class="btn btn-primary btn-lg o_website_form_send">Verzenden</a>
      <span id="o_website_form_result"></span>
    </div>
  </div>
</form>

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