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Form analysis
2 forms found in the DOM

<form> <select name="help" id="help">
    <option value="" selected="">How can we help?</option>
    <option value="support">User Support</option>
    <option value="presales">Sales Inquiry</option>
    <option value="media">Media Inquiry</option>
  </select></form>

Name: Media Inquiry Form — POST

<form class="elementor-form" method="post" name="Media Inquiry Form"> <input type="hidden" name="post_id" value="577"> <input type="hidden" name="form_id" value="26eb463"> <input type="hidden" name="referer_title"
    value="Contact Us - Primary.Health Vaccination &amp; Testing Solutions"> <input type="hidden" name="queried_id" value="577">
  <div class="elementor-form-fields-wrapper elementor-labels-above">
    <div class="elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-100"> <label for="form-field-name" class="elementor-field-label"> Name </label> <input size="1" type="text"
        name="form_fields[name]" id="form-field-name" class="elementor-field elementor-size-sm  elementor-field-textual"></div>
    <div class="elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-100 elementor-field-required"> <label for="form-field-email" class="elementor-field-label"> Email </label> <input size="1"
        type="email" name="form_fields[email]" id="form-field-email" class="elementor-field elementor-size-sm  elementor-field-textual" required="required" aria-required="true"></div>
    <div class="elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-message elementor-col-100"> <label for="form-field-message" class="elementor-field-label"> Message </label><textarea
        class="elementor-field-textual elementor-field  elementor-size-sm" name="form_fields[message]" id="form-field-message" rows="4"></textarea></div>
    <div class="elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_f027d54 elementor-col-100"> <label for="form-field-field_f027d54" class="elementor-field-label"> Subject </label> <input size="1" type="text"
        name="form_fields[field_f027d54]" id="form-field-field_f027d54" class="elementor-field elementor-size-sm  elementor-field-textual"></div>
    <div class="elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons"> <button type="submit" class="elementor-button elementor-size-sm"> <span> <span class=" elementor-button-icon"> </span> <span
            class="elementor-button-text">Submit</span> </span> </button></div>
  </div>
</form>

Text Content

 * About
   * About Primary
   * Clients
   * Testimonials
   * Careers
 * Platform
 * Services
   * Academic Research
   * California Testing & Vaccination Program
   * COVID-19 Testing & Vaccination
   * Employer Testing & Vaccine Verification
   * Providers and Labs
   * School Rapid Testing
   * Vaccine Verification
 * Resources
   * Blog
   * Events
   * CA Schools COVID-19 Testing – Parents
   * CA Schools COVID-19 Testing – Schools
   * Our Research
   * News
   * Press Resources
 * Contact Us
 * Request a Demo
 * Administrator Login

Menu
 * About
   * About Primary
   * Clients
   * Testimonials
   * Careers
 * Platform
 * Services
   * Academic Research
   * California Testing & Vaccination Program
   * COVID-19 Testing & Vaccination
   * Employer Testing & Vaccine Verification
   * Providers and Labs
   * School Rapid Testing
   * Vaccine Verification
 * Resources
   * Blog
   * Events
   * CA Schools COVID-19 Testing – Parents
   * CA Schools COVID-19 Testing – Schools
   * Our Research
   * News
   * Press Resources
 * Contact Us
 * Request a Demo
 * Administrator Login

This icon serves as a link to download the eSSENTIAL Accessibility assistive
technology app for individuals with physical disabilities. It is featured as
part of our commitment to diversity and inclusion.


CONTACT US


USER SUPPORT

For technical or customer support


SALES

Technology solutions for your COVID-19 testing or vaccination program


MEDIA

For media or press inquiries

How can we help?User SupportSales InquiryMedia Inquiry
Name
Email
Message
Subject
Submit

Brought to you by Primary Health


ARE YOU INQUIRING ABOUT SETTING UP A TEST OR VACCINE FOR YOURSELF OR YOUR
FAMILY?

Yes, I need to set up an appointment No, I have a sales inquiry
Looking to make a difference?
Work With Us

Primary Diagnostics, Inc.
595 Pacific Ave Floor 4
San Francisco, CA 94133

1-855-970-3223

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COMPANY

 * About
 * News
 * Careers
 * Research
 * Contact


SERVICES

 * Product
 * Clients
 * Schools
 * Features


SOFTWARE

 * Terms of Service
 * Privacy Policy
 * Administrator Login
 * Accessibility Policy


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