www.healthyhomecommunity.com Open in urlscan Pro
2606:4700:3037::6815:52b7  Public Scan

Form analysis
1 forms found in the DOM

POST https://www.healthyhomecommunity.com/forms/291305/form_submissions

<form data-parsley-validate="true" data-kjb-disable-on-submit="true" action="https://www.healthyhomecommunity.com/forms/291305/form_submissions" accept-charset="UTF-8" method="post" novalidate=""><input name="utf8" type="hidden" value="✓"><input
    type="hidden" name="authenticity_token" value="LFDAIpOzYMIFkWM+hKESCcH2F/iKXk5itgure2TTUMUSETIkYQvVJv+br86uiXztIpdpOEmCgTMxx1S9IrMYOQ=="><input type="text" name="website_url" autofill="off" placeholder="Skip this field" style="display: none;"
    data-parsley-id="7183">
  <ul class="parsley-errors-list" id="parsley-id-7183"></ul><input type="hidden" name="kjb_fk_checksum" autofill="off" value=""><input type="hidden" name="form_submission[landing_page_id]" value="2148512426" autofill="off">
  <div class="fields-wrapper">
    <input type="hidden" name="thank_you_url" value="">
    <div class="text-field form-group"><input type="text" name="form_submission[name]" id="form_submission_name" value="" required="required" class="form-control" placeholder="First Name" data-parsley-id="2039">
      <ul class="parsley-errors-list" id="parsley-id-2039"></ul>
    </div>
    <div class="email-field form-group"><input required="required" class="form-control" placeholder="Email" data-parsley-remote="true" data-parsley-remote-validator="kjb_email_validator" type="email" name="form_submission[email]"
        id="form_submission_email" data-parsley-id="2676">
      <ul class="parsley-errors-list" id="parsley-id-2676"></ul>
    </div>
    <div class="recaptcha-field form-group">
      <div>
        <script src="https://www.google.com/recaptcha/api.js?onload=recaptchaInit_966C95&amp;render=explicit" async="" defer=""></script>
        <input id="recaptcha_966C95" type="text" name="g-recaptcha-response-data" data-parsley-id="2203">
        <ul class="parsley-errors-list" id="parsley-id-2203"></ul>
        <div id="recaptcha_966C95_container" class="recaptcha-container">
          <div class="grecaptcha-badge" data-style="bottomright"
            style="width: 256px; height: 60px; display: block; transition: right 0.3s ease 0s; position: fixed; bottom: 14px; right: -186px; box-shadow: gray 0px 0px 5px; border-radius: 2px; overflow: hidden;">
            <div class="grecaptcha-logo"><iframe title="reCAPTCHA" width="256" height="60" role="presentation" name="a-c8yg3ygkpemn" frameborder="0" scrolling="no"
                sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
                src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6Lc_Wc0pAAAAAF53oyvx7dioTMB422PcvOC-vMgd&amp;co=aHR0cHM6Ly93d3cuaGVhbHRoeWhvbWVjb21tdW5pdHkuY29tOjQ0Mw..&amp;hl=de&amp;v=Xv-KF0LlBu_a0FJ9I5YSlX5m&amp;size=invisible&amp;cb=dtqonttkba5e"></iframe>
            </div>
            <div class="grecaptcha-error"></div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
              style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
          </div><iframe style="display: none;"></iframe>
        </div>
        <style type="text/css">
          .recaptcha-field {
            position: absolute;
            width: 0px;
            height: 0px;
            overflow: hidden;
            z-index: 10;
          }
        </style>
        <script type="text/javascript">
          window.recaptchaInit_966C95 = function() {
            initKajabiRecaptcha("recaptcha_966C95", "recaptcha_966C95_container", "6Lc_Wc0pAAAAAF53oyvx7dioTMB422PcvOC-vMgd");
          };
        </script>
      </div>
    </div>
    <div>
      <button id="form-button" class="form-btn btn--solid btn--auto btn--medium" type="submit" kjb-settings-id="sections_1606331107149_blocks_1606331107149_1_settings_btn_text" role="button"> Submit </button>
    </div>
  </div>
</form>

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