purerx.pharmetika.com Open in urlscan Pro
50.31.172.20  Public Scan

Form analysis
4 forms found in the DOM

POST /login

<form accept-charset="utf-8" action="/login" id="login_form" method="post" class="form-signin" role="form" onsubmit="requestAnimationFrame(() => document.getElementById('original_request_url').value=null)">
  <h3><strong>Sign in</strong> to your account</h3>
  <div class="append-icon">
    <input type="text" name="userID" id="userID" class="form-control form-white username" placeholder="Username" required="">
    <i class="icon-user"></i>
  </div>
  <div class="append-icon m-b-20">
    <input type="password" name="password" class="form-control form-white password" placeholder="Password" required="">
    <i class="icon-lock"></i>
  </div>
  <button type="submit" id="submit-form" class="btn btn-lg btn-dark btn-rounded ladda-button" data-style="expand-left">Sign In</button>
  <span class="forgot-password"><a href="/login/password/forgot">Reset Password?</a></span>
</form>

POST /login

<form accept-charset="utf-8" action="/login" id="login_form" method="post" class="form-signin" role="form">
  <h3><strong>Scan</strong> Key</h3>
  <div class="append-icon m-b-20">
    <input type="password" name="key" autocomplete="off" class="form-control form-white password" placeholder="Scan" required="">
    <i class="fal fa-qrcode" aria-hidden="true"></i>
  </div>
  <button type="submit" id="submit-form" class="btn btn-lg btn-dark btn-rounded ladda-button" data-style="expand-left">Sign In</button>
</form>

GET /provider_access/login

<form accept-charset="utf-8" action="/provider_access/login" id="provider_access_login_form" method="get" class="form-signin" role="form">
  <h3><strong>Practitioner</strong> Login</h3>
  <button type="submit" id="submit-form" class="btn btn-lg btn-dark btn-rounded ladda-button" data-style="expand-left">Sign In</button>
</form>

<form class="form-password" role="form">
  <h3><strong>Reset</strong> your password</h3>
  <div class="append-icon m-b-20">
    <input type="text" name="name" id="name" class="form-control form-white username" placeholder="Username" required="">
    <i class="icon-lock"></i>
  </div>
  <button type="submit" id="submit-password" class="btn btn-lg btn-danger btn-block ladda-button" data-style="expand-left">Send Password Reset Link</button>
  <div class="clearfix m-t-60">
    <p class="pull-left m-t-20 m-b-0"><a id="login" href="#">Have an account? Sign In</a></p>
    <!--                         <p class="pull-right m-t-20 m-b-0"><a href="/user-signup2.html">New here? Sign up</a></p> -->
  </div>
</form>

Text Content

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