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104.111.240.138  Public Scan

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5 forms found in the DOM

<form class="form store-locator__search__form" novalidate="novalidate">
  <div class="form__group">
    <input type="text" class="form__input" id="store-locator-search" name="store-locator-search" aria-label="Enter Address" required="">
    <a href="#"><i class="ra-icon ra-icon-location ra-icon-location-dims store-locator__search__icon"><span class="sr-only">Current Location</span></i></a>
  </div>
  <div class="store-locator__search__btn clearfix">
    <button class="cmp-button btn-rounded btn-bordered color-cerulean" type="submit" role="button">
      <span class="cmp-button__text find_stores">Find Stores</span>
    </button>
  </div>
</form>

---

<form class="form store-locator__schedule__form">
  <div class="store-locator__schedule__inputs">
    <div class="form__group">
      <span class="label color-slate-grey">Pick-Up Date (MM/DD/YYYY)</span>
      <div class="store-locator__schedule__icon-input">
        <i class="fal fa-calendar color-peacock-blue"><span class="sr-only">Pick Up Date</span></i>
        <div>
          <input data-toggle="datepicker" class="form__input" id="store-locator-pickup-date" name="store-locator-pickup-date" autocomplete="off" required="">
        </div>
      </div>
    </div>
    <div class="form__group">
      <span class="label color-slate-grey">Time</span>
      <div class="store-locator__schedule__icon-input">
        <div>
          <input data-toggle="timepicker" class="form__input" id="store-locator-pickup-time" name="store-locator-pickup-time" type="text" autocomplete="off" required="">
        </div>
      </div>
    </div>
  </div>
  <div class="store-locator__schedule__error-template" data-template-id="search-schedule-form-error"></div>
  <div class="store-locator__schedule__btns">
    <button id="store-locator-cancel" class="cmp-button btn-rounded btn-bordered color-cerulean store-locator__cancel-trigger" type="button" role="button">
      <span class="cmp-button__text">Cancel</span>
    </button>
    <button id="store-locator-submit" class="store-locator__schedule__submit-btn cmp-button btn-rounded background-green color-white" type="button" role="button" data-analytics-track="true" data-analytics-confirm="confirm selection" disabled="">
      <span class="cmp-button__text">Confirm Selection</span>
      <i class="fas fa-chevron-right"></i>
    </button>
  </div>
</form>

---

GET /shop/catalogsearch/result/

<form class="cx-header-menu__search-form" action="/shop/catalogsearch/result/" method="get">
  <label for="cx-header-menu__search-textbox" class="sr-only">Search</label>
  <input class="cx-header-menu__search-textbox rfk_sb" id="cx-header-menu-search-textbox" name="q" type="search" placeholder="Search"
    aria-label="Quick search is available for terms that you search. Press ESC to close Quick search, or press TAB to navigate through search results" data-rfkid="rfkid_6" autocorrect="off" spellcheck="false" aria-live="assertive" data-tdi="0"
    autocomplete="off">
  <button class="background-green color-white cx-header-menu__search-handle" aria-label="Zip code Search button" tabindex="0">
    <i class="ra-icon ra-icon-cx-search"></i>
  </button>
</form>

---

<form class="form login-signup__loginform" novalidate="novalidate">
  <div class="login-signup__loginfields" data-template-id="login-template"></div>
  <input class="g-recaptcha" type="hidden" name="captchatoken" size="1" value="">
  <!-- validation message login -->
  <div class="text login-signup__validation" id="login-messages" data-template-id="login-signup-validation-template"></div>
  <div class="login-signup__login-btns clearfix" data-template-id="login-signup-buttons-template"></div>
</form>

---

<form class="form login-signup__signupform" novalidate="novalidate">
  <div class="login-signup__wellness-fields" data-template-id="wellness-signup-template"></div>
  <div class="login-signup__pharmacy-fields" data-template-id="pharmacy-signup-template"></div>
  <div class="login-signup__security-questions-fields" data-template-id="signup-security-questions-template"></div>
  <div class="login-signup__prescription-holder" data-template-id="prescription-holder-template"></div>
  <div class="login-signup__wellness-only-signup" data-template-id="wellness-only-signup-template"></div>
  <div class="login-signup__wellness-communication" data-template-id="wellness-communication-template"></div>
  <input class="g-recaptcha" type="hidden" name="captchatoken" size="1" value="">
  <!-- validation message signup -->
  <div class="text login-signup__validation" id="signup-messages" data-template-id="login-signup-validation-template"></div>
  <div class="login-signup__login-btns clearfix" data-template-id="login-signup-buttons-template"></div>
  <div class="text login-signup__pharmacy-msg" data-template-id="login-signup__pharmacy-msg-template"></div>
  <!--<div class="text login-signup__without-pharmacy-lbl" data-template-id="login-signup__without-pharmacy-template"></div>-->
</form>

---

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ONLINE PHARMACY AND STORE | RITE AID

Stay informed on coronavirus Learn more

 * COVID-19 VACCINE UPDATES
   
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