www.helprx.info Open in urlscan Pro
3.230.221.176  Public Scan

Form analysis
14 forms found in the DOM

<form class="pharmacy-form new-pharmacy-form" id="view-form-walmart">
  <input type="text" name="name" class="form-control name-input new-name-input" placeholder="Full Name" value="">
  <input type="email" name="email" class="form-control email-input new-email-input" placeholder="email@domain.com">
  <button type="button" class="btn view-via-walmart-btn new-view-via-walmart-btn">View my free card</button>
</form>

---

<form class="pharmacy-form new-pharmacy-form" id="view-form-cvs">
  <input type="text" name="name" class="form-control name-input new-name-input" placeholder="Full Name" value="">
  <input type="email" name="email" class="form-control email-input new-email-input" placeholder="email@domain.com">
  <button type="button" class="btn view-via-cvs-btn new-view-via-walmart-btn nw-view-via-css-btn">View my free card</button>
</form>

---

<form class="pharmacy-form new-pharmacy-form" id="view-form-other-pharmacy">
  <input type="text" name="name" class="form-control name-input new-name-input" placeholder="Full Name" value="">
  <input type="email" name="email" class="form-control email-input new-email-input" placeholder="email@domain.com">
  <button type="button" class="btn view-via-other-pharmacy-btn new-view-via-other-pharmacy-btn">View my free card</button>
</form>

---

<form class="pharmacy-form new-pharmacy-form" id="print-form-walmart">
  <div>
    <label class="label-txt margin-tp-10">Full Name</label>
    <input type="text" name="name" class="form-control name-input new-name-input" placeholder="Full Name" value="">
  </div>
  <div>
    <label class="label-txt">Email</label>
    <input type="email" name="email" class="form-control email-input new-email-input" placeholder="email@domain.com">
  </div>
  <button type="button" class="btn print-via-walmart-btn new-print-via-walmart-btn">Print my free coupon</button>
</form>

---

<form class="pharmacy-form new-pharmacy-form" id="print-form-cvs">
  <div>
    <label class="label-txt margin-tp-10">Full Name</label>
    <input type="text" name="name" class="form-control name-input new-name-input" placeholder="Full Name" value="">
  </div>
  <div>
    <label class="label-txt">Email</label>
    <input type="email" name="email" class="form-control email-input new-email-input" placeholder="email@domain.com">
  </div>
  <button type="button" class="btn print-via-cvs-btn new-print-via-cvs-btn">Print my free coupon</button>
</form>

---

<form class="pharmacy-form new-pharmacy-form" id="print-form-other-pharmacy">
  <div>
    <label class="label-txt margin-tp-10">Full Name</label>
    <input type="text" name="name" class="form-control name-input new-name-input" placeholder="Full Name" value="">
  </div>
  <div>
    <label class="label-txt">Email</label>
    <input type="email" name="email" class="form-control email-input new-email-input" placeholder="email@domain.com">
  </div>
  <button type="button" class="btn print-via-other-pharmacy-btn new-print-via-cvs-btn">Print my free coupon</button>
</form>

---

<form class="sms-form new-sms-form" id="sms-form">
  <div class="other-pharmacy-full-name">
    <label class="label-txt margin-tp-10">Full Name</label>
    <input type="text" name="name" class="form-control name-input new-name-input" placeholder="Full Name" value="">
  </div>
  <div class="other-pharmacy-email">
    <label class="label-txt email-lbl">Email</label>
    <input type="email" name="email" class="form-control email-input new-email-input" placeholder="email@domain.com">
  </div>
  <div>
    <label class="label-txt margin-tp-10">Phone Number</label>
    <input type="tel" name="number" class="form-control phone-input new-phone-input phone-numbers-only" id="phone-input" placeholder="(123) 456-7891">
  </div>
  <button type="button" class="btn send-to-phone-btn new-send-to-phone-btn send-to-phone-btn-sm">Send</button>
  <input type="hidden" name="coupon_id" class="coupon_id" value="1020"> <!--value is populated by JS (1020 is a place holder)-->
  <input type="hidden" value="SMS" id="event_category">
  <input type="hidden" value="SMS ExitFull Name" id="event_action">
  <input type="hidden" name="sms_status" value="">
  <input type="hidden" name="userinfo_id" value="">
</form>

---

<form class="sms-form pharmacy-form new-pharmacy-form new-sms-form-walmart" id="sms-form-walmart">
  <!--<div>
            <label class="label-txt margin-tp-10">Full Name</label>
            <input type="text" name="name" class="form-control name-input new-name-input" placeholder="Full Name" value="">
          </div>
          <div>
            <label class="label-txt email-lbl">Email</label>
            <input type="email" name="email" class="form-control email-input new-email-input" placeholder="email@domain.com">
          </div>-->
  <div>
    <label class="label-txt">Phone Number</label>
    <input type="tel" name="number" class="form-control phone-input new-phone-input phone-numbers-only" id="phone-input-walmart" placeholder="(123) 456-7891">
  </div>
  <button type="button" class="btn send-to-phone-btn new-send-to-phone-btn">Send</button>
</form>

---

<form class="sms-form pharmacy-form new-pharmacy-form sms-form-cvs" id="sms-form-cvs">
  <!--<div>
            <label class="label-txt margin-tp-10">Full Name</label>
            <input type="text" name="name" class="form-control name-input new-name-input" placeholder="Full Name" value="">
          </div>
          <div>
            <label class="label-txt email-lbl">Email</label>
            <input type="email" name="email" class="form-control email-input new-email-input" placeholder="email@domain.com">
          </div>-->
  <div>
    <label class="label-txt">Phone Number</label>
    <input type="tel" name="number" class="form-control phone-input new-phone-input phone-numbers-only" id="phone-input-cvs" placeholder="(123) 456-7891">
  </div>
  <button type="button" class="btn send-to-phone-btn new-send-to-phone-btn">Send</button>
</form>

---

<form class="new-mail-form email-form new-email-form" id="email-form">
  <div class="other-pharmacy-full-name">
    <label class="label-txt margin-tp-10">Full Name</label>
    <input type="text" name="name" class="form-control name-input new-name-input" placeholder="Full Name" value="">
  </div>
  <div>
    <label class="label-txt margin-tp-10">Email</label>
    <input type="email" name="email" id="email-input" class="form-control email-input new-email-input" placeholder="email@domain.com">
  </div>
  <button type="button" class="btn email-now-btn new-email-now-btn email-now-btn-sm">Send</button>
  <input type="hidden" name="coupon_id" class="coupon_id" value="1020"> <!--value is populated by JS (1020 is a place holder)-->
  <input type="hidden" name="userinfo_id" value="">
  <input type="hidden" value="Email" id="event_category">
  <input type="hidden" value="wallgreen" id="pharmacy_name" name="pharmacy_name">
  <input type="hidden" value="Email Exit" id="event_action">
</form>

---

<form class="email-form pharmacy-form new-pharmacy-form new-email-form-walmart new-mail-form" id="email-form-walmart">
  <!--<div>
            <label class="label-txt margin-tp-10">Full Name</label>
            <input type="text" name="name" class="form-control name-input new-name-input" placeholder="Full Name" value="">
          </div>-->
  <div>
    <label class="label-txt">Email</label>
    <input type="email" name="email" id="email-input-walmart" class="form-control email-input new-email-input" placeholder="email@domain.com">
  </div>
  <button type="button" class="btn email-now-btn new-email-now-btn">Send</button>
</form>

---

<form class="email-form pharmacy-form new-pharmacy-form new-mail-form new-email-form-cvs" id="email-form-cvs">
  <!--<div>
            <label class="label-txt margin-tp-10">Full Name</label>
            <input type="text" name="name" class="form-control name-input new-name-input" placeholder="Full Name" value="">
          </div>-->
  <div>
    <label class="label-txt">Email</label>
    <input type="email" name="email" id="email-input-cvs" class="form-control email-input new-email-input" placeholder="email@domain.com">
  </div>
  <button type="button" class="btn email-now-btn new-email-now-btn">Send</button>
</form>

---

POST /discounts

<form id="search_form" method="POST" action="/discounts">
  <input type="text" name="search" placeholder="Enter your drug name here" id="discount_sphinx_search" style=" height: 16px; " class="ui-autocomplete-input" autocomplete="off" role="textbox" aria-autocomplete="list" aria-haspopup="true">
  <input type="submit" value="" name="btnSubmit" style="margin: 3px 0 0 -2px;height: 45px; display: block; background: url('/assets/homepage.png') no-repeat scroll -214px 0px transparent; position: relative; padding: 0px; width: 145px;">
</form>

---

GET /conditions

<form action="/conditions" method="GET" id="conditions_search_form">
  <select name="condition_search" id="condition_search" rel="field2">
    <option value="">Enter your condition name here</option>
    <option value="adhd">ADHD</option>
    <option value="als">ALS</option>
    <option value="acne">Acne</option>
    <option value="addiction-substance-abuse">Addiction/Substance Abuse</option>
    <option value="aging">Aging</option>
    <option value="allergies">Allergies</option>
    <option value="anemia">Anemia</option>
    <option value="anemia--2">Anemia</option>
    <option value="angina--2">Angina</option>
    <option value="angina-pectoris">Angina Pectoris</option>
    <option value="2">Antibiotics</option>
    <option value="anxiety">Anxiety</option>
    <option value="arthritis">Arthritis</option>
    <option value="asthma">Asthma</option>
    <option value="bacterial-infection">Bacterial Infection</option>
    <option value="bipolar-disorder">Bipolar Disorder</option>
    <option value="birth-control">Birth Control</option>
    <option value="bladder-prostate">Bladder &amp; Prostate</option>
    <option value="cancer">Cancer</option>
    <option value="depression">Depression</option>
    <option value="diabetes">Diabetes</option>
    <option value="ear-infections">Ear Infections</option>
    <option value="28">Epilepsy</option>
    <option value="epilepsy">Epilepsy </option>
    <option value="erectile-dysfunction">Erectile Dysfunction</option>
    <option value="eye-care">Eye Care</option>
    <option value="fatigue">Fatigue</option>
    <option value="fertility">Fertility</option>
    <option value="fungal-infection">Fungal Infection</option>
    <option value="hiv-aids">HIV &amp; AIDS</option>
    <option value="hair-loss">Hair Loss</option>
    <option value="headache-migraine">Headache Migraine</option>
    <option value="heart-health">Heart Health</option>
    <option value="heartburn-digestion">Heartburn &amp; Digestion</option>
    <option value="high-blood-pressure">High Blood Pressure</option>
    <option value="infection">Infection</option>
    <option value="inflammation">Inflammation</option>
    <option value="lyme-disease">Lyme Disease</option>
    <option value="multiple-sclerosis">Multiple Sclerosis</option>
    <option value="muscle-pain">Muscle Pain</option>
    <option value="muscle-spasms">Muscle Spasms</option>
    <option value="nausea">Nausea</option>
    <option value="nausea--2">Nausea</option>
    <option value="newborn">Newborn</option>
    <option value="ocd">OCD</option>
    <option value="oral-care-dental-care">Oral Care/Dental Care</option>
    <option value="pain">Pain</option>
    <option value="parkinsons">Parkinsons</option>
    <option value="pet-medicine">Pet Medicine</option>
    <option value="stds">STDs</option>
    <option value="schizophrenia">Schizophrenia</option>
    <option value="skin-care">Skin Care</option>
    <option value="sleep-help">Sleep Help</option>
    <option value="stroke">Stroke</option>
    <option value="thyroid">Thyroid</option>
    <option value="type-2-diabetes">Type 2 Diabetes</option>
    <option value="weight-loss-diet">Weight Loss &amp; Diet</option>
  </select>
  <input type="submit" value="" name="btnSubmit" style="margin: 3px 0 0 -2px;height: 45px; display: block; background: url('/assets/homepage.png') no-repeat scroll -214px 0px transparent; position: relative; padding: 0px; width: 145px;">
</form>

---

Text Content

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YOUR SOURCE FOR PRESCRIPTION SAVINGS COUPONS

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 * Drug Search
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Search our prescription discounts by condition. We offer drugs for many chronic
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Enter your condition name hereADHD ALS Acne Addiction/Substance Abuse Aging
Allergies Anemia Anemia Angina Angina Pectoris Antibiotics Anxiety Arthritis
Asthma Bacterial Infection Bipolar Disorder Birth Control Bladder & Prostate
Cancer Depression Diabetes Ear Infections Epilepsy Epilepsy Erectile Dysfunction
Eye Care Fatigue Fertility Fungal Infection HIV & AIDS Hair Loss Headache
Migraine Heart Health Heartburn & Digestion High Blood Pressure Infection
Inflammation Lyme Disease Multiple Sclerosis Muscle Pain Muscle Spasms Nausea
Nausea Newborn OCD Oral Care/Dental Care Pain Parkinsons Pet Medicine STDs
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ABOUT HELPRX.INFO

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ABOUT

HelpRx.info is a trusted provider of prescription discounts, drug coupons and a
prescription discount card. Our prescription discounts are pre-activated,
ready-to-use and free. We have provided our cardholders with over $1,000,000,000
in savings. We will never charge you a fee for our discounts or our prescription
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HOW

Through the power of prescription discount programs, we can offer you
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WHERE

Our prescription discounts, prescription drug coupons and prescription discount
cards can be used at virtually every pharmacy nationwide. Additionally, if your
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OTHER INFO

If you have additional questions about our prescription discounts, drug coupons
and discount card, please visit our FAQ page or contact us. We are here to help
you get the best prescription drug prices and to make your prescription costs
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$1,000,000,000. We hope to make your health and wellness more affordable too.





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This is not insurance: Pricing may be lower than your health insurance co-pay,
but it cannot be used to lower your co-pay. Ask your pharmacist to help you find
the best possible price. This coupon cannot be used in conjunction with
Medicare, Medicaid, or any government-funded program


All Rights Reserved. Pharmacy names, logos, brands, and other trademarks are the
property of their respective owners. Use of them does not imply any affiliation
with or endorsement by them.


ABOUT OUR SAVINGS:

HelpRx.info is a discount pharmacy service, partnered with a leading pharmacy
benefit manager. We negotiate lower prices on prescription medications, that we
pass on to our members for free. There is no cost to use our cards and coupon,
and anyone can take advantage of our discounts, regardless of healthcare
coverage.

Our savings assurance of “up to 75% off” comes from historical data from actual
claims. This data includes savings for both brand name and generic medications.

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