silverscriptemployerpdp.memberdoc.com
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198.200.137.183
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Submitted URL: https://silverscriptemployerpdp.memberdoc.com/
Effective URL: https://silverscriptemployerpdp.memberdoc.com/login
Submission: On June 17 via api from US — Scanned from DE
Effective URL: https://silverscriptemployerpdp.memberdoc.com/login
Submission: On June 17 via api from US — Scanned from DE
Form analysis
1 forms found in the DOMPOST /login
<form action="/login" method="post"><input name="__RequestVerificationToken" type="hidden" value="QnrMJXZ_qD2hYlGQqhFRtrfi4jjr0HRosejSBD301eavyPy8SKkVCSJu7Ips_o5gRJtYklp3-It4uRayXxknMe4AC4A1">
<div class="form-item">
<label class="form-label dialog-label" for="MemberID">Member ID</label>
<i id="login-info-popover" class="ico-info" data-bs-container="body" data-bs-custom-class="info-popover" data-bs-toggle="popover" data-bs-trigger="hover focus" data-bs-placement="top">
<img src="./Content/Icon/icon_help.svg">
</i>
<input class="form-control dialog-input" data-val="true" data-val-maxlength="Member ID cannot exceed 100 characters. Please re-enter Member ID." data-val-maxlength-max="100" data-val-required="The Member ID field is required." id="MemberID"
name="MemberID" type="text" value="">
<span class="field-validation-valid form-label dialog-label text-danger" data-valmsg-for="MemberID" data-valmsg-replace="true"></span>
</div>
<div class="form-item last-form-item">
<label class="form-label dialog-label" for="ZipCode">Zip Code</label>
<input class="form-control dialog-input" data-val="true" data-val-maxlength="Zip Code cannot exceed 5 characters. Please re-enter Zip Code." data-val-maxlength-max="5" data-val-regex="Please enter a valid Zip Code."
data-val-regex-pattern="([0-9]+)" data-val-required="The Zip Code field is required." id="ZipCode" name="ZipCode" type="text" value="">
<span class="field-validation-valid form-label dialog-label text-danger" data-valmsg-for="ZipCode" data-valmsg-replace="true"></span>
</div>
<div id="help" class="form-text float-right btn-forget">
<a href="javascript:void(0);" id="help-popover" class="ico-info" data-bs-container="body" data-bs-custom-class="info-popover" data-bs-toggle="popover" data-bs-trigger="focus" data-bs-placement="top">Forgot Member ID?</a>
</div>
<input id="hdnLanguage" name="Language" type="hidden" value="en"> <button type="submit" class="btn btn-primary btn-login" id="btn-login">Log in</button>
</form>
Text Content
English Español English Español Plan Portal We've got you covered. Please provide the following information to obtain access to your documents. Member ID Zip Code Forgot Member ID? Log in