garrettstrongadvising.site Open in urlscan Pro
2606:4700:3037::ac43:91b2  Public Scan

Form analysis
2 forms found in the DOM

POST /create-contact.php

<form class="form-all-item" id="contact-form" action="/create-contact.php" method="post">
  <fieldset>
    <div class="mb-3">
      <input type="text" class="form-control" name="name" id="name" placeholder="Full name">
    </div>
    <div class="mb-3">
      <input type="email" class="form-control" name="email" id="email" placeholder="Email address">
    </div>
    <div class="mb-3">
      <input type="text" class="form-control" name="dob" id="dob" placeholder="Your Date of Birth">
    </div>
    <div class="mb-3">
      <input type="text" class="form-control" name="state" id="state" placeholder="Your State">
    </div>
    <div class="mb-3">
      <input type="text" class="form-control" name="city" id="city" placeholder="Your City">
    </div>
    <div class="mb-3">
      <input type="text" class="form-control" name="phone_number" id="phone" placeholder="Phone number">
      <div>
        <textarea class="form-control" rows="3" name="street" id="street" placeholder="Your street"></textarea>
      </div>
    </div>
    <div class="mb-3">
      <input type="checkbox" name="agreement" value="1"> I agree , By submitting my cell phone number to receive automated sms/mms messages with more information or quote from GARRETT STRONG ADVISING. Message frequency may vary. Reply STOP to cancel,
      Reply HELP for contact information. message and date rates may apply <a href="terms-conditions.html">Terms &amp; Conditions</a> | <a href="privacy-policy.html">Privacy Policy</a>
    </div>
    <button class="btnn btnn-primary contact-btn">Send</button>
  </fieldset>
</form>

POST /opt-contact.php

<form method="POST" action="/opt-contact.php">
  <div class="modal-body">
    <label>Phone Number</label>
    <input type="text" class="form-control" placeholder="Phone" name="ph" required="">
  </div>
  <div class="modal-footer">
    <button type="button" class="btn btn-secondary closeModalButton">Close</button>
    <button type="submit" class="btn btn-primary">Submit</button>
  </div>
</form>

Text Content

GARRETT STRONG ADVISING

 * Home
 * Terms Conditions
 * Privacy Policy


 * Home
 * About
 * Project
 * Blog
 * Contact




JAMELL GARRETT

I am a licensed healthcare agent and I help families and individuals explore the
right affordable health coverage packages to secure a health plan that fit their
needs best..

Scroll Down
to Explore




What is will do for you

EXPLORE OUR OFFERINGS

HEALTH INSURANCE PLANS

Let us help you find the perfect health insurance plan for your family's needs
and budget.

AFFORDABLE COVERAGE OPTIONS

We offer a variety of affordable coverage options to fit your specific
healthcare needs and budget.

PERSONALIZED HEALTH COVERAGE

Our licensed healthcare agents will work with you one-on-one to find the best
personalized health coverage package for you and your loved ones.





Get in touch

CONTACT OUR TEAM

DROP ME A LINE.

I agree , By submitting my cell phone number to receive automated sms/mms
messages with more information or quote from GARRETT STRONG ADVISING. Message
frequency may vary. Reply STOP to cancel, Reply HELP for contact information.
message and date rates may apply Terms & Conditions | Privacy Policy
Send

+18135325998

JJGarrett2125@gmail.com



UNSUBSCRIBE

X
Phone Number
Close Submit
Copyright © 2024 — GARRETT STRONG ADVISING All Rights Reserved.
Unsubscribe
Light Dark