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auth.rxsavingssolutions.com Open in urlscan Pro
2600:9000:2269:2800:15:18e0:a40:93a1  Public Scan

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Submitted URL: https://protect-us.mimecast.com/s/XrYpCG6YKwhnyKxxflu8s0?domain=click.salesforce.rxsavingssolutions.com
Effective URL: https://auth.rxsavingssolutions.com/activate?utm_campaign=email-1&utm_content=employer&utm_medium=email&utm_source=launch
Submission: On May 10 via api from US — Scanned from US

Form analysis 1 forms found in the DOM

<form data-v-4e670d42="" autocomplete="off" novalidate="novalidate" data-v-d412be70="">
  <div data-v-4e670d42="" class="leading-6 mb-4">Please enter your last name and date of birth so we can confirm your account. <div data-v-4e670d42="" class="tooltip">
      <div aria-describedby="tooltip" class="inline-block" aria-expanded="false"><svg data-v-4e670d42="" aria-hidden="true" focusable="false" data-prefix="far" data-icon="info-circle" role="img" xmlns="http://www.w3.org/2000/svg"
          viewBox="0 0 512 512" class="tooltip-trigger cursor-pointer svg-inline--fa fa-info-circle fa-w-16" data-testid="popover-trigger">
          <path fill="currentColor"
            d="M256 8C119.043 8 8 119.083 8 256c0 136.997 111.043 248 248 248s248-111.003 248-248C504 119.083 392.957 8 256 8zm0 448c-110.532 0-200-89.431-200-200 0-110.495 89.472-200 200-200 110.491 0 200 89.471 200 200 0 110.53-89.431 200-200 200zm0-338c23.196 0 42 18.804 42 42s-18.804 42-42 42-42-18.804-42-42 18.804-42 42-42zm56 254c0 6.627-5.373 12-12 12h-88c-6.627 0-12-5.373-12-12v-24c0-6.627 5.373-12 12-12h12v-64h-12c-6.627 0-12-5.373-12-12v-24c0-6.627 5.373-12 12-12h64c6.627 0 12 5.373 12 12v100h12c6.627 0 12 5.373 12 12v24z"
            class=""></path>
        </svg></div>
    </div>
  </div>
  <div data-v-4e670d42="" class="flex flex-col">
    <div data-v-43658b79="" data-v-4e670d42="" class="flex flex-col"><label data-v-43658b79="" for="lastName" class="mb-1 font-family-bold font-bold leading-6">
        <div data-v-43658b79="" class="flex flex-row justify-between"><span data-v-43658b79="" data-testid="Last Name">Last Name</span><span data-v-43658b79="" data-testid="card-helper-link"
            class="helper-link font-family-regular justify-end lg:hidden"></span></div>
      </label>
      <div data-v-43658b79="" class="relative flex flex-col"><input data-v-bc26e9b8="" data-v-4e670d42="" type="text" id="lastName" tabindex="10" required="required" data-private=""
          class="border rounded md:rounded-lg text-input px-2 min-h-inputField mb-6" data-v-43658b79=""><!----><!----><!----></div>
    </div>
    <div data-v-43658b79="" data-v-4e670d42="" class="flex flex-col"><label data-v-43658b79="" for="dateOfBirth" class="mb-1 font-family-bold font-bold leading-6">
        <div data-v-43658b79="" class="flex flex-row justify-between"><span data-v-43658b79="" data-testid="Date of Birth">Date of Birth</span><span data-v-43658b79="" data-testid="card-helper-link"
            class="helper-link font-family-regular justify-end lg:hidden"></span></div>
      </label>
      <div data-v-43658b79="" class="relative flex flex-col"><input data-v-3cbc3e33="" data-v-4e670d42="" inputmode="numeric" placeholder="MM/DD/YYYY" id="dateOfBirth" tabindex="20" type="text" required="required" data-private=""
          class="border rounded-lg text-input px-2 w-32 min-h-inputField mb-6" data-v-43658b79=""><!----><!----><!----><!----></div>
    </div>
    <div data-v-8c87fac0="" data-v-4e670d42="" class="leading-6 flex-row mb-6 ml-4"><label data-v-8c87fac0="" class="cursor-pointer relative block"><label data-v-058750de="" data-v-8c87fac0="" for="terms"
          class="checkbox-container floating-checkbox mt-1"><input data-v-058750de="" type="checkbox" id="terms" data-testid="terms" tabindex="30" class="form-check-input" value="false"><span data-v-058750de="" class="checkbox"></span></label><span
          data-v-8c87fac0="" class="label pl-2">I have read, understand and agree to the <a class="link underline" target="_blank" href="https://rxsavingssolutions.com/terms-and-conditions">Terms and Conditions</a> and the
          <a class="link underline" target="_blank" href="https://rxsavingssolutions.com/privacy-policy">Privacy Policy</a>.</span></label></div><!----><button data-v-4e670d42=""
      class="w-button font-normal text-ml leading-6 BaseButton max-w-2xl px-4 py-2 w-24 pendo-activation-eligibility-step" type="submit" tabindex="40"><span>Next</span><!----></button>
  </div>
  <div data-v-4e670d42="" class="w-full pr-20 mt-12 mb-6 bottom-0">
    <hr data-v-4e670d42="" class="mb-4 horizontal-rule">
    <a data-v-4e670d42="" href="/" class="router-link-active"><button data-v-d248d31a="" data-v-4e670d42="" type="button" class="underline base-link-button pendo-log-in-instead-link" tabindex="50">Log In Instead </button></a>
  </div>
</form>

Text Content

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Please enter your last name and date of birth so we can confirm your account.

Last Name

Date of Birth

I have read, understand and agree to the Terms and Conditions and the Privacy
Policy.
Next

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