www.patientpoint.com Open in urlscan Pro
2606:4700::6811:4932  Public Scan

Form analysis
2 forms found in the DOM

GET /search

<form action="/search" method="get" id="views-exposed-form-search-page-1" accept-charset="UTF-8" data-once="form-updated" data-drupal-form-fields="edit-site-search">
  <div class="form--inline PPSearch clearfix">
    <div class="close-mobile-search"></div>
    <div class="js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-site-search form-item-site-search search-wrap">
      <label for="edit-site-search" class="search-label">Search</label>
      <input placeholder="Search" class="site-search-input form-text" data-drupal-selector="edit-site-search" type="text" id="edit-site-search" name="site-search" value="" size="30" maxlength="128">
    </div>
    <div data-drupal-selector="edit-actions" class="form-actions js-form-wrapper form-wrapper" id="edit-actions--3"><input class="site-search-button button js-form-submit form-submit" data-drupal-selector="edit-submit-search" type="submit"
        id="edit-submit-search" value="Search">
    </div>
  </div>
</form>

POST /

<form
  class="webform-submission-form webform-submission-add-form webform-submission-general-contact-short-webform-form webform-submission-general-contact-short-webform-add-form webform-submission-general-contact-short-webform-block_content-4636-form webform-submission-general-contact-short-webform-block_content-4636-add-form webform-submission-general-contact-short-webform-block-content-4636-add-form js-webform-details-toggle webform-details-toggle"
  data-drupal-selector="webform-submission-general-contact-short-webform-block-content-4636-add-form" action="/" method="post" id="webform-submission-general-contact-short-webform-block-content-4636-add-form" accept-charset="UTF-8"
  data-once="form-updated" data-drupal-form-fields="edit-first-name,edit-last-name,edit-email,edit-organization-provider,edit-organization-agency,edit-organization-local,edit-organization-other,edit-actions-submit,edit-url">
  <div class="form-client-provider textGrp clearfix js-form-wrapper form-wrapper" data-drupal-selector="edit-text-grp" id="edit-text-grp">
    <div class="js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-first-name form-item-first-name">
      <label for="edit-first-name" class="js-form-required form-required">First Name</label>
      <input class="textBox form-text required" data-webform-required-error="&quot;First Name&quot; is a required field." data-drupal-selector="edit-first-name" type="text" id="edit-first-name" name="first_name" value="" size="60" maxlength="255"
        required="required" aria-required="true">
    </div>
    <div class="js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-last-name form-item-last-name">
      <label for="edit-last-name" class="js-form-required form-required">Last Name</label>
      <input class="textBox form-text required" data-webform-required-error="&quot;Last Name&quot; is a required field." data-drupal-selector="edit-last-name" type="text" id="edit-last-name" name="last_name" value="" size="60" maxlength="255"
        required="required" aria-required="true">
    </div>
    <div class="js-form-item form-item js-form-type-email form-type-email js-form-item-email form-item-email">
      <label for="edit-email" class="js-form-required form-required">Email</label>
      <input class="textBox form-email required" data-webform-required-error="&quot;Email&quot; is a required field." data-drupal-selector="edit-email" type="email" id="edit-email" name="email" value="" size="60" maxlength="254" required="required"
        aria-required="true">
    </div>
  </div>
  <fieldset data-drupal-selector="edit-radio-grp" id="edit-radio-grp" class="js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper">
    <legend>
      <span class="visually-hidden fieldset-legend">Radio Group</span>
    </legend>
    <div class="fieldset-wrapper">
      <div class="radioItem radios--wrapper fieldgroup form-composite js-form-wrapper form-wrapper" data-drupal-selector="edit-organization" id="edit-organization--wrapper">
        <div id="edit-organization" class="js-webform-radios webform-options-display-side-by-side form-radios">
          <div class="js-form-item form-item js-form-type-radio form-type-radio js-form-item-organization form-item-organization">
            <input class="radioItem form-radio" data-drupal-selector="edit-organization-provider" type="radio" id="edit-organization-provider" name="organization" value="provider">
            <label for="edit-organization-provider" class="option">Healthcare Provider</label>
          </div>
          <div class="js-form-item form-item js-form-type-radio form-type-radio js-form-item-organization form-item-organization">
            <input class="radioItem form-radio" data-drupal-selector="edit-organization-agency" type="radio" id="edit-organization-agency" name="organization" value="agency">
            <label for="edit-organization-agency" class="option">Brand &amp; Agency Partners</label>
          </div>
          <div class="js-form-item form-item js-form-type-radio form-type-radio js-form-item-organization form-item-organization">
            <input class="radioItem form-radio" data-drupal-selector="edit-organization-local" type="radio" id="edit-organization-local" name="organization" value="local">
            <label for="edit-organization-local" class="option">Local Healthcare Business</label>
          </div>
          <div class="js-form-item form-item js-form-type-radio form-type-radio js-form-item-organization form-item-organization">
            <input class="radioItem form-radio" data-drupal-selector="edit-organization-other" type="radio" id="edit-organization-other" name="organization" value="other">
            <label for="edit-organization-other" class="option">Other</label>
          </div>
        </div>
      </div>
    </div>
  </fieldset>
  <input data-drupal-selector="edit-posturl" type="hidden" name="posturl" value="http://go.patientpoint.com/l/127251/2021-11-18/4d1glj">
  <div class="client-submit form-actions webform-actions js-form-wrapper form-wrapper" data-drupal-selector="edit-actions" id="edit-actions"><input class="webform-button--submit CTAButton button button--primary js-form-submit form-submit"
      data-drupal-selector="edit-actions-submit" type="submit" id="edit-actions-submit" name="op" value="Submit">
  </div>
  <input autocomplete="off" data-drupal-selector="form-0uo50wr2wylukbcavrvlhvmkppzgkti3clyn43zd-4y" type="hidden" name="form_build_id" value="form-0UO50wr2WylUKBCavrvlhVmKPPzGKTi3clyN43Zd_4Y">
  <input data-drupal-selector="edit-webform-submission-general-contact-short-webform-block-content-4636-add-form" type="hidden" name="form_id" value="webform_submission_general_contact_short_webform_block_content_4636_add_form">
  <div class="url-textfield js-form-wrapper form-wrapper" style="display: none !important;">
    <div class="js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-url form-item-url">
      <label for="edit-url">Leave this field blank</label>
      <input autocomplete="off" data-drupal-selector="edit-url" type="text" id="edit-url" name="url" value="" size="20" maxlength="128" class="form-text">
    </div>
  </div>
</form>

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THE PATIENT ENGAGEMENT PLATFORM

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