provisionsgroup.com Open in urlscan Pro
141.193.213.10  Public Scan

Submitted URL: https://www2.provisionsgroup.com/e/955473/il-utm-campaign-HIPAAChecklist/dgp87/629865939/h/3_neqNz3vIx9rJ-q93pRvI966LlwBvfO6d1w6l...
Effective URL: https://provisionsgroup.com/healthcare-it/hipaa-checklist/?utm_source=ChecklistFollowUp2A&utm_medium=Email&utm_campaign=HIPA...
Submission: On October 12 via manual from US — Scanned from DE

Form analysis 2 forms found in the DOM

POST /healthcare-it/hipaa-checklist/#gf_38

<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_38" id="gform_38" class="form-input-border-0" action="/healthcare-it/hipaa-checklist/#gf_38" data-formid="38" novalidate="" data-hs-cf-bound="true">
  <div class="gform-body gform_body">
    <div id="gform_fields_38" class="gform_fields top_label form_sublabel_below description_below">
      <fieldset id="field_38_12" class="gfield gfield--type-name gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_38_12">
        <legend class="form-label gfield_label gform-field-label form-label gfield_label_before_complex">Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
        <div class="row g-2 ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name no_last_name no_suffix gf_name_has_1 ginput_container_name gform-grid-row" id="input_38_12">
          <span id="input_38_12_3_container" class="col name_first gform-grid-col gform-grid-col--size-auto">
            <input type="text" class="form-control" name="input_12.3" id="input_38_12_3" value="" tabindex="100" aria-required="true" placeholder="Name">
            <label class="small text-muted" for="input_38_12_3">First</label>
          </span>
        </div>
      </fieldset>
      <div id="field_38_23" class="gfield gfield--type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_38_23"><label
          class="form-label gfield_label gform-field-label" for="input_38_23">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_email">
          <input name="input_23" id="input_38_23" autocomplete="email" type="email" value="" class="form-control" tabindex="104" placeholder="Email" aria-required="true" aria-invalid="false">
        </div>
      </div>
      <div id="field_38_39" class="gfield gfield--type-captcha gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_38_39"><label
          class="form-label gfield_label gform-field-label" for="input_38_39">Captcha</label>
        <div id="input_38_39" class="ginput_container ginput_recaptcha gform-initialized" data-sitekey="6LcBVL0ZAAAAAGRK_Dvy0CoYLvdUOAN5TX5VMCEg" data-theme="dark" data-tabindex="-1" data-size="invisible" data-badge="bottomleft">
          <div class="grecaptcha-badge" data-style="bottomleft"
            style="width: 256px; height: 60px; display: block; transition: left 0.3s ease 0s; position: fixed; bottom: 14px; left: -186px; box-shadow: gray 0px 0px 5px; border-radius: 2px; overflow: hidden;">
            <div class="grecaptcha-logo"><iframe title="reCAPTCHA" width="256" height="60" role="presentation" name="a-67l90hnsgr8o" frameborder="0" scrolling="no"
                sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox"
                src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6LcBVL0ZAAAAAGRK_Dvy0CoYLvdUOAN5TX5VMCEg&amp;co=aHR0cHM6Ly9wcm92aXNpb25zZ3JvdXAuY29tOjQ0Mw..&amp;hl=en&amp;v=lLirU0na9roYU3wDDisGJEVT&amp;theme=dark&amp;size=invisible&amp;badge=bottomleft&amp;cb=jalttw21q7jr"
                tabindex="-1"></iframe></div>
            <div class="grecaptcha-error"></div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
              style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
          </div><iframe style="display: none;"></iframe>
        </div>
      </div>
    </div>
  </div>
  <div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_38" class="gform_button btn btn-dark button" value="Submit" tabindex="105"
      onclick="if(window[&quot;gf_submitting_38&quot;]){return false;}  if( !jQuery(&quot;#gform_38&quot;)[0].checkValidity || jQuery(&quot;#gform_38&quot;)[0].checkValidity()){window[&quot;gf_submitting_38&quot;]=true;}  "
      onkeypress="if( event.keyCode == 13 ){ if(window[&quot;gf_submitting_38&quot;]){return false;} if( !jQuery(&quot;#gform_38&quot;)[0].checkValidity || jQuery(&quot;#gform_38&quot;)[0].checkValidity()){window[&quot;gf_submitting_38&quot;]=true;}  jQuery(&quot;#gform_38&quot;).trigger(&quot;submit&quot;,[true]); }">
    <input type="hidden" name="gform_ajax" value="form_id=38&amp;title=&amp;description=&amp;tabindex=99&amp;theme=data-form-theme='gravity-theme'">
    <input type="hidden" class="gform_hidden" name="is_submit_38" value="1">
    <input type="hidden" class="gform_hidden" name="gform_submit" value="38">
    <input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
    <input type="hidden" class="gform_hidden" name="state_38" value="WyJbXSIsImQyN2UxZjAyNTA2ZmYzYzNlY2I5YWRiZDA2NDExYTRmIl0=">
    <input type="hidden" class="gform_hidden" name="gform_target_page_number_38" id="gform_target_page_number_38" value="0">
    <input type="hidden" class="gform_hidden" name="gform_source_page_number_38" id="gform_source_page_number_38" value="1">
    <input type="hidden" name="gform_field_values" value="">
  </div>
</form>

POST /healthcare-it/hipaa-checklist/#gf_17

<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_17" id="gform_17" class="form-input-border-0" action="/healthcare-it/hipaa-checklist/#gf_17" data-formid="17" novalidate="" data-hs-cf-bound="true">
  <div class="gform-body gform_body">
    <div id="gform_fields_17" class="gform_fields top_label form_sublabel_below description_below">
      <fieldset id="field_17_3"
        class="gfield gfield--type-checkbox gfield--type-choice gfield--width-full form-check-inline gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible"
        data-js-reload="field_17_3">
        <legend class="form-label gfield_label gform-field-label form-label gfield_label_before_complex">Preferences<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></legend>
        <div class="ginput_container ginput_container_checkbox">
          <div class="gfield_checkbox" id="input_17_3">
            <div class="form-check gchoice gchoice_17_3_1">
              <input class="form-check-input gfield-choice-input" name="input_3.1" type="checkbox" value="Consulting Updates" id="choice_17_3_1" tabindex="20">
              <label class="form-check-label" for="choice_17_3_1" id="label_17_3_1">Consulting Updates</label>
            </div>
            <div class="form-check gchoice gchoice_17_3_2">
              <input class="form-check-input gfield-choice-input" name="input_3.2" type="checkbox" value="Staffing Updates" id="choice_17_3_2" tabindex="21">
              <label class="form-check-label" for="choice_17_3_2" id="label_17_3_2">Staffing Updates</label>
            </div>
            <div class="form-check gchoice gchoice_17_3_3">
              <input class="form-check-input gfield-choice-input" name="input_3.3" type="checkbox" value="Career Insights" id="choice_17_3_3" tabindex="22">
              <label class="form-check-label" for="choice_17_3_3" id="label_17_3_3">Career Insights</label>
            </div>
          </div>
        </div>
      </fieldset>
      <fieldset id="field_17_1" class="gfield gfield--type-name gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_17_1">
        <legend class="form-label gfield_label gform-field-label form-label gfield_label_before_complex">Name<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></legend>
        <div class="row g-2 ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row" id="input_17_1">
          <span id="input_17_1_3_container" class="col name_first gform-grid-col gform-grid-col--size-auto">
            <input type="text" class="form-control" name="input_1.3" id="input_17_1_3" value="" tabindex="24" aria-required="true" placeholder="First Name">
            <label class="small text-muted" for="input_17_1_3">First</label>
          </span>
          <span id="input_17_1_6_container" class="col name_last gform-grid-col gform-grid-col--size-auto">
            <input type="text" class="form-control" name="input_1.6" id="input_17_1_6" value="" tabindex="26" aria-required="true" placeholder="Last Name">
            <label class="small text-muted" for="input_17_1_6">Last</label>
          </span>
        </div>
      </fieldset>
      <div id="field_17_2" class="gfield gfield--type-email gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_17_2"><label
          class="form-label gfield_label gform-field-label" for="input_17_2">Email</label>
        <div class="ginput_container ginput_container_email">
          <input name="input_2" id="input_17_2" autocomplete="email" type="email" value="" class="form-control" tabindex="28" placeholder="Email" aria-invalid="false">
        </div>
      </div>
    </div>
  </div>
  <div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_17" class="gform_button btn btn-dark button" value="Submit" tabindex="29"
      onclick="if(window[&quot;gf_submitting_17&quot;]){return false;}  if( !jQuery(&quot;#gform_17&quot;)[0].checkValidity || jQuery(&quot;#gform_17&quot;)[0].checkValidity()){window[&quot;gf_submitting_17&quot;]=true;}  "
      onkeypress="if( event.keyCode == 13 ){ if(window[&quot;gf_submitting_17&quot;]){return false;} if( !jQuery(&quot;#gform_17&quot;)[0].checkValidity || jQuery(&quot;#gform_17&quot;)[0].checkValidity()){window[&quot;gf_submitting_17&quot;]=true;}  jQuery(&quot;#gform_17&quot;).trigger(&quot;submit&quot;,[true]); }"
      data-conditional-logic="visible"> <input type="hidden" name="gform_ajax" value="form_id=17&amp;title=1&amp;description=1&amp;tabindex=20&amp;theme=data-form-theme='gravity-theme'">
    <input type="hidden" class="gform_hidden" name="is_submit_17" value="1">
    <input type="hidden" class="gform_hidden" name="gform_submit" value="17">
    <input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
    <input type="hidden" class="gform_hidden" name="state_17" value="WyJbXSIsImQyN2UxZjAyNTA2ZmYzYzNlY2I5YWRiZDA2NDExYTRmIl0=">
    <input type="hidden" class="gform_hidden" name="gform_target_page_number_17" id="gform_target_page_number_17" value="0">
    <input type="hidden" class="gform_hidden" name="gform_source_page_number_17" id="gform_source_page_number_17" value="1">
    <input type="hidden" name="gform_field_values" value="">
  </div>
</form>

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