chat.eservices.baxter.com Open in urlscan Pro
3.132.45.113  Public Scan

Form analysis
1 forms found in the DOM

GET chatOrCallback.html

<form action="chatOrCallback.html" id="chatform" method="GET">
  <div id="data_section_1">
    <label id="pselect1">Please select an area about which you'd like to chat</label><br>
    <select name="chatareaid" id="question_1" data-precheck="true">
      <option id="q9" value="">Choose an area</option>
      <option id="q1" value="1">I have a question about an order or return</option>
      <option id="q2" value="2">I have a question about the website</option>
    </select>
    <input id="chatarea" name="chatarea" type="hidden" class="question_1">
    <input id="chatUsername" name="chatUsername" type="hidden">
  </div>
  <div id="data_section_2" data-parent="question_1" class="chat-survey-sub-question">
    <br>
    <label id="pselect2">Please provide the issue details</label><br>
    <select name="chatissueid" id="question_2" data-precheck="true"></select>
    <input id="chatissue" name="chatissue" type="hidden" class="question_2">
  </div>
  <br>
  <div id="data_section_3" data-parent="question_2" class="chat-survey-sub-question">
    <label id="pselect3">Please provide your name</label><br>
    <input id="username2" size="10" type="text" class="form-control chat-survey-user-name validate-fields">
    <br>
    <br>
    <p><input id="strtBtn2" class="btn btn-primary btn-block chat-survey-user-button chat-form-submit index-submit" type="button" value="Start Chat" onclick="validatePageAndSubmit();"></p>
    <input type="image" name="Start Chat" src="transparent.gif">
  </div>
  <div id="data_section_4" data-parent="question_2" class="chat-survey-sub-question">
    <label id="pselect4">Please provide your name</label><br>
    <input id="username1" size="10" type="text" class="form-control chat-survey-user-name validate-fields">
    <br>
    <label id="pselect5">Please provide your account number</label><br>
    <input name="useraccountnumber" id="useraccountnumber" size="10" type="text" class="form-control chat-survey-user-name validate-fields">
    <br>
    <label id="pselect6">Please provide the order or PO you are inquiring upon</label><br>
    <input name="userpo" id="userpo" size="10" type="text" class="form-control chat-survey-user-name validate-fields">
    <br>
    <br>
    <p><input id="strtBtn" class="btn btn-primary btn-block chat-survey-user-button chat-form-submit index-submit" type="button" value="Start Chat" onclick="validatePageAndSubmit();"></p>
    <input type="image" name="Start Chat" src="transparent.gif">
  </div>
</form>

Text Content

ESERVICES CENTER

 


WELCOME TO ESERVICES CHAT

Please select an area about which you'd like to chat
Choose an areaI have a question about an order or returnI have a question about
the website

Please provide the issue details


Please provide your name






Please provide your name

Please provide your account number

Please provide the order or PO you are inquiring upon






Baxter.com