alightsurveys.ipsosloyalty.com Open in urlscan Pro
209.143.205.73  Public Scan

Form analysis
1 forms found in the DOM

POST /Survey/PageView

<form action="/Survey/PageView" id="Page" method="post"><input data-val="true" data-val-number="The field ID must be a number." data-val-required="The ID field is required." id="ID" name="ID" type="hidden" value="345"><input id="UniqueID"
    name="UniqueID" type="hidden" value="367EDB92-AA77-4655-8F83-2292672C4311"><input id="Name" name="Name" type="hidden" value="WELCOME_PAGE"><input id="UserAction" name="UserAction" type="hidden" value=""><input id="VisibilityIDs_True"
    name="VisibilityIDs_True" type="hidden" value="3869"><input id="VisibilityIDs_False" name="VisibilityIDs_False" type="hidden" value="3870, 3047, 3219, 3879, 3880"><input id="SurveyToken" name="SurveyToken" type="hidden" value="M1CC5"><input
    id="ResponseToken" name="ResponseToken" type="hidden" value="HL4B041H"><input data-val="true" data-val-number="The field GlobalLanguageID must be a number." data-val-required="The GlobalLanguageID field is required." id="GlobalLanguageID"
    name="GlobalLanguageID" type="hidden" value="1"><input id="URLString" name="URLString" type="hidden" value="M1CC5/HL4B041H/////"> <br>
  <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12" id="4DFB293A-2860-4A0A-B8A6-B758A87751EA" data-uniqueid="4DFB293A-2860-4A0A-B8A6-B758A87751EA" data-name="YBR_CC5_WELCOME_PAGE_1">
    <div class=""> We appreciate your feedback about your recent experience using Benefits Direct to enroll in your benefits. We’ll use your feedback to evaluate and improve the website.<br><br> The survey usually takes 5 minutes or less. Your
      individual responses are confidential. Thanks in advance for completing this survey. </div>
  </div>
  <div class="col-lg-2 col-md-2  col-sm-1 col-xs-1">&nbsp;</div>
  <br>
  <div class="container">
    <div id="CustomStdMessage" class="text-left col-lg-12 col-md-12 col-sm-12 col-xs-12 ">
    </div>
    <div id="PageRegExMessage" class="text-left col-lg-12 col-md-12 col-sm-12 col-xs-12 ">
    </div>
    <div id="ValidationMessage" class="text-left col-lg-12 col-md-12 col-sm-12 col-xs-12 ">
    </div>
    <div class="col-lg-2 col-md-2  col-sm-1 col-xs-1">&nbsp;</div>
    <div class="col-lg-12 col-md-12  col-sm-12 col-xs-12"></div>
    <div class="col-lg-2 col-md-2  col-sm-1 col-xs-1">&nbsp;</div>
    <div id="buttoncontainer" class="col-lg-12 col-md-12  col-sm-12 col-xs-12">
      <div class="row">
        <div class="">
          <div class="col-lg-3 col-md-4 col-sm-12 col-xs-12" style="padding-bottom:4px">
            <input type="button" class="btn btn-primary  btn-sm btn-block " value="Next >" name="Next" onclick="SubmitValidatedPage('Next')" data-uniqueid="C473D0DA-E17E-4721-955F-12148C4B771F">
          </div>
        </div>
        <div class="">
          <div class="col-lg-3 col-md-4 col-sm-12 col-xs-12" style="padding-bottom:4px">
            <input type="button" class="btn btn-primary  btn-sm  btn-block" value="Save" name="Save" onclick="SubmitValidatedPage('Save')" data-uniqueid="832E7687-54C6-40A9-849B-44C82985B3E5">
          </div>
        </div>
      </div>
    </div>
    <div class="col-lg-2 col-md-2  col-sm-1 col-xs-1">&nbsp;</div>
  </div>
</form>

Text Content

 

 
 



We appreciate your feedback about your recent experience using Benefits Direct
to enroll in your benefits. We’ll use your feedback to evaluate and improve the
website.

The survey usually takes 5 minutes or less. Your individual responses are
confidential. Thanks in advance for completing this survey.
 

 

 

 
FALSE
Please enter a number between 1 and 99, then click ‘Next’ to Continue
Please enter a response, then click ‘Next’ to Continue
Please enter a response, then click ‘Finish’ to Continue
Your responses have been saved. You may log on using the same survey link in
your email invitation to complete the survey within 7 days of receipt of the
survey invitation.

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