www.optimaldentalhealth.co.uk Open in urlscan Pro
2606:4700:3035::ac43:99ee  Public Scan

Submitted URL: https://optimaldentalhealth.co.uk/
Effective URL: https://www.optimaldentalhealth.co.uk/
Submission: On July 01 via api from US — Scanned from DE

Form analysis 2 forms found in the DOM

Name: form_waitlistPOST form/sendemail-waitlist.php

<form action="form/sendemail-waitlist.php" method="post" name="form_waitlist" id="form_waitlist" onsubmit="return checkFields_waitlist()">
  <input name="recipient" value="hello@optimaldentalhealth.co.uk" type="hidden">
  <input name="Page_title" id="Page_title_waitlist" value="" type="hidden">
  <input name="Hostname" id="Hostname_waitlist" value="" type="hidden">
  <input name="subject" value="Website Join The Waitlist Form" type="hidden">
  <input name="redirect" value="../thanks-waitlist" type="hidden">
  <div class="row g-3">
    <div class="col-md-4">
      <div class="form-floating">
        <input class="form-control" type="text" id="Full_Name_waitlist" name="Full_Name" placeholder="Full Name *" required="">
        <label for="Full_Name_waitlist">Full Name *</label>
      </div>
    </div>
    <div class="col-md-4">
      <div class="form-floating">
        <input class="form-control" type="text" id="Email_waitlist" name="Email" placeholder="Email *" required="">
        <label for="Email_waitlist">Email *</label>
      </div>
    </div>
    <div class="col-md-4">
      <div class="form-floating">
        <input class="form-control" type="text" id="PhoneNumber_waitlist" name="PhoneNumber" placeholder="Phone Number *" required="">
        <label for="PhoneNumber_waitlist">Phone Number *</label>
      </div>
    </div>
    <div class="col-12 text-start">
      <div class="form-check">
        <input type="checkbox" class="form-check-input" id="Privacy_Policy_waitlist" name="I_consent_to_my_personal_data_being_collected_and_stored_as_per_the_Privacy_Policy_waitlist" value="Yes">
        <label class="form-check-label" for="Privacy_Policy_waitlist">I consent to my personal data being collected and stored as per the
          <a href="https://www.dental-focus.com/cookie-policy/privacy-policy.php" rel="shadowbox" class="">Privacy Policy</a>. *</label>
      </div>
    </div>
    <div class="col-12 text-start">
      <div class="form-check">
        <input type="checkbox" class="form-check-input" id="marketing_communications_waitlist" name="I_consent_to_my_personal_data_being_collected_and_stored_for_the_purpose_of_marketing_communications" value="Yes">
        <label class="form-check-label" for="marketing_communications_waitlist">I consent to my personal data being collected and stored for the purpose of marketing communications.</label>
      </div>
    </div>
    <div class="col-12">
      <div class="g-recaptcha d-inline-block" id="RecaptchaField_waitlist" data-theme="light">
        <div style="width: 304px; height: 78px;">
          <div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-79wirf9ssqqo" frameborder="0" scrolling="no"
              sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
              src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6Lcn6ycpAAAAAJjlSPZ4D5JzviKRPsUi2uNaJB7U&amp;co=aHR0cHM6Ly93d3cub3B0aW1hbGRlbnRhbGhlYWx0aC5jby51azo0NDM.&amp;hl=de&amp;v=rKbTvxTxwcw5VqzrtN-ICwWt&amp;theme=light&amp;size=normal&amp;cb=1uzkbljlk7n5"></iframe>
          </div><textarea id="g-recaptcha-response-1" 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 class="col-12">
      <input name="Submit" type="submit" value="Send Now" class="btn btn-secondary border-1" onclick="return checkFields_waitlist()">
    </div>
  </div>
</form>

Name: formPOST form/sendemail.php

<form action="form/sendemail.php" method="post" name="form" id="form" onsubmit="return checkFields()">
  <input name="recipient" value="hello@optimaldentalhealth.co.uk" type="hidden">
  <input name="Page_title" id="Page_title_ask" value="" type="hidden">
  <input name="Hostname" id="Hostname_ask" value="" type="hidden">
  <input name="subject" value="Website Contact Us Form" type="hidden">
  <input name="redirect" value="../thanks" type="hidden">
  <div class="row g-3">
    <div class="col-md-6">
      <div class="form-floating">
        <input class="form-control" type="text" id="Full_Name_ask" name="Full_Name" placeholder="Full Name *" required="">
        <label for="Full_Name_ask">Full Name *</label>
      </div>
    </div>
    <div class="col-md-6">
      <div class="form-floating">
        <input class="form-control" type="text" id="Telephone" name="Telephone" placeholder="Telephone">
        <label for="Telephone">Telephone</label>
      </div>
    </div>
    <div class="col-md-6">
      <div class="form-floating">
        <input class="form-control" type="text" id="Email_ask" name="Email" placeholder="Email *" required="">
        <label for="Email_ask">Email *</label>
      </div>
    </div>
    <div class="col-md-6">
      <div class="form-floating">
        <select class="form-select" id="How_Found_ask" name="How_Found" required="">
          <option value="" disabled="" selected="">How did you find us? *</option>
          <option value="Google Search">Google Search</option>
          <option value="Recommendation">Recommendation</option>
          <option value="Walking Past">Walking Past</option>
          <option value="Other">Other</option>
        </select>
        <label for="How_Found_ask">Select *</label>
      </div>
    </div>
    <div class="col-12">
      <div class="form-floating">
        <textarea class="form-control" id="Message" name="Message" placeholder="Message" rows="4"></textarea>
        <label for="Message">Message</label>
      </div>
    </div>
    <div class="col-12 text-start">
      <div class="form-check">
        <input type="checkbox" class="form-check-input" id="Privacy_Policy" name="I_consent_to_my_personal_data_being_collected_and_stored_as_per_the_Privacy_Policy" value="Yes">
        <label class="form-check-label" for="Privacy_Policy">I consent to my personal data being collected and stored as per the <a href="https://www.dental-focus.com/cookie-policy/privacy-policy.php" rel="shadowbox">Privacy Policy</a>. *</label>
      </div>
    </div>
    <div class="col-12 text-start">
      <div class="form-check">
        <input type="checkbox" class="form-check-input" id="marketing_communications" name="I_consent_to_my_personal_data_being_collected_and_stored_for_the_purpose_of_marketing_communications" value="Yes">
        <label class="form-check-label" for="marketing_communications">I consent to my personal data being collected and stored for the purpose of marketing communications.</label>
      </div>
    </div>
    <div class="col-12">
      <div class="g-recaptcha d-inline-block" id="RecaptchaField_ask" data-theme="light">
        <div style="width: 304px; height: 78px;">
          <div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-y43769corr1w" frameborder="0" scrolling="no"
              sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
              src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6Lcn6ycpAAAAAJjlSPZ4D5JzviKRPsUi2uNaJB7U&amp;co=aHR0cHM6Ly93d3cub3B0aW1hbGRlbnRhbGhlYWx0aC5jby51azo0NDM.&amp;hl=de&amp;v=rKbTvxTxwcw5VqzrtN-ICwWt&amp;theme=light&amp;size=normal&amp;cb=3iltgpvxnt90"></iframe>
          </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>
      </div>
    </div>
    <div class="col-12">
      <input name="Submit" type="submit" value="Send Now" class="btn btn-primary border-0" onclick="return checkFields()">
    </div>
  </div>
</form>

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1 Melcombe Street, London NW1 6AE
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WELCOME TO OPTIMAL DENTAL HEALTH

Your London-based dental practice where prioritising your overall well-being
begins with dentistry. Our expert team of healthcare professionals is committed
to empowering you with the necessary insights and tools to achieve and maintain
optimal health. We focus on utilising minimally invasive techniques and
meticulously selected materials to enhance your dental health. At Optimal Dental
Health, we go beyond just your smile by integrating regular dental care with
essential lifestyle interventions, continuously monitoring and tailoring your
care to meet your needs. Discover how we can help you actively improve your
health, providing numerous reasons to smile confidently.

Good things coming your way...
How to Find Us
Be the first to join the waitlist
Full Name *
Email *
Phone Number *
I consent to my personal data being collected and stored as per the Privacy
Policy. *
I consent to my personal data being collected and stored for the purpose of
marketing communications.




CONTACT US

Fields with (*) are required.
Please contact us via this website or email without disclosing confidential
information.

Full Name *
Telephone
Email *
How did you find us? * Google Search Recommendation Walking Past Other Select *
Message
I consent to my personal data being collected and stored as per the Privacy
Policy. *
I consent to my personal data being collected and stored for the purpose of
marketing communications.


Optimal Dental Health
1 Melcombe Street,
London NW1 6AE
Email
hello@optimaldentalhealth.co.uk
 * 

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