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18.245.60.42  Public Scan

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Submitted URL: https://click.yourpharmacybenefits.com/u/?qs=d770e3d8a8a4a53d4b035db9f6bf1c843632a36d7362650bc9e5920f880893e6e111dfacad4115d42775d00a94...
Effective URL: https://www.healthsafe-id.com/rt/login?resume=%2Fas%2FmAQT2RIq0v%2Fresume%2Fas%2Fauthorization.ping&TARGET=https%3A%2F%2Fwww.h...
Submission: On November 17 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

<form id="sign-in-form">
  <div class="FormContainer_root__vYBq4 FormContainer_removeTopBottomSpacing__rAsfz">
    <div id="username_container">
      <div class="has-rds-mb-8"><label for="username" class="is-rds-body-3 has-rds-text-black-bis is-block InputField_label__36B9a"><span>Username</span></label></div>
      <div class="InputField_fieldWrapper__dExM0 is-flex"><input name="username" id="username" type="text" class="InputField_field__9nwvt has-rds-pv-8 has-rds-ph-16" autocomplete="off" autocapitalize="on" inputmode="text" aria-required="false"
          aria-describedby="username-error" value="">
        <div aria-live="polite" class="InputField_validMessage__DaRIZ"></div>
      </div>
      <div id="username-error">
        <div id="username-error" class="FieldError_root__mpEpc is-flex" aria-live="polite" aria-atomic="true"></div>
      </div>
    </div>
    <div id="password_container">
      <div class="has-rds-mb-8"><label for="password" class="is-rds-body-3 has-rds-text-black-bis is-block InputField_label__36B9a"><span>Password</span></label></div>
      <div class="InputField_fieldWrapper__dExM0 is-flex"><input name="password" id="password" type="password" class="InputField_field__9nwvt has-rds-pv-8 has-rds-ph-16" autocomplete="current-password" autocapitalize="off" inputmode="text"
          aria-required="false" aria-describedby="password-error" value="">
        <div aria-live="polite" class="InputField_validMessage__DaRIZ"></div>
      </div>
      <div id="password-error">
        <div id="password-error" class="FieldError_root__mpEpc is-flex" aria-live="polite" aria-atomic="true"></div>
      </div>
    </div>
    <div class="Checkbox_root__2NY2a"><input type="checkbox" id="rememberMe" class="Checkbox_checkbox__SEHMP" aria-invalid="false"><label for="rememberMe" class="Checkbox_label__4auCM"><svg class="Checkbox_checkboxControl__hEMSC" aria-hidden="true"
          viewBox="0 0 24 24" version="1.1" xmlns="http://www.w3.org/2000/svg">
          <rect class="Checkbox_checkboxOuter__-5D5D" x="0" y="0" width="24" height="24"></rect>
          <rect class="Checkbox_checkboxInner__Jjo4J" x="3" y="3" width="18" height="18"></rect>
          <polyline class="Checkbox_checkboxCheck__d0FKX" stroke-width="2" stroke-linejoin="round" stroke-linecap="round" points="7.5,12.5 10.5,15.5 17.5,8.5"></polyline>
        </svg><span id="remember-me-checkbox-label" class="is-rds-body-3 Checkbox_text__Jaonn has-rds-text-grey-darker"><span>Remember my username <b>(Optional)</b></span></span></label></div>
    <div class="ButtonGroup_root__hX3im ButtonGroup_layoutVertical__MWVaY">
      <div aria-live="polite"><button type="submit" id="submitBtn" class="rds-primary-button is-rds-fullwidth">Sign in</button></div><a id="go-to-register-flow" href="/rt/register/orx/en" class="rds-secondary-button">Register now</a>
      <p class="is-rds-body-1 has-text-centered has-rds-text-grey-darker">Forgot <a class="rds-link-inline" id="go-to-forgot-username-flow" href="/rt/username/orx/en">username</a> or
        <a class="rds-link-inline" id="go-to-forgot-password-flow" href="/rt/password/orx/en">password</a>?</p>
    </div>
  </div>
</form>

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