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Submitted URL: https://9ydeq.r.a.d.sendibm1.com/mk/up/sh/6rqJ8GwSbkJhKojn0YClZ2oPX5Z/vnBv9UzDIMIo
Effective URL: https://d9808d8b.sibforms.com/serve/update/MUIFAMV3_qKKqiKjcAx-nOQKXvWR355TGNy7XH0t0hThw_cs5R4SHa7RNzw7zia9QEY_j3_XAn-x1CRLNIW...
Submission: On August 01 via manual from PH — Scanned from FR
Effective URL: https://d9808d8b.sibforms.com/serve/update/MUIFAMV3_qKKqiKjcAx-nOQKXvWR355TGNy7XH0t0hThw_cs5R4SHa7RNzw7zia9QEY_j3_XAn-x1CRLNIW...
Submission: On August 01 via manual from PH — Scanned from FR
Form analysis 1 forms found in the DOM
POST
<form id="sib-form" method="POST" action="" data-type="update" novalidate="true">
<div style="padding: 8px 0;">
<div class="sib-form-block sib-image-form-block" style="text-align: center">
<img src="https://img.mailinblue.com/5724082/images/content_library/original/6410853c5606c509d467811e.png" style="width: 250px;height: 51px;" alt="" title="">
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-form-block" style="font-size:32px; text-align:center; font-weight:700; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent; text-align:center">
<p>Update your Preferences</p>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-input sib-form-block">
<div class="form__entry entry_block">
<div class="form__label-row ">
<label class="entry__label" style="font-weight: 700; text-align:left; font-size:16px; text-align:left; font-weight:700; font-family:"Helvetica", sans-serif; color:#3c4858;" for="EMAIL" data-required="*">Email Address</label>
<div class="entry__field">
<input class="input " type="text" id="EMAIL" name="EMAIL" autocomplete="off" value="a********@m**.com" data-required="true" required="">
</div>
</div>
<label class="entry__error entry__error--primary" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#661d1d; background-color:#ffeded; border-radius:3px; border-color:#ff4949;">
</label>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-input sib-form-block">
<div class="form__entry entry_block">
<div class="form__label-row ">
<label class="entry__label" style="font-weight: 700; text-align:left; font-size:16px; text-align:left; font-weight:700; font-family:"Helvetica", sans-serif; color:#3c4858;" for="FIRSTNAME" data-required="*">First Name</label>
<div class="entry__field">
<input class="input " maxlength="200" type="text" id="FIRSTNAME" name="FIRSTNAME" autocomplete="off" value="Amanda" data-required="true" required="">
</div>
</div>
<label class="entry__error entry__error--primary" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#661d1d; background-color:#ffeded; border-radius:3px; border-color:#ff4949;">
</label>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-input sib-form-block">
<div class="form__entry entry_block">
<div class="form__label-row ">
<label class="entry__label" style="font-weight: 700; text-align:left; font-size:16px; text-align:left; font-weight:700; font-family:"Helvetica", sans-serif; color:#3c4858;" for="LASTNAME" data-required="*">Last Name</label>
<div class="entry__field">
<input class="input " maxlength="200" type="text" id="LASTNAME" name="LASTNAME" autocomplete="off" value="Yu" data-required="true" required="">
</div>
</div>
<label class="entry__error entry__error--primary" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#661d1d; background-color:#ffeded; border-radius:3px; border-color:#ff4949;">
</label>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-input sib-form-block">
<div class="form__entry entry_block">
<div class="form__label-row ">
<label class="entry__label" style="font-weight: 700; text-align:left; font-size:16px; text-align:left; font-weight:700; font-family:"Helvetica", sans-serif; color:#3c4858;" for="COMPANY" data-required="*">Company</label>
<div class="entry__field">
<input class="input " maxlength="200" type="text" id="COMPANY" name="COMPANY" autocomplete="off" value="Mallinckrodt Pharmaceuticals" data-required="true" required="">
</div>
</div>
<label class="entry__error entry__error--primary" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#661d1d; background-color:#ffeded; border-radius:3px; border-color:#ff4949;">
</label>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-select sib-form-block" data-required="true">
<div class="form__entry entry_block">
<div class="form__label-row ">
<label class="entry__label" style="font-weight: 700; text-align:left; font-size:16px; text-align:left; font-weight:700; font-family:"Helvetica", sans-serif; color:#3c4858;" for="ORGANIZATION_TYPE" data-required="*">Organization
Type</label>
<div class="entry__field">
<select class="input" id="ORGANIZATION_TYPE" name="ORGANIZATION_TYPE" data-required="true">
<option value="" disabled="" selected="" hidden="">Select one</option>
<option class="sib-menu__item" value="1"> Association/Society </option>
<option class="sib-menu__item" value="2"> Academia (college/university) </option>
<option class="sib-menu__item" value="3"> Biotech </option>
<option class="sib-menu__item" value="4"> Consultant </option>
<option class="sib-menu__item" value="5"> CRO </option>
<option class="sib-menu__item" value="6"> Educational Services </option>
<option class="sib-menu__item" value="7"> Government Entity </option>
<option class="sib-menu__item" value="8"> Investor/Trader </option>
<option class="sib-menu__item" value="9"> Large Pharma </option>
<option class="sib-menu__item" value="10"> Nonprofit Organization </option>
<option class="sib-menu__item" value="11"> Payer </option>
<option class="sib-menu__item" value="12"> Product Supplier </option>
<option class="sib-menu__item" value="13"> Other </option>
</select>
</div>
</div>
<label class="entry__error entry__error--primary" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#661d1d; background-color:#ffeded; border-radius:3px; border-color:#ff4949;">
</label>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-select sib-form-block" data-required="true">
<div class="form__entry entry_block">
<div class="form__label-row ">
<label class="entry__label" style="font-weight: 700; text-align:left; font-size:16px; text-align:left; font-weight:700; font-family:"Helvetica", sans-serif; color:#3c4858;" for="JOB_LEVEL_ROLE" data-required="*">Job
Level/Role</label>
<div class="entry__field">
<select class="input" id="JOB_LEVEL_ROLE" name="JOB_LEVEL_ROLE" data-required="true">
<option value="" disabled="" selected="" hidden="">Select one</option>
<option class="sib-menu__item" value="1"> Analyst or Research Assistant or Specialist </option>
<option class="sib-menu__item" value="2"> Assistant/Associate Director </option>
<option class="sib-menu__item" value="3"> Associate </option>
<option class="sib-menu__item" value="4"> CEO/President </option>
<option class="sib-menu__item" value="5"> Chief Officer/Scientist </option>
<option class="sib-menu__item" value="6"> Manager (all levels; also includes Officer) </option>
<option class="sib-menu__item" value="7"> Medical Science Liaison </option>
<option class="sib-menu__item" value="8"> Professor, Lecturer, or Teacher in academic setting </option>
<option class="sib-menu__item" value="9"> Research Scientist </option>
<option class="sib-menu__item" value="10"> Senior Director/Scientist </option>
<option class="sib-menu__item" value="11"> Student </option>
<option class="sib-menu__item" value="12"> Trader </option>
<option class="sib-menu__item" value="13"> Vice President/Executive </option>
<option class="sib-menu__item" value="14"> Other </option>
</select>
</div>
</div>
<label class="entry__error entry__error--primary" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#661d1d; background-color:#ffeded; border-radius:3px; border-color:#ff4949;">
</label>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-input sib-form-block">
<div class="form__entry entry_block">
<div class="form__label-row ">
<label class="entry__label" style="font-weight: 700; text-align:left; font-size:16px; text-align:left; font-weight:700; font-family:"Helvetica", sans-serif; color:#3c4858;" for="COUNTRY_TEXT" data-required="*">Country</label>
<div class="entry__field">
<input class="input " maxlength="200" type="text" id="COUNTRY_TEXT" name="COUNTRY_TEXT" autocomplete="off" value="United States" data-required="true" required="">
</div>
</div>
<label class="entry__error entry__error--primary" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#661d1d; background-color:#ffeded; border-radius:3px; border-color:#ff4949;">
</label>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-input sib-form-block">
<div class="form__entry entry_block">
<div class="form__label-row ">
<label class="entry__label" style="font-weight: 700; text-align:left; font-size:16px; text-align:left; font-weight:700; font-family:"Helvetica", sans-serif; color:#3c4858;" for="STATE_PROVINCE">State or Province</label>
<div class="entry__field">
<input class="input " maxlength="200" type="text" id="STATE_PROVINCE" name="STATE_PROVINCE" autocomplete="off" value="New Jersey">
</div>
</div>
<label class="entry__error entry__error--primary" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#661d1d; background-color:#ffeded; border-radius:3px; border-color:#ff4949;">
</label>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-checkbox-group sib-form-block" data-required="true">
<div class="form__entry entry_mcq">
<div class="form__label-row ">
<label class="entry__label" style="font-weight: 700; text-align:left; font-size:16px; text-align:left; font-weight:700; font-family:"Helvetica", sans-serif; color:#3c4858;" data-required="*">Update your topics of interest</label>
<div style="">
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="AI and Machine Learning" value="10" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">AI and Machine
Learning</span> </label>
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<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Biosimilars" value="16" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Biosimilars</span>
</label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Clinical Outcomes" value="18" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Clinical
Outcomes</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Clinical Trials" value="35" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Clinical
Trials</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Comparative Effectiveness Research" value="36" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Comparative
Effectiveness Research</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Decision Science" value="37" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Decision
Science</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Economic Evaluation" value="20" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Economic
Evaluation</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Epidemiology and Public Health" value="19" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Epidemiology and
Public Health</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Health Economics" value="11" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Health
Economics</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Health Policy and Regulatory" value="21" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Health Policy and
Regulatory</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Health Service Delivery and Process of Care" value="22" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Health Service
Delivery and Process of Care</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Health Technology Assessment" value="14" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Health Technology
Assessment</span> </label>
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<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Market Access" value="15" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Market Access</span>
</label>
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<div class="entry__choice">
<label class="checkbox__label">
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Pharmaceuticals, and Vaccines</span> </label>
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<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Medical Technologies" value="23" data-required="true">
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Technologies</span> </label>
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<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Methodological and Statistical Research" value="29" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Methodological and
Statistical Research</span> </label>
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<label class="checkbox__label">
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<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Organizational
Practices</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Outcomes Research" value="12" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Outcomes
Research</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Patient-Centered Research" value="24" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Patient-Centered
Research</span> </label>
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<div class="entry__choice">
<label class="checkbox__label">
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<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Payer Insight</span>
</label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Pricing" value="17" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Pricing</span>
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</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Real-World Data and Information Systems" value="25" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Real-World Data and
Information Systems</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Real-world Evidence" value="13" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Real-world
Evidence</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Regulatory Issues" value="32" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Regulatory
Issues</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Specialized Treatment Areas" value="26" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Specialized Treatment
Areas</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Specialty Pharmacy" value="34" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Specialty
Pharmacy</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Specific Diseases and Conditions" value="27" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Specific Diseases and
Conditions</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Stakeholder Engagement" value="39" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Stakeholder
Engagement</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Study Approaches & Methodology" value="28" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Study Approaches
& Methodology</span> </label>
</div>
<div class="entry__choice">
<label class="checkbox__label">
<input type="checkbox" class="input_replaced" name="lists_40[]" data-value="Wearable Technologies" value="33" data-required="true">
<span class="checkbox checkbox_tick_positive" style="margin-left:"></span><span style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#3C4858; background-color:transparent;">Wearable
Technologies</span> </label>
</div>
</div>
</div>
<label class="entry__error entry__error--primary" style="font-size:16px; text-align:left; font-family:"Helvetica", sans-serif; color:#661d1d; background-color:#ffeded; border-radius:3px; border-color:#ff4949;">
</label>
</div>
</div>
</div>
<div style="padding: 8px 0;">
<div class="sib-checkbox-group sib-form-block" data-required="true">
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