ahip.informz.net
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35.171.221.3
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http://ahip.informz.net/ahip/pages/Unsubscribe_Standard?_zs=jbl5n&_zmi=MPID
Submission: On November 01 via api from US — Scanned from DE
Submission: On November 01 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
<form class="formData" autocomplete="off">
<!-- H o n e y p o t -->
<label class="ohnohoney" for="name"></label>
<input class="ohnohoney" autocomplete="off" type="search" id="name" name="name" placeholder="Your name here">
<label class="ohnohoney" for="email"></label>
<input class="ohnohoney" autocomplete="off" type="search" id="email" name="email" placeholder="Your e-mail here">
<div class="form_messages" style="background-color:#ffffff;border-radius:4px;border:1px solid #999999;margin:40px;padding:5px;text-align: center;display:none"></div>
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src="//ahip.informz.net/ahip/data/images/Branding/AHIP%20Logos_NEW_rebranding/AHIP_Logo_OverBlue_RGB.png" class="ui-resizable" style="resize: none; position: static; display: block; height: 70px; width: 240px;" width="800" height="242">
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<h1 style="color: rgb(255, 255, 255); font-weight: bold; font-size: 36px; margin-top: 0px; margin-bottom: 0px; line-height: 36px; letter-spacing: 0px;"><b>We'll Miss You</b></h1>
<h1 style="color: rgb(255, 255, 255); font-weight: bold; font-size: 36px; margin-top: 0px; margin-bottom: 0px; line-height: 36px; letter-spacing: 0px;">
<p></p>
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<div style="width: 435px; height: 95px; text-align: left; color: rgb(255, 255, 255); line-height: 24px; letter-spacing: 0px; font-weight: normal; font-size: 16px; margin-top: 0px; margin-bottom: 0px; overflow: hidden;"
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data-medium-editor-editor-index="2" medium-editor-index="3e7a10b4-abcf-9992-c839-4a7e90ba060a" data-placeholder="Type your text">
<p class="" style="">By clicking "unsubscribe me" below, you're opting out of receiving member newsletters from AHIP, including PROMOTIONAL emails focused on conferences, online courses and more.</p>
</div>
</div>
</div>
</div>
<div>
<div style="position: absolute; top: 418px; left: 215px; cursor: text; border-radius: 4px;" class="form_designer_field" id="175DB5D9-6247-5702-5F2F-AE9E68C9AF5A_live">
<div style="width: 435px; height: 60px; text-align: left; color: rgb(255, 255, 255); line-height: 24px; letter-spacing: 0px; font-weight: normal; font-size: 16px; margin-top: 0px; margin-bottom: 0px; overflow: hidden;"
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data-medium-editor-editor-index="5" medium-editor-index="97c4ca68-013b-7105-db31-e64489996f12" data-placeholder="Type your text">
<p style="">Please Tell Us Why You're Unsubscribing</p>
</div>
</div>
</div>
</div>
<div>
<div style="position: absolute; top: 485px; left: 215px; cursor: text; border-radius: 4px;" class="form_designer_field" id="DA8CDF88-D78A-ABAA-2F93-9C019C468E22_live">
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<table>
<tbody>
<tr>
<td> <input id="DA8CDF88-D78A-ABAA-2F93-9C019C468E22" type="radio" name="radio_val" value="I receive too many emails" style="pointer-events: unset;" placeholder="I receive too many emails" autocomplete="off"> </td>
<td>
<div style="display:inline-block;" id="editable_DA8CDF88-D78A-ABAA-2F93-9C019C468E22" dataidval="DA8CDF88-D78A-ABAA-2F93-9C019C468E22" class="form_designer_field_editable" spellcheck="true" data-medium-editor-element="true"
role="textbox" aria-multiline="true" data-medium-editor-editor-index="6" medium-editor-index="5febdf5a-6120-00b6-3a27-b81611b8e24f" data-placeholder="Type your text">I receive too many emails</div>
</td>
</tr>
</tbody>
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</div>
</div>
<div>
<div style="position: absolute; top: 535px; left: 215px; cursor: text; border-radius: 4px;" class="form_designer_field" id="05EC09AC-B222-FF8D-C172-AE22C2ADD236_live">
<div id="container05EC09AC-B222-FF8D-C172-AE22C2ADD236" class="ui-resizable"
style="width: 270px; margin-bottom: 0px; margin-top: 0px; color: rgb(255, 255, 255); font-weight: bold; font-size: 16px; font-family: Open Sans; border-color: transparent; border-style: solid; border-width: 1px 8px 1px 1px; border-image: none 100% / 1 / 0 stretch; border-radius: 2px 8px 8px 2px; padding-right: 8px; margin-right: 8px; float: left; min-width: 50px; min-height: 10px; padding-top: 0px; padding-bottom: 0px; height: auto; line-height: 24px; letter-spacing: 0px;">
<table>
<tbody>
<tr>
<td> <input id="05EC09AC-B222-FF8D-C172-AE22C2ADD236" type="radio" name="radio_val" value="I'm leaving the industry" style="pointer-events: unset;" placeholder="I'm leaving the industry" autocomplete="off"> </td>
<td>
<div style="display:inline-block;" id="editable_05EC09AC-B222-FF8D-C172-AE22C2ADD236" dataidval="05EC09AC-B222-FF8D-C172-AE22C2ADD236" class="form_designer_field_editable" spellcheck="true" data-medium-editor-element="true"
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<div>
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<table>
<tbody>
<tr>
<td> <input id="6175C6C0-49BD-5DEB-FD23-9A837ACCC7CE" type="radio" name="radio_val" value="Other. Please explain below." style="pointer-events: unset;" placeholder="Other. Please explain below." autocomplete="off"> </td>
<td>
<div style="display:inline-block;" id="editable_6175C6C0-49BD-5DEB-FD23-9A837ACCC7CE" dataidval="6175C6C0-49BD-5DEB-FD23-9A837ACCC7CE" class="form_designer_field_editable" spellcheck="true" data-medium-editor-element="true"
role="textbox" aria-multiline="true" data-medium-editor-editor-index="8" medium-editor-index="1316b0b2-fadd-45ec-b751-1cf5824781f0" data-placeholder="Type your text">Other. Please explain below.</div>
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<div>
<div style="position: absolute; top: 653px; left: 170px; cursor: text; border-radius: 4px;" class="form_designer_field" id="A957392F-5F2C-1231-4CAB-162F814300A8_live"><textarea name="text_area" maxlength="1000"
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<p>You are unsubscribing <b>stickneyhe@upmc.edu</b>.</p>
</div>
</div>
</div>
</div>
<div>
<div style="position: absolute; top: 1264.33px; left: 250px; cursor: text; border-radius: 4px;" class="form_designer_field" id="submitButton_live">
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<input type="hidden" name="isf_form_id" value="1625"><input type="hidden" name="isf_id" value="533004325">
</form>Text Content
Template Name: Characters remaining: Template Description: Characters remaining: Name: Filename: Select the destination folder: Select a folder * Report * Edit * Test * Activate * Deactivate * Save As Template * Copy * Delete * Undelete * Archive * Set as In Progress * Form * Content Only * Unsubscribe Form * Custom Some non-required fields on this form are blank. Do you wish to save with blank values? Unsubscribe_Standard WE'LL MISS YOU By clicking "unsubscribe me" below, you're opting out of receiving member newsletters from AHIP, including PROMOTIONAL emails focused on conferences, online courses and more. Please Tell Us Why You're Unsubscribing I receive too many emails I'm leaving the industry Other. Please explain below. You are unsubscribing stickneyhe@upmc.edu. Unsubscribe Me