wassermatrix.ch Open in urlscan Pro
173.212.201.195  Public Scan

URL: https://wassermatrix.ch/
Submission: On March 12 via api from CH — Scanned from CH

Form analysis 2 forms found in the DOM

POST

<form class="contact-form form-style-2" action="" method="POST">
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      <option value="">- Anrede - bitte auswählen - </option>
      <option value="geehrte Frau">Frau</option>
      <option value="geehrter Herr">Herr</option>
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  <div class="form-group" id="agree2">
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    <p style="font-size:12px;">&nbsp;Mit der Anmeldung über das Formular akzeptiere ich die <a target="_blank" href="/rechtliches/agbs-datenschutz/">Datenschutzerklärung.</a></p>
  </div>
  <div id="FormAlert2"></div>
  <p>* Pflichtfeld, müssen ausgefüllt werden</p>
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POST

<form class="contact-form form-style-2" action="" method="POST">
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        <option value="geehrte Frau">Frau</option>
        <option value="geehrter Herr">Herr</option>
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      <option value="Vietnam">Vietnam</option>
      <option value="Wallis and Futuna">Wallis and Futuna</option>
      <option value="Yemen">Yemen</option>
      <option value="Zambia">Zambia</option>
      <option value="Zimbabwe">Zimbabwe</option>
      <option value="KKTC">KKTC</option>
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  </div>
  <div class="form-group">
    <input type="text" class="form-control" id="eMail" name="eMail" placeholder="E-Mail">
  </div>
  <div class="form-group">
    <input type="text" class="form-control" id="telefon" name="telefon" placeholder="Telefon">
  </div>
  <div class="form-group">
    <input type="text" class="form-control" id="Ihrwunschtermin" name="Ihrwunschtermin" placeholder="Ihr Wunschtermin">
  </div>
  <div class="form-group">
    <label for="recipient-name" class="form-control-label">Uhrzeit*</label>
    <select class="form-control text-color-dark border-0" aria-label="Bevorzugte Zeit" required="" id="Bevorzugte2" name="Bevorzugte2">
      <option value="">Bitte auswählen</option>
      <option value="Vormittags">Vormittags</option>
      <option value="Nachmittags">Nachmittags</option>
      <option value="Ganztags">Ganztags</option>
    </select>
  </div>
  <div class="form-group">
    <textarea maxlength="5000" rows="5" class="form-control" name="message" id="message" placeholder="Thema des Termins" required=""></textarea>
  </div>
  <div class="form-group" id="agree1">
    <input style="float:left;margin-top:5px;" type="checkbox" name="agree1" value="1" id="agree1">
    <p style="font-size:12px;">&nbsp;Mit der Anmeldung über das Formular akzeptiere ich die <a target="_blank" href="/rechtliches/agbs-datenschutz/">Datenschutzerklärung.</a></p>
  </div>
  <p>* Pflichtfeld, müssen ausgefüllt werden</p>
  <div id="FormAlert"></div>
</form>

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KONTAKT

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- Land - Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla
Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria
Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin
Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin
Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde
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Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue
Norfolk Island North Korea Norway Oman Pakistan Palau Panama Papua New Guinea
Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar R
Romania Russia Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint
Pierre and Miquelon Saint Vincent and the Grenadines San Marino Sao Tome and
Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia
Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka Sudan
Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand
Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and
Caicos Islands Tuvalu U.S. Virgin Islands Uganda Ukraine United Arab Emirates
United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela
Vietnam Wallis and Futuna Yemen Zambia Zimbabwe KKTC



Uhrzeit* Bitte auswählen Vormittags Nachmittags Ganztags


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* Pflichtfeld, müssen ausgefüllt werden


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