en.medshr.net Open in urlscan Pro
34.107.188.231  Public Scan

Form analysis
1 forms found in the DOM

POST https://en.medshr.net/join?referer=%2F

<form class="ccmsForm cmsEditor auth-register cms-editor-model cms-editor-model-is-new" id="edit-form" enctype="multipart/form-data" method="post" action="https://en.medshr.net/join?referer=%2F" accept-charset="utf-8">
  <fieldset class="fm-fieldset fm-fieldset">
    <legend></legend>
    <div class="fm-field fm-field-c-email control-group fm-field fm-property-email cms-editor-emailfield fm-required" id="f-email"><label for="c-email" class="fm-field-name control-label">Your email address</label>
      <div class="fm-options controls">
        <input class="textbox email" placeholder="Your email address" type="email" name="c-email" value="" id="c-email">
      </div>
    </div>
    <div class="fm-field fm-field-c-password control-group fm-field fm-property-password cms-editor-passwordfield fm-required" id="f-password"><label for="c-password" class="fm-field-name control-label">Password</label>
      <div class="fm-options controls">
        <input class="textbox password" placeholder="Password" type="password" name="c-password" id="c-password">
      </div>
    </div>
    <div class="fm-field fm-field-c-confirm_password control-group fm-field fm-property-confirm_password cms-editor-passwordfield" id="f-confirm_password"><label for="c-confirm_password" class="fm-field-name control-label">Confirm your
        password</label>
      <div class="fm-options controls">
        <input class="textbox password" placeholder="Confirm your password" type="password" name="c-confirm_password" id="c-confirm_password">
      </div>
    </div>
    <div class="fs-unmask fm-property--terms"><span class="fm-checkbox"><input type="checkbox" class="fm-property--terms__check fs-unmask" name="terms" value="1" id="terms-check"><label class="fm-property--terms__label" for="terms-check">I confirm
          that I have read and agreed to the <a href="/pages/privacy" target="_blank">Privacy Policy</a> and <a href="/pages/terms" target="_blank">Terms &amp; Conditions</a></label></span></div>
    <div class="fs-unmask fm-property--terms fm-property--marketing"><span class="fm-checkbox"><input type="checkbox" class="fm-property--terms__check fs-unmask" name="marketing" value="1" id="marketing-check"><label class="fm-property--terms__label"
          for="marketing-check">Receive marketing communications from MedShr</label></span></div>
  </fieldset>
  <div class="fm-footer"><input class="fm-formid" type="hidden" name="c-formid" value="c-formid">
    <input type="hidden" name="csrf_token" value="e138f539ae6faf19cd51553f0d485cfde13cecc7">
    <input type="hidden" name="referer" value="/">
    <button type="submit" class="btn btn-primary btn--pill btn--on-dark btn--wide" name="submitbutton" value="Join MedShr">Join MedShr</button>
  </div><input type="hidden" name="branch"
    value="{&quot;data&quot;:&quot;{\&quot;+clicked_branch_link\&quot;:false,\&quot;+is_first_session\&quot;:true}&quot;,&quot;data_parsed&quot;:{&quot;+clicked_branch_link&quot;:false,&quot;+is_first_session&quot;:true},&quot;has_app&quot;:false,&quot;identity&quot;:null,&quot;developer_identity&quot;:null,&quot;referring_identity&quot;:null,&quot;referring_link&quot;:null}">
</form>

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