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navicentelevate.com Open in urlscan Pro
199.167.73.52  Public Scan

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Submitted URL: http://navicentelevate.com/
Effective URL: https://navicentelevate.com/
Submission: On April 12 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

POST /

<form class="entityform entitytype-subscribe-form" action="/" method="post" id="subscribe-entityform-edit-form" accept-charset="UTF-8">
  <div>
    <div class="pre-instructions">
      <p>* Denotes required field</p>
    </div>
    <div class="field-type-text field-name-field-fname field-widget-text-textfield form-wrapper form-group" id="edit-field-fname">
      <div id="field-fname-add-more-wrapper">
        <div class="form-item form-item-field-fname-und-0-value form-type-textfield form-group"> <label class="control-label" for="edit-field-fname-und-0-value">First Name <span class="form-required" title="This field is required.">*</span></label>
          <input class="text-full form-control form-text required" type="text" id="edit-field-fname-und-0-value" name="field_fname[und][0][value]" value="" size="60" maxlength="255">
        </div>
      </div>
    </div><input type="hidden" name="form_build_id" value="form-DBlBOMz0pTFS8dplsOc1eVDqHOFbJ2Dc5qYWJRWLnTU">
    <input type="hidden" name="form_id" value="subscribe_entityform_edit_form">
    <div class="field-type-text field-name-field-lname field-widget-text-textfield form-wrapper form-group" id="edit-field-lname">
      <div id="field-lname-add-more-wrapper">
        <div class="form-item form-item-field-lname-und-0-value form-type-textfield form-group"> <label class="control-label" for="edit-field-lname-und-0-value">Last Name <span class="form-required" title="This field is required.">*</span></label>
          <input class="text-full form-control form-text required" type="text" id="edit-field-lname-und-0-value" name="field_lname[und][0][value]" value="" size="60" maxlength="255">
        </div>
      </div>
    </div>
    <div class="field-type-text field-name-field-subscriber-email field-widget-text-textfield form-wrapper form-group" id="edit-field-subscriber-email">
      <div id="field-subscriber-email-add-more-wrapper">
        <div class="form-item form-item-field-subscriber-email-und-0-value form-type-textfield form-group"> <label class="control-label" for="edit-field-subscriber-email-und-0-value">Email <span class="form-required"
              title="This field is required.">*</span></label>
          <input class="text-full form-control form-text required" type="text" id="edit-field-subscriber-email-und-0-value" name="field_subscriber_email[und][0][value]" value="" size="60" maxlength="255">
        </div>
      </div>
    </div>
    <div class="field-type-text field-name-field-subscriber-zip field-widget-text-textfield form-wrapper form-group" id="edit-field-subscriber-zip">
      <div id="field-subscriber-zip-add-more-wrapper">
        <div class="form-item form-item-field-subscriber-zip-und-0-value form-type-textfield form-group"> <label class="control-label" for="edit-field-subscriber-zip-und-0-value">Zip <span class="form-required"
              title="This field is required.">*</span></label>
          <input class="text-full form-control form-text required" type="text" id="edit-field-subscriber-zip-und-0-value" name="field_subscriber_zip[und][0][value]" value="" size="60" maxlength="255">
        </div>
      </div>
    </div>
    <div class="field-type-entityreference field-name-field-categories field-widget-options-buttons form-wrapper form-group" id="edit-field-categories">
      <div class="form-item form-item-field-categories-und form-type-checkboxes form-group"> <label class="control-label" for="edit-field-categories-und">Categories</label>
        <div id="edit-field-categories-und" class="form-checkboxes">
          <div class="form-item form-item-field-categories-und-511 form-type-checkbox checkbox"> <label class="control-label" for="edit-field-categories-und-511"><input type="checkbox" id="edit-field-categories-und-511"
                name="field_categories[und][511]" value="511" class="form-checkbox"> <span class="views-field views-field-name"> <span class="field-content">Adolescent and Child Health</span> </span></label>
          </div>
          <div class="form-item form-item-field-categories-und-163 form-type-checkbox checkbox"> <label class="control-label" for="edit-field-categories-und-163"><input type="checkbox" id="edit-field-categories-und-163"
                name="field_categories[und][163]" value="163" class="form-checkbox"> <span class="views-field views-field-name"> <span class="field-content">Behavioral Health</span> </span></label>
          </div>
          <div class="form-item form-item-field-categories-und-162 form-type-checkbox checkbox"> <label class="control-label" for="edit-field-categories-und-162"><input type="checkbox" id="edit-field-categories-und-162"
                name="field_categories[und][162]" value="162" class="form-checkbox"> <span class="views-field views-field-name"> <span class="field-content">Cancer</span> </span></label>
          </div>
          <div class="form-item form-item-field-categories-und-512 form-type-checkbox checkbox"> <label class="control-label" for="edit-field-categories-und-512"><input type="checkbox" id="edit-field-categories-und-512"
                name="field_categories[und][512]" value="512" class="form-checkbox"> <span class="views-field views-field-name"> <span class="field-content">General Health and Wellness</span> </span></label>
          </div>
          <div class="form-item form-item-field-categories-und-159 form-type-checkbox checkbox"> <label class="control-label" for="edit-field-categories-und-159"><input type="checkbox" id="edit-field-categories-und-159"
                name="field_categories[und][159]" value="159" checked="checked" class="form-checkbox"> <span class="views-field views-field-name"> <span class="field-content">Heart and Vascular Health</span> </span></label>
          </div>
          <div class="form-item form-item-field-categories-und-514 form-type-checkbox checkbox"> <label class="control-label" for="edit-field-categories-und-514"><input type="checkbox" id="edit-field-categories-und-514"
                name="field_categories[und][514]" value="514" class="form-checkbox"> <span class="views-field views-field-name"> <span class="field-content">Infant and Toddler Health</span> </span></label>
          </div>
          <div class="form-item form-item-field-categories-und-156 form-type-checkbox checkbox"> <label class="control-label" for="edit-field-categories-und-156"><input type="checkbox" id="edit-field-categories-und-156"
                name="field_categories[und][156]" value="156" checked="checked" class="form-checkbox"> <span class="views-field views-field-name"> <span class="field-content">Men's Health</span> </span></label>
          </div>
          <div class="form-item form-item-field-categories-und-154 form-type-checkbox checkbox"> <label class="control-label" for="edit-field-categories-und-154"><input type="checkbox" id="edit-field-categories-und-154"
                name="field_categories[und][154]" value="154" class="form-checkbox"> <span class="views-field views-field-name"> <span class="field-content">Nutrition</span> </span></label>
          </div>
          <div class="form-item form-item-field-categories-und-153 form-type-checkbox checkbox"> <label class="control-label" for="edit-field-categories-und-153"><input type="checkbox" id="edit-field-categories-und-153"
                name="field_categories[und][153]" value="153" class="form-checkbox"> <span class="views-field views-field-name"> <span class="field-content">Orthopedics</span> </span></label>
          </div>
          <div class="form-item form-item-field-categories-und-151 form-type-checkbox checkbox"> <label class="control-label" for="edit-field-categories-und-151"><input type="checkbox" id="edit-field-categories-und-151"
                name="field_categories[und][151]" value="151" class="form-checkbox"> <span class="views-field views-field-name"> <span class="field-content">Senior Health</span> </span></label>
          </div>
          <div class="form-item form-item-field-categories-und-149 form-type-checkbox checkbox"> <label class="control-label" for="edit-field-categories-und-149"><input type="checkbox" id="edit-field-categories-und-149"
                name="field_categories[und][149]" value="149" class="form-checkbox"> <span class="views-field views-field-name"> <span class="field-content">Weight Management</span> </span></label>
          </div>
          <div class="form-item form-item-field-categories-und-147 form-type-checkbox checkbox"> <label class="control-label" for="edit-field-categories-und-147"><input type="checkbox" id="edit-field-categories-und-147"
                name="field_categories[und][147]" value="147" checked="checked" class="form-checkbox"> <span class="views-field views-field-name"> <span class="field-content">Women's Health</span> </span></label>
          </div>
        </div>
      </div>
    </div>
    <div class="form-actions form-wrapper form-group" id="edit-actions"><button type="submit" id="edit-submit" name="op" value="Subscribe" class="btn btn-default form-submit">Subscribe</button>
    </div>
  </div>
</form>

Text Content

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resources. Make informed choices for a healthier you.

Highlights include:
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* Denotes required field

First Name *
Last Name *
Email *
Zip *
Categories
Adolescent and Child Health
Behavioral Health
Cancer
General Health and Wellness
Heart and Vascular Health
Infant and Toddler Health
Men's Health
Nutrition
Orthopedics
Senior Health
Weight Management
Women's Health
Subscribe

We take your privacy seriously and will not share your name, email address, or
physical address with anyone. All information we receive from you will remain
under our control and will not be revealed, released, or traded to any third
party or any other customer. Your email address will be used for the sole
purpose of sending useful information from us to you.

Atrium Health Navicent
777 Hemlock Street,
Macon, Georgia 31201

This publication in no way seeks to diagnose or treat illness or to serve as a
substitute for professional medical care.

Atrium Health Navicent complies with applicable Federal civil rights laws and
does not discriminate on the basis of race, color, national origin, age,
disability or sex. For more information, see link on our home page at
http://www.navicenthealth.org.


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