sca-approach.co.uk Open in urlscan Pro
2606:4700:3032::ac43:cd3b  Public Scan

URL: https://sca-approach.co.uk/
Submission: On August 06 via api from US — Scanned from DE

Form analysis 5 forms found in the DOM

#

<form action="#" class="appointment-form ftco-animate">
  <h3>Free Consultation</h3>
  <div class="">
    <div class="form-group">
      <input type="text" class="form-control" placeholder="First Name">
    </div>
    <div class="form-group">
      <input type="text" class="form-control" placeholder="Last Name">
    </div>
  </div>
  <div class="">
    <div class="form-group">
      <div class="form-field">
        <div class="select-wrap">
          <div class="icon"><span class="ion-ios-arrow-down"></span></div>
          <select name="" id="" class="form-control">
            <option value="">Select Your Services</option>
            <option value="">Neurology</option>
            <option value="">Cardiology</option>
            <option value="">Dental</option>
            <option value="">Ophthalmology</option>
            <option value="">Other Services</option>
          </select>
        </div>
      </div>
    </div>
    <div class="form-group">
      <input type="text" class="form-control" placeholder="Phone">
    </div>
  </div>
  <div class="">
    <div class="form-group">
      <div class="input-wrap">
        <div class="icon"><span class="ion-md-calendar"></span></div>
        <input type="text" class="form-control appointment_date" placeholder="Date">
      </div>
    </div>
    <div class="form-group">
      <div class="input-wrap">
        <div class="icon"><span class="ion-ios-clock"></span></div>
        <input type="text" class="form-control appointment_time" placeholder="Time">
      </div>
    </div>
  </div>
  <div class="">
    <div class="form-group">
      <textarea name="" id="" cols="30" rows="2" class="form-control" placeholder="Message"></textarea>
    </div>
    <div class="form-group">
      <input type="submit" value="Appointment" class="btn btn-secondary py-3 px-4">
    </div>
  </div>
</form>

#

<form action="#" class="bg-light p-5 contact-form">
  <div class="form-group">
    <input type="text" class="form-control" placeholder="Your Name">
  </div>
  <div class="form-group">
    <input type="text" class="form-control" placeholder="Your Email">
  </div>
  <div class="form-group">
    <input type="text" class="form-control" placeholder="Subject">
  </div>
  <div class="form-group">
    <textarea name="" id="" cols="30" rows="7" class="form-control" placeholder="Message"></textarea>
  </div>
  <div class="form-group">
    <input type="submit" value="Send Message" class="btn btn-secondary py-3 px-5">
  </div>
</form>

POST

<form action="" method="POST">
  <input type="hidden" name="_token" value="Vo3rnQMO5W4aqLjqUh7hbBU6nwINl7QkgoYw8kkt">
  <div class="form-group">
    <input type="email" name="user_email" class="form-control" id="email11" placeholder="Email">
    <span id="user_email_error" class="span-error text-danger"></span>
  </div>
  <div class="form-group">
    <input type="password" name="password" class="form-control" id="password11" placeholder="Password">
    <span id="password_error" class="span-error text-danger"></span>
  </div>
  <span id="login_error" class="span-error text-danger"></span>
  <button type="button" id="button_submit_login" class="new-btn">Login</button>
  <a class="forgot-pass-btn" id="forgot_pass">forgot password</a>
</form>

POST

<form action="" method="POST" id="form_data">
  <meta name="csrf-token" content="Vo3rnQMO5W4aqLjqUh7hbBU6nwINl7QkgoYw8kkt">
  <div class="form-group">
    <input type="text" class="form-control" id="username1" name="user_name" placeholder="Username">
    <span id="user_name_error" class="span-error text-danger"></span>
  </div>
  <div class="form-group">
    <input type="email" class="form-control" id="email" name="user_email" placeholder="Email">
    <span id="register_user_email_error" class="span-error text-danger"></span>
  </div>
  <div class="form-group">
    <input type="password" name="password" class="form-control" id="password" placeholder="Password">
    <span id="register_password_error" class="span-error text-danger"></span>
  </div>
  <div class="form-group">
    <input type="password" name="password_confirmation" class="form-control" id="confirmPass1" placeholder="Confirm Password">
    <span id="password_confirmation_error" class="span-error text-danger"></span>
  </div>
  <div class="by-joining"> By joining, you may receive emails and updates related to your account. You can unsubscribe at anytime. </div>
  <button id="button_submit" class="new-btn">Create Account</button>
  <div class="forgot-pass-btn"><a href="javascript:void(0)">Already have an Account? login</a></div>
</form>

POST

<form action="" method="POST">
  <input type="hidden" name="_token" value="Vo3rnQMO5W4aqLjqUh7hbBU6nwINl7QkgoYw8kkt"> <span id="send_email" class="send-email"></span>
  <div class="form-group">
    <input type="email" name="user_email" class="form-control" id="forget-email" placeholder="Email">
    <span id="forget_user_email_error" class="span-error text-danger"></span>
  </div>
  <button type="button" id="send_reset_link" class="new-btn">Send Reset Link</button>
  <a class="forgot-pass-btn" id="back_to_sign_up">Back to Sign Up</a>
</form>

Text Content

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OUR PATIENT SAYS

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CONTACT US

Far far away, behind the word mountains, far from the countries Vokalia and
Consonantia


ADDRESS

198 West 21th Street, Suite 721 New York NY 10016


CONTACT NUMBER

+ 1235 2355 98


EMAIL ADDRESS

info@yoursite.com


WEBSITE

yoursite.com


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