www.walgreens.com
Open in
urlscan Pro
23.53.35.136
Public Scan
URL:
https://www.walgreens.com/register/pharmacyRegistration.jsp?type=155&ec=hn:EML_Rx_RefillReminder_RRI2_99991231_p015-change...
Submission: On June 05 via manual from US — Scanned from US
Submission: On June 05 via manual from US — Scanned from US
Form analysis 2 forms found in the DOM
/search/results.jsp
<form action="/search/results.jsp" class="input__search-contain" data-reactid="740"><input type="text" value="" id="ntt-placeholder" class="blue-shadow ellipsis" name="Ntt" placeholder="Search" aria-label="Search by keyword or item number"
autocomplete="off" autocorrect="off" title="Search" role="combobox" aria-describedby="ntt-placeholder" aria-live="polite" aria-autocomplete="list" aria-controls="wag-typeaheadlists" aria-expanded="false" data-reactid="741"><button
class="icon icon_16 icon__dismiss-v2 search-reset" type="reset" title="Clear Search" aria-label="Clear Search input" data-reactid="742"><svg id="pf-icon__dismiss-v2" viewBox="0 0 32 32" data-reactid="743">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__dismiss-v2" data-reactid="744"></use>
</svg></button><button type="submit" class="icon icon_20 icon__search" title="Search" style="pointer-events:auto;" data-reactid="745"><svg aria-label="Search" id="pf-icon__search" viewBox="0 0 32 32" aria-hidden="true" data-reactid="746">
<use href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__search" data-reactid="747"></use>
</svg></button></form><form class="form__on-light-bg" autocomplete="off"> <!-------Full Name Component----->
<div id="wag-reg-fullname-InnerHTML">
<div class="form__input"> <span class="input__contain" id="wag-RXUser-firstname-field"> <input type="text" name="firstName" id="wag-RXUser-firstname" autocomplete="off" aria-describedby="firstname-error-text" required="" placeholder="First name">
<label class="input__title" for="wag-RXUser-firstname">*First name</label></span><span id="firstname-error-text" class="error_container"> <span class="wag-condition-text input__error-text wag-hide" id="wag-RXUser-firstname-error"
aria-live="polite" aria-atomic="true"><span class="icon icon__alert icon_lsg"><svg focusable="false" aria-hidden="true">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span class="sr-only">Error</span><span>Please enter your first name.</span></span><span class="wag-condition-text input__error-text wag-hide" id="wag-RXUser-firstname-error-invalidformat" aria-live="polite"
aria-atomic="true"><span class="icon icon__alert icon_lsg"><svg focusable="false" aria-hidden="true">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span class="sr-only">Error</span><span>Please enter a valid first name only with letters.</span></span><span class="wag-condition-text input__error-text wag-hide" id="wag-RXUser-firstname-error-invalidname"
aria-live="polite" aria-atomic="true"><span class="icon icon__alert icon_lsg" svg="" focusable="false" aria-hidden="true">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</span><span class="sr-only">Error</span><span>Please enter the correct first name.</span></span></span> </div>
<div class="form__input"> <span class="input__contain" id="wag-RXUser-lastname-field"> <input type="text" name="lastName" id="wag-RXUser-lastname" autocomplete="off" aria-describedby="lastname-error-text" required="" placeholder="Last name">
<label class="input__title" for="wag-RXUser-lastname">*Last name</label></span><span id="lastname-error-text" class="error_container"> <span class="wag-condition-text input__error-text wag-hide" id="wag-RXUser-lastname-error"
aria-live="polite" aria-atomic="true"><span class="icon icon__alert icon_lsg"><svg focusable="false" aria-hidden="true">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span class="sr-only">Error</span><span>Please enter your last name.</span></span><span class="wag-condition-text input__error-text wag-hide" id="wag-RXUser-lastname-error-invalidformat" aria-live="polite"
aria-atomic="true"><span class="icon icon__alert icon_lsg"><svg focusable="false" aria-hidden="true">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span class="sr-only">Error</span><span>Please enter a valid last name only with letters.</span></span><span class="wag-condition-text input__error-text wag-hide" id="wag-RXUser-lastname-error-invalidname" aria-live="polite"
aria-atomic="true"><span class="icon icon__alert icon_lsg"><svg focusable="false" aria-hidden="true">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span class="sr-only">Error</span><span>Please enter the correct first name.</span></span></span> </div>
</div><!------- First Name view ----->
<section class="mt20 col-12 p0 wag-hide" id="fnameHide">
<p class="mt0"><strong>First name</strong></p>
<p id="covidFname"></p>
</section><!------- Last Name view ----->
<section class="mt20 col-12 p0 wag-hide" id="lnameHide">
<p class="mt0"><strong>Last name</strong></p>
<p id="covidLname"></p>
</section><!------- DOB view ----->
<section class="mt20 col-12 p0 wag-hide" id="dob">
<p class="mt0"><strong>Date of birth</strong></p>
<p id="covidDob"></p>
</section>
<section class="col-lg-11 col-md-11 col-sm-10 col-xs-10 p0 mt20">
<div class="form__input"> <span class="input__contain" id="wag-RXUser-DOB-field"> <input type="text" name="date" id="wag-RXUser-DOB" autocomplete="off" aria-describedby="dob-error-text" maxlength="10" required="true"
aria-label="Date of birth.Please enter date of birth in 2 digits for month 2 digits for days 4 digits for year. Must be 13 years or older" placeholder="MM/DD/YYYY"> <label class="input__title" for="wag-RXUser-DOB">Date of birth</label>
</span> </div>
<div class="tool-tip wag-form-input-tooltip" id="dobInfo"> <span class="tool-tip__trigger" tabindex="0" aria-describedby="tool-tip__text_dob" role="button"> <span class="icon icon__question-mark"
aria-label="date of birth information text read only"> <svg aria-hidden="true" focusable="false" viewBox="0 0 64 64" width="100%" height="100%">
<title>Help information</title>
<path
d="M32 43.616c-6.4 0-11.616-5.216-11.616-11.616s5.216-11.616 11.616-11.616 11.616 5.216 11.616 11.616-5.216 11.616-11.616 11.616zM32 21.92c-5.536 0-10.080 4.512-10.080 10.080s4.512 10.080 10.080 10.080 10.080-4.512 10.080-10.080-4.544-10.080-10.080-10.080z">
</path>
<path d="M32.416 35.84c0 0.53-0.43 0.96-0.96 0.96s-0.96-0.43-0.96-0.96c0-0.53 0.43-0.96 0.96-0.96s0.96 0.43 0.96 0.96z"></path>
<path
d="M31.36 34.080c-0.416 0-0.768-0.352-0.768-0.768 0-1.504 1.024-2.048 1.76-2.464 0.768-0.416 1.088-0.64 1.088-1.44 0-0.16-0.032-0.608-0.256-0.928s-0.608-0.48-1.152-0.48c-0.544 0-0.928 0.16-1.184 0.512-0.224 0.288-0.288 0.704-0.288 0.96 0 0.416-0.352 0.768-0.768 0.768s-0.768-0.352-0.768-0.768c0-0.32 0.064-1.088 0.544-1.824 0.384-0.544 1.12-1.184 2.464-1.184 2.208 0 2.976 1.6 2.976 2.976 0 1.76-1.152 2.368-1.92 2.784-0.704 0.384-0.96 0.544-0.96 1.088 0 0.416-0.32 0.768-0.768 0.768z">
</path>
</svg> </span> </span>
<div id="tool-tip__text_dob" class="tool-tip__overlay tool-tip__blue" role="tooltip" aria-expanded="false">
<p>To keep your records complete and provide you with accurate health info.</p>
</div>
</div><span id="dob-error-text" class="error_container"><span class="wag-condition-text input__error-text wag-hide" id="wag-RXUser-DOB-error" aria-live="polite" aria-atomic="true"><span class="icon icon__alert icon_lsg" aria-label="Error"><svg
focusable="false" aria-hidden="true">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span>Please enter valid date of birth.</span></span><span class="wag-condition-text input__error-text wag-hide" id="wag-RXUser-DOB-error-invalide" aria-live="polite" aria-atomic="true"><span class="icon icon__alert icon_lsg"
aria-label="Error"><svg focusable="false" aria-hidden="true">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span>Account holders must be 13 years of age or older.</span></span><span class="wag-condition-text input__error-text wag-hide" id="wag-RXUser-DOB-error-ageinvalid" aria-live="polite" aria-atomic="true"><span
class="icon icon__alert icon_lsg" aria-label="Error"><svg focusable="false" aria-hidden="true">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span id="wag-RXUser-DOB-error-ageinvalid-txt"></span></span></span>
</section>
<section class="col-lg-12 p0 mt20">
<div id="wag-reg-joinBrandCreateNew-InnerHTML">
<section id="wag-cmp-4668" class="phoneNoContainer col-12 p0">
<section id="wag-cmp-4668View" class="col-12 p0">
<section id="wagph7097" class="phoneNoComponent col-12 p0 ">
<div class="col-12 p0 mr100">
<div class="form__input pl0 pr0 col-12"><span class="input__contain" id="wagph7097-phoneno-field"><input type="text" aria-describedby="wagph7097-phoneno-error-desc" name="phoneno" id="wagph7097-phone-number" class="phone-number"
data-phoneid="" value="" placeholder="000-000-0000" required=""> <label class="input__title" for="wagph7097-phone-number"><span>*</span>Phone</label> </span>
<div id="wagph7097-phoneno-error-desc"><span class="wag-phoneno-error input__error-text col-12 p0 wag-hide" aria-live="polite" aria-atomic="true"><span class="icon icon__alert icon_lsg"><svg aria-hidden="true" focusable="false">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span class="sr-only">Error</span><span class="wag-phoneno-access-text sr-only"></span><span class="wag-phoneno-error-text" aria-hidden="true" focusable="false"></span></span></div>
</div>
</div>
</section>
</section>
<section class="col-12 p0">
<a id="addPhone" href="javascript:void(0);" style="line-height:50px;" class="mt25 wag-hide"><span class="icon icon__plus-add" style="vertical-align:middle;" aria-hidden="true"><svg aria-hidden="true" focusable="false"><use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__plus-add"></use></svg></span><strong class="font__eighteen" style="vertical-align:middle;">Add new number</strong></a>
</section>
</section>
</div>
</section>
<section class="col-lg-12 p0 mt20 wag-reg-tabFocus"><span class="select__contain"> <label for="wag-phonetype-select">Phone type</label> <span class="icon icon__arrow-down icon_lsg" aria-hidden="true"> <svg aria-hidden="true" focusable="false">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__arrow-down"></use>
</svg> </span> <select id="wag-phonetype-select" aria-label="Phone type drop-down list">
<option value="Cell">Cell</option>
<option value="Home">Home</option>
<option value="Work">Work</option>
</select></span></section>
<div class="clearfix"></div><!-------Email Password Component----->
<div class="form__input" id="wag-email-InnerHTML">
<div class="form__input"> <span class="input__contain" id="wag-email-field"> <input type="text" name="registerData" id="wag-email" placeholder="" maxlength="64" value="" autocomplete="off" aria-describedby="email-error-text" required=""> <label
class="input__title" for="wag-email">*Email</label> <span> </span></span></div><span id="email-error-text" class="error_container">
<p class="wag-condition-text input__error-text wag-hide" id="wag-email-error" aria-live="polite" aria-atomic="true"><span class="icon icon__alert icon_lsg"><svg focusable="false" aria-hidden="true">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span class="sr-only">Error</span><span>Please enter your email address.</span></p>
<p class="wag-condition-text input__error-text wag-hide" id="wag-email-notvalid-error" aria-live="polite" aria-atomic="true"><span class="icon icon__alert icon_lsg"><svg focusable="false" aria-hidden="true">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span class="sr-only">Error</span><span>Please enter your email address.</span></p>
<div class="input__error-text wag-hide" id="wag-email-res-error" aria-live="polite" aria-atomic="true"><span class="icon icon__alert icon_lsg email-err-icon"><svg focusable="false" aria-hidden="true">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span class="sr-only">Email</span><span class="wag-condition-text input__error-text" id="wag-email-res-error-msg"></span></div>
</span>
</div>
<div class="form__input" id="wag-password-InnerHTML">
<div class="tool-tip wag-password-required-text"> <span class="tool-tip__trigger" tabindex="0" aria-describedby="tool-tip__text_psw"> <span class="icon icon__question-mark bold" style="text-decoration: underline;">Requirements</span> </span>
<div id="tool-tip__text_psw" class="tool-tip__overlay tool-tip__blue" role="tooltip">
<ul class="wag-bullets pl15 wag-popover-psw-font list-styles list-styles__unordered">
<li>At least 8 characters containing at least 1 number and 1 letter</li>
<li>Can't be the same as your name or email</li>
<li>Can't be a commonly used or at-risk password, including:<ul class="psw-tool-tip-sublist">
<li>- Common words with a number after them</li>
<li>- Common keyboard sequences (example: asdf1234)</li>
<li>- Common words with a letter replaced by a number or symbol</li>
</ul>
</li>
</ul>
</div>
</div>
<div class="clearfix"></div>
<div class="form__input m0" style="margin-top: 0;"><span class="input__contain" id="wag-password-field"><input type="password" name="registerPassword" id="wag-password" placeholder="" data-attr-minlen="8" value="" autocomplete="new-password"
aria-describedby="psw-error-text password-sr" required=""><label class="input__title" for="wag-password">*Password</label> <span> </span></span></div><span id="password-sr" class="sr-only">Minimum 8 characters at least 1 letter and 1 number
case-sensitive.</span>
<p class="wag-condition-text wag-condition-text-color input__success-text" aria-hidden="true"><span class="icon icon__info icon_lsg wag-condition-text-color"><svg aria-hidden="true" focusable="false">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__info"></use>
</svg></span><span>Minimum 8 characters; at least 1 letter and 1 number; case-sensitive.</span></p><span id="psw-error-text" class="error_container">
<p class="wag-condition-text input__error-text wag-hide" id="wag-password-error" aria-live="polite" aria-atomic="true"><span class="icon icon__alert icon_lsg"><svg aria-hidden="true" focusable="false">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span class="sr-only">Error</span><span>Please enter your password.</span></p>
<p class="wag-condition-text input__error-text wag-hide" id="wag-password-minlen-error" aria-live="polite" aria-atomic="true"><span class="icon icon__alert icon_lsg"><svg aria-hidden="true" focusable="false">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span class="sr-only">Error</span><span>Password needs to have a minimum of 8 characters.</span></p>
<p class="wag-condition-text input__error-text wag-hide" id="wag-password-format-error" aria-live="polite" aria-atomic="true"><span class="icon icon__alert icon_lsg"><svg aria-hidden="true" focusable="false">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span class="sr-only">Error</span><span>Your password must contain both numbers and letters.</span></p>
<p class="wag-condition-text input__error-text wag-hide" id="wag-password-res-error" aria-live="polite" aria-atomic="true"></p>
</span>
<div class="clearfix"></div>
<section class="col-lg-12 p0 mt10 check-box__blue">
<p class="check-box showpsw-checkbox-container"> <input id="wag-showpassword-checkbox" type="checkbox" tabindex="0"> <label for="wag-showpassword-checkbox" style="outline: none;"><span class="check"></span><span>Show password</span></label>
</p>
</section><span class="sr-only custom__open-modal" id="openSingleMatchOverlay"></span>
</div> <!-------Security Question Component----->
<section class="col-lg-12 p0 mt20" id="RXUsersecurityquestionTemplate">
<div id="RxUsersecurityQuestionComponentInnerHTML">
<div class="form__input col-lg-11 col-md-11 col-sm-10 col-xs-10 p0"><span class="select__contain wag-reg-tabFocus" id="wag-RXUser-securityQus-field"> <label for="wag-securityquestion-select">Security question</label> <span
class="icon icon__arrow-down" aria-hidden="true"> <svg aria-hidden="true" focusable="false">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__arrow-down"></use>
</svg> </span> <select id="wag-securityquestion-select" aria-describedby="security-qus-error-text" required="">
<option value="">Choose security question</option>
<option value="0">What was your childhood nickname?</option>
<option value="1">What was your favorite place to visit as a child?</option>
<option value="2">In what city or town was your first job?</option>
<option value="3">What model was your first car?</option>
<option value="4">On what street was your childhood home?</option>
<option value="5">What is your oldest sibling's middle name?</option>
<option value="6">Who was your best friend in grade school?</option>
<option value="7">Who was your childhood hero?</option>
<option value="8">What was the name of your first stuffed toy?</option>
<option value="9">Where was your wedding reception held?</option>
<option value="10">In what city does your nearest sibling live?</option>
<option value="11">Who was your favorite childhood friend?</option>
<option value="12">What school did you attend for sixth grade?</option>
<option value="13">When is your oldest sibling's birthday?</option>
</select></span>
<div class="tool-tip wag-form-input-tooltip"> <span class="tool-tip__trigger" tabindex="0" aria-describedby="tool-tip__text_que" role="button" aria-label="Security question information text read only"> <span class="icon icon__question-mark"
aria-hidden="true"> <svg aria-hidden="true" focusable="false" viewBox="0 0 64 64" width="100%" height="100%">
<path
d="M32 43.616c-6.4 0-11.616-5.216-11.616-11.616s5.216-11.616 11.616-11.616 11.616 5.216 11.616 11.616-5.216 11.616-11.616 11.616zM32 21.92c-5.536 0-10.080 4.512-10.080 10.080s4.512 10.080 10.080 10.080 10.080-4.512 10.080-10.080-4.544-10.080-10.080-10.080z">
</path>
<path d="M32.416 35.84c0 0.53-0.43 0.96-0.96 0.96s-0.96-0.43-0.96-0.96c0-0.53 0.43-0.96 0.96-0.96s0.96 0.43 0.96 0.96z"></path>
<path
d="M31.36 34.080c-0.416 0-0.768-0.352-0.768-0.768 0-1.504 1.024-2.048 1.76-2.464 0.768-0.416 1.088-0.64 1.088-1.44 0-0.16-0.032-0.608-0.256-0.928s-0.608-0.48-1.152-0.48c-0.544 0-0.928 0.16-1.184 0.512-0.224 0.288-0.288 0.704-0.288 0.96 0 0.416-0.352 0.768-0.768 0.768s-0.768-0.352-0.768-0.768c0-0.32 0.064-1.088 0.544-1.824 0.384-0.544 1.12-1.184 2.464-1.184 2.208 0 2.976 1.6 2.976 2.976 0 1.76-1.152 2.368-1.92 2.784-0.704 0.384-0.96 0.544-0.96 1.088 0 0.416-0.32 0.768-0.768 0.768z">
</path>
</svg> </span> </span>
<div id="tool-tip__text_que" class="tool-tip__overlay tool-tip__blue" role="tooltip" aria-expanded="false">
<p>This helps verify your identity if you lose or forget your password.</p>
</div>
</div><span id="security-qus-error-text" class="error_container">
<p class="wag-condition-text input__error-text wag-hide" id="wag-RXUser-securityQus-error" aria-live="polite" aria-atomic="true"><span class="icon icon__alert icon_lsg" aria-label="error"><svg focusable="false" aria-hidden="true">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span>Please select a security question.</span></p>
</span>
</div>
<div class="clearfix"></div>
<div class="form__input"> <span class="input__contain" id="wag-RXUser-security-field"> <input type="text" name="securityAns" id="wag-RXUser-securityanswer" aria-describedby="security-ans-error-cont" required="" placeholder="Security Answer">
<label class="input__title" for="wag-RXUser-securityanswer">Security Answer</label> </span>
<div id="security-ans-error-cont" class="wag-hide"><span class="wag-condition-text input__error-text wag-hide" id="wag-RXUser-security-empty-error" aria-live="polite" aria-atomic="true"><span class="icon icon__alert icon_lsg"
aria-label="error"><svg aria-hidden="true" focusable="false">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span>Please enter an answer for your security question.</span></span><span class="wag-condition-text input__error-text wag-hide" id="wag-RXUser-security-invalid-error" aria-live="polite" aria-atomic="true"><span
class="icon icon__alert icon_lsg" aria-label="error"><svg aria-hidden="true" focusable="false">
<use xlink:href="/images/adaptive/livestyleguide/walgreens-com/v5/themes/images/icons/symbol-defs.svg#icon__alert"></use>
</svg></span><span>Please enter alphabets, numeric and spaces only.</span></span></div>
</div>
</div>
</section><!-------Points and Terms Component----->
<div id="wag-reg-points&terms-InnerHTML" class="wag-reg-points-terms">
<hr class="wag-hr-200 mt30">
<section class="col-lg-12 p0 mt10"></section>
<section class="col-lg-12 p0 mt10 check-box__blue sms-option-check wag-hide">
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