www.medentmobile.com
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65.114.41.8
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Submitted URL: https://www.medentmobile.com/portal/document.php?form_name=123&field_index=0&field_type=popup_pdf_0&form_id=d1418&practice_id...
Effective URL: https://www.medentmobile.com/portal/index.php?main_section=login&practice_id=4cdR9zn5&primary_tab=messages
Submission: On May 02 via manual from US — Scanned from DE
Effective URL: https://www.medentmobile.com/portal/index.php?main_section=login&practice_id=4cdR9zn5&primary_tab=messages
Submission: On May 02 via manual from US — Scanned from DE
Form analysis
1 forms found in the DOMName: form1 — POST https://www.medentmobile.com/cgi-bin/portalcgi
<form id="form1" name="form1" action="https://www.medentmobile.com/cgi-bin/portalcgi" method="post" data-ajax="false">
<input name="action" type="hidden" value="login">
<input name="practice_id" type="hidden" value="4cdR9zn5">
<input name="session_id" type="hidden" value="5ab04219b04c4d05109c24f622587adc_4cdR9zn5">
<div>
<div>
<label for="user">Login</label>
<input type="text" id="user" name="user" placeholder="" maxlength="12" autocomplete="off" autocapitalize="off" required="" autofocus="">
</div>
<button class="ppbutton" type="submit" name="Submit" value="Login" data-enhanced="true">Sign in</button>
<br><a href="https://www.medentmobile.com/portal/index.php?practice_id=4cdR9zn5&mode=1&main_section=forgot_password">Forgot password?</a>
<br><a href="https://www.medentmobile.com/portal/index.php?practice_id=4cdR9zn5&mode=1&main_section=forgot_user_or_password">Forgot login name?</a>
</div>
<h2 class="hidden_header">Account Activation</h2>
<div class="separatorSpaceTop"> New to the patient portal?<br>
<a href="https://www.medentmobile.com/portal/index.php?practice_id=4cdR9zn5&mode=1&main_section=portal_signup" class="pp_button" data-role="button">Activate account</a>
</div>
<input type="hidden" id="pp_session_id" name="pp_session_id" value="5ab04219b04c4d05109c24f622587adc_4cdR9zn5"><input type="hidden" id="pp_practice_id" name="pp_practice_id" value="4cdR9zn5">
</form>
Text Content
NORTH WIND PRIMARY CARE PLLC PORTAL SIGN IN Login Sign in Forgot password? Forgot login name? ACCOUNT ACTIVATION New to the patient portal? Activate account