patient-connect.affidea.ie Open in urlscan Pro
40.67.248.173  Public Scan

Form analysis
1 forms found in the DOM

POST /sign-in

<form action="/sign-in" method="post">
  <input name="__RequestVerificationToken" type="hidden" value="PNZnGQcfx4bUGJBNuIHbRxilnJQe-lzHyzOnbA1l4prFCGk7JEyn7G5rl4fxQDIF1VZh5R9Jth2-rUZxtl0Kag3bsziFSaewGzWUDya8m881">
  <input id="RedirectUrl" name="RedirectUrl" type="hidden" value="/">
  <div class="row">
    <div class="input-field">
      <input data-val="true" data-val-required="Please enter your username." id="Username" name="Username" placeholder="Email or mobile number" type="text" value="">
      <label for="email_mobile" class="active">Enter your email or mobile number</label>
      <span class="field-validation-valid" data-valmsg-for="Username" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="row">
    <div class="input-field">
      <input data-val="true" data-val-required="Please enter your password." id="Password" name="Password" placeholder="Password" type="password">
      <label for="password" class="active">Enter your password</label>
      <span class="field-validation-valid" data-valmsg-for="Password" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="row center" style="padding: 10px 0 10px 0">
    <input class="filled-in" id="RememberMe" name="RememberMe" type="checkbox" value="true"><input name="RememberMe" type="hidden" value="false">
    <label for="RememberMe">Remember me</label>
  </div>
  <div class="row center">
    <button id="sign-in" class="btn-large waves-effect waves-light full-width loading-btn hover-effect" type="submit" name="action">Sign in</button>
  </div>
  <div class="row center hide-on-med-and-down" style="padding: 10px 0 10px 0">
    <a id="forgot-password" href="/recover-register-account">Recover or register your account</a>
  </div>
  <div class="row center hide-on-large-only" style="padding: 10px 0 10px 0">
    <p><a id="forgot-password" href="/recover-register-account">Recover or register your account</a></p>
    <br>
  </div>
</form>

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Multi-factor authentication (MFA) will be enforced from 01/02/2022. MFA enhances
your account's security by requiring you to present a second factor in addition
to your username and password when you sign in.
×


HAVE YOU RECEIVED A ACTIVATION SMS OR EMAIL?

Affidea Connect Patient will automatically create an account for you with your
email address or mobile number that you have provided to your radiology
provider.

If you haven't received an activation message, you can request another one by
clicking on the button below.

1. RECEIVE ACTIVATION LINK

Follow the link in the SMS message or Email to take you to the activation
process.

2. CONFIRM YOUR DETAILS

For security reasons, you will be asked to confirm your personal details.

3. ACCOUNT ACTIVATED!

Your images will be automatically subscribed to your account.

Resend activation link





Access your medical images anywhere, anytime.





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Enter your password
Remember me
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