upmc-nj.com
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18.210.87.86
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Submitted URL: https://www.upmc-nj.com/
Effective URL: https://upmc-nj.com/
Submission: On October 03 via api from US — Scanned from DE
Effective URL: https://upmc-nj.com/
Submission: On October 03 via api from US — Scanned from DE
Form analysis 2 forms found in the DOM
POST /
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class="gfield_label gform-field-label" for="input_2_1">Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_1" id="input_2_1" type="text" value="" class="medium" aria-required="true" aria-invalid="false"> </div>
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class="gfield_label gform-field-label" for="input_2_2">Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_phone"><input name="input_2" id="input_2_2" type="tel" value="" class="medium" aria-required="true" aria-invalid="false"></div>
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class="gfield_label gform-field-label" for="input_2_3">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_3" id="input_2_3" type="email" value="" class="large" aria-required="true" aria-invalid="false">
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class="gfield_label gform-field-label" for="input_2_4">Message<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_4" id="input_2_4" class="textarea small" aria-required="true" aria-invalid="false" rows="10" cols="50"></textarea></div>
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data-js-reload="field_2_5">Please use this form for general information purposes only. DO NOT send personal health information through this form. Specific patient care must be addressed during your appointment.</li>
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<div class="ginput_container"><input name="input_6" id="input_2_6" type="text" value="" autocomplete="new-password"></div>
<div class="gfield_description" id="gfield_description_2_6">This field is for validation purposes and should be left unchanged.</div>
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<input type="hidden" name="gform_field_values" value="">
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</form>POST /
<form method="post" enctype="multipart/form-data" id="gform_2" action="/" data-formid="2" novalidate="">
<div class="gform-body gform_body">
<ul id="gform_fields_2" class="gform_fields top_label form_sublabel_below description_below validation_below">
<li id="field_2_1" class="gfield gfield--type-text gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_2_1"><label
class="gfield_label gform-field-label" for="input_2_1">Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_1" id="input_2_1" type="text" value="" class="medium" aria-required="true" aria-invalid="false"> </div>
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<li id="field_2_2" class="gfield gfield--type-phone gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_2_2"><label
class="gfield_label gform-field-label" for="input_2_2">Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_phone"><input name="input_2" id="input_2_2" type="tel" value="" class="medium" aria-required="true" aria-invalid="false"></div>
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<li id="field_2_3" class="gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_2_3"><label
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<div class="ginput_container ginput_container_email">
<input name="input_3" id="input_2_3" type="email" value="" class="large" aria-required="true" aria-invalid="false">
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<li id="field_2_4" class="gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_2_4"><label
class="gfield_label gform-field-label" for="input_2_4">Message<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_4" id="input_2_4" class="textarea small" aria-required="true" aria-invalid="false" rows="10" cols="50"></textarea></div>
</li>
<li id="field_2_5" class="gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible"
data-js-reload="field_2_5">Please use this form for general information purposes only. DO NOT send personal health information through this form. Specific patient care must be addressed during your appointment.</li>
<li id="field_2_6" class="gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_2_6"><label
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<div class="ginput_container"><input name="input_6" id="input_2_6" type="text" value="" autocomplete="new-password"></div>
<div class="gfield_description" id="gfield_description_2_6">This field is for validation purposes and should be left unchanged.</div>
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<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_2" class="gform_button button" value="Submit"
onclick="if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_2"]){return false;} if( !jQuery("#gform_2")[0].checkValidity || jQuery("#gform_2")[0].checkValidity()){window["gf_submitting_2"]=true;} jQuery("#gform_2").trigger("submit",[true]); }">
<input type="hidden" class="gform_hidden" name="is_submit_2" value="1">
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<input type="hidden" class="gform_hidden" name="state_2" value="WyJbXSIsImRhMGZhMDczZTI1ZTBlNGRjNGFiMDRlMmQxMTg0ZWVkIl0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_2" id="gform_target_page_number_2" value="0">
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<input type="hidden" name="gform_field_values" value="">
</div>
</form>Text Content
Call Us: (732) 873-6868 RELIEVE YOUR PAIN AND RECLAIM YOUR LIFE WITH ADVANCED PAIN MANAGEMENT AND WORKERS’ COMPENSATION SUPPORT At University Pain & Spine Center, we specialize in treating chronic pain and spine conditions with advanced, minimally invasive therapies. Our expert team is dedicated to helping you manage pain effectively, so you can return to your daily activities with ease. Whether you’re dealing with joint pain, spinal discomfort, or need support through a worker’s compensation claim, we are here to provide the care you need. Contact Us GET IN TOUCH * Name* * Phone* * Email* * Message* * Please use this form for general information purposes only. DO NOT send personal health information through this form. Specific patient care must be addressed during your appointment. * Phone This field is for validation purposes and should be left unchanged. EXPLORE ADVANCED PAIN RELIEF SOLUTIONS At University Pain & Spine Center, our specialists utilize advanced, science-backed therapies to help patients manage chronic pain and support the body’s natural healing processes. By offering targeted treatments, we aim to address areas of pain or injury effectively. Our approach is particularly effective for conditions such as joint pain, tendonitis, and spinal injuries, promoting natural healing and reducing inflammation. This non-surgical, minimally invasive method provides a promising alternative for those seeking relief from pain without relying on medications or invasive procedures. Contact Us CONTACT US GET IN TOUCH * Name* * Phone* * Email* * Message* * Please use this form for general information purposes only. DO NOT send personal health information through this form. Specific patient care must be addressed during your appointment. * Name This field is for validation purposes and should be left unchanged. Call Us (732) 873-6868 University Pain & Spine Center | Sitemap | Accessibility | Website by DOCTOR Multimedia Call Us Text Us Skip to content Open toolbar Accessibility Tools Accessibility Tools * Increase TextIncrease Text * Decrease TextDecrease Text * GrayscaleGrayscale * High ContrastHigh Contrast * Negative ContrastNegative Contrast * Light BackgroundLight Background * Links UnderlineLinks Underline * Readable FontReadable Font * Reset Reset