www.performancehealth.com Open in urlscan Pro
151.101.129.55  Public Scan

Submitted URL: https://e.performancehealth.com/c/AQjawAoQhKdAGIu-qoACII6CqhGsxnp_h6lHIueIboMYOVNoh-GvECC0StGLh1kcaex1DA
Effective URL: https://www.performancehealth.com/contact-customer-service?utm_campaign=1053572_phus-gpo_info_aptqi_240516_3164-f&utm_medium=email...
Submission: On May 16 via manual from US — Scanned from DE

Form analysis 5 forms found in the DOM

POST https://www.performancehealth.com/customer/account/loginPost/

<form class="form form-login form-login-dropdown" action="https://www.performancehealth.com/customer/account/loginPost/" method="post" id="login-form" data-hasrequired="* Required Fields" novalidate="novalidate">
  <input name="form_key" type="hidden" value="XjktCjE7xoaVk1tS">
  <div class="field email required">
    <label class="label" for="email"><span>Email</span></label>
    <div class="control">
      <input name="login[username]" placeholder="email" autocomplete="off" id="email" type="email" class="input-text" title="Email" data-validate="{required:true, 'validate-email':true}" aria-required="true">
    </div>
  </div>
  <div class="field password required">
    <label class="label" for="login-dropdown-pass"><span>Password</span></label>
    <div class="control">
      <input name="login[password]" type="password" placeholder="password" autocomplete="off" class="input-text" id="login-dropdown-pass" title="Password" data-validate="{required:true}" aria-required="true">
    </div>
  </div>
  <div class="actions-toolbar">
    <div class="primary"><button type="submit" class="action login primary" name="send" id="send2"><span>Login</span></button></div>
    <div class="secondary"><a class="action remind" href="https://www.performancehealth.com/customer/account/forgotpassword/"><span>Forgot Password?</span></a></div>
    <div class="tertiary"><a href="javascript:void(0)" class="action register-button"><span>Create an Account</span></a></div>
  </div>
</form>

GET https://www.performancehealth.com/catalogsearch/result/

<form class="form minisearch" id="search_mini_form" action="https://www.performancehealth.com/catalogsearch/result/" method="get">
  <div class="field search">
    <label class="label" for="search" data-role="minisearch-label">
      <span>Search</span>
    </label>
    <div class="control">
      <input id="search" type="text" name="q" value="" placeholder="Search for products, SKUs, categories, or brands" class="input-text" maxlength="255" role="combobox" aria-haspopup="false" aria-autocomplete="both" autocomplete="off"
        aria-expanded="false">
      <div id="search_autocomplete" class="search-autocomplete"></div>
      <div class="nested">
        <a class="action advanced" href="https://www.performancehealth.com/catalogsearch/advanced/" data-action="advanced-search">
        Advanced Search    </a>
      </div>
    </div>
  </div>
  <div class="actions">
    <button type="submit" title="Search" class="action search" aria-label="Search" disabled="">
      <span>Search</span>
    </button>
  </div>
</form>

POST https://www.performancehealth.com/newsletter/subscriber/new/

<form class="form subscribe" novalidate="novalidate" action="https://www.performancehealth.com/newsletter/subscriber/new/" method="post" id="newsletter-validate-detail">
  <div class="field newsletter">
    <label class="label" for="newsletter"><span>Sign Up for Our Newsletter:</span></label>
    <div class="control">
      <input name="email" type="email" id="newsletter" placeholder="Enter your email address" data-validate="{required:true, 'validate-email':true}">
    </div>
  </div>
  <div class="actions">
    <button class="action subscribe primary" title="Subscribe" type="submit">
      <span>Subscribe</span>
    </button>
  </div>
  <div class="amgdpr-checkbox field choice  required" data-role="amasty-gdpr-consent" data-amgdpr-content-from="subscription">
    <input type="hidden" name="amgdpr_agreement[privacy_checkbox]" value="0">
    <input type="checkbox" name="amgdpr_agreement[privacy_checkbox]" title="Privacy Checkbox" value="1" id="amprivacy-checkbox-66460b0f449d7" class="amgdpr-checkbox" data-consent-id="1" required="" data-validate="{required:true}">
    <label for="amprivacy-checkbox-66460b0f449d7" class="label amgdpr-label">
      <span class="amgdpr-text"> I have read and accept the <a href="#">privacy policy</a> </span>
    </label>
  </div>
  <input type="hidden" name="am-gdpr-checkboxes-from" value="subscription">
</form>

POST https://www.performancehealth.com/company/account/register/

<form class="form self-identify" method="post" action="https://www.performancehealth.com/company/account/register/" enctype="multipart/form-data" autocomplete="off">
  <input name="form_key" type="hidden" value="XjktCjE7xoaVk1tS">
  <fieldset class="fieldset registration-company-or-individual">
    <legend class="registration-section-heading">
      <span> Are you registering as part of a business or organization?</span>
    </legend>
    <br>
    <div class="field company-or-individual radio-buttons">
      <label for="company_or_individual[company]" class="registration-option-text">
        <div class="control">
          <input type="radio" class="input-radio registration-option" name="register[company_or_individual]" id="company_or_individual[company]" value="company">
        </div>
        <span>Yes</span>
      </label>
      <label for="company_or_individual[individual]" class="registration-option-text">
        <div class="control">
          <input type="radio" class="input-radio registration-option" name="register[company_or_individual]" id="company_or_individual[individual]" value="individual">
        </div>
        <span>No</span>
      </label>
    </div>
    <div class="registration-individual-button registration-form-button" id="individual_register_button" style="display: none;">
      <input type="button" value="Let's Go!">
    </div>
  </fieldset>
  <fieldset class="fieldset registration-company" style="display:none;">
    <legend class="registration-section-heading">
      <span>Does your business/organization have an existing account with Performance Health?</span>
    </legend>
    <br>
    <span class="note link-existing-account-notice">It is important to link your existing account for billing purposes. If you do not know your account number, please call customer service at 1.800.323.5547</span>
    <div class="field existing-or-new radio-buttons">
      <label for="existing_or_new[existing]" class="registration-option-text">
        <div class="control">
          <input type="radio" class="input-radio registration-option" name="register[existing_or_new]" id="existing_or_new[existing]" value="existing">
        </div>
        <span>Yes</span>
      </label>
      <label for="existing_or_new[new]" class="registration-option-text">
        <div class="control">
          <input type="radio" class="input-radio registration-option" name="register[existing_or_new]" id="existing_or_new[new]" value="new">
        </div>
        <span>No</span>
      </label>
    </div>
    <div class="registration-new-company-button registration-form-button" id="new_company_register_button" style="display: none;">
      <input type="button" value="Let's Go!">
    </div>
  </fieldset>
  <fieldset class="fieldset find_company" style="display: none;">
    <legend class="registration-section-heading">
      <span>Let's get linked to your ordering account.</span>
    </legend><br>
    <div class="registration-section-sub-heading company-info-sub-heading">
      <span>Company Information</span>
    </div>
    <div class="field account-number _required">
      <label class="label" for="company_account_number">
        <span>Billing Account Number</span>
      </label>
      <div class="control">
        <input type="text" class="input-text" name="find_company[account_number]" id="company_account_number" value="" title="Billing Account Number" data-validate="{required:true}">
      </div>
      <p></p>
    </div>
    <div class="field postcode _required">
      <label class="label" for="company_postcode">
        <span>Billing ZIP/Post Code</span>
      </label>
      <div class="control">
        <input type="text" class="input-text" name="find_company[postcode]" id="company_postcode" value="" title="Billing ZIP/Post Code" data-validate="{required:true}">
      </div>
    </div>
    <div class="registration-section-sub-heading customer-info-sub-heading">
      <span>User Information</span>
    </div>
    <div class="field firstname _required">
      <label class="label" for="company_user_firstname">
        <span>User First Name</span>
      </label>
      <div class="control">
        <input type="text" class="input-text" name="find_company[firstname]" id="company_user_firstname" value="" title="User First Name" data-validate="{required:true}">
      </div>
    </div>
    <div class="field lastname _required">
      <label class="label" for="company_user_lastname">
        <span>User Last Name</span>
      </label>
      <div class="control">
        <input type="text" class="input-text" name="find_company[lastname]" id="company_user_lastname" value="" title="User Last Name" data-validate="{required:true}">
      </div>
    </div>
    <div class="field email _required">
      <label class="label" for="company_user_email">
        <span>User Email Address</span>
      </label>
      <div class="control">
        <input type="text" class="input-text" name="find_company[email]" id="company_user_email" value="" title="User Email Address" data-validate="{required:true,'validate-email':true}">
      </div>
    </div>
    <div class="field choice newsletter">
      <input type="checkbox" name="is_subscribed" title="Sign Up for Newsletter" value="1" id="is_subscribed_company" checked="checked" class="checkbox">
      <label for="is_subscribed_company" class="label"><span>Don't miss out! Sign up to receive the latest deals, new product alerts, and industry insight from Performance Health US.</span></label>
    </div>
    <div class="registration-verify-company-button registration-form-button" id="verify_company_register_button">
      <input type="button" id="verify-button" value="Verify">
      <span class="note">Please note this can take up to a minute.</span>
    </div>
  </fieldset>
  <div class="fieldset company-found" style="display: none;">
    <br>
    <input type="hidden" class="company-found-data" id="company_data_company_id" name="company_id">
    <div class="company-found-data" id="company_msg_found"><span>This Company has been verified</span></div><br>
    <span class="company-found-data" id="company_data_company_name"></span><br>
    <span class="company-found-data" id="company_data_billing_account_number"></span><br>
    <span class="company-found-data" id="company_data_street_one"></span><br>
    <span class="company-found-data" id="company_data_street_two" style="display:none;"></span>
    <span class="company-found-data" id="company_data_street_three" style="display:none;"></span>
    <span class="company-found-data" id="company_data_city"></span><br>
    <span class="company-found-data" id="company_data_region"></span><br>
    <span class="company-found-data" id="company_data_postcode"></span><br>
    <span class="company-found-data" id="company_data_telephone"></span><br><br>
    <span class="company-found-message"></span><br>
    <div class="password-container fields" id="new-customer-password-container" style="display: none;">
      <div class="field password _required">
        <label for="new-customer-password" class="label"><span>Password</span></label>
        <div class="control">
          <input type="password" name="password" id="new-customer-password" title="Password" class="input-text" data-password-min-length="8" data-password-min-character-sets="3" data-validate="{required:true, 'validate-customer-password':true}"
            autocomplete="off">
          <div id="new-customer-password-strength-meter-container" data-role="password-strength-meter" aria-live="polite">
            <div id="new-customer-password-strength-meter" class="password-strength-meter"> Password Strength: <span id="new-customer-password-strength-meter-label" data-role="password-strength-meter-label"> No Password </span>
            </div>
          </div>
        </div>
      </div>
      <div class="field confirmation _required">
        <label for="new-customer-password-confirmation" class="label"><span>Confirm Password</span></label>
        <div class="control">
          <input type="password" name="password_confirmation" title="Confirm Password" id="new-customer-password-confirmation" class="input-text" data-validate="{required:true, equalToPassword:'#new-customer-password'}" autocomplete="off">
        </div>
      </div>
    </div>
    <div class="field-recaptcha" id="recaptcha-e33e6fc7097f373dea506f87c908c3e7b6e60d31-container" data-bind="scope:'recaptcha-e33e6fc7097f373dea506f87c908c3e7b6e60d31'">
      <!-- ko template: getTemplate() -->
      <div data-bind="{
    attr: {
        'id': getReCaptchaId() + '-wrapper'
    },
    'afterRender': renderReCaptcha()
}" id="recaptcha-e33e6fc7097f373dea506f87c908c3e7b6e60d31-wrapper">
        <div class="g-recaptcha" id="recaptcha-e33e6fc7097f373dea506f87c908c3e7b6e60d31">
          <div class="grecaptcha-badge" data-style="inline" style="width: 256px; height: 60px; box-shadow: gray 0px 0px 5px;">
            <div class="grecaptcha-logo"><iframe title="reCAPTCHA" width="256" height="60" role="presentation" name="a-xvuezync3zgz" frameborder="0" scrolling="no"
                sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
                src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6LeyzTwbAAAAAHywkk-GcpH1z69gjOug9F2b0YPb&amp;co=aHR0cHM6Ly93d3cucGVyZm9ybWFuY2VoZWFsdGguY29tOjQ0Mw..&amp;hl=de&amp;v=vjbW55W42X033PfTdVf6Ft4q&amp;theme=light&amp;size=invisible&amp;badge=inline&amp;cb=b30u7j6v7eux"></iframe>
            </div>
            <div class="grecaptcha-error"></div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
              style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
          </div><iframe style="display: none;"></iframe>
        </div>
        <!-- ko if: (!getIsInvisibleRecaptcha()) --><!-- /ko -->
      </div>
      <!-- /ko -->
    </div>
    <div class="registration-individual-company-button registration-form-button" id="individual_company_registration_button">
      <input type="submit" value="Let's Go!">
    </div>
  </div>
  <div class="fieldset company-not-found" style="display: none;">
    <br>
    <span class="company-not-found-message"></span><br>
    <div class="registration-company-not-found-company-create registration-form-button" id="company-not-found-company-create">
      <input type="button" value="Let's Go!">
    </div>
  </div>
  <input type="text" name="token" style="display: none">
</form>

POST

<form class="form form-login" method="post" data-bind="event: {submit: login }" id="login-form">
  <div class="fieldset login" data-bind="attr: {'data-hasrequired': $t('* Required Fields')}" data-hasrequired="* Required Fields">
    <div class="field email required">
      <label class="label" for="customer-email"><span data-bind="i18n: 'Email Address'">Email Address</span></label>
      <div class="control">
        <input name="username" id="customer-email" type="email" class="input-text" data-mage-init="{&quot;mage/trim-input&quot;:{}}" data-bind="attr: {autocomplete: autocomplete}" data-validate="{required:true, 'validate-email':true}"
          autocomplete="off">
      </div>
    </div>
    <div class="field password required">
      <label for="pass" class="label"><span data-bind="i18n: 'Password'">Password</span></label>
      <div class="control">
        <input name="password" type="password" class="input-text" id="pass" data-bind="attr: {autocomplete: autocomplete}" data-validate="{required:true}" autocomplete="off">
      </div>
    </div>
    <!-- ko foreach: getRegion('additional-login-form-fields') -->
    <!-- ko template: getTemplate() -->
    <input name="captcha_form_id" type="hidden" data-bind="value: formId,  attr: {'data-scope': dataScope}" value="user_login" data-scope="">
    <!-- ko if: (isRequired() && getIsVisible())--><!-- /ko -->
    <!-- /ko -->
    <!-- /ko -->
    <div class="actions-toolbar">
      <input name="context" type="hidden" value="checkout">
      <div class="primary">
        <button type="submit" class="action action-login secondary" name="send" id="send2">
          <span data-bind="i18n: 'Sign In'">Sign In</span>
        </button>
      </div>
      <div class="secondary">
        <a class="action" data-bind="attr: {href: forgotPasswordUrl}" href="https://www.performancehealth.com/customer/account/forgotpassword/">
                                <span data-bind="i18n: 'Forgot Your Password?'">Forgot Your Password?</span>
                            </a>
      </div>
    </div>
  </div>
</form>

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 * print800.547.4333
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