signallamp-health.breezy.hr
Open in
urlscan Pro
54.85.208.45
Public Scan
URL:
https://signallamp-health.breezy.hr/r/ab6fdda34f71
Submission: On November 07 via manual — Scanned from DE
Submission: On November 07 via manual — Scanned from DE
Form analysis 1 forms found in the DOM
Name: form —
<form name="form" ng-submit="submit()" ng-class="formSubmitted ? "formSubmitted" : """ novalidate="" class="ng-pristine ng-invalid ng-invalid-required"><input type="hidden" id="questions"
value="[{"text":"Full Name","type":{"id":"text","name":"Text"},"required":true},{"text":"How long have you known Kristi Fenske?","type":{"id":"text","name":"Text"},"required":true},{"text":"How does Kristi Fenske get along with colleagues and patients?","type":{"id":"text","name":"Text"},"required":true},{"text":"How does Kristi Fenske react in stressful situations?","type":{"id":"paragraph","name":"Paragraph"},"required":true},{"text":"Would you trust Kristi Fenske with confidential information?","type":{"id":"paragraph","name":"Paragraph"},"required":true},{"text":"Any reason to question Kristi Fenske's reliability?","type":{"id":"paragraph","name":"Paragraph"},"required":true},{"text":"Do you recommend Kristi Fenske for the position?","type":{"id":"paragraph","name":"Paragraph"},"required":true}]"><!-- ngIf: questionnaire.questions -->
<div ng-if="questionnaire.questions" class="section questions ng-scope">
<ul><!-- ngRepeat: question in questionnaire.questions -->
<li ng-repeat="question in questionnaire.questions" class="question ng-scope"><!-- ngIf: question.type.id == "text" || !question.type -->
<div ng-if="question.type.id == "text" || !question.type" class="ng-scope">
<h3 class="ng-binding">Full Name</h3><!-- ngIf: question.body && question.body.length > 0 --><input ng-model="question.response" type="text" placeholder="" ng-required="true" name=""
class="ng-pristine ng-invalid ng-invalid-required placeholder" required="required">
<div ng-show="formSubmitted" class="error-container ng-hide"><span ng-show="question.required && !question.response" class="error">A response is required</span></div>
</div><!-- end ngIf: question.type.id == "text" || !question.type --><!-- ngIf: question.type.id == "paragraph" --><!-- ngIf: question.type.id == "multiplechoice" --><!-- ngIf: question.type.id == "checkboxes" -->
</li><!-- end ngRepeat: question in questionnaire.questions -->
<li ng-repeat="question in questionnaire.questions" class="question ng-scope"><!-- ngIf: question.type.id == "text" || !question.type -->
<div ng-if="question.type.id == "text" || !question.type" class="ng-scope">
<h3 class="ng-binding">How long have you known Kristi Fenske?</h3><!-- ngIf: question.body && question.body.length > 0 --><input ng-model="question.response" type="text" placeholder="" ng-required="true" name=""
class="ng-pristine ng-invalid ng-invalid-required placeholder" required="required">
<div ng-show="formSubmitted" class="error-container ng-hide"><span ng-show="question.required && !question.response" class="error">A response is required</span></div>
</div><!-- end ngIf: question.type.id == "text" || !question.type --><!-- ngIf: question.type.id == "paragraph" --><!-- ngIf: question.type.id == "multiplechoice" --><!-- ngIf: question.type.id == "checkboxes" -->
</li><!-- end ngRepeat: question in questionnaire.questions -->
<li ng-repeat="question in questionnaire.questions" class="question ng-scope"><!-- ngIf: question.type.id == "text" || !question.type -->
<div ng-if="question.type.id == "text" || !question.type" class="ng-scope">
<h3 class="ng-binding">How does Kristi Fenske get along with colleagues and patients?</h3><!-- ngIf: question.body && question.body.length > 0 --><input ng-model="question.response" type="text" placeholder="" ng-required="true" name=""
class="ng-pristine ng-invalid ng-invalid-required placeholder" required="required">
<div ng-show="formSubmitted" class="error-container ng-hide"><span ng-show="question.required && !question.response" class="error">A response is required</span></div>
</div><!-- end ngIf: question.type.id == "text" || !question.type --><!-- ngIf: question.type.id == "paragraph" --><!-- ngIf: question.type.id == "multiplechoice" --><!-- ngIf: question.type.id == "checkboxes" -->
</li><!-- end ngRepeat: question in questionnaire.questions -->
<li ng-repeat="question in questionnaire.questions" class="question ng-scope"><!-- ngIf: question.type.id == "text" || !question.type --><!-- ngIf: question.type.id == "paragraph" -->
<div ng-if="question.type.id == "paragraph"" class="ng-scope">
<h3 class="ng-binding">How does Kristi Fenske react in stressful situations?</h3><!-- ngIf: question.body && question.body.length > 0 --><textarea name="cQuestionTextarea" ng-model="question.response" placeholder="" ng-required="true"
class="description full ng-pristine ng-invalid ng-invalid-required placeholder" required="required"></textarea>
<div ng-show="formSubmitted" class="error-container ng-hide"><span ng-show="question.required && !question.response" class="error">A response is required</span></div>
</div><!-- end ngIf: question.type.id == "paragraph" --><!-- ngIf: question.type.id == "multiplechoice" --><!-- ngIf: question.type.id == "checkboxes" -->
</li><!-- end ngRepeat: question in questionnaire.questions -->
<li ng-repeat="question in questionnaire.questions" class="question ng-scope"><!-- ngIf: question.type.id == "text" || !question.type --><!-- ngIf: question.type.id == "paragraph" -->
<div ng-if="question.type.id == "paragraph"" class="ng-scope">
<h3 class="ng-binding">Would you trust Kristi Fenske with confidential information?</h3><!-- ngIf: question.body && question.body.length > 0 --><textarea name="cQuestionTextarea" ng-model="question.response" placeholder=""
ng-required="true" class="description full ng-pristine ng-invalid ng-invalid-required placeholder" required="required"></textarea>
<div ng-show="formSubmitted" class="error-container ng-hide"><span ng-show="question.required && !question.response" class="error">A response is required</span></div>
</div><!-- end ngIf: question.type.id == "paragraph" --><!-- ngIf: question.type.id == "multiplechoice" --><!-- ngIf: question.type.id == "checkboxes" -->
</li><!-- end ngRepeat: question in questionnaire.questions -->
<li ng-repeat="question in questionnaire.questions" class="question ng-scope"><!-- ngIf: question.type.id == "text" || !question.type --><!-- ngIf: question.type.id == "paragraph" -->
<div ng-if="question.type.id == "paragraph"" class="ng-scope">
<h3 class="ng-binding">Any reason to question Kristi Fenske's reliability?</h3><!-- ngIf: question.body && question.body.length > 0 --><textarea name="cQuestionTextarea" ng-model="question.response" placeholder="" ng-required="true"
class="description full ng-pristine ng-invalid ng-invalid-required placeholder" required="required"></textarea>
<div ng-show="formSubmitted" class="error-container ng-hide"><span ng-show="question.required && !question.response" class="error">A response is required</span></div>
</div><!-- end ngIf: question.type.id == "paragraph" --><!-- ngIf: question.type.id == "multiplechoice" --><!-- ngIf: question.type.id == "checkboxes" -->
</li><!-- end ngRepeat: question in questionnaire.questions -->
<li ng-repeat="question in questionnaire.questions" class="question ng-scope"><!-- ngIf: question.type.id == "text" || !question.type --><!-- ngIf: question.type.id == "paragraph" -->
<div ng-if="question.type.id == "paragraph"" class="ng-scope">
<h3 class="ng-binding">Do you recommend Kristi Fenske for the position?</h3><!-- ngIf: question.body && question.body.length > 0 --><textarea name="cQuestionTextarea" ng-model="question.response" placeholder="" ng-required="true"
class="description full ng-pristine ng-invalid ng-invalid-required placeholder" required="required"></textarea>
<div ng-show="formSubmitted" class="error-container ng-hide"><span ng-show="question.required && !question.response" class="error">A response is required</span></div>
</div><!-- end ngIf: question.type.id == "paragraph" --><!-- ngIf: question.type.id == "multiplechoice" --><!-- ngIf: question.type.id == "checkboxes" -->
</li><!-- end ngRepeat: question in questionnaire.questions -->
</ul>
</div><!-- end ngIf: questionnaire.questions -->
<div class="apply-container">
<ul class="apply-buttons">
<li class="apply-button"><button type="submit" ng-disabled="isSubmitting" ng-class="submitting === true ? "submitting" : """ class="button green large bzyButtonColor"><i class="fa fa-refresh fa-spin"></i><span
class="polygot">Submit Feedback</span></button></li>
</ul>
<div ng-show="formSubmitted && (form.$invalid)" class="error-container ng-hide"><span class="error">Your feedback contains errors.</span></div><!-- ngIf: errorMessage -->
</div>
</form>Text Content
* FEEDBACK SUBMITTED Your feedback has been submitted successfully. Thanks! * FULL NAME A response is required * HOW LONG HAVE YOU KNOWN KRISTI FENSKE? A response is required * HOW DOES KRISTI FENSKE GET ALONG WITH COLLEAGUES AND PATIENTS? A response is required * HOW DOES KRISTI FENSKE REACT IN STRESSFUL SITUATIONS? A response is required * WOULD YOU TRUST KRISTI FENSKE WITH CONFIDENTIAL INFORMATION? A response is required * ANY REASON TO QUESTION KRISTI FENSKE'S RELIABILITY? A response is required * DO YOU RECOMMEND KRISTI FENSKE FOR THE POSITION? A response is required * Submit Feedback Your feedback contains errors. Powered bybreezy