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2 forms found in the DOM

POST https://pyramed-demo.trackmyverivax.com/login

<form method="POST" action="https://pyramed-demo.trackmyverivax.com/login">
  <input type="hidden" name="_token" value="GS0xSc8nEoX4ZKoayCy1YZKpBnXA3qhvuRX72587">
  <div class="form-group row justify-content-center">
    <!-- <label for="email" class="col-md-4 col-form-label text-md-right">E-Mail Address</label> -->
    <div class="col-md-10">
      <input id="email" type="email" class="form-control-blue " name="email" value="" required="" autocomplete="email" autofocus="" placeholder="E-Mail Address">
    </div>
  </div>
  <div class="form-group row justify-content-center">
    <!-- <label for="password" class="col-md-4 col-form-label text-md-right">Password</label> -->
    <div class="col-md-10">
      <div class="text-right">
        <a class="btn btn-link" href="https://pyramed-demo.trackmyverivax.com/password/reset">
                                            Reset Password
                                        </a>
      </div>
      <input id="password" type="password" class="form-control-blue " name="password" required="" autocomplete="current-password" placeholder="Password">
    </div>
  </div>
  <div class="form-group row justify-content-center">
    <div class="col-md-10 text-center">
      <div class="form-check">
        <input class="form-check-input" type="checkbox" name="remember" id="remember">
        <label class="form-check-label" for="remember"> Remember Me </label>
      </div>
    </div>
  </div>
  <div class="form-group row justify-content-center">
    <div class="col-md-10 text-center">
      <button type="submit" class="btn btn-primary form-control"> Sign in </button>
    </div>
  </div>
</form>

POST /affirm

<form id="affirm-form" target="_blank" method="POST" action="/affirm">
  <input type="hidden" name="_token" value="GS0xSc8nEoX4ZKoayCy1YZKpBnXA3qhvuRX72587"> <input style="width:400px;" name="email" id="affirm-email" type="email" class="form-control-blue" required="" autocomplete="email" autofocus=""
    placeholder="app.modals.EMail">
  <input type="hidden" name="affirmed" id="affirmed" value="Yes">
  <br>
  <input type="submit" class="btn btn-primary affirm" value="I can affirm"> <span class="btn btn-warning" onclick="$('#affirmed').val('No');$('#affirm-form').submit()">I cannot affirm</span>
</form>

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AFFIRMATION STATEMENT

I affirm that I meet one of the 1A criteria listed below
 * Health care personnel including, but not limited to:
    * Emergency medical service personnel
    * Nurses
    * Physicians
    * Dentists
    * Dental hygienists
    * Chiropractors
    * Therapists
    * Phlebotomists
    * Pharmacists
    * Technicians
    * Pharmacy technicians
    * Health professions students and trainees
    * Direct support professionals
    * Clinical personnel in school settings or correctional facilities
    * Contractual HCP not directly employed by the health care facility
    * Persons not directly involved in patient care but potentially exposed to
      infectious material that can transmit disease among or from health care
      personnel and patients
    * Persons ages 65 and older
    * Persons ages 16-64 with high risk conditions

 * Cancer
 * COPD
 * Down Syndrome
 * Heart conditions, such as heart failure, coronary artery disease, or
   cardiomyopathies
 * Immunocompromised state (weakened immune system) from solid organ transplant
   or from blood or bone marrow transplant, immune deficiencies , HIV, use of
   corticosteroids, or use of other immune weakening medicines
 * Obesity (BMI of 30 kg/m2 or higher but &#62 40 kg/m2)
 * Severe obesity (BMI &#8805 40 kg/m2)
 * Pregnancy
 * Sickle cell disease
 * app.modals.Smoking
 * Type 2 diabetes mellitus





I cannot affirm
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Terms and Conditions

Terms of Use

TrackMy Solutions Agreement of Terms of Use. These terms apply to use of all
TrackMy Solutions technology products. TrackMy Vaccines, a web application
triggered from URL trackmyvaccine.com, here in referenced as TrackMyVaccine

By visiting, using and/or submitting information to TrackMyVaccine, you are
accepting this Agreement of Terms of Use (this "Agreement") and our Privacy
Policy.

This Agreement is made by and between TrackMy Solutions, a Missouri corporation
("TrackMy"), and you, a user of TrackMyVaccine. This Agreement sets forth the
terms and conditions that apply to your access and use of the Internet websites
owned and operated by TrackMy Solutions and its affiliates, including, but not
limited to, the website located at the URL TrackMyVaccine ("TrackMyVaccine"),
and URL Trackmyvaccine.com.

Applicability of this Agreement

This Agreement is intended to apply to you, TrackMy, its affiliates and all
Internet websites owned and operated by TrackMy and its affiliates, including,
but not limited to, TrackMyVaccine and trackmyvaccine.com .

Your Right to Access and Use TrackMyVaccine

Your right to access and use TrackMyVaccine is personal to you and is not
transferable by you to any other person or entity. You are only entitled to
access and use TrackMyVaccine for lawful purposes and pursuant to the terms and
conditions of this Agreement. Your access and use of TrackMyVaccine may be
interrupted from time to time for any of several reasons, including, but not
limited to, the malfunction of TrackMy's equipment, periodic updating,
maintenance or repair activities that TrackMy may undertake from time to time,
or other actions that TrackMy, in its sole discretion, may elect to take.
TrackMy reserves the right to suspend or discontinue the availability of
TrackMyVaccine for access and use at any time in its sole discretion and without
prior notice to you.

Disclaimer

TrackMy Solutions (TrackMy Vaccine product) leverages APIs for information/data
to offer up the best user experience possible. Do not rely on TrackMy Solutions
products to make decisions regarding medical care, as our products are intended
for informational purposes. Always speak to your health provider about the risks
and benefits of using TrackMy Solutions products.

Your Registration with TrackMyVaccine

Certain services and features of TrackMyVaccine are accessible only to
registered users. The rights to register with TrackMyVaccine and to be issued a
username or password by TrackMy are available only to those individuals who
provide to TrackMy the requested accurate, complete and current personally
identifiable information. You must inform TrackMy of any changes to or updates
of any personally identifiable information that you provide to TrackMy. You can
submit changes or updates to TrackMy via our contact form. TrackMy reserves the
right to deny or revoke issuance of any username or password TrackMy issues, at
any time and without prior notice.

Your Compliance with this Agreement

In order to determine your compliance with this Agreement, TrackMy may monitor
your access and use of TrackMyVaccine in accordance with TrackMy's Privacy
Policy for TrackMyVaccine . Any action by you that, in TrackMy's sole
discretion, violates the terms and conditions of this Agreement, or restricts,
inhibits or prevents any third party from accessing, using or enjoying
TrackMyVaccine , or through the use of TrackMyVaccine , defames, abuses,
harasses, offends or threatens any other user or third party, shall not be
permitted, and may result in your loss of the right to access and use of
TrackMyVaccine .

Your Transmissions, Submissions and Postings to TrackMyVaccine

If you transmit, submit or post information to TrackMyVaccine that is not
personally identifiable information, you automatically grant TrackMy the
royalty-free, non-exclusive right and license to use, copy, format, adapt and
publicly display such information (in whole or in part) worldwide, and/or to
incorporate the same in other Content (defined below) and/or works in any form,
media or technology now known or developed in the future. TrackMy may, in its
sole discretion, edit, refuse to post or remove any information you transmit,
submit or post to TrackMyVaccine

You shall not transmit, submit or post information to TrackMyVaccine that
contains any viruses, worms, Trojan horses, trap doors, back doors, easter eggs,
time bombs, cancelbots or other code or computer programming routines that
contain contaminating or destructive properties or that are intended to damage,
detrimentally interfere with, surreptitiously intercept or expropriate any
system, data or personal information.

TrackMy Development Clause/Data Upload

TrackMyVaccine is an active website available to the public. We are offering use
of the technology currently yet are continually making enhancements and
improvements to the product. We make all efforts to ensure we are not exchanging
any data inappropriately and have safeguards in place to ensure no data leakage.

TrackMy Data Share

With agreeing to these terms you allow TrackMy to share any data that we deem
relevant (that has been entered either by yourself into our databases, or by us
on your behalf) to improve any health-related outcomes, or personal related
outcomes. The sharing of this data will be done in a secure format and may or
may not eventually benefit you as a user.

TrackMy's Intellectual Property Rights

The names "TrackMy" and "TrackMyVaccine" and the TrackMy and TrackMyVaccine
trademarks, logos and graphics are trademarks of TrackMy, and may not be used by
you without the prior express written permission of TrackMy, which permission
may be withheld in TrackMy's sole discretion.

The data and content viewable on, contained in, or downloadable from,
TrackMyVaccine , including, without limitation, the coursework available on
TrackMyVaccine (collectively, the "Content"), is copyrighted by TrackMy and/or
other third parties. TrackMy also owns a copyright of a collective work in the
selection, coordination, arrangement, presentation, display and enhancement of
the Content. Viewing, reading, printing, downloading or otherwise using the
Content does not entitle you to any ownership or intellectual property rights to
the Content.

You shall be solely responsible for any damage resulting from your infringement
of TrackMy's and other third parties' intellectual property rights regarding the
"TrackMy" and "TrackMyVaccine" names, the TrackMy and TrackMyVaccine trademarks,
logos and graphics, and/or the Content, and/or any other harm incurred by
TrackMy or third parties as a direct or indirect result of your copying,
distributing, redistributing, transmitting, publishing or using any of the same
for purposes that are contrary to the terms and conditions of this Agreement.

Framing, Linking and Metatagging TrackMyVaccine

You may not frame or utilize any framing techniques regarding TrackMyVaccine
and/or the Content. You may not link to TrackMyVaccine without the express
written permission of TrackMy. You may not use any metatags or any other hidden
text utilizing TrackMy, TrackMyVaccine or any of TrackMy's trademarks.

Your Use of the Content

Without the prior written consent of TrackMy, you may only print, download or
otherwise use the Content in the form of: (i) one machine-readable copy; (ii)
one backup copy; and (iii) one print copy, for your noncommercial use; provided,
however, that you shall not delete any proprietary notices or materials with
regard to the foregoing manifestations of the Content. Except as otherwise
permitted under the copyright laws of the United States, no other copying,
compilation, distribution, redistribution, transmission, publication or use of
the Content, other than the non-commercial use of the Content as permitted by
this Agreement, is permitted by you without the express prior written permission
of TrackMy, which permission may be withheld in TrackMy's sole discretion.

TrackMy Makes No Representations or Warranties Regarding the Content or the
Merchandise The Content is being provided to you on an "as-is" basis, and the
merchandise sold on TrackMyVaccine (the "Merchandise") is being sold on an
"as-is" basis. TrackMy does not make any representations, warranties or
guarantees, express or implied, regarding the accuracy, correctness, or
completeness of the Content and/or the Merchandise, nor the safety, reliability,
title, merchantability, conformity or fitness for a particular purpose of the
Content and/or the Merchandise. It is your sole responsibility to independently
evaluate the accuracy, correctness, completeness, safety and reliability of the
Content and the Merchandise.

TrackMy makes no representation, warranty or guarantee that TrackMyVaccine or
the Content is free of infection from any viruses, worms, Trojan horses, trap
doors, back doors, easter eggs, time bombs, cancelbots or other code or computer
programming routines that contain contaminating or destructive properties or
that are intended to damage, detrimentally interfere with, surreptitiously
intercept or expropriate any system, data or personal information.

Other Features and Services Available Via TrackMyVaccine

Other features and services available via TrackMyVaccine , including, without
limitation, management of professional licensing requirements and reporting of
professional licensing requirements to state licensing agencies, are provided
for your convenience only. You are ultimately responsible to ensure that any
service or other convenience provided by such features and services are
ultimately performed, and performed in compliance with all laws, rules and
regulations, including, without limitation, timeliness of submission or
reporting. TrackMy shall in no event be liable for any penalties or damages that
may occur as a result your access or use of, or reliance upon, any convenience
features or services available via TrackMyVaccine.

Your Responsibility for Equipment and Related Costs

You are responsible for obtaining and maintaining all telephone, computer
hardware, Internet access services and other equipment or services needed to
access and use TrackMyVaccine, and all costs and fees associated with Internet
access or long distance charges incurred with regard to your access and use of
TrackMyVaccine .

Limitations on TrackMy's Liability

TrackMy shall in no event be responsible to, or liable to, you, or any third
party, whether in contract, warranty, tort (including negligence) or otherwise,
for any damages, including, but not limited to, special, incidental, indirect or
consequential damages that include, but are not limited to, damages for any loss
of profit, revenue or business, as a direct or indirect result of: (i) your
breach or violation of the terms and conditions of this Agreement; (ii) your
access and use of TrackMyVaccine and the access and use of TrackMyVaccine under
any username or password issued to you by TrackMy; (iii) your inability to
access or use TrackMyVaccine or any username or password issued to you by
TrackMy; (iv) your downloading of any of the Content for your use; or (v) your
reliance upon or use of the Content and/or the Merchandise. Use of the Content
and/or the Merchandise is at your sole risk.

You shall defend, indemnify and hold harmless TrackMy and its officers,
directors, shareholders, employees, independent contractors, agents,
representatives and affiliates from and against all claims and expenses,
including, but not limited to, attorneys' fees, arising out of, or attributable
to: (i) any breach or violation of this Agreement by you; (ii) your failure to
provide accurate, complete and current personally identifiable information
requested pursuant to registration; (iii) your access or use of TrackMyVaccine ;
(iv) your access or use of TrackMyVaccine under any username or password that
may be issued to you by TrackMy; and/or (v) your use of the Content and/or the
Merchandise.

Your Indemnification of TrackMy

You shall defend, indemnify and hold harmless TrackMy and its officers,
directors, shareholders, employees, independent contractors, agents,
representatives and affiliates from and against all claims and expenses,
including, but not limited to, attorneys' fees, arising out of, or attributable
to: (i) any breach or violation of this Agreement by you; (ii) your failure to
provide accurate, complete and current personally identifiable information
requested pursuant to registration; (iii) your access or use of TrackMyVaccine ;
(iv) your access or use of TrackMyVaccine under any username or password that
may be issued to you by TrackMy; and/or (v) your use of the Content and/or the
Merchandise.

Amendments of this Agreement

TrackMy reserves the right to amend this Agreement at any time in its sole
discretion and without notice. Your right to access and use TrackMyVaccine is
subject only to our most current Agreement of Terms of Use. Changes, revisions
or deletions with regard to this Agreement shall be effective immediately upon
their inclusion in, or deletion from, this Agreement, and the posting of the
same in this Agreement on TrackMyVaccine .

You are advised and encouraged to visit TrackMyVaccine on a regular basis to
review our most current Agreement of Terms of Use, and review any changes that
may have been made. Unless you elect to opt-out of this Agreement, you agree to
be bound by our most current Agreement of Terms of Use, including any changes
that have been made.

If at any time you wish to opt-out of this Agreement, please contact TrackMy via
our contact form. However, keep in mind that your opting-out of this Agreement
cancels your ability to access and use TrackMyVaccine .

TrackMy's Remedies

You acknowledge that TrackMy may be irreparably damaged if this Agreement is not
specifically enforced, and damages at law would be an inadequate remedy.
Therefore, in the event of a breach or threatened breach of any provision of
this Agreement by you, TrackMy shall be entitled, in addition to all rights and
remedies, to an injunction restraining such breach or threatened breach, without
being required to show any actual damage or to post an injunction bond, and/or
to a decree for specific performance of the provisions of this Agreement.

For purposes of this Section, you agree that any action or proceeding with
regard to such injunction restraining such breach or threatened breach shall be
brought in the courts of record in Jackson County, Missouri. You consent to the
jurisdiction of such courts and waive any objection to the laying of the venue
of any such action or proceeding in such court. You agree that service of any
court paper may be effected on such party by mail or in such other manner as may
be provided under applicable laws, rules of procedure or local rules.

Termination of this Agreement

You may terminate or opt out of this Agreement at any time by contacting TrackMy
via our contact form (or sending an email to info@trackmysolutions.us).
Termination or opting out of this Agreement by you shall result in your loss of
the right to access and use TrackMyVaccine . Following your termination or
opting out of this Agreement, the provisions of this Agreement regarding
"Limitations of TrackMy\'s Liability," "Your Indemnification of TrackMy,"
"Governing Law and Arbitration" and "Miscellaneous" shall survive. TrackMy may
terminate this Agreement or any usernames or passwords that may be issued to
you, at any time, without prior notice, for any reason, or for no reason.

Governing Law and Arbitration

This Agreement is to be governed and construed in accordance with the internal
laws of the State of Missouri, without regard for principles of conflicts of
laws. Any civil action, claim, dispute or proceeding arising out of or relating
to this Agreement, except for an injunctive action regarding a breach or
threatened breach of any provision of this Agreement by you, shall be referred
to final and binding arbitration, before a single arbitrator, under the
commercial arbitration rules of the American Arbitration Association in Jackson
County, Missouri. The arbitrator shall be selected by you and TrackMy, and if
you and TrackMy are unable to reach agreement on selection of the arbitrator
within thirty (30) days after the notice of arbitration is served, then the
arbitrator shall be selected by the American Arbitration Association.

Judgment upon any award rendered by the arbitrator shall be final, binding and
conclusive upon you and TrackMy and your and TrackMy's respective
administrators, executors, legal representatives, successors and assigns, and
may be entered in any court of competent jurisdiction. Notwithstanding the
previous sentence, in no event shall either you or TrackMy be entitled to
punitive, special, indirect or consequential damages and both you and TrackMy
hereby waive your and TrackMy's respective rights to any punitive, special,
indirect or consequential damages, including, but not limited to, damages for
any loss of profit, revenue or business.

Miscellaneous

If any portion of this Agreement is deemed unlawful, void or unenforceable by
any arbitrator or court of competent jurisdiction, this Agreement as a whole
shall not be deemed unlawful, void or unenforceable, but only that portion of
this Agreement that is unlawful, void or unenforceable shall be stricken from
this Agreement.

The headings contained in this Agreement are for convenience of reference only,
are not to be considered a part of this Agreement, and shall not limit or
otherwise affect in any way the meaning or interpretation of this Agreement.

All covenants, agreements, representations and warranties made in this
Agreement, as may be amended by TrackMy from time to time, shall survive your
acceptance of this Agreement and the termination of this Agreement. This
Agreement represents the entire understanding and agreement between you and
TrackMy regarding the subject matter of this Agreement, and supersedes all other
previous agreements, understandings and/or representations regarding the same.


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