ecom.lifelinescreening.com Open in urlscan Pro
2606:4700:10::ac43:2ab0  Public Scan

Form analysis
2 forms found in the DOM

POST /Locations-short

<form action="/Locations-short" class="location-search" id="applyFilter" method="post" novalidate="novalidate">
  <div class="form-row">
    <div class="col-5 col-lg-1 form-group">
      <label for="ZipCode">ZIP Code</label>
      <input class="form-control zip zip-error" data-val="true" data-val-length="Invalid zip code" data-val-length-max="5" data-val-length-min="5" data-val-required="Zip is required" id="ZipCode" maxlength="5" name="ZipCode" type="tel" value="">
      <span class="field-validation-valid validation" data-valmsg-for="ZipCode" data-valmsg-replace="true" id="validation"></span>
    </div>
    <div class="col-7 col-lg-2 form-group hidden">
      <label for="Distance">Distance from ZIP</label>
      <select class="form-control" data-val="true" data-val-number="The field Distance must be a number." data-val-required="The Distance field is required." id="Distance" name="Distance">
        <option value="10">10 miles</option>
        <option selected="selected" value="25">25 miles</option>
        <option value="50">50 miles</option>
        <option value="100">100 miles</option>
      </select><span class="field-validation-valid validation" data-valmsg-for="Distance" data-valmsg-replace="true"></span>
    </div>
    <div class="col-12 col-lg-3 form-group hidden">
      <label for="SortBy">Sort by:</label>
      <select class="form-control" id="SortBy" name="SortBy">
        <option selected="selected" value="Distance ASC">Distance (Closest)</option>
        <option value="ScreeningDate ASC">Date (Earliest)</option>
      </select><span class="field-validation-valid validation" data-valmsg-for="SortBy" data-valmsg-replace="true"></span>
    </div>
    <div class="col-6 col-lg-2 form-group hidden">
      <label for="DaysAway">Dates Within:</label>
      <select class="form-control" data-val="true" data-val-number="The field Dates Within: must be a number." data-val-required="The Dates Within: field is required." id="DaysAway" name="DaysAway">
        <option value="7">7 Days</option>
        <option value="14">14 Days</option>
        <option value="28">4 Weeks</option>
        <option value="42">6 Weeks</option>
        <option selected="selected" value="84">12 Weeks</option>
      </select><span class="field-validation-valid validation" data-valmsg-for="DaysAway" data-valmsg-replace="true"></span>
    </div>
    <div class="col-6  col-lg-2 form-group hidden">
      <label for="PreferredTimeOfDay">Time of Day</label>
      <select class="form-control" data-val="true" data-val-required="The PreferredTimeOfDay field is required." id="PreferredTimeOfDay" name="PreferredTimeOfDay">
        <option selected="selected" value="Morning">Morning</option>
        <option value="Afternoon">Afternoon</option>
      </select><span class="field-validation-valid validation" data-valmsg-for="PreferredTimeOfDay" data-valmsg-replace="true"></span>
    </div>
    <div class="col-auto  col-lg-2 form-group text-right">
      <div>&nbsp;</div>
      <button id="btnSearchLocation" type="submit" class="btn btn-primary ga-search"> Search Locations </button>
    </div>
  </div>
</form>

POST /Locations-standard/Update

<form action="/Locations-standard/Update" id="frmLocations" method="post">
  <div class="container">
    <div class="button-nav-container-top" id="topContainer">
    </div>
  </div>
  <div class="container" id="bottomContainer">
    <div class="button-nav-container-bottom">
    </div>
  </div>
</form>

Text Content

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SCHEDULE A SCREENING

Step 1. Locations
Step 2. Payment


SCREENING LOCATIONS NEAR YOU



Use the zip code field to find a screening location.

ZIP Code
Distance from ZIP 10 miles 25 miles 50 miles 100 miles
Sort by: Distance (Closest) Date (Earliest)
Dates Within: 7 Days 14 Days 4 Weeks 6 Weeks 12 Weeks
Time of Day Morning Afternoon
 
Search Locations


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