screening.mhanational.org Open in urlscan Pro
141.193.213.20  Public Scan

Submitted URL: http://screening.mhanational.org/
Effective URL: https://screening.mhanational.org/
Submission: On May 12 via api from US — Scanned from DE

Form analysis 3 forms found in the DOM

GET https://screening.mhanational.org/

<form role="search" method="get" class="search-form" action="https://screening.mhanational.org/">
  <label for="mha-search-form">
    <span class="screen-reader-text">Search</span>
    <input type="search" id="mha-search-form" class="search-field" placeholder="Search" value="" name="s">
  </label>
  <input type="submit" class="search-submit" value="SEARCH SITE">
</form>

Name: loginform-headerPOST https://screening.mhanational.org/wp-login.php?wpe-login=true

<form name="loginform-header" id="loginform-header" action="https://screening.mhanational.org/wp-login.php?wpe-login=true" method="post">
  <p class="login-username float-label">
    <label for="user_login">Email Address</label>
    <input type="text" name="log" id="user_login" autocomplete="username" class="input" value="" size="20">
  </p>
  <p class="login-password float-label">
    <label for="user_pass">Password</label>
    <input type="password" name="pwd" id="user_pass" autocomplete="current-password" spellcheck="false" class="input" value="" size="20">
  </p>
  <p class="login-remember"><label><input name="rememberme" type="checkbox" id="rememberme" value="forever"> Remember Me</label></p>
  <p class="login-submit">
    <input type="submit" name="wp-submit" id="wp-submit" class="button button-primary" value="Log In">
    <input type="hidden" name="redirect_to" value="https://screening.mhanational.org/">
  </p>
</form>

POST /

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  <div class="gform-body gform_body">
    <ul id="gform_fields_4" class="gform_fields top_label form_sublabel_below description_below validation_below">
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          class="gfield_label gform-field-label" for="input_4_1">First Name</label>
        <div class="ginput_container ginput_container_text"><input name="input_1" id="input_4_1" type="text" value="" class="medium" aria-invalid="false"> </div>
      </li>
      <li id="field_4_6" class="gfield gfield--type-text gfield--width-full float-label field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_4_6"><label
          class="gfield_label gform-field-label" for="input_4_6">Last Name</label>
        <div class="ginput_container ginput_container_text"><input name="input_6" id="input_4_6" type="text" value="" class="medium" aria-invalid="false"> </div>
      </li>
      <li id="field_4_2" class="gfield gfield--type-email float-label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_4_2"><label
          class="gfield_label gform-field-label" for="input_4_2">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_2" id="input_4_2" type="email" value="" class="medium" aria-required="true" aria-invalid="false">
        </div>
      </li>
      <li id="field_4_4" class="gfield gfield--type-text float-label field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_4_4"><label
          class="gfield_label gform-field-label" for="input_4_4">Phone Number (Optional)</label>
        <div class="ginput_container ginput_container_text"><input name="input_4" id="input_4_4" type="text" value="" class="medium" aria-invalid="false"> </div>
      </li>
      <li id="field_4_7" class="gfield gfield--type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-js-reload="field_4_7">
        <div class="ginput_container ginput_container_text"><input name="input_7" id="input_4_7" type="hidden" class="gform_hidden" aria-invalid="false" value=""></div>
      </li>
      <li id="field_4_5" class="gfield gfield--type-captcha gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible" data-js-reload="field_4_5"><label
          class="gfield_label gform-field-label" for="input_4_5">CAPTCHA</label>
        <div id="input_4_5" class="ginput_container ginput_recaptcha gform-initialized" data-sitekey="6LftXuYZAAAAAOyPYz_3N6shIU7JiSovAbrGHjWf" data-theme="light" data-tabindex="0" data-badge="">
          <div style="width: 304px; height: 78px;">
            <div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-iegel99gc2cv" 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=6LftXuYZAAAAAOyPYz_3N6shIU7JiSovAbrGHjWf&amp;co=aHR0cHM6Ly9zY3JlZW5pbmcubWhhbmF0aW9uYWwub3JnOjQ0Mw..&amp;hl=en&amp;v=vjbW55W42X033PfTdVf6Ft4q&amp;theme=light&amp;size=normal&amp;cb=osg59ot9n7v"></iframe>
            </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>
      </li>
      <li id="field_4_8" 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_4_8"><label
          class="gfield_label gform-field-label" for="input_4_8">Phone</label>
        <div class="ginput_container"><input name="input_8" id="input_4_8" type="text" value="" autocomplete="new-password"></div>
        <div class="gfield_description" id="gfield_description_4_8">This field is for validation purposes and should be left unchanged.</div>
      </li>
    </ul>
  </div>
  <div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_4" class="gform_button button" value="Submit"
      onclick="if(window[&quot;gf_submitting_4&quot;]){return false;}  if( !jQuery(&quot;#gform_4&quot;)[0].checkValidity || jQuery(&quot;#gform_4&quot;)[0].checkValidity()){window[&quot;gf_submitting_4&quot;]=true;}  "
      onkeypress="if( event.keyCode == 13 ){ if(window[&quot;gf_submitting_4&quot;]){return false;} if( !jQuery(&quot;#gform_4&quot;)[0].checkValidity || jQuery(&quot;#gform_4&quot;)[0].checkValidity()){window[&quot;gf_submitting_4&quot;]=true;}  jQuery(&quot;#gform_4&quot;).trigger(&quot;submit&quot;,[true]); }">
    <input type="hidden" name="gform_ajax" value="form_id=4&amp;title=&amp;description=&amp;tabindex=0&amp;theme=legacy">
    <input type="hidden" class="gform_hidden" name="is_submit_4" value="1">
    <input type="hidden" class="gform_hidden" name="gform_submit" value="4">
    <input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
    <input type="hidden" class="gform_hidden" name="state_4" value="WyJbXSIsIjdkODliOTcwYTljYWM4NjI3YmU2NTdjNDI2YjFhYzE5Il0=">
    <input type="hidden" class="gform_hidden" name="gform_target_page_number_4" id="gform_target_page_number_4" value="0">
    <input type="hidden" class="gform_hidden" name="gform_source_page_number_4" id="gform_source_page_number_4" value="1">
    <input type="hidden" name="gform_field_values" value="">
  </div>
</form>

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