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Form analysis
2 forms found in the DOM

POST /Account/NotMyOrg

<form action="/Account/NotMyOrg" id="notMyOrgForm" method="post"><input name="__RequestVerificationToken" type="hidden" value="KGyL6Je2MClEpIPHK33gKP5BatG4sorp9oR-h9o08iTqG2xsbsG6hj5PkJuStA25QLNfrdpdBsgnFLmP6QZMdZEG2ds1">
  <a href="javascript:document.getElementById('notMyOrgForm').submit()">Not My Organization</a>
</form>

POST /

<form action="/" method="post" novalidate="novalidate"><input name="__RequestVerificationToken" type="hidden" value="jIc4x3cHWikEjoWH3Izw_UIyfoFR9GU2rnt7g93c_YwVusAcCp7Vbb27cYSfDozkHESMI0q_lbcHRrE_BsTCoAlx2A41"><input id="ReturnUrl" name="ReturnUrl"
    type="hidden" value="">
  <div class="form-group">
    <div class="form-group">
      <input aria-label="Username" autofocus="autofocus" class="form-control" data-val="true" data-val-required="Please enter your username." id="UserName" name="UserName" placeholder="Username" type="text" value="">
    </div>
    <div class="form-group">
      <input aria-label="Password" class="form-control" data-val="true" data-val-required="Please enter your password." id="Password" name="Password" placeholder="Password" type="password">
    </div>
    <div class="form-group">
      <div class="checkbox">
        <input data-val="true" data-val-required="The Remember Me? field is required." id="RememberMe" name="RememberMe" type="checkbox" value="true"><input name="RememberMe" type="hidden" value="false">
        <label for="RememberMe">Remember Me?</label>
      </div>
    </div>
  </div>
  <input type="submit" value="Sign In" class="button expanded">
  <div class="validation-summary-valid text-danger" data-valmsg-summary="true">
    <ul>
      <li style="display:none"></li>
    </ul>
  </div>
</form>

Text Content

WELCOME TO THE BENEFITS4ME WELLNESS PROGRAM

Benefits4Me
Not My Organization

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 * 

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CONTACT AN ADVOCATE


855.737.8585

answers@HealthAdvocate.com
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