survey3.medallia.com Open in urlscan Pro
147.75.243.92  Public Scan

Form analysis
1 forms found in the DOM

Name: surveyform — POST /?feedless-kohls-3ce9f39d7eb9b83d72d4672db59cd294

<form name="surveyform" action="/?feedless-kohls-3ce9f39d7eb9b83d72d4672db59cd294" method="post"><!-- react-empty: 4 -->
  <div><!-- react-empty: 6 --><input type="hidden" name="is_embedded" id="is_embedded" value="false">
    <header><a class="layout_skipNav" href="#content">Skip to Content</a>
      <div class="layout_layoutContainer">
        <div class="layout_mainHeader layout_clearfix">
          <div class="layout_mainHeaderLeft">
            <h1 class="layout_invisibleTitle" tabindex="0" aria-label="Survey"></h1><img class="layout_logo" src="https://sea1.cdn.survey.medallia.com/922e33766fd02835fae525f2fc0f9ad45821d00b" alt="Page_logo">
          </div>
          <div class="layout_mainHeaderRight"><span id="languageSelector" class="">
              <div>
                <div class="layout_notMobileScreenOnly">
                  <div class="dropdown_dropdownLabel dropdown_dropdownLabel_isInactive">Choose Language:</div>
                  <div class="dropdown_dropdownContainer ">
                    <div class="dropdown_dropdownSelector dropdown_dropdownSelector_isInactive" role="button" tabindex="0" aria-haspopup="true" aria-expanded="false" title="" aria-label="Choose Language:">
                      <div class="dropdown_dropdownTitle">English</div><i aria-hidden="true" class="medallicons_medallicons dropdown_dropdownIcon"></i>
                    </div>
                    <div role="application">
                      <ul role="menu" class="dropdown_dropdownList">
                        <li role="menuitem" tabindex="-1" class="dropdown_dropdownListItem" data-test-name="option-english">
                          <!-- react-text: 27 -->English<!-- /react-text --><i aria-hidden="true" class="medallicons_medallicons dropdown_dropdownIcon"></i></li>
                        <li role="menuitem" tabindex="-1" class="dropdown_dropdownListItem" data-test-name="option-spanish"><!-- react-text: 30 -->Spanish<!-- /react-text --></li>
                      </ul>
                    </div>
                  </div>
                </div>
                <div class="layout_mobileScreenOnly">
                  <div class="dropdown_dropdownLabel dropdown_dropdownLabel_isInactive">Choose Language:</div>
                  <div class="dropdown_dropdownContainer ">
                    <div class="dropdown_dropdownSelector dropdown_dropdownSelector_isInactive" title="" aria-haspopup="true" aria-expanded="false" role="button" tabindex="0" aria-label="Choose Language:">
                      <div class="dropdown_dropdownTitle">English</div><i aria-hidden="true" class="medallicons_medallicons dropdown_dropdownIcon"></i>
                    </div>
                  </div>
                </div>
              </div><input type="hidden" name="lang" id="activeLang" value="en">
            </span></div>
        </div>
      </div>
    </header>
    <div class="layout_layoutContainer"><input type="hidden" name="stay_main-pager" value="0"><input type="hidden" name="nodeId" value="survey3-fe6"><input type="hidden" name="ballotVer" value="2"><input type="hidden" name="currentPage"
        value="0"><input type="hidden" name="defPgrAction" value="next"><!-- react-empty: 44 --></div>
    <div role="main" id="content" class="layout_layoutContainer layout_layoutContainer_fadeInUp">
      <div class="htmlBlock"><br>We hope you enjoyed your recent visit to Kohl's. Your feedback is extremely valuable to us, as we continually strive to provide exceptional service. You hereby acknowledge that a Kohl's representative may reach out to
        you to discuss your survey responses. <br><br> Using the information found at the bottom of your receipt, please complete the following fields. Please enter your store number and access code. Enter numbers only. Do not include hyphens or
        other characters.</div>
      <div class="htmlBlock">
        <img src="https://sea1.cdn.survey.medallia.com/fb7d4862e5f09cf2cd47d02225bae5e2828ea287">
      </div>
      <div class="questionBlock textfieldQuestion">
        <fieldset>
          <legend class="question_questionTitle"><span class="validation_validationBlock validationMessage validation_requiredBlock"><i aria-hidden="true" class="medallicons_medallicons validation_validationIcon"></i><span
                class="validation_caption">Required</span></span><span class="questionCaption">Store Number</span></legend>
          <div class="layout_answers">
            <div class="textField_textfieldContainer layout_answer"><input type="text" id="spl_q_bp_store_receipt_unit_txt" name="spl_q_bp_store_receipt_unit_txt" title="Store Number" class="textField_textField" value="" maxlength="4"
                aria-required="true"></div>
          </div>
        </fieldset>
      </div>
      <div class="questionBlock textfieldQuestion">
        <fieldset>
          <legend class="question_questionTitle"><span class="validation_validationBlock validationMessage validation_requiredBlock"><i aria-hidden="true" class="medallicons_medallicons validation_validationIcon"></i><span
                class="validation_caption">Required</span></span><span class="questionCaption">Access Code</span></legend>
          <div class="layout_answers">
            <div class="textField_textfieldContainer layout_answer"><input type="text" id="spl_e_kohls_store_receipt_code_txt" name="spl_e_kohls_store_receipt_code_txt" title="Access Code" class="textField_textField" value="" aria-required="true">
            </div>
          </div>
        </fieldset>
      </div>
    </div>
    <nav class="layout_layoutContainer layout_layoutContainer_fadeIn">
      <div class="navigationButtons_navigationButtonsContainer navigationButtons_navigationButtonsContainer_hasOneButton">
        <div class="navigationButtons_pageButtonContainer"><button type="submit" class="beginButton button_button button_button_isPrimary _moveForwardButton_" id="buttonBegin" value="Begin Survey" name="forward_main-pager"><span
              class="button_buttonCaption">Begin Survey</span><i aria-hidden="true" class="medallicons_medallicons button_buttonArrowIcon"></i></button></div>
      </div>
    </nav>
    <footer class="layout_layoutContainer layout_layoutContainer_fadeIn">
      <div id="customfooter" class="customFooter">
        <div>
          <div class="layout_footer"><i class="medallicons_medallicons layout_medalliaLogo"></i>
            <div class="layout_legalLinks"><a href="http://surveysupport.medallia.com/s/" target="_blank" rel="external">Survey Support</a> <a href="https://www.kohls.com/feature/privacy-policy.jsp" target="_blank" rel="external">Privacy Policy</a>
              <a href="http://survey.medallia.com/static/cookie-policy/index.html" target="_blank">Cookie Policy</a></div>
          </div>
        </div><!-- react-empty: 77 -->
      </div>
    </footer>
  </div>
</form>

Text Content

Skip to Content

Choose Language:
English

 * English
 * Spanish

Choose Language:
English



We hope you enjoyed your recent visit to Kohl's. Your feedback is extremely
valuable to us, as we continually strive to provide exceptional service. You
hereby acknowledge that a Kohl's representative may reach out to you to discuss
your survey responses.

Using the information found at the bottom of your receipt, please complete the
following fields. Please enter your store number and access code. Enter numbers
only. Do not include hyphens or other characters.

RequiredStore Number

RequiredAccess Code

Begin Survey

Survey Support Privacy Policy Cookie Policy