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Submission: On June 07 via api from US — Scanned from DE
Submission: On June 07 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
<form class="flex flex-col gap-8 sm:gap-10">
<div>
<div style="opacity: 1; transform: none;">
<div class="flex flex-col gap-4">
<header class="flex flex-row items-center">
<h1 class="h4 font-semibold">Enter Pet Info</h1>
</header>
<div class="flex flex-1 flex-col gap-6">
<div>
<div class="grid grid-cols-2 gap-6 sm:grid-cols-11 lg:grid-cols-12">
<div class="relative flex flex-col col-span-2 sm:col-span-7 lg:col-span-3">
<div class="relative flex items-center rounded-md border border-none bg-background-primary shadow-faux-border"><input
class="px-4 h-11 w-full bg-background-primary rounded-md text-content-primary text-base appearance-none focus:outline-none peer placeholder:opacity-0 focus:placeholder:opacity-100 placeholder:text-content-secondary input-value-false"
placeholder=" " id="policies.0.name" value="" name="policies.0.name"><label class="font-medium text-content-secondary peer-disabled:cursor-not-allowed peer-disabled:opacity-70 label--floating text-base bg-background-primary"
for="policies.0.name">Pet Name *</label></div>
</div>
<div class="relative flex flex-col col-span-2 sm:col-span-4 lg:col-span-2"><label class="font-medium text-content-secondary peer-disabled:cursor-not-allowed peer-disabled:opacity-70 label--floating text-xs bg-background-primary"
id="policies.0.age-label" for="policies.0.age"></label>
<div tabindex="-1" class="pointer-events-none absolute left-0 top-0 size-[1px] opacity-0"></div><button type="button" role="combobox" aria-controls="radix-:r2m:" aria-expanded="false" aria-autocomplete="none" dir="ltr"
data-state="closed" data-placeholder=""
class="flex max-h-11 w-full items-center justify-between rounded-md bg-background-primary px-4 py-2 text-left text-base font-medium text-content-secondary shadow-faux-border disabled:cursor-not-allowed disabled:opacity-50 relative h-11 min-w-[142px] flex-1"
id="policies.0.age" aria-label="Age *" aria-labelledby="policies.0.age-label"><span class="truncate"><span style="pointer-events: none;">Age *</span></span><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24"
viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="size-4 opacity-50" aria-hidden="true">
<path d="m6 9 6 6 6-6"></path>
</svg></button><select aria-hidden="true" tabindex="-1"
style="position: absolute; border: 0px; width: 1px; height: 1px; padding: 0px; margin: -1px; overflow: hidden; clip: rect(0px, 0px, 0px, 0px); white-space: nowrap; overflow-wrap: normal;">
<option value=""></option>
<option value="0">8 weeks to 11 months</option>
<option value="1">1 year</option>
<option value="2">2 years</option>
<option value="3">3 years</option>
<option value="4">4 years</option>
<option value="5">5 years</option>
<option value="6">6 years</option>
<option value="7">7 years</option>
<option value="8">8 years</option>
<option value="9">9 years</option>
<option value="10">10 years</option>
<option value="11">11 years</option>
<option value="12">12 years</option>
<option value="13">13 years</option>
<option value="14">14 years</option>
<option value="15">15 years</option>
<option value="16">16 years</option>
<option value="17">17 years</option>
<option value="18">18 years</option>
<option value="19">19 years</option>
<option value="20">20 years</option>
</select>
</div>
<div class="relative flex flex-col col-span-1 sm:col-span-3 lg:col-span-2">
<div role="group" dir="ltr" class="flex h-11 flex-row rounded-md text-xs font-extrabold text-content-primary disabled:cursor-wait" tabindex="0" style="outline: none;"><button type="button" data-state="on" role="radio"
aria-checked="true"
class="flex w-full cursor-pointer flex-col items-center justify-center whitespace-nowrap p-1 text-center focus:rounded-none first:focus:rounded-l-md first:focus:rounded-r-none last:focus:rounded-l-none last:focus:rounded-r-md disabled:cursor-wait sm:px-3 border-2 border-stroke-brand-b bg-background-primary font-bold rounded-l-md"
tabindex="-1" data-radix-collection-item=""><span class="text-content-primary"><svg aria-hidden="true" focusable="false" data-prefix="fas" data-icon="dog" class="svg-inline--fa fa-dog fa-lg " role="img"
xmlns="http://www.w3.org/2000/svg" viewBox="0 0 576 512">
<path fill="currentColor"
d="M309.6 158.5L332.7 19.8C334.6 8.4 344.5 0 356.1 0c7.5 0 14.5 3.5 19 9.5L392 32h52.1c12.7 0 24.9 5.1 33.9 14.1L496 64h56c13.3 0 24 10.7 24 24v24c0 44.2-35.8 80-80 80H464 448 426.7l-5.1 30.5-112-64zM416 256.1L416 480c0 17.7-14.3 32-32 32H352c-17.7 0-32-14.3-32-32V364.8c-24 12.3-51.2 19.2-80 19.2s-56-6.9-80-19.2V480c0 17.7-14.3 32-32 32H96c-17.7 0-32-14.3-32-32V249.8c-28.8-10.9-51.4-35.3-59.2-66.5L1 167.8c-4.3-17.1 6.1-34.5 23.3-38.8s34.5 6.1 38.8 23.3l3.9 15.5C70.5 182 83.3 192 98 192h30 16H303.8L416 256.1zM464 80a16 16 0 1 0 -32 0 16 16 0 1 0 32 0z">
</path>
</svg></span><label aria-disabled="false" class="text-sm cursor-pointer font-bold">Dog</label></button><button type="button" data-state="off" role="radio" aria-checked="false"
class="flex w-full cursor-pointer flex-col items-center justify-center whitespace-nowrap p-1 text-center focus:rounded-none first:focus:rounded-l-md first:focus:rounded-r-none last:focus:rounded-l-none last:focus:rounded-r-md disabled:cursor-wait sm:px-3 border-2 border-stroke-transparent bg-background-secondary hover:bg-background-tertiary rounded-r-md"
tabindex="-1" data-radix-collection-item=""><span class="text-content-secondary"><svg aria-hidden="true" focusable="false" data-prefix="fas" data-icon="cat" class="svg-inline--fa fa-cat fa-lg " role="img"
xmlns="http://www.w3.org/2000/svg" viewBox="0 0 576 512">
<path fill="currentColor"
d="M320 192h17.1c22.1 38.3 63.5 64 110.9 64c11 0 21.8-1.4 32-4v4 32V480c0 17.7-14.3 32-32 32s-32-14.3-32-32V339.2L280 448h56c17.7 0 32 14.3 32 32s-14.3 32-32 32H192c-53 0-96-43-96-96V192.5c0-16.1-12-29.8-28-31.8l-7.9-1c-17.5-2.2-30-18.2-27.8-35.7s18.2-30 35.7-27.8l7.9 1c48 6 84.1 46.8 84.1 95.3v85.3c34.4-51.7 93.2-85.8 160-85.8zm160 26.5v0c-10 3.5-20.8 5.5-32 5.5c-28.4 0-54-12.4-71.6-32h0c-3.7-4.1-7-8.5-9.9-13.2C357.3 164 352 146.6 352 128v0V32 12 10.7C352 4.8 356.7 .1 362.6 0h.2c3.3 0 6.4 1.6 8.4 4.2l0 .1L384 21.3l27.2 36.3L416 64h64l4.8-6.4L512 21.3 524.8 4.3l0-.1c2-2.6 5.1-4.2 8.4-4.2h.2C539.3 .1 544 4.8 544 10.7V12 32v96c0 17.3-4.6 33.6-12.6 47.6c-11.3 19.8-29.6 35.2-51.4 42.9zM432 128a16 16 0 1 0 -32 0 16 16 0 1 0 32 0zm48 16a16 16 0 1 0 0-32 16 16 0 1 0 0 32z">
</path>
</svg></span><label aria-disabled="false" class="text-sm cursor-pointer font-medium text-content-secondary">Cat</label></button></div>
</div>
<div class="relative flex flex-col col-span-1 sm:col-span-3 lg:col-span-2">
<div role="group" dir="ltr" class="flex h-11 flex-row rounded-md text-xs font-extrabold text-content-primary disabled:cursor-wait" tabindex="0" style="outline: none;"><button type="button" data-state="off" role="radio"
aria-checked="false"
class="flex w-full cursor-pointer flex-col items-center justify-center whitespace-nowrap p-1 text-center focus:rounded-none first:focus:rounded-l-md first:focus:rounded-r-none last:focus:rounded-l-none last:focus:rounded-r-md disabled:cursor-wait sm:px-3 border-2 border-stroke-transparent bg-background-secondary hover:bg-background-tertiary rounded-l-md"
tabindex="-1" data-radix-collection-item=""><span class="text-content-secondary"><svg aria-hidden="true" focusable="false" data-prefix="fas" data-icon="mars" class="svg-inline--fa fa-mars fa-lg " role="img"
xmlns="http://www.w3.org/2000/svg" viewBox="0 0 448 512">
<path fill="currentColor"
d="M289.8 46.8c3.7-9 12.5-14.8 22.2-14.8H424c13.3 0 24 10.7 24 24V168c0 9.7-5.8 18.5-14.8 22.2s-19.3 1.7-26.2-5.2l-33.4-33.4L321 204.2c19.5 28.4 31 62.7 31 99.8c0 97.2-78.8 176-176 176S0 401.2 0 304s78.8-176 176-176c37 0 71.4 11.4 99.8 31l52.6-52.6L295 73c-6.9-6.9-8.9-17.2-5.2-26.2zM400 80l0 0h0v0zM176 416a112 112 0 1 0 0-224 112 112 0 1 0 0 224z">
</path>
</svg></span><label aria-disabled="false" class="text-sm cursor-pointer font-medium text-content-secondary">Male</label></button><button type="button" data-state="on" role="radio" aria-checked="true"
class="flex w-full cursor-pointer flex-col items-center justify-center whitespace-nowrap p-1 text-center focus:rounded-none first:focus:rounded-l-md first:focus:rounded-r-none last:focus:rounded-l-none last:focus:rounded-r-md disabled:cursor-wait sm:px-3 border-2 border-stroke-brand-b bg-background-primary font-bold rounded-r-md"
tabindex="-1" data-radix-collection-item=""><span class="text-content-primary"><svg aria-hidden="true" focusable="false" data-prefix="fas" data-icon="venus" class="svg-inline--fa fa-venus fa-lg " role="img"
xmlns="http://www.w3.org/2000/svg" viewBox="0 0 384 512">
<path fill="currentColor"
d="M80 176a112 112 0 1 1 224 0A112 112 0 1 1 80 176zM224 349.1c81.9-15 144-86.8 144-173.1C368 78.8 289.2 0 192 0S16 78.8 16 176c0 86.3 62.1 158.1 144 173.1V384H128c-17.7 0-32 14.3-32 32s14.3 32 32 32h32v32c0 17.7 14.3 32 32 32s32-14.3 32-32V448h32c17.7 0 32-14.3 32-32s-14.3-32-32-32H224V349.1z">
</path>
</svg></span><label aria-disabled="false" class="text-sm cursor-pointer font-bold">Female</label></button></div>
</div>
<div class="relative flex flex-col col-span-2 sm:col-span-5 lg:col-span-3"><label class="font-medium text-content-secondary peer-disabled:cursor-not-allowed peer-disabled:opacity-70 label--floating text-xs bg-background-primary"
id="policies.0.breed-label" for="policies.0.breed"></label>
<div tabindex="-1" class="pointer-events-none absolute left-0 top-0 size-[1px] opacity-0"></div><button
class="inline-flex items-center text-base font-medium transition-colors disabled:pointer-events-none disabled:opacity-50 rounded-md border border-stroke-primary bg-background-primary text-content-secondary hover:bg-background-secondary hover:text-content-primary h-11 px-4 py-3 relative w-full min-w-[200px] justify-between border-none shadow-faux-border"
type="button" role="combobox" aria-expanded="false" id="policies.0.breed" aria-labelledby="policies.0.breed-label" aria-label="Breed *" aria-haspopup="dialog" aria-controls="radix-:r2r:" data-state="closed"><span
class="absolute max-w-[80%] truncate sm:max-w-[85%]">Breed *</span><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round"
stroke-linejoin="round" class="absolute right-4 size-4 opacity-50">
<path d="m7 15 5 5 5-5"></path>
<path d="m7 9 5-5 5 5"></path>
</svg></button>
</div>
</div>
</div>
<div class="flex flex-col items-center justify-center gap-2 sm:flex-row sm:justify-start"><button
class="inline-flex items-center justify-center text-base font-medium transition-colors disabled:pointer-events-none disabled:opacity-50 rounded-md text-content-primary hover:bg-background-secondary h-11 px-4 py-3 text-nowrap"
type="button"><span class="mr-2 flex"><svg aria-hidden="true" focusable="false" data-prefix="fas" data-icon="plus" class="svg-inline--fa fa-plus " role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 448 512">
<path fill="currentColor" d="M256 80c0-17.7-14.3-32-32-32s-32 14.3-32 32V224H48c-17.7 0-32 14.3-32 32s14.3 32 32 32H192V432c0 17.7 14.3 32 32 32s32-14.3 32-32V288H400c17.7 0 32-14.3 32-32s-14.3-32-32-32H256V80z"></path>
</svg></span>Add Another Pet</button>
<div
class="inline-flex items-center px-2 text-xs leading-5 transition-colors focus:outline-none bg-background-success text-content-success hover:bg-background-success-secondary hover:text-content-primary-invert rounded-md sm:rounded-full">
10% multi-pet discount on all additional pets</div>
</div>
<hr class="mb-6 border-stroke-primary">
</div>
<div class="flex flex-col gap-6">
<div class="grid grid-cols-1 gap-6 lg:grid-cols-2">
<div class="-m-2 space-y-1 rounded-lg p-2 pb-1 bg-background-brand-b-secondary">
<div class="relative flex flex-col flex-1">
<div class="relative flex items-center rounded-md border border-none bg-background-primary shadow-faux-border"><input
class="px-4 h-11 w-full bg-background-primary rounded-md text-content-primary text-base appearance-none focus:outline-none peer placeholder:opacity-0 focus:placeholder:opacity-100 placeholder:text-content-secondary input-value-false"
placeholder=" " id="zip-code-*" autocomplete="postal-code" value="" name="ratingZipcode"><label
class="font-medium text-content-secondary peer-disabled:cursor-not-allowed peer-disabled:opacity-70 label--floating text-base bg-background-primary" for="zip-code-*">Zip Code *</label></div>
</div><span class="flex items-center justify-center gap-1 text-xs leading-5 text-content-primary"><svg aria-hidden="true" focusable="false" data-prefix="fas" data-icon="gift" class="svg-inline--fa fa-gift text-content-primary"
role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512">
<path fill="currentColor"
d="M190.5 68.8L225.3 128H224 152c-22.1 0-40-17.9-40-40s17.9-40 40-40h2.2c14.9 0 28.8 7.9 36.3 20.8zM64 88c0 14.4 3.5 28 9.6 40H32c-17.7 0-32 14.3-32 32v64c0 17.7 14.3 32 32 32H480c17.7 0 32-14.3 32-32V160c0-17.7-14.3-32-32-32H438.4c6.1-12 9.6-25.6 9.6-40c0-48.6-39.4-88-88-88h-2.2c-31.9 0-61.5 16.9-77.7 44.4L256 85.5l-24.1-41C215.7 16.9 186.1 0 154.2 0H152C103.4 0 64 39.4 64 88zm336 0c0 22.1-17.9 40-40 40H288h-1.3l34.8-59.2C329.1 55.9 342.9 48 357.8 48H360c22.1 0 40 17.9 40 40zM32 288V464c0 26.5 21.5 48 48 48H224V288H32zM288 512H432c26.5 0 48-21.5 48-48V288H288V512z">
</path>
</svg><span>See if you qualify for a <strong>$25 Amazon Gift Card!*</strong></span></span>
</div>
<div class="relative flex flex-col flex-1">
<div class="relative flex items-center rounded-md border border-none bg-background-primary shadow-faux-border"><input
class="px-4 h-11 w-full bg-background-primary rounded-md text-content-primary text-base appearance-none focus:outline-none peer placeholder:opacity-0 focus:placeholder:opacity-100 placeholder:text-content-secondary input-value-false"
placeholder="my@email.com" id="email-address-*" autocomplete="email" type="email" value="" name="email"><label
class="font-medium text-content-secondary peer-disabled:cursor-not-allowed peer-disabled:opacity-70 label--floating text-base bg-background-primary" for="email-address-*">Email Address *</label></div>
</div>
</div>
<div class="grid grid-cols-1 gap-6 lg:grid-cols-3">
<div class="relative flex flex-col flex-1">
<div class="relative flex items-center rounded-md border border-none bg-background-primary shadow-faux-border"><input
class="px-4 h-11 w-full bg-background-primary rounded-md text-content-primary text-base appearance-none focus:outline-none peer placeholder:opacity-0 focus:placeholder:opacity-100 placeholder:text-content-secondary input-value-false"
placeholder=" " id="first-name-*" autocomplete="given-name" value="" name="firstName"><label
class="font-medium text-content-secondary peer-disabled:cursor-not-allowed peer-disabled:opacity-70 label--floating text-base bg-background-primary" for="first-name-*">First Name *</label></div>
</div>
<div class="relative flex flex-col flex-1">
<div class="relative flex items-center rounded-md border border-none bg-background-primary shadow-faux-border"><input
class="px-4 h-11 w-full bg-background-primary rounded-md text-content-primary text-base appearance-none focus:outline-none peer placeholder:opacity-0 focus:placeholder:opacity-100 placeholder:text-content-secondary input-value-false"
placeholder=" " id="last-name-*" autocomplete="family-name" value="" name="lastName"><label
class="font-medium text-content-secondary peer-disabled:cursor-not-allowed peer-disabled:opacity-70 label--floating text-base bg-background-primary" for="last-name-*">Last Name *</label></div>
</div>
<div class="relative flex flex-col flex-1">
<div class="relative flex items-center rounded-md border border-none bg-background-primary shadow-faux-border"><input
class="px-4 h-11 w-full bg-background-primary rounded-md text-content-primary text-base appearance-none focus:outline-none peer placeholder:opacity-0 focus:placeholder:opacity-100 placeholder:text-content-secondary input-value-false"
placeholder="(555) 555-5555" id="mobile-number-(optional)" autocomplete="tel-national" type="tel" value="" name="phone"><label
class="font-medium text-content-secondary peer-disabled:cursor-not-allowed peer-disabled:opacity-70 label--floating text-base bg-background-primary" for="mobile-number-(optional)">Mobile number (optional)</label></div>
</div>
</div>
</div>
<div class="mt-2 flex flex-col gap-4 text-xs text-content-secondary">
<p class="leading-5">By clicking "Select Coverage" you agree that Spot Pet Insurance and its affiliates may communicate with you via email, text, or phone through the email and/or phone numbers provided to Spot. Spot may use automated
technology (e.g., prerecorded messages, autodialers) to contact you. You are not required to provide your phone number to Spot Pet Insurance. Your consent to these terms is not a condition of being able to purchase pet insurance. Your
information is collected and used in accordance with Spot Pet Insurance <a href="https://spotpet.com/privacy" target="_blank" class="underline">Privacy Policy</a>. Text messages are subject to the Spot Pet Insurance
<a href="https://spotpet.com/privacy#texting-terms" target="_blank" class="underline">Texting Terms</a>. Opt out any time.</p>
<div class=" max-w-[976px] text-xs text-content-secondary">Amazon.com Gift Card* is subject to eligibility, not available in all states. <a href="https://spotpet.com/amz-terms" class="underline" target="_blank">Eligibility terms</a>.</div>
</div>
<hr class="mt-3 border-stroke-primary">
</div>
</div>
</div>
<div class="flex flex-col gap-8 sm:gap-10">
<div class="relative flex justify-center"><button
class="inline-flex items-center justify-center text-base font-medium transition-colors disabled:pointer-events-none disabled:opacity-50 rounded-md bg-background-brand-secondary text-content-primary-invert hover:bg-background-brand-tertiary focus:rounded-md h-11 px-4 py-3"
type="button">
<div class="flex items-center gap-2">Select Coverage</div><span class="ml-2 flex"><svg aria-hidden="true" focusable="false" data-prefix="fas" data-icon="chevron-right" class="svg-inline--fa fa-chevron-right " role="img"
xmlns="http://www.w3.org/2000/svg" viewBox="0 0 320 512">
<path fill="currentColor" d="M310.6 233.4c12.5 12.5 12.5 32.8 0 45.3l-192 192c-12.5 12.5-32.8 12.5-45.3 0s-12.5-32.8 0-45.3L242.7 256 73.4 86.6c-12.5-12.5-12.5-32.8 0-45.3s32.8-12.5 45.3 0l192 192z"></path>
</svg></span>
</button></div>
<div class="mx-auto flex max-w-[720px] flex-col gap-2 text-center text-sm text-content-primary">
<h3 class="text-sm font-bold">Free Pet Insurance Quote in 30 Seconds</h3>
<p class="text-left">Get your free quote on a pet insurance plan for your cat or dog. When adventure calls, ensure your pet always answers. Submit the form to get your <span class="font-bold">free pet insurance quote.</span></p>
</div>
</div>
</form>Text Content
1-800-905-1595 Spot Pet Insurance ENTER PET INFO Pet Name * Age *8 weeks to 11 months1 year2 years3 years4 years5 years6 years7 years8 years9 years10 years11 years12 years13 years14 years15 years16 years17 years18 years19 years20 years DogCat MaleFemale Breed * Add Another Pet 10% multi-pet discount on all additional pets -------------------------------------------------------------------------------- Zip Code * See if you qualify for a $25 Amazon Gift Card!* Email Address * First Name * Last Name * Mobile number (optional) By clicking "Select Coverage" you agree that Spot Pet Insurance and its affiliates may communicate with you via email, text, or phone through the email and/or phone numbers provided to Spot. Spot may use automated technology (e.g., prerecorded messages, autodialers) to contact you. You are not required to provide your phone number to Spot Pet Insurance. Your consent to these terms is not a condition of being able to purchase pet insurance. Your information is collected and used in accordance with Spot Pet Insurance Privacy Policy. Text messages are subject to the Spot Pet Insurance Texting Terms. Opt out any time. Amazon.com Gift Card* is subject to eligibility, not available in all states. Eligibility terms. -------------------------------------------------------------------------------- Select Coverage FREE PET INSURANCE QUOTE IN 30 SECONDS Get your free quote on a pet insurance plan for your cat or dog. When adventure calls, ensure your pet always answers. Submit the form to get your free pet insurance quote. Terms & ConditionsPrivacySources & CitationsAgency InformationSample PolicyADA NoticeSitemap Spot NOTICE TO CALIFORNIA RESIDENTSSpot NOTICE TO MAINE RESIDENTS Pre-existing conditions are not covered. Waiting periods, annual deductible, co-insurance, benefit limits, and exclusions may apply. For all terms and conditions visit spotpetins.com/sample-policy. Preventive Care reimbursements are based on a schedule. Accident & Illness coverage reimbursements are based on the invoice. Products, schedules, discounts, and rates may vary and are subject to change. More information is available at checkout. Insurance products are underwritten by either Independence American Insurance Company (NAIC #26581. A Delaware insurance company located at 11333 N. Scottsdale Rd, Ste. 160, Scottsdale, AZ 85254), or United States Fire Insurance Company (NAIC #21113. Morristown, NJ). Please refer to your policy forms to determine the underwriter for your policy. Insurance is produced by Spot Pet Insurance Services, LLC. (NPN # 19246385. 990 Biscayne Blvd Suite 603, Miami, FL 33132). CA License #6000188. PTZ Insurance Agency Ltd. (NPN: 5328528. domiciled in Illinois with offices at 1208 Massillon Road, Suite G200, Akron, Ohio 44306) is responsible for administration and claims adjudication. (California residents only: PTZ Insurance Agency Ltd., d.b.a PIA Insurance Agency Ltd. CA license #0E36937). © 2024 United States Fire Insurance Company. Spot Pet Insurance Logo, Copyright 2024, Spot Pet Insurance. All Rights Reserved.