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2606:4700:3108::ac42:292b  Public Scan

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URL: https://www.physiciansweekly.com/newsletter-preference/
Submission: On August 19 via api from US — Scanned from DE

Form analysis 5 forms found in the DOM

<form class="register_form_new">
  <div style="display: none;" id="error_msg3"></div>
  <input type="hidden" name="popup_email2_second" id="popup_email2_second" value="">
  <input type="hidden" name="sidbar" id="sidbar" value="Sidebar">
  <div class="left_spec">
    <label class="fields special">
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Allergy"><span>Allergy</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Cardiology"><span>Cardiology</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Critical Care"><span>Critical Care</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Dermatology"><span>Dermatology</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Diabetes"><span>Diabetes</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Emergency"><span>Emergency</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Gastroenterology"><span>Gastroenterology</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Infectious Disease"><span>Infectious Disease</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Neurology"><span>Neurology</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Nephrology"><span>Nephrology</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="OBGYN"><span>OBGYN</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Oncology"><span>Oncology</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Opththalmology"><span>Opththalmology</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Pain"><span>Pain</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Pediatrics"><span>Pediatrics</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Primary Care"><span>Primary Care</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Pulmonology"><span>Pulmonology</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Psychiatry"><span>Psychiatry</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Rheumatology"><span>Rheumatology</span></span>
      <span class="item_cutom"><input type="checkbox" name="specialty2[]" value="Surgery"><span>Surgery</span></span>
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  <div class="right_zip">
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    <label class="fields"><input type="text" id="zip_code2" class="zip_code" maxlength="5" placeholder="Enter Zip Code"></label>
    <span class="action_custom"><a class="save_data_btn2_second" href="javascript:void(0);">Save</a><span class="not_now"><a href="#" class="skip_btn_sub2">Not Now</a></span></span>
  </div>
</form>

GET https://www.physiciansweekly.com/

<form role="search" class="et-search-form" method="get" action="https://www.physiciansweekly.com/">
  <input type="search" class="et-search-field" placeholder="Search" value="" name="s" title="Search for:">
  <button class="et-search-submit"></button>
</form>

POST 

<form class="custom_form" method="post">
  <p class="hdng">Newsletter Preference</p>
  <input type="text" id="myTextField" value="">
  <div class="show_msg">
    <input type="hidden" class="cm_id" value="">
    <div class="validation_error" style="display: none;"></div>
    <p class="add-fields first-list">
      <label>Email <span class="star">*</span></label>
      <input type="text" name="email" class="email" value="">
    </p>
    <p class="add-fields">
      <label style="font-size:15px" "="">Select your free newsletter subscriptions below:</label>
<label><input type=" checkbox" name="sample" class="selectall all-hide"><br> <br>
      </label>
    </p>
    <div class="add-fileds-one">
      <label class="container"><input type="checkbox" name="specialties" value="Allergy"> Allergy<span class="checkmark"></span></label><br><label class="container"><input type="checkbox" name="specialties" value="Cardiology"> Cardiology<span
          class="checkmark"></span></label><br><label class="container"><input type="checkbox" name="specialties" value="Critical Care"> Critical Care<span class="checkmark"></span></label><br><label class="container"><input type="checkbox"
          name="specialties" value="Dermatology"> Dermatology<span class="checkmark"></span></label><br><label class="container"><input type="checkbox" name="specialties" value="Diabetes"> Diabetes<span class="checkmark"></span></label><br><label
        class="container"><input type="checkbox" name="specialties" value="Emergency"> Emergency<span class="checkmark"></span></label><br><label class="container"><input type="checkbox" name="specialties" value="Gastroenterology">
        Gastroenterology<span class="checkmark"></span></label><br><label class="container"><input type="checkbox" name="specialties" value="Infectious Disease"> Infectious Disease<span class="checkmark"></span></label><br><label
        class="container"><input type="checkbox" name="specialties" value="Neurology"> Neurology<span class="checkmark"></span></label><br><label class="container"><input type="checkbox" name="specialties" value="Nephrology"> Nephrology<span
          class="checkmark"></span></label><br>
      <div class="add-fileds-Two"></div><label class="container"><input type="checkbox" name="specialties" value="OBGYN"> OBGYN<span class="checkmark"></span></label><br><label class="container"><input type="checkbox" name="specialties"
          value="Oncology"> Oncology<span class="checkmark"></span></label><br><label class="container"><input type="checkbox" name="specialties" value="Ophthalmology"> Ophthalmology<span class="checkmark"></span></label><br><label
        class="container"><input type="checkbox" name="specialties" value="Pain"> Pain<span class="checkmark"></span></label><br><label class="container"><input type="checkbox" name="specialties" value="Pediatrics"> Pediatrics<span
          class="checkmark"></span></label><br><label class="container"><input type="checkbox" name="specialties" value="Primary Care"> Primary Care<span class="checkmark"></span></label><br><label class="container"><input type="checkbox"
          name="specialties" value="Pulmonology"> Pulmonology<span class="checkmark"></span></label><br><label class="container"><input type="checkbox" name="specialties" value="Psychiatry"> Psychiatry<span class="checkmark"></span></label><br><label
        class="container"><input type="checkbox" name="specialties" value="Rheumatology"> Rheumatology<span class="checkmark"></span></label><br><label class="container"><input type="checkbox" name="specialties" value="Surgery"> Surgery<span
          class="checkmark"></span></label><br>
    </div>
    <p></p>
    <input type="checkbox" value="opt-out" name="opt-out" style="margin-top: 40px; margin-bottom: 40px;" class="opt-out"><label style="margin-left:10px; font-size:15px">Opt-out from all the lists and purge my data.</label><br> <br>
    <div class="bottom-fields">
      <div class="submit-buttons">
        <button id="submit_detail" class="submit">Save Preference</button>
      </div>
    </div>
  </div>
</form>

<form class="subscription_form" id="" data-source="ig-es">
  <div class="es_caption">For latest news and updates</div>
  <input type="hidden" id="number1" value="">
  <input type="hidden" id="number2" value="">
  <div id="error"></div>
  <span class="error" id="invalid_email">Email-id is invalid</span>
  <div class="es-field-wrap"><label><br><input class="es_required_field es_txt_email s_email" id="semail" type="email" name="email" value="" placeholder="Enter your email..." required=""></label></div>
  <input type="submit" name="submit" class="es_subscription_form_submit es_submit_button es_textbox_button" id="subscription_form_submit" value="Subscribe">
</form>

<form class="subscription_form2" id="" data-source="ig-es">
  <div class="es_caption">For latest news and updates</div>
  <input type="hidden" id="number1" value="">
  <input type="hidden" id="number2" value="">
  <div id="error2"></div>
  <span class="error2" id="invalid_email2" style="display:none;color:red;">Email-id is invalid</span>
  <div class="es-field-wrap"><label><br><input class="es_required_field es_txt_email s_email2" id="semail" type="email" name="email" value="" placeholder="Enter your email..." required=""></label></div>
  <input type="submit" name="submit" class="es_subscription_form_submit es_submit_button es_textbox_button" id="subscription_form_submit2" value="Subscribe">
</form>

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Allergy
Cardiology
Critical Care
Dermatology
Diabetes
Emergency
Gastroenterology
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Neurology
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