www.livehealthyignite.com Open in urlscan Pro
2606:4700:10::6816:1065  Public Scan

Form analysis
1 forms found in the DOM

POST /inquiries

<form class="js-validate" id="new_inquiry" action="/inquiries" accept-charset="UTF-8" method="post" novalidate="novalidate"><input type="hidden" name="authenticity_token"
    value="uFQyOpUvM1lWDle3IDj/gkwyODWy/LXQ/W0lj4NNekDgiRpF99xAIVMSNpcqJjTE2SOZXvWuop70goM/sa8J3g==" autocomplete="off">
  <div class="row">
    <div class="col-6 form-group mb-3">
      <label for="inquiry_name">Name</label>
      <input class="form-control" placeholder="Name" required="required" type="text" name="inquiry[name]" id="inquiry_name">
    </div>
    <div class="col-6 form-group mb-3">
      <label for="inquiry_email">Email</label>
      <input class="form-control" placeholder="Email" required="required" type="email" name="inquiry[email]" id="inquiry_email">
    </div>
    <div class="col-12 form-group mb-3">
      <label for="inquiry_category">Category</label>
      <select class="form-control" required="required" name="inquiry[category]" id="inquiry_category">
        <option value="">-- Select --</option>
        <option value="Login Information">Login Information</option>
        <option value="Sign Up Information">Sign Up Information</option>
        <option value="Challenge Recording">Challenge Recording</option>
        <option value="Incentives / Swag">Incentives / Swag</option>
        <option value="Demo Request">Demo Request</option>
        <option value="Mobile Application">Mobile Application</option>
        <option value="Other">Other</option>
      </select>
    </div>
    <div class="col-12 form-group mb-3">
      <label for="inquiry_message">Message</label>
      <textarea class="form-control" placeholder="Message / Request" rows="5" required="required" name="inquiry[message]" id="inquiry_message"></textarea>
    </div>
    <div class="col-12 margin-bottom-sm">
      <div class="g-recaptcha" data-sitekey="6LdFR8chAAAAAIzqfJk23NnAcyAf4Gy-3cg965v_">
        <div style="width: 304px; height: 78px;">
          <div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-90p1dj1x7mcg" 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=6LdFR8chAAAAAIzqfJk23NnAcyAf4Gy-3cg965v_&amp;co=aHR0cHM6Ly93d3cubGl2ZWhlYWx0aHlpZ25pdGUuY29tOjQ0Mw..&amp;hl=de&amp;v=rz4DvU-cY2JYCwHSTck0_qm-&amp;size=normal&amp;cb=3fdfpijjovso"></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>
    </div>
  </div>
  <input autocomplete="off" type="hidden" name="inquiry[user_id]" id="inquiry_user_id">
  <div class="row">
    <div class="col-12 col-md-12 form-group mb-3">
      <input type="submit" name="commit" value="Submit" class="btn btn-primary" data-disable-with="Submit">
    </div>
  </div>
</form>

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YOUR ROADMAP TO WELLNESS

Welcome to the Live Healthy America / Navigate Wellbeing Solutions portal!

YOUR ROADMAP TO WELLNESS

Ready to change your wellness culture?

Wellness challenges and products that are so simple and easy to use- with online
tracking via web/mobile for participants, as well as turn-key reporting and
management for program managers. Best of all, our dedicated service team can
help with everything from program communications to answering participants’
questions to make the process easy.

Looking for a more robust employee solution? Visit www.navigatewell.com! 

Contact us at info@navigatewell.com  or Call 888-282-0822 for a demo!


CONTACT

Email: info@navigatewell.com

Phone: 888-282-0822



Name
Email
Category -- Select -- Login Information Sign Up Information Challenge Recording
Incentives / Swag Demo Request Mobile Application Other
Message




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