ochsner.perkspot.com Open in urlscan Pro
2620:1ec:bdf::45  Public Scan

Submitted URL: https://url1941.psmark.perkspot.com/ls/click?upn=u001.JX5yNMmulKenkKh8ieBztAqgFmqnC-2Bnxzv6GBQq-2Fla3Bgj9glXDJfeO2maHOvWfXkeOe7MEXlb...
Effective URL: https://ochsner.perkspot.com/filter/2900?epid=3
Submission: On April 10 via manual from US — Scanned from DE

Form analysis 3 forms found in the DOM

POST #

<form id="__AntiForgeryForm" action="#" method="post"><input name="__RequestVerificationToken" type="hidden"
    value="b1KEXGozc5TXP-mbZB_HhB-eqR2k9C9CJts8bmZgusQb6Ib-LMKP2ZkZEMcB8hMN5lBb2K_GP1TLbcx7Giq01809ccJvRylXojyCr4RKNuoxrZZ0Z_1fUcrnozGaD4uAhwJThgFffe6D2DODti2Plg2"></form>

<form id="offer-feedback-form">
  <input name="__RequestVerificationToken" type="hidden" value="Y388ADVLQcdyiEjFcPpOShzoC9QZH0ZLoQ3dGE7edkp4VTih9goAjPjKlvPREvNKXx2059Sfdoh_eoUV29uPAzlhF6ys_rCvI4d0Nyczs6bAWPq6vVw5JB4AccDsJ2u3JxPyaYTpU2uwpeKP4twdog2">
  <ul class="report-offer-options" data-bind="visible: (!isOptionSelected()), foreach: offerFeedbackModalOptions()">
    <li>
      <div data-bind="click: function(data, event) { perkspot.perxui.populateOfferFeedback($data, offerFeedbackTypeId) }">
        <input data-bind="attr: { accesskey: offerFeedbackTypeId, id: htmlId }" type="radio" name="report-offer-radio" tabindex="-1">
        <label data-bind="attr: { for: htmlId }" tabindex="0"><span data-bind="text: title"></span></label>
      </div>
    </li>
  </ul>
  <div class="my-feedback-selection" data-bind="visible: isOptionSelected()">
    <span class="feedback-section-title">My Feedback:</span>
    <span data-bind="text: offerFeedbackModalTitle()"></span>
  </div>
  <div class="my-feedback-selection-text">
    <span class="feedback-section-title"><label id="additional-info-textarea-label" for="additionalinfo" data-bind="text: offerFeedbackModalInfoText"></label></span>
    <i data-bind="if: isOfferFeedbackModalTextRequired" class="required">*Required</i>
  </div>
  <textarea id="additionalinfo" class="form-control" data-bind="visible: isOptionSelected, attr: { placeholder: offerFeedbackModalPlaceholderText }, event: { keyup: offerFeedbackModalKeyup }"></textarea>
</form>

<form id="send-referral" class="send-referral">
  <input name="__RequestVerificationToken" type="hidden" value="xvc12eMkt5GaKqaJhgRjw6N3vp8DFjzq1QfHN-O5wSc-EacRSyITIXkhbdQDOeWw4Xn6L4uFqRvHs0cROCD8_B4C0hC8fECp6c-DaDytxqgPE75KI3RcTSG0x-oAPBuGooyny158BtX0MjfXB-cXJg2">
  <div class="referral-form-head">
    <h3>Refer a Friend</h3>
  </div>
  <div class="form-group">
    <label for="select-referral-type">Who are You Referring?</label>
    <select id="select-referral-type" class="form-control" data-parsley-required="">
      <option value="">Select an option:</option>
      <option id="coworker" value="1">Coworker</option>
      <option id="friend" value="2">Friend</option>
      <option id="family" value="3">Family</option>
    </select>
    <div class="input-container">
      <label for="send-referral-email">Enter Email Address</label>
      <input id="send-referral-email" class="form-control" type="text" placeholder="example@example.com" data-parsley-type="email" data-parsley-error-message="Please enter a valid email." data-parsley-required="">
    </div>
    <button id="send-referral-button" class="button">Send Referral</button>
  </div>
</form>

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