clinicalevante2015.canalpaciente.org Open in urlscan Pro
80.94.184.131  Public Scan

Form analysis
2 forms found in the DOM

POST /patient-portal-webapp/login?_csrf=a85185e8-d21d-4889-9456-da54681d7186

<form id="loginForm" class="form-horizontal" action="/patient-portal-webapp/login?_csrf=a85185e8-d21d-4889-9456-da54681d7186" method="post" autocomplete="off" novalidate="novalidate"><input type="hidden" id="apiSiteCaptcha" name="apiSiteCaptcha"
    path="apiSiteCaptcha" value="6LdKqDgUAAAAAO5jNb6qykOLsXUYyejVEy-mMN18">
  <input type="hidden" id="recaptchaResp" name="recaptchaResp" path="recaptchaResp">
  <div class="collapse navbar-collapse" id="bs-example-navbar-collapse-1">
    <ul class="nav navbar-nav navbar-right">
      <li>
        <div class="btn-group .btn-mini">
          <a class="btn dropdown-toggle" data-toggle="dropdown" href="#">
					      	 <img src="/patient-portal-webapp/themes/common/img/en.png">
						     <span class="caret"></span>
					      </a>
          <ul class="dropdown-menu" id="flags">
            <li><a href="javascript:changeLocale('en')"><img src="/patient-portal-webapp/themes/common/img/en.png">English</a></li>
            <li><a href="javascript:changeLocale('es')"><img src="/patient-portal-webapp/themes/common/img/es.png">Spanish</a></li>
          </ul>
        </div>
      </li>
    </ul>
  </div>
  <div class="panel panel-default">
    <div class="panel-heading">
      <div class="panel-title">Sign in</div>
      <div style="float:right; font-size: 80%; position: relative; top:-10px"><a href="forgot/unlock">Unlock account</a> </div>
    </div>
    <div class="panel-body">
      <div class="alert alert-dismissible alert-danger" style="display:none" id="divError">
        <button type="button" class="close" data-dismiss="alert">×</button>
        <p id="textError"></p>
      </div>
      <div class="form-group">
        <label for="username" class="col-lg-3 control-label"> Email </label>
        <div class="col-lg-9">
          <input type="text" id="username" name="username" class="form-control" aria-required="true">
        </div>
      </div>
      <div class="form-group">
        <label for="password" class="col-lg-3 control-label">Password</label>
        <div class="col-lg-9">
          <input style="display:none" type="password" name="fakePasswordRemembered">
          <input type="password" id="password" name="password" class="form-control" placeholder="Password">
          <span class="help-block"><a href="forgot/password">Forgot password?</a></span>
        </div>
      </div>
      <div id="blockRealPerson" style="display:none" class="form-group">
        <div class="g-recaptcha col-lg-9 col-lg-offset-3" id="recaptchaG">
          <div style="width: 304px; height: 78px;">
            <div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-5tkznbuyuqin" 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=6LdKqDgUAAAAAO5jNb6qykOLsXUYyejVEy-mMN18&amp;co=aHR0cHM6Ly9jbGluaWNhbGV2YW50ZTIwMTUuY2FuYWxwYWNpZW50ZS5vcmc6NDQz&amp;hl=en&amp;v=1kRDYC3bfA-o6-tsWzIBvp7k&amp;size=normal&amp;cb=qdh1tpv9rbzg"></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><!--  panel body -->
    <div class="panel-footer">
      <div class="form-actions">
        <input type="submit" value="Sign in" class="btn btn-primary btn-block">
      </div>
    </div><!--  panel-footer -->
  </div><!-- end panel -->
  <div>
    <input type="hidden" name="_csrf" value="a85185e8-d21d-4889-9456-da54681d7186">
  </div>
</form>

<form class="form-horizontal">
  <div class="modal-dialog">
    <!-- Modal content -->
    <div class="modal-content">
      <div class="modal-header">
        <button type="button" class="close" data-dismiss="modal">×</button>
        <h4 class="modal-title"> Contact</h4>
      </div>
      <div class="modal-body">
      </div>
    </div>
  </div>
</form>

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    * Spanish

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