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Submitted URL: https://www.ne16.com/t/6136367/55401448/2465644/1/1000401/?f5d63f87=SEIyMDIzMTEyNS1TdHJldGNoaW5n&b44ed14b=OWY4MTlmZmQ...
Effective URL: https://www.health.harvard.edu/promotions/harvard-health-publications/harvard-health-online-jul2018-test?utm_source=delivra&utm...
Submission: On February 15 via api from US — Scanned from DE
Effective URL: https://www.health.harvard.edu/promotions/harvard-health-publications/harvard-health-online-jul2018-test?utm_source=delivra&utm...
Submission: On February 15 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: order — POST /promotions/harvard-health-publications/harvard-health-online/process
<form action="/promotions/harvard-health-publications/harvard-health-online/process" method="post" name="order" id="order-frm">
<input type="hidden" name="_token" value="5QVkhjwMWQzGbV4YiXsqZB8XmPzZoHMvpdwwANuf">
<div id="my_title_McwcloOh8ueMOcWe_wrap" style="display: none" aria-hidden="true">
<input id="my_title_McwcloOh8ueMOcWe" name="my_title_McwcloOh8ueMOcWe" type="text" value="" autocomplete="nope" tabindex="-1">
<input name="valid_from" type="text" value="eyJpdiI6IndCRjJDRm9qYW1oTmJsVG9ndkxrQlE9PSIsInZhbHVlIjoieDI0QWRHVi9SbG5VWGFMbFFKWVFGUT09IiwibWFjIjoiYjQ5ZTY2YmYxYTFlZmZjOTdmNzU4ZGY2NjFhYmJiODZjZjA1YzczMTdhMmE3NWE1YTUwMTY2ODJiN2Y2YWFlNiIsInRhZyI6IiJ9"
autocomplete="off" tabindex="-1">
</div>
<div class="row order-form-format-select">
<div class="col-xs-12">
<div class="landing-order-form">
<h3 class="maroon-headline">Choose Your Savings:</h3>
<table border="0" width="95%" cellpadding="0" cellspacing="0" id="product-selection">
<tbody>
<tr id="electronic-offer" class="transition ease-in-out delay-150">
<td align="left" valign="top" width="5%" style="padding-bottom: 10px;">
<input type="radio" class="format-selector recalc" name="products[1][1][E][format]" id="products[1][1][E][format]" value="E" checked="">
</td>
<td align="left" valign="top" width="95%" style="padding-bottom: 10px;" class="product-format-cell">
<label class="product-format-label" for="products[1][1][E][format]"> Regular Premier Membership: <span class="cross">$9.99 </span>now just $4.99 for one month. If you enjoy your Harvard Health Online membership you can continue
at this same discounted rate of just $4.99/month billed automatically each quarter. <span class="bigger bold"> Online Access </span> — <span class="price">
<span class="country-intl country-australia country-canada country-meta" style="display: none;">US</span> $ 4.99 <input type="hidden" id="price-E-1-1" name="products[1][1][E][price]" value="4.99">
</span>
<div class="country-meta country-intl country-australia" style="display: none;"><strong>Ensure prompt delivery at the best price available!</strong></div>
</label>
</td>
</tr>
<tr id="electronic-offer" class="transition ease-in-out delay-150">
<td align="left" valign="top" width="5%" style="padding-bottom: 10px;">
<input type="radio" class="format-selector recalc" name="products[1][12][E][format]" id="products[1][12][E][format]" value="E">
</td>
<td align="left" valign="top" width="95%" style="padding-bottom: 10px;" class="product-format-cell">
<label class="product-format-label" for="products[1][12][E][format]">
<span style="color: #bf121b;"><em>Best deal!</em></span> Save even more and get an annual Premier Membership to Harvard Health Online and all the privileges for just $48/year. That’s 60% OFF the regular rate. <span
class="bigger bold"> Online Access </span> — <span class="price">
<span class="country-intl country-australia country-canada country-meta" style="display: none;">US</span> $ 48.00 <input type="hidden" id="price-E-1-12" name="products[1][12][E][price]" value="48.00">
</span>
<div class="country-meta country-intl country-australia" style="display: none;"><strong>Ensure prompt delivery at the best price available!</strong></div>
</label>
</td>
</tr>
<tr class="country-usa country-meta">
<td align="left" valign="top" width="5%" style="padding-bottom: 10px; display: none;" class="physical-formats-only">
<div class="expedited-shipping-field-container">
<input type="checkbox" id="expedited_shipping" name="ship_method" class="recalc" value="fedex_smartpost" disabled="">
</div>
</td>
<td align="left" valign="top" width="95%" style="padding-bottom: 10px; display: none;" class="product-format-cell physical-formats-only">
<label class="shipping-option-label" for="expedited_shipping" style="color: #5A749B;">
<span class="bigger bold" style="color: #5A749B;">ADD PRIORITY PRINT DELIVERY</span> — <span class="price" style="color: #5A749B;"> Additional $3.00 </span>
<span class="country-usa country-meta" style="color: rgb(90, 116, 155);"><br>FedEx SmartPost (2 – 6 business days, US orders only)</span>
</label>
</td>
</tr>
</tbody>
</table>
</div>
</div>
</div>
<div class="row order-form-responsive">
<div class="col-xs-12 col-sm-6 order-form-section">
<div class="customer-info">
<h3 class="maroon-headline">Contact Info:</h3>
<div class="form-row">
<label for="first_name" class="form-label required first_name "> First Name: </label>
<div class="form-input">
<input id="first_name" type="text" name="first_name" size="15" maxlength="15" value="">
</div>
</div>
<div class="form-row">
<label for="last_name" class="form-label required last_name "> Last Name: </label>
<div class="form-input">
<input id="last_name" type="text" name="last_name" size="15" maxlength="20" value="">
</div>
</div>
<div class="form-row" id="country-row">
<label for="country" class="form-label "> Country: </label>
<div class="form-input form-input-full">
<select name="country" id="country" class="recalc" style="width: 248px;">
<option value="AFGHANISTAN">Afghanistan</option>
<option value="ALAND ISLANDS">Aland Islands</option>
<option value="ALBANIA">Albania</option>
<option value="ALGERIA">Algeria</option>
<option value="AMERICAN SAMOA">American Samoa</option>
<option value="ANDORRA">Andorra</option>
<option value="ANGOLA">Angola</option>
<option value="ANGUILLA">Anguilla</option>
<option value="ANTARCTICA">Antarctica</option>
<option value="ANTIGUA AND BARBUDA">Antigua and Barbuda</option>
<option value="ARGENTINA">Argentina</option>
<option value="ARMENIA">Armenia</option>
<option value="ARUBA">Aruba</option>
<option value="AUSTRALIA">Australia</option>
<option value="AUSTRIA">Austria</option>
<option value="AZERBAIJAN">Azerbaijan</option>
<option value="BAHAMAS">Bahamas</option>
<option value="BAHRAIN">Bahrain</option>
<option value="BANGLADESH">Bangladesh</option>
<option value="BARBADOS">Barbados</option>
<option value="BELARUS">Belarus</option>
<option value="BELGIUM">Belgium</option>
<option value="BELIZE">Belize</option>
<option value="BENIN">Benin</option>
<option value="BERMUDA">Bermuda</option>
<option value="BHUTAN">Bhutan</option>
<option value="BOLIVIA">Bolivia</option>
<option value="BOSNIA AND HERZEGOVINA">Bosnia and Herzegovina</option>
<option value="BOTSWANA">Botswana</option>
<option value="BOUVET ISLAND">Bouvet Island</option>
<option value="BRAZIL">Brazil</option>
<option value="BRITISH INDIAN OCEAN TERRITORY">British Indian Ocean Territory</option>
<option value="BRUNEI DARUSSALAM">Brunei Darussalam</option>
<option value="BULGARIA">Bulgaria</option>
<option value="BURKINA FASO">Burkina Faso</option>
<option value="BURUNDI">Burundi</option>
<option value="CAMBODIA">Cambodia</option>
<option value="CAMEROON">Cameroon</option>
<option value="CANADA">Canada</option>
<option value="CAPE VERDE">Cape Verde</option>
<option value="CAYMAN ISLANDS">Cayman Islands</option>
<option value="CENTRAL AFRICAN REPUBLIC">Central African Republic</option>
<option value="CHAD">Chad</option>
<option value="CHILE">Chile</option>
<option value="CHINA">China</option>
<option value="CHRISTMAS ISLAND">Christmas Island</option>
<option value="COCOS (KEELING) ISLANDS">Cocos (Keeling) Islands</option>
<option value="COLOMBIA">Colombia</option>
<option value="COMOROS">Comoros</option>
<option value="CONGO">Congo</option>
<option value="CONGO, THE DEMOCRATIC REPUBLIC">Congo, The Democratic Republic</option>
<option value="COOK ISLANDS">Cook Islands</option>
<option value="COSTA RICA">Costa Rica</option>
<option value="COTE D'IVOIRE">Cote d'Ivoire</option>
<option value="CROATIA">Croatia</option>
<option value="CUBA">Cuba</option>
<option value="CYPRUS">Cyprus</option>
<option value="CZECH REPUBLIC">Czech Republic</option>
<option value="DENMARK">Denmark</option>
<option value="DJIBOUTI">Djibouti</option>
<option value="DOMINICA">Dominica</option>
<option value="DOMINICAN REPUBLIC">Dominican Republic</option>
<option value="ECUADOR">Ecuador</option>
<option value="EGYPT">Egypt</option>
<option value="EL SALVADOR">El Salvador</option>
<option value="EQUATORIAL GUINEA">Equatorial Guinea</option>
<option value="ERITREA">Eritrea</option>
<option value="ESTONIA">Estonia</option>
<option value="ETHIOPIA">Ethiopia</option>
<option value="FALKLAND ISLANDS">Falkland Islands</option>
<option value="FAROE ISLANDS">Faroe Islands</option>
<option value="FIJI">Fiji</option>
<option value="FINLAND">Finland</option>
<option value="FRANCE">France</option>
<option value="FRENCH GUIANA">French Guiana</option>
<option value="FRENCH POLYNESIA">French Polynesia</option>
<option value="FRENCH SOUTHERN TERRITORIES">French Southern Territories</option>
<option value="GABON">Gabon</option>
<option value="GAMBIA">Gambia</option>
<option value="GEORGIA">Georgia</option>
<option value="GERMANY">Germany</option>
<option value="GHANA">Ghana</option>
<option value="GIBRALTAR">Gibraltar</option>
<option value="GREECE">Greece</option>
<option value="GREENLAND">Greenland</option>
<option value="GRENADA">Grenada</option>
<option value="GUADELOUPE">Guadeloupe</option>
<option value="GUAM">Guam</option>
<option value="GUATEMALA">Guatemala</option>
<option value="GUINEA">Guinea</option>
<option value="GUINEA-BISSAU">Guinea-Bissau</option>
<option value="GUYANA">Guyana</option>
<option value="HAITI">Haiti</option>
<option value="HEARD ISLAND AND MCDONALD ISLA">Heard Island and McDonald Islands</option>
<option value="HOLY SEE (VATICAN CITY STATE)">Holy See (Vatican City State)</option>
<option value="HONDURAS">Honduras</option>
<option value="HONG KONG">Hong Kong</option>
<option value="HUNGARY">Hungary</option>
<option value="ICELAND">Iceland</option>
<option value="INDIA">India</option>
<option value="INDONESIA">Indonesia</option>
<option value="IRAN">Iran</option>
<option value="IRAQ">Iraq</option>
<option value="IRELAND">Ireland</option>
<option value="ISLE OF MAN">Isle of Man</option>
<option value="ISRAEL">Israel</option>
<option value="ITALY">Italy</option>
<option value="JAMAICA">Jamaica</option>
<option value="JAPAN">Japan</option>
<option value="JORDAN">Jordan</option>
<option value="KAZAKHSTAN">Kazakhstan</option>
<option value="KENYA">Kenya</option>
<option value="KIRIBATI">Kiribati</option>
<option value="KOREA (SOUTH)">Korea (South)</option>
<option value="KOREA, REPUBLIC OF">Korea, Republic of</option>
<option value="KUWAIT">Kuwait</option>
<option value="KYRGYZSTAN">Kyrgyzstan</option>
<option value="LAOS PEOPLES DEMOCRATIC REPUBL">Lao People's Democratic Republic</option>
<option value="LATVIA">Latvia</option>
<option value="LEBANON">Lebanon</option>
<option value="LESOTHO">Lesotho</option>
<option value="LIBERIA">Liberia</option>
<option value="LIBYAN ARAB JAMAHIRIYA">Libyan Arab Jamahiriya</option>
<option value="LIECHTENSTEIN">Liechtenstein</option>
<option value="LITHUANIA">Lithuania</option>
<option value="LUXEMBOURG">Luxembourg</option>
<option value="MACAU">Macau</option>
<option value="MACEDONIA">Macedonia</option>
<option value="MADAGASCAR">Madagascar</option>
<option value="MALAWI">Malawi</option>
<option value="MALAYSIA">Malaysia</option>
<option value="MALDIVES">Maldives</option>
<option value="MALI">Mali</option>
<option value="MALTA">Malta</option>
<option value="MARSHALL ISLANDS">Marshall Islands</option>
<option value="MARTINIQUE">Martinique</option>
<option value="MAURITANIA">Mauritania</option>
<option value="MAURITIUS">Mauritius</option>
<option value="MAYOTTE">Mayotte</option>
<option value="MEXICO">Mexico</option>
<option value="MICRONESIA, FEDERATED STATES O">Micronesia, Federated States of</option>
<option value="MOLDOVA, REPUBLIC OF">Moldova, Republic of</option>
<option value="MONACO">Monaco</option>
<option value="MONGOLIA">Mongolia</option>
<option value="MONTENEGRO">Montenegro</option>
<option value="MONTSERRAT">Montserrat</option>
<option value="MOROCCO">Morocco</option>
<option value="MOZAMBIQUE">Mozambique</option>
<option value="MYANMAR">Myanmar</option>
<option value="NAMIBIA">Namibia</option>
<option value="NAURU">Nauru</option>
<option value="NEPAL">Nepal</option>
<option value="NETHERLANDS">Netherlands</option>
<option value="NETHERLANDS ANTILLES">Netherlands Antilles</option>
<option value="NEW CALEDONIA">New Caledonia</option>
<option value="NEW ZEALAND">New Zealand</option>
<option value="NICARAGUA">Nicaragua</option>
<option value="NIGER">Niger</option>
<option value="NIGERIA">Nigeria</option>
<option value="NIUE">Niue</option>
<option value="NORFOLK ISLAND">Norfolk Island</option>
<option value="NORTHERN MARIANA ISLANDS">Northern Mariana Islands</option>
<option value="NORWAY">Norway</option>
<option value="OMAN">Oman</option>
<option value="PAKISTAN">Pakistan</option>
<option value="PALAU">Palau</option>
<option value="PALESTINIAN TERRITORY">Palestinian Territory</option>
<option value="PANAMA">Panama</option>
<option value="PAPUA NEW GUINEA">Papua New Guinea</option>
<option value="PARAGUAY">Paraguay</option>
<option value="PERU">Peru</option>
<option value="PHILIPPINES">Philippines</option>
<option value="PITCAIRN">Pitcairn</option>
<option value="POLAND">Poland</option>
<option value="PORTUGAL">Portugal</option>
<option value="PUERTO RICO">Puerto Rico</option>
<option value="QATAR">Qatar</option>
<option value="REPUBLIC OF GEORGIA">Republic of Georgia</option>
<option value="REPUBLIC OF SINGAPORE">Republic of Singapore</option>
<option value="REUNION">Reunion</option>
<option value="ROMANIA">Romania</option>
<option value="RUSSIAN FEDERATION">Russian Federation</option>
<option value="RWANDA">Rwanda</option>
<option value="SAINT BARTHELEMY">Saint Barthelemy</option>
<option value="SAINT HELENA">Saint Helena</option>
<option value="SAINT KITTS AND NEVIS">Saint Kitts and Nevis</option>
<option value="SAINT LUCIA">Saint Lucia</option>
<option value="SAINT MARTIN">Saint Martin</option>
<option value="SAINT PIERRE AND MIQUELON">Saint Pierre and Miquelon</option>
<option value="SAINT VINCENT AND THE GRENADIN">Saint Vincent and the Grenadines</option>
<option value="SAMOA (INDEPENDENT)">Samoa (Independent)</option>
<option value="SAN MARINO">San Marino</option>
<option value="SAO TOME AND PRINCIPE">Sao Tome and Principe</option>
<option value="SAUDI ARABIA">Saudi Arabia</option>
<option value="SENEGAL">Senegal</option>
<option value="SERBIA">Serbia</option>
<option value="SERBIA AND MONTENEGRO">Serbia and Montenegro</option>
<option value="SEYCHELLES">Seychelles</option>
<option value="SIERRA LEONE">Sierra Leone</option>
<option value="SINGAPORE">Singapore</option>
<option value="SLOVAKIA">Slovakia</option>
<option value="SLOVENIA">Slovenia</option>
<option value="SOLOMON ISLANDS">Solomon Islands</option>
<option value="SOMALIA">Somalia</option>
<option value="SOUTH AFRICA">South Africa</option>
<option value="SOUTH GEORGIA AND THE SOUTH SA">South Georgia and the South Sandwich Islands</option>
<option value="SOUTH KOREA">South Korea</option>
<option value="SPAIN">Spain</option>
<option value="SRI LANKA">Sri Lanka</option>
<option value="SUDAN">Sudan</option>
<option value="SURINAME">Suriname</option>
<option value="SVALBARD AND JAN MAYEN ISLANDS">Svalbard and Jan Mayen Islands</option>
<option value="SWAZILAND">Swaziland</option>
<option value="SWEDEN">Sweden</option>
<option value="SWITZERLAND">Switzerland</option>
<option value="SYRIAN ARAB REPUBLIC">Syrian Arab Republic</option>
<option value="TAIWAN">Taiwan</option>
<option value="TAJIKISTAN">Tajikistan</option>
<option value="TANZANIA">Tanzania</option>
<option value="THAILAND">Thailand</option>
<option value="THE NETHERLANDS">The Netherlands</option>
<option value="TIMOR-LESTE">Timor-Leste</option>
<option value="TOGO">Togo</option>
<option value="TOKELAU">Tokelau</option>
<option value="TONGA">Tonga</option>
<option value="TRINIDAD AND TOBAGO">Trinidad and Tobago</option>
<option value="TUNISIA">Tunisia</option>
<option value="TURKEY">Turkey</option>
<option value="TURKMENISTAN">Turkmenistan</option>
<option value="TURKS AND CAICOS ISLANDS">Turks and Caicos Islands</option>
<option value="TUVALU">Tuvalu</option>
<option value="UGANDA">Uganda</option>
<option value="UKRAINE">Ukraine</option>
<option value="UNITED ARAB EMIRATES">United Arab Emirates</option>
<option value="UNITED KINGDOM">United Kingdom</option>
<option value="URUGUAY">Uruguay</option>
<option value="USA" selected="">USA</option>
<option value="UZBEKISTAN">Uzbekistan</option>
<option value="VANUATU">Vanuatu</option>
<option value="VENEZUELA">Venezuela</option>
<option value="VIETNAM">Vietnam</option>
<option value="VIRGIN ISLANDS (BRITISH)">Virgin Islands (British)</option>
<option value="VIRGIN ISLANDS (U.S.)">Virgin Islands (U.S.)</option>
<option value="WALLIS AND FUTUNA">Wallis and Futuna</option>
<option value="WEST INDIES">West Indies</option>
<option value="WESTERN SAHARA">Western Sahara</option>
<option value="YEMEN">Yemen</option>
<option value="ZAMBIA">Zambia</option>
<option value="ZIMBABWE">Zimbabwe</option>
</select>
</div>
</div>
<div class="form-row" style="padding-bottom: 0px;">
<label for="address_1" class="form-label required address "> Address </label>
<div class="form-input">
<input id="address_1" type="text" name="address_1" size="30" maxlength="40" value="">
</div>
</div>
<!-- Address 2 -->
<div class="form-row">
<label for="address_2" class="form-label"> Address 2 </label>
<div class="form-input">
<input id="address_2" type="text" name="address_2" size="30" maxlength="30" value="">
</div>
</div>
<div class="form-row">
<label for="city" class="form-label required city "> City </label>
<div class="form-input">
<input id="city" type="text" name="city" size="25" maxlength="25" value="">
</div>
</div>
<div class="form-row" id="state_province_row">
<label id="state-province-input-label" class="form-label required state_province " for="state-province-usa">
<span id="state_province-label">State</span>: </label>
<div class="form-input form-input-full">
<div style="width: 248px;">
<div class="country-specific-state-province">
<div id="state_provinces-usa" class="country-specific">
<select name="state_province" class="recalc" id="state-province-usa">
<option value="">Choose one...</option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District of Columbia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
<optgroup label="Territories">
<option value="AS">American Samoa</option>
<option value="FM">Federated States of Micronesia</option>
<option value="GU">Guam</option>
<option value="MH">Marshall Islands</option>
<option value="AA">Military America (AA)</option>
<option value="AE">Military Europe (AE)</option>
<option value="AP">Military Pacific (AP)</option>
<option value="MP">Northern Mariana Islands</option>
<option value="PW">Palau</option>
<option value="PR">Puerto Rico</option>
<option value="VI">U.S. Virgin Islands</option>
</optgroup>
</select>
</div>
<div id="state_provinces-canada" class="country-specific" style="display: none;">
<select name="state_province" class="recalc" disabled="">
<option value="">Choose one...</option>
<option value="AB">Alberta</option>
<option value="BC">British Columbia</option>
<option value="MB">Manitoba</option>
<option value="NB">New Brunswick</option>
<option value="NL">Newfoundland and Labrador</option>
<option value="NT">Northwest Territories</option>
<option value="NS">Nova Scotia</option>
<option value="NU">Nunavut</option>
<option value="ON">Ontario</option>
<option value="PE">Prince Edward Island</option>
<option value="QC">Quebec</option>
<option value="SK">Saskatchewan</option>
<option value="YT">Yukon</option>
</select>
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<div id="state_provinces-australia" class="country-specific" style="display: none;">
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