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https://www.halaxy.com/a/signup

html halaxy.com collected 2026-10-03 20:28:46 UTC 169,362 bytes, 1,835 lines download raw bytes

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8            Halaxy  - Signup to practice management software         </title>
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197                                    </div>
198
199                                <div>        <div class="d-flex"><select class="form-control form-control"
200                                                        
201    id="form_country" name="form[country]"
202        
203                                     class="form-control"
204                        
205                                                        ><option value="">Select country</option><option
206                value="1"  data-code="AF">Afghanistan</option><option
207                value="3"  data-code="AL">Albania</option><option
208                value="4"  data-code="DZ">Algeria</option><option
209                value="5"  data-code="AS">American Samoa</option><option
210                value="6"  data-code="AD">Andorra</option><option
211                value="7"  data-code="AO">Angola</option><option
212                value="10"  data-code="AG">Antigua and Barbuda</option><option
213                value="11"  data-code="AR">Argentina</option><option
214                value="12"  data-code="AM">Armenia</option><option
215                value="14"  data-code="AU">Australia</option><option
216                value="16"  data-code="AZ">Azerbaijan</option><option
217                value="17"  data-code="BS">Bahamas</option><option
218                value="18"  data-code="BH">Bahrain</option><option
219                value="19"  data-code="BD">Bangladesh</option><option
220                value="20"  data-code="BB">Barbados</option><option
221                value="21"  data-code="BY">Belarus</option><option
222                value="23"  data-code="BZ">Belize</option><option
223                value="24"  data-code="BJ">Benin</option><option
224                value="25"  data-code="BM">Bermuda</option><option
225                value="26"  data-code="BT">Bhutan</option><option
226                value="27"  data-code="BO">Bolivia</option><option
227                value="28"  data-code="BA">Bosnia and Herzegovina</option><option
228                value="29"  data-code="BW">Botswana</option><option
229                value="31"  data-code="BR">Brazil</option><option
230                value="33"  data-code="BN">Brunei</option><option
231                value="35"  data-code="BF">Burkina Faso</option><option
232                value="36"  data-code="BI">Burundi</option><option
233                value="37"  data-code="KH">Cambodia</option><option
234                value="38"  data-code="CM">Cameroon</option><option
235                value="39"  data-code="CA">Canada</option><option
236                value="40"  data-code="CV">Cape Verde</option><option
237                value="41"  data-code="KY">Cayman Islands</option><option
238                value="42"  data-code="CF">Central African Republic</option><option
239                value="43"  data-code="TD">
239Chad</option><option
240                value="44"  data-code="CL">Chile</option><option
241                value="45"  data-code="CN">China</option><option
242                value="48"  data-code="CO">Colombia</option><option
243                value="49"  data-code="KM">Comoros</option><option
244                value="51"  data-code="CD">Congo (Democratic Republic)</option><option
245                value="50"  data-code="CG">Congo (Republic)</option><option
246                value="52"  data-code="CK">Cook Islands</option><option
247                value="53"  data-code="CR">Costa Rica</option><option
248                value="54"  data-code="CI">Cote D&#039;Ivoire</option><option
249                value="56"  data-code="CU">Cuba</option><option
250                value="60"  data-code="DJ">Djibouti</option><option
251                value="61"  data-code="DM">Dominica</option><option
252                value="62"  data-code="DO">Dominican Republic</option><option
253                value="63"  data-code="EC">Ecuador</option><option
254                value="64"  data-code="EG">Egypt</option><option
255                value="65"  data-code="SV">El Salvador</option><option
256                value="66"  data-code="GQ">Equatorial Guinea</option><option
257                value="67"  data-code="ER">Eritrea</option><option
258                value="69"  data-code="ET">Ethiopia</option><option
259                value="70"  data-code="FK">Falkland Islands (Malvinas)</option><option
260                value="72"  data-code="FJ">Fiji</option><option
261                value="75"  data-code="GF">French Guiana</option><option
262                value="76"  data-code="PF">French Polynesia</option><option
263                value="78"  data-code="GA">Gabon</option><option
264                value="79"  data-code="GM">Gambia</option><option
265                value="80"  data-code="GE">Georgia</option><option
266                value="82"  data-code="GH">Ghana</option><option
267                value="83"  data-code="GI">Gibraltar</option><option
268                value="86"  data-code="GD">Grenada</option><option
269                value="87"  data-code="GP">Guadeloupe</option><option
270                value="88"  data-code="GU">Guam</option><option
271                value="89"  data-code="GT">Guatemala</option><option
272                value="91"  data-code="GN">Guinea</option><option
273                value="92"  data-code="GW">Guinea-Bissau</option><option
274                value="93"  data-code="GY">Guyana</option><option
275                value="94"  data-code="HT">Haiti</option><option
276                value="97"  data-code="HN">Honduras</option><option
277                value="98"  data-code="HK">Hong Kong</option><option
278                value="100"  data-code="IS">Iceland</option><option
279                value="101"  data-code="IN">India</option><option
280                value="102"  data-code="ID">Indonesia</option><option
281                value="103"  data-code="IR">Iran</option><option
282                value="104"  data-code="IQ">Iraq</option><option
283                value="107"  data-code="IL">Israel</option><option
284                value="109"  data-code="JM">Jamaica</option><option
285                value="110"  data-code="JP">Japan</option><option
286                value="112"  data-code="JO">Jordan</option><option
287                value="113"  data-code="KZ">Kazakhstan</option><option
288                value="114"  data-code="KE">Kenya</option><option
289                value="115"  data-code="KI">Kiribati</option><option
290                value="118"  data-code="KW">Kuwait</option><option
291                value="119"  data-code="KG">Kyrgyzstan</option><option
292                value="120"  data-code="LA">Laos</option><option
293                value="122"  data-code="LB">Lebanon</option><option
294                value="123"  data-code="LS">Lesotho</option><option
295                value="124"  data-code="LR">Liberia</option><option
296                value="125"  data-code="LY">Libya</option><option
297                value="126"  data-code="LI">Liechtenstein</option><option
298                value="129"  data-code="MO">Macao</option><option
299                value="130"  data-code="MK">Macedonia</option><option
300                value="131"  data-code="MG">Madagascar</option><option
301                value="132"  data-code="MW">Malawi</option><option
302                value="133"  data-code="MY">Malaysia</option><option
303                value="134"  data-code="MV">Maldives</option><option
304                value="135"  data-code="ML">Mali</option><option
305                value="137"  data-code="MH">Marshall Islands</option><option
306                value="138"  data-code="MQ">Martinique</option><option
307                value="139"  data-code="MR">Mauritania</option><option
308                value="140"  data-code="MU">Mauritius</option><option
309                value="142"  data-code="MX">Mexico</option><option
310                value="143"  data-code="FM">Micronesia</option><option
311                value="144"  data-code="MD">Moldova</option><option
312                value="145"  data-code="MC">Monaco</option><option
313                value="146"  data-code="MN">Mongolia</option><option
314                value="147"  data-code="ME">Montenegro</option><option
315                value="148"  data-code="MS">Montserrat</option><option
316                value="149"  data-code="MA">Morocco</option><option
317                value="150"  data-code="MZ">Mozambique</option><option
318                value="151"  data-code="MM">Myanmar</option><option
319                value="152"  data-code="NA">Namibia</option><option
320                value="153"  data-code="NR">Nauru</option><option
321                value="154"  data-code="NP">Nepal</option><option
322                value="157"  data-code="NC">New Caledonia</option><option
323                value="158"  data-code="NZ">New Zealand</option><option
324                value="159"  data-code="NI">Nicaragua</option><option
325                value="160"  data-code="NE">Niger</option><option
326                value="161"  data-code="NG">Nigeria</option><option
327                value="162"  data-code="NU">Niue</option><option
328                value="165"  data-code="NO">Norway</option><option
329                value="166"  data-code="OM">Oman</option><option
330                value="167"  data-code="PK">Pakistan</option><option
331                value="168"  data-code="PW">Palau</option><option
332                value="169"  data-code="PS">Palestine</option><option
333                value="170"  data-code="PA">Panama</option><option
334                value="171"  data-code="PG">Papua New Guinea</option><option
335                value="172"  data-code="PY">Paraguay</option><option
336                value="173"  data-code="PE">
336Peru</option><option
337                value="174"  data-code="PH">Philippines</option><option
338                value="175"  data-code="PN">Pitcairn</option><option
339                value="178"  data-code="PR">Puerto Rico</option><option
340                value="179"  data-code="QA">Qatar</option><option
341                value="180"  data-code="RE">Reunion</option><option
342                value="182"  data-code="RU">Russia</option><option
343                value="183"  data-code="RW">Rwanda</option><option
344                value="186"  data-code="KN">Saint Kitts and Nevis</option><option
345                value="187"  data-code="LC">Saint Lucia</option><option
346                value="190"  data-code="VC">Saint Vincent and the Grenadines</option><option
347                value="191"  data-code="WS">Samoa</option><option
348                value="192"  data-code="SM">San Marino</option><option
349                value="193"  data-code="ST">Sao Tome and Principe</option><option
350                value="194"  data-code="SA">Saudi Arabia</option><option
351                value="195"  data-code="SN">Senegal</option><option
352                value="196"  data-code="RS">Serbia</option><option
353                value="197"  data-code="SC">Seychelles</option><option
354                value="198"  data-code="SL">Sierra Leone</option><option
355                value="199"  data-code="SG">Singapore</option><option
356                value="202"  data-code="SB">Solomon Islands</option><option
357                value="203"  data-code="SO">Somalia</option><option
358                value="204"  data-code="ZA">South Africa</option><option
359                value="117"  data-code="KR">South Korea</option><option
360                value="207"  data-code="LK">Sri Lanka</option><option
361                value="208"  data-code="SD">Sudan</option><option
362                value="209"  data-code="SR">Suriname</option><option
363                value="211"  data-code="SZ">Swaziland</option><option
364                value="213"  data-code="CH">Switzerland</option><option
365                value="214"  data-code="SY">Syria</option><option
366                value="215"  data-code="TW">Taiwan</option><option
367                value="216"  data-code="TJ">Tajikistan</option><option
368                value="217"  data-code="TZ">Tanzania</option><option
369                value="218"  data-code="TH">Thailand</option><option
370                value="219"  data-code="TL">Timor-Leste</option><option
371                value="220"  data-code="TG">Togo</option><option
372                value="221"  data-code="TK">Tokelau</option><option
373                value="222"  data-code="TO">Tonga</option><option
374                value="223"  data-code="TT">Trinidad and Tobago</option><option
375                value="224"  data-code="TN">Tunisia</option><option
376                value="225"  data-code="TR">Turkey</option><option
377                value="226"  data-code="TM">Turkmenistan</option><option
378                value="227"  data-code="TC">Turks and Caicos Islands</option><option
379                value="228"  data-code="TV">Tuvalu</option><option
380                value="229"  data-code="UG">Uganda</option><option
381                value="230"  data-code="UA">Ukraine</option><option
382                value="231"  data-code="AE">United Arab Emirates</option><option
383                value="233"  data-code="US" selected="selected">United States of America (USA)</option><option
384                value="235"  data-code="UY">Uruguay</option><option
385                value="236"  data-code="UZ">Uzbekistan</option><option
386                value="237"  data-code="VU">Vanuatu</option><option
387                value="238"  data-code="VE">Venezuela</option><option
388                value="239"  data-code="VN">Vietnam</option><option
389                value="240"  data-code="VG">Virgin Islands (British)</option><option
390                value="241"  data-code="VI">Virgin Islands (U.S.)</option><option
391                value="242"  data-code="WF">Wallis And Futuna</option><option
392                value="243"  data-code="EH">Western Sahara</option><option
393                value="244"  data-code="YE">Yemen</option><option
394                value="245"  data-code="ZM">Zambia</option><option
395                value="246"  data-code="ZW">Zimbabwe</option></select></div>        
396    </div>
397                    </div>
398    
399                </div>
400            </div>
401
402            <div class="form-row">
403                <div class="col-12">
404                            
405                
406                        <div id="row-form_timezone" class="form-group">
407                                        
408            
409                            <div class="inline">
410                    
411
412                                                                                    
413                    
414                                    </div>
415
416                                <div><select
417        class="w-100 form-control form-control"         id="form_timezone" name="form[timezone]"
418                
419                                                     class="form-control"
420                                        ><option
421                value="Pacific/Midway">(GMT-11:00) Midway Island, Samoa</option><option
422                value="Pacific/Honolulu">(GMT-10:00) Hawaii</option><option
423                value="Pacific/Marquesas">(GMT-09:30) Marquesas Islands</option><option
424                value="America/Adak">(GMT-09:00) Aleutian Islands</option><option
425                value="Pacific/Gambier">(GMT-09:00) Gambier Islands</option><option
426                value="America/Anchorage">(GMT-08:00) Alaska</option><option
427                value="Pacific/Pitcairn">(GMT-08:00) Pitcairn Islands</option><option
428                value="America/Phoenix">
428(GMT-07:00) Arizona</option><option
429                value="America/Tijuana">(GMT-07:00) Pacific Time (US and Canada); Tijuana, Baja California</option><option
430                value="America/Managua">(GMT-06:00) Central America</option><option
431                value="America/Chihuahua">(GMT-06:00) Chihuahua, La Paz, Mazatlan</option><option
432                value="Pacific/Galapagos">(GMT-06:00) Galapagos Islands</option><option
433                value="America/Mexico_City">(GMT-06:00) Guadalajara, Mexico City, Monterrey</option><option
434                value="America/Edmonton">(GMT-06:00) Mountain Time (US and Canada)</option><option
435                value="America/Regina">(GMT-06:00) Saskatchewan</option><option
436                value="America/Bogota">(GMT-05:00) Bogota, Lima, Quito</option><option
437                value="America/Chicago">(GMT-05:00) Central Time (US and Canada)</option><option
438                value="Pacific/Easter">(GMT-05:00) Easter Island</option><option
439                value="America/Caracas">(GMT-04:00) Caracas</option><option
440                value="America/New_York">(GMT-04:00) Eastern Time (US and Canada)</option><option
441                value="America/Indiana/Indianapolis">(GMT-04:00) Indiana (East)</option><option
442                value="America/Manaus">(GMT-04:00) Manaus</option><option
443                value="America/Asuncion">(GMT-03:00) Asuncion</option><option
444                value="America/Halifax">(GMT-03:00) Atlantic Time (Canada)</option><option
445                value="America/Sao_Paulo">(GMT-03:00) Brasilia</option><option
446                value="America/Argentina/Buenos_Aires">(GMT-03:00) Buenos Aires, Georgetown</option><option
447                value="America/Argentina/San_Juan">(GMT-03:00) Georgetown, La Paz, San Juan</option><option
448                value="America/Montevideo">(GMT-03:00) Montevideo</option><option
449                value="America/Santiago">(GMT-03:00) Santiago</option><option
450                value="America/St_Johns">(GMT-02:30) Newfoundland</option><option
451                value="America/Noronha">(GMT-02:00) Fernando de Noronha</option><option
452                value="Atlantic/South_Georgia">(GMT-02:00) Mid-Atlantic</option><option
453                value="America/Miquelon">(GMT-02:00) Saint Pierre and Miquelon</option><option
454                value="Atlantic/Cape_Verde">(GMT-01:00) Cape Verde Islands</option><option
455                value="America/Godthab">(GMT-01:00) Greenland</option><option
456                value="Atlantic/Azores">(GMT) Azores</option><option
457                value="Africa/Casablanca">(GMT) Casablanca</option><option
458                value="UTC">(GMT) Coordinated Universal Time</option><option
459                value="Atlantic/Reykjavik">(GMT) Monrovia, Reykjavik</option><option
460                value="Europe/London">(GMT+01:00) Greenwich Mean Time: Dublin, Edinburgh, Lisbon, London</option><option
461                value="Africa/Lagos">(GMT+01:00) West Central Africa</option><option
462                value="Europe/Berlin">(GMT+02:00) Amsterdam, Berlin, Bern, Rome, Stockholm, Vienna</option><option
463                value="Europe/Belgrade">(GMT+02:00) Belgrade, Bratislava, Budapest, Ljubljana, Prague</option><option
464                value="Europe/Paris">(GMT+02:00) Brussels, Copenhagen, Madrid, Paris</option><option
465                value="Africa/Harare">(GMT+02:00) Harare, Pretoria</option><option
466                value="Europe/Sarajevo">(GMT+02:00) Sarajevo, Skopje, Warsaw, Zagreb</option><option
467                value="Antarctica/Troll">(GMT+02:00) Troll Station, Antarctica</option><option
468                value="Africa/Windhoek">(GMT+02:00) Windhoek</option><option
469                value="Asia/Amman">(GMT+03:00) Amman</option><option
470                value="Europe/Athens">(GMT+03:00) Athens, Bucharest, Istanbul</option><option
471                value="Asia/Baghdad">(GMT+03:00) Baghdad</option><option
472                value="Asia/Beirut">(GMT+03:00) Beirut</option><option
473                value="Africa/Cairo">(GMT+03:00) Cairo</option><option
474                value="Europe/Helsinki">(GMT+03:00) Helsinki, Kiev, Riga, Sofia, Tallinn, Vilnius</option><option
475                value="Asia/Jerusalem">(GMT+03:00) Jerusalem</option><option
476                value="Asia/Kuwait">(GMT+03:00) Kuwait, Riyadh</option><option
477                value="Europe/Minsk">(GMT+03:00) Minsk</option><option
478                value="Europe/Moscow">(GMT+03:00) Moscow, St. Petersburg, Volgograd</option><option
479                value="Africa/Nairobi">(GMT+03:00) Nairobi</option><option
480                value="Asia/Tehran">(GMT+03:30) Tehran</option><option
481                value="Asia/Muscat">(GMT+04:00) Abu Dhabi, Muscat</option><option
482                value="Asia/Baku">(GMT+04:00) Baku, Tbilisi, Yerevan</option><option
483                value="Indian/Mauritius">(GMT+04:00) Port Louis</option><option
484                value="Asia/Tbilisi">(GMT+04:00) Tbilisi</option><option
485                value="Asia/Yerevan">(GMT+04:00) Yerevan</option><option
486                value="Asia/Kabul">(GMT+04:30) Kabul</option><option
487                value="Asia/Almaty">(GMT+05:00) Almaty, Novosibirsk</option><option
488                value="Asia/Yekaterinburg">(GMT+05:00) Ekaterinburg</option><option
489                value="Asia/Karachi">(GMT+05:00) Islamabad, Karachi</option><option
490                value="Asia/Tashkent">
490(GMT+05:00) Tashkent</option><option
491                value="Asia/Kolkata">(GMT+05:30) Chennai, Kolkata, Mumbai, New Delhi</option><option
492                value="Asia/Colombo">(GMT+05:30) Sri Jayawardenepura</option><option
493                value="Asia/Kathmandu">(GMT+05:45) Kathmandu</option><option
494                value="Asia/Dhaka">(GMT+06:00) Astana, Dhaka</option><option
495                value="Asia/Rangoon">(GMT+06:30) Yangon (Rangoon)</option><option
496                value="Asia/Bangkok">(GMT+07:00) Bangkok, Hanoi, Jakarta</option><option
497                value="Asia/Krasnoyarsk">(GMT+07:00) Krasnoyarsk</option><option
498                value="Asia/Hong_Kong">(GMT+08:00) Beijing, Chongqing, Hong Kong, Urumqi</option><option
499                value="Asia/Irkutsk">(GMT+08:00) Irkutsk, Ulaanbaatar</option><option
500                value="Asia/Kuala_Lumpur">(GMT+08:00) Kuala Lumpur, Singapore</option><option
501                value="Australia/Perth">(GMT+08:00) Perth</option><option
502                value="Asia/Taipei">(GMT+08:00) Taipei</option><option
503                value="Australia/Eucla">(GMT+08:45) Eucla</option><option
504                value="Asia/Tokyo">(GMT+09:00) Osaka, Sapporo, Tokyo</option><option
505                value="Asia/Seoul">(GMT+09:00) Seoul</option><option
506                value="Asia/Yakutsk">(GMT+09:00) Yakutsk</option><option
507                value="Australia/Darwin">(GMT+09:30) Darwin</option><option
508                value="Australia/Brisbane">(GMT+10:00) Brisbane</option><option
509                value="Pacific/Guam">(GMT+10:00) Guam, Port Moresby</option><option
510                value="Asia/Vladivostok">(GMT+10:00) Vladivostok</option><option
511                value="Australia/Adelaide">(GMT+10:30) Adelaide</option><option
512                value="Pacific/Bougainville">(GMT+11:00) Bougainville</option><option
513                value="Australia/Sydney">(GMT+11:00) Canberra, Melbourne, Sydney</option><option
514                value="Australia/Hobart">(GMT+11:00) Hobart</option><option
515                value="Pacific/Kosrae">(GMT+11:00) Kosrae, Micronesia</option><option
516                value="Australia/Lord_Howe">(GMT+11:00) Lord Howe Island</option><option
517                value="Asia/Magadan">(GMT+11:00) Magadan, Solomon Islands, New Caledonia</option><option
518                value="Pacific/Noumea">(GMT+11:00) New Caledonia</option><option
519                value="Pacific/Pohnpei">(GMT+11:00) Pohnpei, Micronesia</option><option
520                value="Pacific/Efate">(GMT+11:00) Port Vila, Vanuatu</option><option
521                value="Pacific/Guadalcanal">(GMT+11:00) Solomon Islands</option><option
522                value="Pacific/Fiji">(GMT+12:00) Fiji, Kamchatka, Marshall Is.</option><option
523                value="Pacific/Norfolk">(GMT+12:00) Norfolk Island</option><option
524                value="Asia/Kamchatka">(GMT+12:00) Petropavlovsk-Kamchatsky</option><option
525                value="Pacific/Auckland">(GMT+13:00) Auckland, Wellington</option><option
526                value="Pacific/Tongatapu">(GMT+13:00) Nuku&#039;alofa</option><option
527                value="Pacific/Chatham">(GMT+13:45) Chatham Islands</option><option
528                value="Pacific/Kiritimati">(GMT+14:00) Kiritimati</option></select>
529    </div>
530                    </div>
531    
532                </div>
533            </div>
534
535            <div class="alert alert-danger d-none">
536                <div id="error-text"></div>
537            </div>
538
539            <div class="form-actions form-actions-center">
540                <div class="form-actions get-started mb-4">
541                    <button class="btn btn-grey btn-processing w-75 d-none" name="processing" id="processing">
542                        Processing
543                    </button>
544                    <button type="submit" class="btn btn-primary w-75 go-to-step2-btn main-action-btn" name="step1">
545                        Get Started
546                    </button>
547                </div>
548            </div>
549        </div>
550    </div>
551</div>
552
553<div class="col-12 col-md-8 col-lg-3 right-container bg-white signup-step2 d-none">
554
555    <div class="px-2 pt-sm-0 pb-sm-0 px-lg-4 pt-lg-3 pb-lg-4">
556        <div class="text-center mt-5">
557            <div class="heading text-midnight-blue mb-3">Access Details</div>
558
559            <img alt="Timeline second step" class="pb-4 second-step-timeline"
560                 src="https://cdn.halaxy.com/h/images/timeline/Timeline-Second-Step.svg">
561
562            <div class="form-row pb-4">
563                <div class="col-6">
564                            
565                
566                        <div id="row-form_firstname" class="form-group">
567                                        
568            
569                            <div class="inline">
570                    
571
572                                                                                    
573                    
574                                    </div>
575
576                                <div>        <input
577                                            type="text"
578                    
579                                        
580    id="form_firstname" name="form[firstname]"
581         required="required"
582         placeholder="First Name"
583                                         class="form-control"
584                        
585
586                                        
587                                    />    </div>
588                    </div>
589    
590                </div>
591                <div class="col-6">
592                            
593                
594                        <div id="row-form_lastname" class="form-group">
595                                        
596            
597                            <div class="inline">
598                    
599
600                                                                                    
601                    
602                                    </div>
603
604                                <div>        <input
605                                            type="text"
606                    
607                                        
608    id="form_lastname" name="form[lastname]"
609         required="required"
610         placeholder="Last Name"
611                                         class="form-control"
612                        
613
614                                        
615                                    />    </div>
616                    </div>
617    
618                </div>
619            </div>
620
621            <div class="form-row pb-2">
622                <div class="col-11">
623                            
624                
625                        <div id="row-form_password" class="form-group">
626                                        
627            
628                            <div class="inline">
629                    
630
631                                                                                    
632                    
633                                    </div>
634
635                                <div>        <input
636                                            type="password"
637                    
638                                        
639    id="form_password" name="form[password]"
640         required="required"
641                                     class="name form-control"
642                         placeholder="Password"
643            
644
645                                        
646                                    />    </div>
647                    </div>
648    
649                </div>
650                <div class="col-1">
651                    <i class="icon icon-eye-crossed toggle-pwd-visibility stardust-color"></i>
652                </div>
653            </div>
654
655
656            <div class="form-row pb-4">
657                <div class="alert alert-secondary">
658                    
659<div>
660    <strong>Password Requirements:</strong>
661    <ul class="mb-0">
662        <li>
663            At least 12 characters
664        </li>
665        <li>
666            Contains a number
667        </li>
668        <li>
669            Contains a lowercase letter
670        </li>
671        <li>
672            Contains an uppercase letter
673        </li>
674        <li>
675            Contains a symbol - e.g. #?!@$%^&*-
676        </li>
677                    </ul>
678</div>
679                </div>
680            </div>
681
682            <div class="form-row">
683                <div class="col-12 radio-button-q">
684                            
685                
686                        <div id="row-form_isPractitioner" class="form-group">
687                                        
688            
689                            <div class="inline">
690                    <label class="control-label cl required">
691                        Select your role:</label>
692
693                                                                                    
694                    
695                                    </div>
696
697                                <div><div         id="form_isPractitioner"            >
698        
699                                                                                
700                                                    
701        <div class="custom-control custom-radio"><input type="radio"
702           class="custom-control-input mt-0"         id="form_isPractitioner_0" name="form[isPractitioner]"
703                 required="required"
704                     value="1" checked="checked" /><label class="custom-control-label required custom-control-label" for="form_isPractitioner_0">Practitioner / Administrator</label></div><div class="custom-control custom-radio"><input type="radio"
705           class="custom-control-input mt-0"         id="form_isPractitioner_1" name="form[isPractitioner]"
706                 required="required"
707                     value="0" /><label class="custom-control-label required custom-control-label" for="form_isPractitioner_1">Patient</label></div>    </div></div>
708                    </div>
709    
710                </div>
711            </div>
712
713            <div class="alert alert-danger d-none">
714                <div id="error-text"></div>
715            </div>
716
717            <div class="patient-block d-none">
718                <div class="form-row pb-4 terms-row">
719                    <div class="col-12">
720                        <div class="mb-2 custom-control custom-checkbox"><input type="checkbox"
721           class="custom-control-input "         id="form_isAgreeTermsPatient" name="form[isAgreeTermsPatient]"
722                 required="required"
723                     value="1" />                <label class="custom-control-label "
724               for="form_isAgreeTermsPatient"></label></div>
725                        <label class="terms-text font-weight-light" for="form_isAgreeTermsPatient">I agree to the <a
726                                    href="/article/terms" target="_blank" class="term-conditions-link ">Terms of Use</a> and
727                            <a href="/article/privacy" target="_blank" class="term-conditions-link">Privacy Policy</a>
728                        </label>
729                    </div>
730                </div>
731
732                <div class="form-actions signup-form-actions">
733                    <div class="form-actions create-account mb-4">
734                        <button class="btn btn-grey btn-processing d-none" name="processing" id="processing">
735                            Processing
736                        </button>
737                        <button type="submit" class="btn btn-primary w-75 create-account-btn main-action-btn" name="login">
738                            Create Account
739                        </button>
740                    </div>
741                </div>
742            </div>
743
744            <div class="practitioner-block">
745                <div class="form-actions form-actions-center">
746                    <div class="form-actions continue mb-4">
747                        <button class="btn btn-grey btn-processing d-none" name="processing" id="processing">
748                            Processing
749                        </button>
750                        <button type="submit" class="btn btn-primary go-to-step3-btn w-75 main-action-btn" name="login">
751                            Continue
752                        </button>
753                    </div>
754                </div>
755            </div>
756        </div>
757    </div>
758</div>
759
760
761<div class="col-12 col-md-8 col-lg-3 right-container bg-white signup-step3 d-none">
762
763    <div class="px-2 pt-sm-0 pb-sm-0 px-lg-4 pt-lg-3 pb-lg-4">
764        <div class="text-center mt-5">
765            <div class="heading text-midnight-blue mb-3">Customise account</div>
766
767            <img alt="Timeline - Third Step" class="pb-4"
768                 src="https://cdn.halaxy.com/h/images/timeline/Timeline-Third-Step.svg">
769
770
771            <div id="mainProfessionList" class="form-row pb-4">
772                <div class="col-11">
773                            
774                
775                        <div id="row-form_profession" class="form-group">
776                                        
777            
778                            <div class="inline">
779                    
780
781                                                                                    
782                    
783                                    </div>
784
785                                <div>        <div class="d-flex"><select class="form-control form-control"
786                                                        
787    id="form_profession" name="form[profession]"
788         required="required"
789                                     class="form-control"
790                                                 
791                                                        ><option value="">select profession</option><optgroup
792                label="practitioner"><option
793                value="24">Acupuncturist</option><option
794                value="47">Anaesthetist</option><option
795                value="11">Audiologist</option><option
796                value="271">Breast and Endocrine Surgeon</option><option
797                value="67">Cardiologist</option><option
798                value="36">Cardiothoracic Surgeon</option><option
799                value="57">Chiropodist</option><option
800                value="12">Chiropractor</option><option
801                value="116">Colorectal Surgeon</option><option
802                value="46">Counsellor</option><option
803                value="293">Dental Hygienist</option><option
804                value="151">Dental Prosthetist</option><option
805                value="44">Dentist</option><option
806                value="231">Dermal Clinician</option><option
807                value="25">Dermatologist</option><option
808                value="13">Diabetes Educator</option><option
809                value="14">Dietitian</option><option
810                value="112">Emergency Medicine Physician</option><option
811                value="48">Endocrinologist</option><option
812                value="37">Ear Nose and Throat Surgeon / Otolaryngologist</option><option
813                value="53">Exercise Physiologist</option><option
814                value="27">Gastroenterologist</option><option
815                value="35">General Surgeon</option><option
816                value="128">Geriatrician</option><option
817                value="69">GP (General Practitioner)</option><option
818                value="28">Gynaecologist</option><option
819                value="121">Haematologist</option><option
820                value="55">Homeopath</option><option
821                value="58">Hypnotherapist</option><option
822                value="141">Immunologist</option><option
823                value="201">Infectious Diseases Physician</option><option
824                value="119">Lactation consultant</option><option
825                value="113">Midwife</option><option
826                value="49">Nephrologist</option><option
827                value="120">Neurologist</option><option
828                value="38">Neurosurgeon</option><option
829                value="100">Nurse</option><option
830                value="123">Nurse Practitioner</option><option
831                value="59">Nutritionist</option><option
832                value="16">Occupational Therapist</option><option
833                value="29">Oncologist</option><option
834                value="41">Ophthalmologist</option><option
835                value="30">Optometrist</option><option
836                value="181">Oral &amp; Maxillofacial Surgeon</option><option
837                value="31">Orthodontist</option><option
838                value="32">Orthopaedic Surgeon</option><option
839                value="104">Orthoptist</option><option
840                value="108">Orthotist / Prosthetist</option><option
841                value="17">Osteopath</option><option
842                value="88">Other</option><option
843                value="40">Paediatrician</option><option
844                value="80">Pain Management Specialist</option><option
845                value="76">Pain Management Specialist (Anaesthetics)</option><option
846                value="281">Paramedic</option><option
847                value="171">Pathologist</option><option
848                value="117">Pharmacist</option><option
849                value="18">Physiotherapist</option><option
850                value="39">Plastic &amp; Reconstructive Surgeon</option><option
851                value="19">Podiatrist</option><option
852                value="51">Psychiatrist</option><option
853                value="20">Psychologist</option><option
854                value="114">Psychotherapist</option><option
855                value="191">Radiologist</option><option
856                value="115">Remedial massage therapist</option><option
857                value="129">Respiratory and Sleep Medicine Physician</option><option
858                value="131">Rheumatologist</option><option
859                value="15">Social Worker</option><option
860                value="124">Sonographer</option><option
861                value="241">Specialist Physician (General Medicine)</option><option
862                value="21">Speech Pathologist</option><option
863                value="221">Sports and Exercise Medicine Physician</option><option
864                value="66">Traditional Chinese Medicine Practitioner</option><option
865                value="34">Urologist</option><option
866                value="42">Vascular Surgeon</option><option
867                value="161">Veterinarian</option></optgroup><optgroup
868                label="Admin staff"><option
869                value="84">Administrator</option><option
870                value="125">Bookkeeper</option><option
871                value="126">Practice Manager</option><option
872                value="92">Receptionist</option></optgroup></select></div>        
873    </div>
874                    </div>
875    
876                </div>
877
878                <div class="col-1">
879                <span
880                        rel="popover"
881                        data-placement="top"
882                        data-title=""
883                        data-content="Required to customise your Halaxy account to your profession."
884                        class="add-on popoverTarget input-append"
885                        data-original-title=""
886                        title=""
887                >
888                                <i class="icon-question-circle"></i>
889                            </span>
890                </div>
891            </div>
892
893            <div id="secondaryProfessionList" class="form-row pb-4 d-none">
894                <div class="col-11">
895                            
896                
897                        <div id="row-form_secondaryProfession" class="form-group">
898                                        
899            
900                            <div class="inline">
901                    
902
903                                                                                    
904                    
905                                    </div>
906
907                                <div>        <div class="d-flex"><select class="form-control form-control"
908                                                        
909    id="form_secondaryProfession" name="form[secondaryProfession]"
910        
911                                     class="form-control"
912                                                 
913                                                        ><option value="">select profession</option><optgroup
914                label="practitioner"><option
915                value="122">Aboriginal Health Worker</option><option
916                value="60">Alexander Technique Practitioner</option><option
917                value="291">Allied Health Assistant</option><option
918                value="65">Antenatal Teacher</option><option
919                value="43">Aromatherapist</option><option
920                value="261">Art Therapist</option><option
921                value="311">Behaviour Support Practitioner</option><option
922                value="61">Bowen Therapist</option><option
923                value="319">Genetic Counsellor</option><option
924                value="118">Kinesiologist</option><option
925                value="72">Local Medical Officer</option><option
926                value="96">Massage Therapist</option><option
927                value="251">Music Therapist</option><option
928                value="68">Myotherapist</option><option
929                value="45">Naturopath</option><option
930                value="211">Other Medical Practitioner</option><option
931                value="22">Personal Trainer</option><option
932                value="315">Phlebologist</option><option
933                value="313">Phlebotomist</option><option
934                value="321">Pilates Practitioner</option><option
935                value="295">Play Therapist</option><option
936                value="52">Reflexologist</option><option
937                value="323">Registered Massage Therapist</option><option
938                value="64">Shiatsu</option><option
939                value="297">Support Worker</option></optgroup></select></div>        
940    </div>
941                    </div>
942    
943                </div>
944
945                <div class="col-1">
946                <span
947                    rel="popover"
948                    data-placement="top"
949                    data-title=""
950                    data-content="Required to customise your Halaxy account to your profession."
951                    class="add-on popoverTarget input-append"
952                    data-original-title=""
953                    title=""
954                >
955                                <i class="icon-question-circle"></i>
956                            </span>
957                </div>
958            </div>
959
960
961
962            <div class="form-row pb-4">
963                <div class="col-11">
964                            
965                
966                        <div id="row-form_registrationNumber" class="form-group">
967                                        
968            
969                            <div class="inline">
970                    
971
972                                                                                    
973                    
974                                    </div>
975
976                                <div>        <input
977                                            type="text"
978                    
979                                        
980    id="form_registrationNumber" name="form[registrationNumber]"
981        
982         placeholder="Registration Number (optional)"
983                                         class="form-control"
984                        
985
986                                        
987                                    />    </div>
988                    </div>
989    
990                </div>
991                <div class="col-1">
992                <span
993                        rel="popover"
994                        data-placement="top"
995                        data-title=""
996                        data-content="The number that you use to identify yourself as a member of your profession in your country."
997                        class="add-on popoverTarget input-append"
998                        data-original-title=""
999                        title=""
1000                >
1001                                <i class="icon-question-circle"></i>
1002                            </span>
1003                </div>
1004            </div>
1005
1006            <div class="form-row pb-4">
1007                <div class="col-12">
1008                    <div class="mb-2 custom-control custom-checkbox"><input type="checkbox"
1009           class="custom-control-input "         id="form_isAgreeTermsPract" name="form[isAgreeTermsPract]"
1010                 required="required"
1011                     value="1" />                <label class="custom-control-label "
1012               for="form_isAgreeTermsPract"></label></div>
1013                    <label class="terms-text font-weight-light" for="form_isAgreeTermsPract">I agree to the <a
1014                                href="/article/terms" target="_blank" class="term-conditions-link ">Terms of Use</a> and
1015                        <a href="/article/privacy" target="_blank" class="term-conditions-link">Privacy Policy</a>
1016                    </label>
1017                </div>
1018            </div>
1019
1020            <div class="alert alert-danger d-none">
1021                <div id="error-text"></div>
1022            </div>
1023
1024            <div class="form-actions form-actions-center">
1025                <div class="form-actions create-account mb-4">
1026                    <button class="btn btn-grey btn-processing d-none" name="processing" id="processing">
1027                        Processing
1028                    </button>
1029                    <button type="submit" class="btn btn-primary w-75 create-account-btn main-action-btn" name="login">
1030                        Create Account
1031                </div>
1032            </div>
1033        </div>
1034    </div>
1035</div>
1036<script type="text/javascript">
1037    const termConditionsLinks = document.querySelectorAll('.term-conditions-link');
1038
1039    const otherProfession = 88;
1040
1041    //if you a have a link inside a checkbox label it won`t check it when clicking the link.
1042    termConditionsLinks.forEach(link => link.addEventListener('click', (e) => {
1043        e.preventDefault();
1044        e.target.parentElement.click();
1045        window.open(e.target.href, '_blank');
1046    }));
1047
1048    var timezonesToFixMap = [];
1049
1050
1051    document.addEventListener('DOMContentLoaded', function () {
1052
1053        var timezoneGuesser = null;
1054        var formTimezone    = $('#form_timezone');
1055
1056
1057        formTimezone.find('option').each(function () {
1058            if ($(this).text().includes(',')) {
1059                var timezoneToReturn = $(this).val();
1060                var searchString     = $(this).text().split(') ')[1].split(', ');
1061
1062                timezonesToFixMap.push({'timezoneToReturn': timezoneToReturn, 'searchString': searchString});
1063            }
1064        });
1065
1066        try {
1067            timezoneGuesser = new Intl.DateTimeFormat().resolvedOptions().timeZone;
1068            timezoneGuesser = timezoneFix(timezoneGuesser);
1069
1070            formTimezone.val(timezoneGuesser);
1071
1072            formTimezone.trigger('change');
1073            formTimezone.trigger('chosen:updated');
1074
1075        } catch (e) {
1076            timezoneGuesser = null;
1077            console.log('Unable to get timezone', e);
1078        }
1079
1080                var fallbackOption = 'America/Detroit';
1081        fallbackOption     = timezoneFix(fallbackOption);
1082        if (timezoneGuesser === null) {
1083            formTimezone.val(fallbackOption);
1084        }
1085        
1086        // This is the fallback version of the main guesser above. It's not as accurate and is only used if the country timezone doesn't work as a backup
1087        if (formTimezone.val() === '' || timezoneGuesser === null) {
1088            var country = $('#form_country option:selected').text();
1089
1090            timezoneGuesser = getTimezoneOffsetString();
1091            formTimezone.find('option').each(function () {
1092                var obj = $(this);
1093                if (obj.text().includes(timezoneGuesser) && obj.val().includes(country)) {
1094                    formTimezone.val($(this).val());
1095
1096                    formTimezone.trigger('change');
1097                    formTimezone.trigger('chosen:updated');
1098                    return false;
1099                }
1100            });
1101        }
1102
1103        cloneOtherOptionToSecondaryProfession()
1104
1105        $('#form_profession').on('change', function () {
1106            toggleProfessionList($(this))
1107        })
1108    });
1109
1110
1111    function getTimezoneOffsetString() {
1112        const offsetInMinutes = new Date().getTimezoneOffset();
1113        const sign            = offsetInMinutes > 0 ? '-' : '+';
1114        const hours           = Math.floor(Math.abs(offsetInMinutes) / 60);
1115        const minutes         = Math.abs(offsetInMinutes) % 60;
1116        return `GMT${sign}${hours.toString().padStart(2, '0')}:${minutes
1117            .toString()
1118            .padStart(2, '0')}`;
1119    }
1120
1121    function timezoneFix(tz) {
1122        var timezoneCity = tz.split('/')[1];
1123
1124        timezonesToFixMap.forEach(item => {
1125            if (item.searchString.includes(timezoneCity)) {
1126                tz = item.timezoneToReturn;
1127            }
1128        });
1129
1130        return tz;
1131    }
1132
1133    function cloneOtherOptionToSecondaryProfession() {
1134        $('#form_secondaryProfession').append(`<option value="${otherProfession}">Other / Unlisted</option>`);
1135        $('#form_secondaryProfession').trigger("chosen:updated");
1136    }
1137
1138    function toggleProfessionList($ele){
1139        const selectedOption = $($ele).val()
1140        // id of 'other' in dropdown
1141
1142        if(selectedOption === otherProfession.toString()) {
1143            $('#secondaryProfessionList').removeClass('d-none')
1144        }else{
1145            $('#form_secondaryProfession').val('')
1146            $('#secondaryProfessionList').addClass('d-none')
1147        }
1148    }
1149
1150</script>
1150
1151                </div>
1152            </div>
1153        </div>
1154    
1155
1156    
1156<script type="text/javascript">
1157        hk_glob = {
1158            paths: {
1159                BaseURL: "/"
1160            },
1161            variables: {
1162                loggedIn: false
1163            }
1164        }
1165    </script>
1165
1166
1167
1168
1169    
1170        
1170<script src="https://cdn.halaxy.com/z/version/125.40/build/runtime.js" crossorigin="anonymous"></script>
1170<script src="https://cdn.halaxy.com/z/version/125.40/build/app.js" crossorigin="anonymous"></script>
1170
1171
1172                        
1172<script src="https://cdn.halaxy.com/z/version/125.40/build/component/ckeditor.js" crossorigin="anonymous"></script>
1172
1173    
1174
1175        
1176<script>
1177
1178        document.addEventListener('DOMContentLoaded', function () {
1179        HkCurrency.currency.symbol              = 'A$';
1180        HkCurrency.currency.format              = '%s %v';
1181        HkCurrency.currency.decimal             = '.';
1182        HkCurrency.currency.groupingSeparator   = ',';
1183        HkCurrency.currency.precision           = '2';
1184        HkCurrency.currency.grouping            = '3';
1185
1186        // Expand the menu items if specified in the visual settings
1187            });
1188
1189    // Keep this outside DOMContentLoaded as its sometimes needed before the dom has loaded
1190    Hk.jwt = '';
1191</script>
vendor: 1 bytes, line 1191
1191
1192<script src="https://cdn.halaxy.com/z/static/vendor/highcharts/highcharts.min.js" crossorigin="anonymous"></script>
1192
1193
1194
1195
1196
1197    
1197<script src="https://cdn.halaxy.com/z/version/125.40/build/component/payment.js" crossorigin="anonymous"></script>
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1197
1198
1199
1200        <script src="https://www.google.com/recaptcha/api.js" async defer></script>
1201    
1201<div id="recaptcha-signup" class="g-recaptcha"
1202         data-sitekey="6LefyrssAAAAAPsEzMShTMsL8ADwXY5qYP0MRss8"
1203         data-callback="onSignupRecaptchaSuccess"
1204         data-size="invisible">
1205    </div>
1206
1207
1208    <!-- Facebook Pixel Code -->
1209    
1209<script>
vendor: 495 bytes, lines 1209-1218
1209
1210        !function(f,b,e,v,n,t,s)
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1213            if(!f._fbq)f._fbq=n;n.push=n;n.loaded=!0;n.version='2.0';
1214            n.queue=[];t=b.createElement(e);t.async=!0;
1215            t.src=v;s=b.getElementsByTagName(e)[0];
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1217            'https://connect.facebook.net/en_US/fbevents.js');
1218        fbq('init', '
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1218');
1219        fbq('track', 'PageView');
1220    
1220</script>
1220
1221    <noscript>
1222        <img height="1" width="1" style="display:none"
1223             src="https://www.facebook.com/tr?id=2396505863998736&ev=PageView&noscript=1"/>
1224    </noscript>
1225    <!-- End Facebook Pixel Code -->
1226            <!-- Google Tag Manager -->
1227        
1227<script>
vendor: 437 bytes, lines 1227-1231
1227(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':
1228                    new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],
1229                                                              j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src=
1230                'https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);
1231            })(window,document,'script','dataLayer','
1231GTM-T29Q5RM
vendor: 3 bytes, line 1231
1231');
1231</script>
1231
1232
1233        <!-- Google Tag Manager (noscript) -->
vendor: 76 bytes, lines 1233-1234
1233
1234        <noscript><iframe src="https://www.googletagmanager.com/ns.html?id=
1234GTM-T29Q5RM
vendor: 117 bytes, lines 1234-1236
1234"
1235                          height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>
1236        
1236<!-- End Google Tag Manager (noscript) -->
1237        <!-- End Google Tag ManageFr -->
1238        
1238<script type="text/javascript">
1239
1240        var countryId = null;
1241        var timezone = null;
1242
1243        $(function () {
1244            if ($('#form_email').val() !== '') {
1245                validateStep1();
1246            }
1247
1248            // This is required to ensure responsiveness
1249            HkUI.injectViewportMeta();
1250
1251            // Load processing icon - not critical to functionality
1252            try {
1253                Hk.Loader.startInsideButton('.btn-processing');
1254            } catch (e) {
1255                console.log('couldn\'t show spinner because ', e);
1256            }
1257            // Display processing button during ajax request
1258            var $loading   = $('button.btn-processing');
1259            var $actionBtn = $('.main-action-btn');
1260            $loading.addClass('d-none');
1261            $actionBtn.removeClass('d-none');
1262            $(document)
1263                .ajaxStart(function () {
1264                    $loading.removeClass('d-none');
1265                    $actionBtn.addClass('d-none');
1266
1267                })
1268                .ajaxStop(function () {
1269                    $loading.addClass('d-none');
1270                    $actionBtn.removeClass('d-none');
1271                });
1272
1273            // Clicking on login button will redirect to login controller action
1274            $('.login-btn').click(function () {
1275                // Redirect to Login page
1276                location.href = "/a/login";
1277            });
1278
1279            // Hide/Display the password entered on clicking eye icon
1280            $('.toggle-pwd-visibility').click(function () {
1281                var type            = $('#form_password').attr('type');
1282                var crossedEyeClass = 'icon-eye-crossed stardust-color';
1283                var eyeClass        = 'icon-eye electric-sky-color';
1284                if (type === 'password') {
1285                    // Make it visible
1286                    $('#form_password').attr('type', 'text');
1287                    $('.toggle-pwd-visibility').removeClass(crossedEyeClass);
1288                    $('.toggle-pwd-visibility').addClass(eyeClass);
1289                } else {
1290                    // Make it hidden
1291                    $('#form_password').attr('type', 'password');
1292                    $('.toggle-pwd-visibility').addClass(crossedEyeClass);
1293                    $('.toggle-pwd-visibility').removeClass(eyeClass);
1294                }
1295            });
1296
1297            $(window).on('keydown', (e) => {
1298                if(e.key === 'Enter') {
1299                    if(!$('.signup-step1').hasClass('d-none')) {
1300                        validateStep1()
1301                    } else if (!$('.signup-step2').hasClass('d-none')) {
1302                        validateStep2(!$('.signup-step2').hasClass('d-none'))
1303                    } else if (!$('.signup-step3').hasClass('d-none')) {
1304                        validateStep3()
1305                    }
1306                }
1307            })
1308
1309            // The Continue button in Step 1
1310            $('.go-to-step2-btn').click(function () {
1311                validateStep1();
1312            });
1313
1314            // The Continue button in Step 2 - only used by practitioners
1315            $('.go-to-step3-btn').click(function () {
1316                validateStep2();
1317            });
1318
1319
1320            // Click on create account button
1321            $('.create-account-btn').click(function () {
1322                if (isPractitioner() == true) {
1323                    validateStep3();
1324                } else {
1325                    validateStep2();
1326                }
1327            });
1328
1329            function createAccount() {
1330                // Execute reCAPTCHA — the callback onSignupRecaptchaSuccess will submit the form
1331                grecaptcha.execute();
1332            }
1333
1334            // Called by onSignupRecaptchaSuccess callback after grecaptcha.execute() validates the user
1335            function submitSignupForm(recaptchaToken) {
1336                data = {
1337                    'form[name][forename]':      $('#form_firstname').val(),
1338                    'form[name][surname]':       $('#form_lastname').val(),
1339                    'form[email][first]':        $('#form_email').val(),
1340                    'form[email][second]':       $('#form_email').val(),
1341                    'form[passwordRaw][first]':  $('#form_password').val(),
1342                    'form[passwordRaw][second]': $('#form_password').val(),
1343                    'form[country]':             countryId,
1344                    'form[timezone]':             timezone,
1345                    'signupLeadId':              $('#form_signupLeadId').val(),
1346                    'g-recaptcha-response':      recaptchaToken
1347                };
1348
1349                //Check whether country is in EU or NOT and set the action url accordingly
1350                // set list of EU country ids as array
1351                var euCountryIds = [15,22,34,55,57,58,59,68,73,74,81,84,99,105,108,121,127,128,136,155,176,177,181,200,201,206,212,232];
1352
1353                // check if selected country id is in array of eu country ids
1354                var isCountryInEu = euCountryIds.indexOf(countryId) !== -1;
1355
1356                if (isCountryInEu === true) {
1357                    urlDomain = '//eu.halaxy.com';
1358                } else {
1359                    urlDomain = '//www.halaxy.com';
1360                }
1361
1362
1363                //Submit form
1364                if (isPractitioner() == true) {
1365                    // @see routes signup & signup_practitioner
1366                    url                        = urlDomain + '/a/signup/practitioner';
1367                    data['form[profession]']   = handleProfessionData();
1368                    data['form[registration]'] = $('#form_registrationNumber').val();
1369                } else {
1370                    url = urlDomain + '/a/signup/patient';
1371                }
1372
1373                console.log(url);
1374                console.log(data);
1375
1376                $.ajax({
1377                    url:     url,
1378                    data:    data,
1379                    method:  'POST',
1380                    success: function (result) {
1381                        console.log('Success');
1382                        // Redirect to Patient homepage if is not practitioner
1383                        if (isPractitioner() == false) {
1384                            location.replace('/a/pa/0/');
1385                        } else if (result && result.status == 'ERROR') {
1386                            // if form has error, display error message
1387                            displayError('Cannot process signup. Please contact Halaxy on [email protected] for assistance.');
1388                        } else {
1389                            // otherwise redirect user to the profile edit page
1390                            if (result && result.status == 'OK') {
1391                                pracId = result.message;
1392                            } else {
1393                                pracId = 0;
1394                            }
1395                            // This will load the calendar as the first page on which they land
1396                            // @see route pr_calendar
1397                            location.replace(urlDomain + '/a/pr/')
1398                        }
1399                    },
1400                    error:   function (error) {
1401                        // Display server error message (e.g. reCAPTCHA failed) or generic fallback
1402                        if (error.responseJSON && error.responseJSON.message) {
1403                            // e.g. "reCAPTCHA verification failed." from JsonResponse
1404                            displayError(error.responseJSON.message);
1405                        } else {
1406                            displayError('Cannot process signup. Please contact Halaxy on [email protected] for assistance.');
1407                        }
1408                        // Reset reCAPTCHA so the user can retry without reloading the page
1409                        grecaptcha.reset();
1410                    }
1411                });
1412            }
1413
1414            // Settings action url to either patient / practitioner
1415            $('#row-form_isPractitioner input').click(function () {
1416                // This is a practitioner - set the actionURL
1417                if (isPractitioner() == true) {
1418                    displayPractitionerBlock();
1419                    $('img.second-step-timeline').attr('src', 'https://cdn.halaxy.com/h/images/timeline/Timeline-Second-Step.svg');
1420                } else {
1421                    displayPatientBlock();
1422                    $('img.second-step-timeline').attr('src', 'https://cdn.halaxy.com/h/images/timeline/Timeline-Second-Step-Patient.svg');
1423                }
1424            });
1425
1426            // Test to see if this user is a practitioner
1427            function isPractitioner() {
1428                var isPrac = $('#row-form_isPractitioner input[type=radio]:checked').val();
1429                if (isPrac == 1) {
1430                    return true;
1431                }
1432                return false;
1433            }
1434
1435            function handleProfessionData() {
1436                const profession = $('#form_profession').val();
1437                const secondaryProfession = $('#form_secondaryProfession').val();
1438
1439                if(!!secondaryProfession) {
1440                    return secondaryProfession
1441                }
1442                return profession
1443            }
1444
1445            // Call API and check Step 1 values
1446            function validateStep1() {
1447                // Hide alert
1448                $('.alert-danger').addClass('d-none');
1449
1450                var email     = $('#form_email').val();
1451                countryId = Number.parseInt($('#form_country').val());
1452                timezone  = $('#form_timezone').val();
1453
1454                if (email == '') {
1455                    displayError('Please enter email.');
1456                    return;
1457                }
1458                if (countryId == '') {
1459                    displayError('Please select a country.');
1460                    return;
1461                }
1462                if (timezone == '' || timezone == null) {
1463                    displayError('Please select a timezone.');
1464                    return;
1465                }
1466                // If not valid email format then error
1467                if (isValidateEmailFormat($('#form_email').val()) == false) {
1468                    displayError('Please enter a valid email.');
1469                    return;
1470                }
1471
1472                var url = '/api/v2/open/signup/leads';
1473                $.ajax({
1474                    url:  url,
1475                    data: {
1476                        email:       email,
1477                        country:     countryId,
1478                        timezone:    timezone,
1479                        httpReferer: "",
1480                    },
1481                    method:         'POST',
1482                    suppressErrors: true,
1483                    success:        function (result) {
1484                        //Successfully received a response
1485                        var signupLeadId;
1486                        if (result.metadata.status == 'already created') {
1487                            signupLeadId = result.metadata.signupLeadId;
1488                        } else {
1489                            signupLeadId = result.metadata.created.signupLeadId;
1490                        }
1491
1492                        if (Number.isInteger(signupLeadId)) {
1493                            $('input[name="form[signupLeadId]"]').val(signupLeadId);
1494                            fbq('track', 'Signup Step 1');
1495                            if (typeof dataLayer !== 'undefined') {
1496                                // dataLayer is undefined for sites that are not setup for google tag manager
1497                                dataLayer.push({'event': 'formSubmitted', 'formName': 'Signup Step 1'});
1498                            }
1499                            goToStep2();
1500                        }
1501                    },
1502                    error:          function (error) {
1503                        console.log('Error');
1504                        console.log(error);
1505                        var allErrors = error.responseJSON.errors;
1506                        var key;
1507                        for (key in allErrors) {
1508                            var message = allErrors[key].message;
1509
1510                            switch (message) {
1511                                case 'email has account already':
1512                                    displayError('This email is already registered. Log in to access your account.');
1513                                    return;
1514                                case 'email is empty':
1515                                    displayError('Please enter email.');
1516                                    return;
1517                                case 'invalid email format':
1518                                    displayError('Please enter a valid email.');
1519                                    return;
1520                                case 'Email addresses using @halaxy.com domain cannot be used.':
1521                                    displayError('Email addresses using @halaxy.com domain cannot be used.');
1522                                    return;
1523                                case 'missing country':
1524                                case 'empty country':
1525                                case 'invalid country':
1526                                    displayError('Please select a country.');
1527                                    return;
1528                                default:
1529                                    displayError('Cannot process signup. Please contact Halaxy on [email protected] for assistance.');
1530                                    return;
1531                            }
1532                        }
1533                    }
1534                });
1535
1536            }
1537
1538            /**
1539             * @todo consider moving to email.js
1540             * @duplicate assets/js/email.js
1541             */
1542            function isValidateEmailFormat(email) {
1543                var re = /^(([^<>()[\]\\.,;:\s@\"]+(\.[^<>()[\]\\.,;:\s@\"]+)*)|(\".+\"))@((\[[0-9]{1,3}\.[0-9]{1,3}\.[0-9]{1,3}\.[0-9]{1,3}\])|(([a-zA-Z\-0-9]+\.)+[a-zA-Z]{2,}))$/;
1544                return re.test(email);
1545            }
1546
1547            /**
1548             * @todo consider moving to assets/js/*
1549             */
1550            function hasNumber(myString) {
1551                return /\d/.test(myString);
1552            }
1553
1554            /**
1555             * @todo consider moving to assets/js/*
1556             */
1557            function hasSpecialCharacters(myString) {
1558                var re = /[.~{}$&+:;=?@#|<>^*%!_\/\\`]/;
1559                return re.test(myString);
1560            }
1561
1562            /**
1563             * @todo consider moving to assets/js/*
1564             */
1565            function validatePasswordFormat(passwordText) {
1566                // At least 12 characters long
1567                if (passwordText.length < 12) {
1568                    return "Password should be min 12 characters";
1569                }
1570
1571                // Must have at least one uppercase letter
1572                if (!/\d/.test(passwordText)) {
1573                    return "Password should contain at least one digit";
1574                }
1575
1576                // Must have at least one lowercase letter
1577                if (!/[A-Z]/.test(passwordText)) {
1578                    return "Password should contain at least one Capital Letter";
1579                }
1580
1581                // Must have a number
1582                if (!/[a-z]/.test(passwordText)) {
1583                    return "Password should contain at least one small Letter";
1584                }
1585
1586                // Must have a special character
1587                if (!/[#?!@$%^&*-]/.test(passwordText)) {
1588                    return "Password should contain at least one special character";
1589                }
1590
1591                return null;
1592            }
1593
1594            // Call API and check Step 2 values
1595            function validateStep2() {
1596
1597                var firstName = $('#form_firstname').val();
1598                var lastName  = $('#form_lastname').val();
1599                var password  = $('#form_password').val();
1600
1601
1602                // Hide alert
1603                $('.alert-danger').addClass('d-none');
1604
1605                if (firstName == '' && lastName == '') {
1606                    displayError('Please enter first and last name');
1607                    return;
1608                }
1609
1610                if (firstName == '') {
1611                    displayError('Please enter first name');
1612                    return;
1613                }
1614
1615
1616                // Most special characters are rejected except for , - " ' ( )
1617                if (hasSpecialCharacters(firstName) == true) {
1618                    displayError('Invalid first name. Punctuation marks other than hyphens and apostrophes are not allowed.');
1619                    return;
1620                }
1621
1622                if (lastName == '') {
1623                    displayError('Please enter last name');
1624                    return;
1625                }
1626
1627                // Most special characters are rejected except for , - " ' ( )
1628                if (hasSpecialCharacters(lastName) == true) {
1629                    displayError('Invalid last name. Punctuation marks other than hyphens and apostrophes are not allowed.');
1630                    return;
1631                }
1632
1633                if (password == '') {
1634                    displayError('Please enter password');
1635                    return;
1636                }
1637
1638                var signupStepPasswordError = validatePasswordFormat(password);
1639                if (!!signupStepPasswordError) {
1640                    displayError(signupStepPasswordError);
1641                    return;
1642                }
1643
1644                if (isPractitioner() == false && $('#form_isAgreeTermsPatient').is(':checked') == false) {
1645                    displayError('You must agree with our Terms of Use and Privacy Policy.');
1646                    return;
1647                }
1648
1649                var url  = "/api/v2/open/signup/leads/" + $('#form_signupLeadId').val();
1650                var data = {
1651                    forename:           firstName,
1652                    surname:            lastName,
1653                    type:               isPractitioner() ? 'practitioner' : 'patient',
1654                    country:            countryId,
1655                    profession:         '',
1656                    registrationNumber: '',
1657                    numberPractitioners: '',
1658                };
1659                $.ajax({
1660                    url:            url,
1661                    data:           data,
1662                    method:         'PUT',
1663                    suppressErrors: true,
1664                    success:        function (result) {
1665                        console.log('Success - step 2');
1666                        if (isPractitioner() == true) {
1667                            fbq('track', 'Signup Step 2');
1668                            if (typeof dataLayer !== 'undefined') {
1669                                // dataLayer is undefined for sites that are not setup for google tag manager
1670                                dataLayer.push({'event': 'formSubmitted', 'formName': 'Signup Step 2'});
1671                            }
1672                            goToStep3();
1673                        } else {
1674                            createAccount();
1675                            fbq('track', 'Patient account created');
1676                            if (typeof dataLayer !== 'undefined') {
1677                                // dataLayer is undefined for sites that are not setup for google tag manager
1678                                dataLayer.push({'event': 'formSubmitted', 'formName': 'Patient Account created'});
1679                            }
1680                        }
1681                    },
1682                    error:          function (error) {
1683                        console.log(error);
1684                        var allErrors = error.responseJSON.errors;
1685                        var key;
1686                        for (key in allErrors) {
1687                            var message = allErrors[key].message;
1688                            switch (message) {
1689                                case 'missing forename':
1690                                case 'empty forename':
1691                                    displayError('Please enter first name');
1692                                    return;
1693                                case 'invalid forename':
1694                                    displayError('Invalid first name. Punctuation marks other than hyphens and apostrophes are not allowed.');
1695                                    return;
1696                                case 'missing surname':
1697                                case 'empty surname':
1698                                    displayError('Please enter last name');
1699                                    return;
1700                                case 'invalid surname':
1701                                    displayError('Invalid last name. Punctuation marks other than hyphens and apostrophes are not allowed.');
1702                                    return;
1703                                case 'missing type':
1704                                case 'empty type':
1705                                case 'invalid signup lead':
1706                                case 'user type is patient but profession is submitted':
1707                                case 'user type is patient but registration number is specified':
1708                                case 'user type is patient but number of practitioners is specified':
1709                                default:
1710                                    console.error('Cannot process signup.', message, data)
1711                                    displayError('Cannot process signup. Please contact Halaxy on [email protected] for assistance.')
1712                                    return;
1713                            }
1714                        }
1715                    }
1716                });
1717
1718            }
1719
1720            // Call API and check Step 3 values
1721            function validateStep3() {
1722                // Hide alert
1723                $('.alert-danger').addClass('d-none');
1724
1725
1726                if ($('#form_profession').val() == '') {
1727                    displayError('Please select profession.');
1728                    return;
1729                }
1730
1731                if (isPractitioner() == true && $('#form_isAgreeTermsPract').is(':checked') == false) {
1732                    displayError('You must agree with our Terms of Use and Privacy Policy.');
1733                    return;
1734                }
1735
1736                var url   = "/api/v2/open/signup/leads/" + $('#form_signupLeadId').val();
1737                let data = {
1738                    forename:           $('#form_firstname').val(),
1739                    surname:            $('#form_lastname').val(),
1740                    type:               isPractitioner() ? 'practitioner' : 'patient',
1741                    country:            countryId,
1742                    profession:         $('#form_profession').val(),
1743                    registrationNumber: $('#form_registrationNumber').val(),
1744                    agreedTnC:          $('#form_isAgreeTermsPract').is(':checked') == true ? 1 : 0,
1745                };
1746                $.ajax({
1747                    url:            url,
1748                    data:           data,
1749                    method:         'PUT',
1750                    suppressErrors: true,
1751                    success:        function (result) {
1752
1753                        if (isPractitioner() == true) {
1754                            createAccount();
1755                            fbq('track', 'Practitioner account created');
1756                            if (typeof dataLayer !== 'undefined') {
1757                                // dataLayer is undefined for sites that are not setup for google tag manager
1758                                dataLayer.push({'event': 'formSubmitted', 'formName': 'Practitioner account created'});
1759                            }
1760                        }
1761
1762                    },
1763                    error:          function (error) {console.log(error);
1764                        var allErrors = error.responseJSON.errors;
1765                        var key;
1766                        for (key in allErrors) {
1767                            var message = allErrors[key].message;
1768                            switch (message) {
1769                                case 'missing profession':
1770                                case 'invalid profession':
1771                                    displayError('Please select a profession.');
1772                                    return;
1773                                case 'missing registration number':
1774                                case 'invalid registration number':
1775                                    displayError('Please enter a registration number.');
1776                                    return;
1777                                case 'missing type':
1778                                case 'empty type':
1779                                case 'invalid signup lead':
1780                                case 'user type is patient but profession is submitted':
1781                                case 'user type is patient but registration number is specified':
1782                                case 'user type is patient but number of practitioners is specified':
1783                                default:
1784                                    console.error('Cannot process signup.', message, data)
1785                                    displayError('Cannot process signup. Please contact Halaxy on [email protected] for assistance.')
1786                                    return;
1787                            }
1788                        }
1789                    }
1790                });
1791
1792            }
1793
1794            function displayError(message) {
1795                $('.alert-danger').removeClass('d-none');
1796                $('div#error-text').html(message);
1797            }
1798
1799            // Using window to expose reCAPTCHA callback globally so the Google reCAPTCHA API can invoke it
1800            window.onSignupRecaptchaSuccess = function (token) {
1801                submitSignupForm(token);
1802            };
1803
1804            function displayPatientBlock() {
1805                $('.patient-block').removeClass('d-none');
1806                $('.practitioner-block').addClass('d-none')
1807            }
1808
1809            function displayPractitionerBlock() {
1810                $('.practitioner-block').removeClass('d-none');
1811                $('.patient-block').addClass('d-none')
1812            }
1813
1814            function goToStep2() {
1815                $('.signup-step1').addClass('d-none');
1816                $('.signup-step2').removeClass('d-none');
1817
1818            }
1819
1820            function goToStep3() {
1821                $('.signup-step2').addClass('d-none');
1822                $('.signup-step3').removeClass('d-none');
1823            }
1824
1825
1826                    });
1827    </script>
1827
1828
1829
1830
1831    
1832
1833    
1834    
1834<script type="text/javascript">window.NREUM||(NREUM={});NREUM.info={"beacon":"bam.nr-data.net","licenseKey":"e514366ee1","applicationID":"338566318","transactionName":"YQBWY0MHCxEFUBFdW1hKdVRFDwoMS0AMU1pDFQ==","queueTime":0,"applicationTime":195,"atts":"TUdVFQsdGB8=","errorBeacon":"bam.nr-data.net","agent":""}</script>
1834</body>
1835</html>

Line numbers count LF bytes from the start of the resource, as the search results do. Vendor segments are library code the classifier recognised; they are stored but not indexed. Bytes are shown as Latin1 characters, one per byte.