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top:27px; } #_form_78_._inline-style p { margin:0; } #_form_78_._inline-style ._button-wrapper { position:relative; margin:27px 12.5px 0 20px; } #_form_78_ ._form-thank-you { position:relative; left:0; right:0; text-align:center; font-size:18px; } @media all and (min-width:320px) and (max-width:667px) { #_form_78_._inline-form._inline-style ._inline-style._button-wrapper { margin-top:20px !important; margin-left:0 !important; } } </style> <form method="POST" action="https://umbertogalbiati.activehosted.com/proc.php" id="_form_78_" class="_form _form_78 _inline-form _dark" novalidate> <input type="hidden" name="u" value="78" /> <input type="hidden" name="f" value="78" /> <input type="hidden" name="s" /> <input type="hidden" name="c" value="0" /> <input type="hidden" name="m" value="0" /> <input type="hidden" name="act" value="sub" /> <input type="hidden" name="v" value="2" /> <div class="_form-content"> <div class="_form_element _x51916388 _full_width _clear" style="text-align: center;"> <img class="_form-image" src="//umbertogalbiati.img-us3.com/admin/1-management-medicale.png?r=0.37838279276474895" style="height:221px;width:181px" /> </div> <div class="_form_element _x73623048 _full_width _clear" > <div class="_form-title"> Iscriviti e riceverai la Guida di Management Medicale per dentisti ed operatori sanitari </div> </div> <div class="_form_element _x48486518 _full_width _clear" > <div class="_html-code"> <p> La mia guida è gratuita, è vero, ma mi è costata tanta applicazione e tempo per produrla. Te la offro con tutto il cuore ma, in cambio, vorrei sapere almeno chi sei. Ti sembra un buon "patto"? Se sei d'accordo, allora per te sarà ben poca cosa compilare i campi richiesti (*) ed inviarmi il modulo. Io controllerò la tua richiesta e, se risulterai compatibile con il mio target, ti invierò una email personale con il link per scaricare l'ebook. Coraggio, mettiti al lavoro, non rimandare più e compila con i tuoi dati (che saranno da me ben protetti) il form qui sotto! </p> </div> </div> <div class="_form_element _x74152408 _full_width " > <label class="_form-label"> Nome* </label> <div class="_field-wrapper"> <input type="text" name="firstname" placeholder="Digita il nome" required/> </div> </div> <div class="_form_element _x44800515 _full_width " > <label class="_form-label"> Cognome* </label> <div class="_field-wrapper"> <input type="text" name="lastname" placeholder="Digita il cognome" required/> </div> </div> <div class="_form_element _field2 _full_width " > <label class="_form-label"> Professione* </label> <div class="_field-wrapper"> <input type="text" name="field[2]" value="" placeholder="Digita la professione" required/> </div> </div> <div class="_form_element _x75049767 _full_width " > <label class="_form-label"> Email* </label> <div class="_field-wrapper"> <input type="text" name="email" placeholder="Digita l'email corretta" required/> </div> </div> <div class="_form_element _field26 _full_width " > <div class="_row"> <label class="_form-label"> Informativa Privacy-GDPR: ho letto l'informativa privacy ed acconsento alla memorizzazione dei miei dati nel vostro archivio secondo quanto stabilito dal regolamento europeoper la protezione dei dati personali679/2016 e GDPR </label> </div> <input data-autofill="false" type="hidden" name="field[26][]" value="~|"> <div class="_row _checkbox-radio"> <input id="field_26SI ACCONSENTO" type="checkbox" name="field[26][]" value="SI ACCONSENTO" required> <span> <label for="field_26SI ACCONSENTO"> SI ACCONSENTO* </label> </span> </div> </div> <div class="_button-wrapper _full_width"> <button id="_form_78_submit" class="_submit" type="submit"> Invia il modulo cliccando qui </button> </div> <div class="_clear-element"> </div> </div> <div class="_form-thank-you" style="display:none;"> </div> </form><script type="text/javascript"> window.cfields = {"2":"professione","26":"informativa_privacygdpr_ho_letto_linformativa_privacy_ed_acconsento_alla_memorizzazione_dei_miei_dati_nel_vostro_archivio_second"}; window._show_thank_you = function(id, message, trackcmp_url) { var form = document.getElementById('_form_' + id + '_'), thank_you = form.querySelector('._form-thank-you'); form.querySelector('._form-content').style.display = 'none'; thank_you.innerHTML = message; thank_you.style.display = 'block'; if (typeof(trackcmp_url) != 'undefined' && trackcmp_url) { // Site tracking URL to use after inline form submission. _load_script(trackcmp_url); } if (typeof window._form_callback !== 'undefined') window._form_callback(id); }; window._show_error = function(id, message, html) { var form = document.getElementById('_form_' + id + '_'), err = document.createElement('div'), button = form.querySelector('button'), old_error = form.querySelector('._form_error'); if (old_error) old_error.parentNode.removeChild(old_error); err.innerHTML = message; err.className = '_error-inner _form_error _no_arrow'; var wrapper = document.createElement('div'); wrapper.className = '_form-inner'; wrapper.appendChild(err); button.parentNode.insertBefore(wrapper, button); document.querySelector('[id^="_form"][id$="_submit"]').disabled = false; if (html) { var div = document.createElement('div'); div.className = '_error-html'; div.innerHTML = html; err.appendChild(div); } }; window._load_script = function(url, callback) { var head = document.querySelector('head'), script = document.createElement('script'), r = false; script.type = 'text/javascript'; script.charset = 'utf-8'; script.src = url; if (callback) { script.onload = script.onreadystatechange = function() { if (!r && (!this.readyState || this.readyState == 'complete')) { r = true; callback(); } }; } head.appendChild(script); }; (function() { if (window.location.search.search("excludeform") !== -1) return false; var getCookie = function(name) { var match = document.cookie.match(new RegExp('(^|; )' + name + '=([^;]+)')); return match ? 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