File: /home/iconnecthealthinsurance/public_html/form-success.php
<?php
//Ip Function
function getClientIp() {
$ipaddress = '';
if (getenv('HTTP_CLIENT_IP'))
$ipaddress = getenv('HTTP_CLIENT_IP');
else if(getenv('HTTP_X_FORWARDED_FOR'))
$ipaddress = getenv('HTTP_X_FORWARDED_FOR');
else if(getenv('HTTP_X_FORWARDED'))
$ipaddress = getenv('HTTP_X_FORWARDED');
else if(getenv('HTTP_FORWARDED_FOR'))
$ipaddress = getenv('HTTP_FORWARDED_FOR');
else if(getenv('HTTP_FORWARDED'))
$ipaddress = getenv('HTTP_FORWARDED');
else if(getenv('REMOTE_ADDR'))
$ipaddress = getenv('REMOTE_ADDR');
else
$ipaddress = 'UNKNOWN';
return $ipaddress;
}
?>
<?php
$actual_link = "http://$_SERVER[HTTP_HOST]$_SERVER[REQUEST_URI]";
?>
<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<link rel="shortcut icon" href="./assets/img/favicon.png">
<title>I Connect Health Insurace</title>
<link rel="stylesheet" href="./assets/css/plugins.css">
<link rel="stylesheet" href="./assets/css/style.css">
<link rel="stylesheet" href="./assets/css/aqua.css">
<script src="https://cdnjs.cloudflare.com/ajax/libs/jquery/3.5.0/jquery.min.js" integrity="sha256-xNzN2a4ltkB44Mc/Jz3pT4iU1cmeR0FkXs4pru/JxaQ=" crossorigin="anonymous"></script>
<script src="https://cdnjs.cloudflare.com/ajax/libs/jquery-validate/1.19.3/jquery.validate.min.js" integrity="sha512-37T7leoNS06R80c8Ulq7cdCDU5MNQBwlYoy1TX/WUsLFC2eYNqtKlV0QjH7r8JpG/S0GUMZwebnVFLPd6SU5yg==" crossorigin="anonymous" referrerpolicy="no-referrer"></script>
<script src="https://cdnjs.cloudflare.com/ajax/libs/jquery-easing/1.4.1/jquery.easing.min.js" integrity="sha512-0QbL0ph8Tc8g5bLhfVzSqxe9GERORsKhIn1IrpxDAgUsbBGz/V7iSav2zzW325XGd1OMLdL4UiqRJj702IeqnQ==" crossorigin="anonymous"></script>
<script>
dataLayer.push({
'event':'ec_formsubmit',
'enhanced_conversion_data': {
"email": 'yourEmailVariable',
"phone_number": 'yourPhoneVariable',
"first_name": 'yourFirstNameVariable',
"last_name": 'yourLastNameVariable',
"street": 'yourStreetAddressVariable',
"city": 'yourCityVariable',
"region": 'yourRegionVariable',
"postal_code": 'yourPostalCodeVariable',
"country": 'yourCountryVariable'
}
})
</script>
</head>
<header class="wrapper bg-light">
<div class="bg-primary text-white fw-bold fs-15">
<div class="container py-1 d-md-flex flex-md-row">
<div class="d-flex flex-row align-items-center me-0 ms-auto" style="margin: auto !important;">
<div class="icon text-white fs-22 mt-1 me-2 d-flex justify-content-center"> <i class="uil uil-phone-volume"></i></div>
<p class="mb-0 text-center"><a href="Tel: (855) 805-6712" style="color: #ffffff">Speak to a Licensed Agent Now!</a></p>
</div>
</div>
<!-- /.container -->
</div>
<nav class="navbar navbar-expand-lg center-nav transparent navbar-light">
<div class="container d-flex justify-content-center">
<div class="navbar-brand">
<a href="/">
<img src="./assets/img/logo.svg" srcset="./assets/img/[email protected] 2x" style="width: 100%;" alt="">
</a>
</div>
<div class="navbar-collapse offcanvas-nav">
<div class="offcanvas-header d-lg-none d-xl-none">
<a href="/">
<img src="./assets/img/logo.svg" srcset="./assets/img/[email protected] 2x" style="width:100% important;" alt="">
</a>
<button type="button" class="btn-close btn-close-white offcanvas-close offcanvas-nav-close" aria-label="Close"></button>
</div>
<!-- /.navbar-nav -->
</div>
<!-- /.navbar-collapse -->
<div class="navbar-other w-100 d-flex ms-auto">
<ul class="navbar-nav flex-row align-items-center ms-auto" data-sm-skip="true">
<li class="nav-item d-none d-md-block">
<a href="Tel: (855) 805-6712" class="btn btn-primary rounded-pill mb-0">Get Quotes: (855) 805-6712</a>
</li>
</ul>
<!-- /.navbar-nav -->
</div>
<!-- /.navbar-other -->
</div>
<!-- /.container -->
</nav>
<!-- /.navbar -->
</header>
<!-- /header -->
<body>
<iframe src=https://tag.trovo-tag.com/e3aecce3a093cad1aff10d117b57c6aa width="1" height="1" style="visibility:hidden;display:none;"></iframe>
<!-- Google Tag Manager (noscript) -->
<noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-N4TTDBV"
height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>
<!-- End Google Tag Manager (noscript) -->
<input type="hidden" id="phoneNumber">
<script src="https://convertmore-js.s3-eu-west-1.amazonaws.com/convertmore.js" type="text/javascript"></script>
<script id="convertmore" type="text/javascript" defer>
convertmore('d9598977-f503-49d5-9c17-21cf0a51039d');
</script>
<!-- START CONTACT -->
<section class="section bg-light" id="contact" style="z-index: 10; background: #ffffff; padding: 100px 0 100px 0">
<div class="container">
<div class="row mt-2 justify-content-center">
<div class="col-lg-12">
<div class="g3cm_holder" data-module="1671" data-showoninit="true" data-conversionid="" data-destination="" data-destinationext="" data-followup="" style="display:none;">Thank you for your inquiry. A representative will be in contact with you shortly.</div>
<!-- START CONTACT -->
<section class="section bg-light" id="contact" style="z-index: 10; background: #ffffff; padding: 200px 0 200px 0">
<div class="container">
<div class="row mt-2 justify-content-center">
<div class="col-lg-12">
<h1 class="display-vhq text-center pb-4" style="color: #0052D4; font-size: 2.5rem; font-weight:600">
Thank You!
</h1>
<h4 style="color: #343f52; font-size: 1rem; font-weight:600" class="text-center">Your request has been successfully submitted. A licensed agent will be in touch very soon!</h4>
<h1 style="font-style: italic; font-size: 1rem;" class="text-center">If you are in need of immediate assistance you can call us directly at <span><a style="color: #0052D4 !important; text-decoration: none;" href="tel:+18555862299">(855) 805-6712</a></span></h4>
</div>
<div class="container pb-md-6">
<div class="row">
<div class="col-lg-12 text-center pt-3" style="background: #f1f1f1;">
<p> By entering a phone number and email address, submitting this form and Clicking "Get Quotes, you represent that you are at least 18 years old and agree to our Privacy Policy and Terms of Use. You also authorize
valuehealthquotes.com and/or its <a href="#demo-modal">marketing partners</a> to contact you for marketing/telemarketing purposes at the number and address provided above, inclding your wireless number if provided, using live
operators, automated telephone dialing systems, pre-recorded messages, text messages and/or emails, even if the number you provide is on a state or Federal Do Not Call registry. You are not required to
consent as a condition of purchasing goods or services and may revoke consent at anytime. I Connect Health Insurace has the option to send communication such as texting via a short code and will not allow third parties to send messages or communications on their behalf.</p>
<p>I Connect Health Insurace is an independent website and is not a federal or state Marketplace website. I Connect Health Insurace does not provide quotes or sell insurance directly to consumers, is not affiliated with
any exchange, and is not a licensed insurance agent or broker. Accordingly, you should not send us (via mail or email) any sensitive information, including personal health information or applications. Any
such communications will not be treated as confidential and will be discarded, as, in offering this website, we are required to comply with the standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. </p>
</div>
<!-- /column -->
</div>
<!-- /.row -->
<!-- /.position-relative -->
<!-- /div -->
</div>
<!-- /.container -->
</div>
</section>
</div>
</div>
</section>
<!-- END CONTACT -->
<!-- /.content-wrapper -->
<footer class="bg-navy text-inverse text-center">
<div class="container pt-4">
<!--/div -->
<div class="row gy-6 gy-lg-0">
<div class="col-md-12 col-lg-12">
<div class="widget">
<p class="mb-4">©I Connect Health Insurace 2019-2023 All Rights Reserved.<a href="/privacy.php"> Privacy Policy </a> | <a href="/terms.php">Terms of Service </a></p>
<!-- /.social -->
</div>
<!-- /.widget -->
</div>
<!-- /column -->
<!-- /column -->
</div>
<!--/.row -->
</div>
<!-- /.container -->
</footer>
<!-- contact init -->
<script type="text/javascript">
window.g3cm = window.g3cm || function () { (g3cm.q = g3cm.q || []).push(arguments) };
g3cm('loadjquery', 'true');
g3cm('phonenumberinput', 'phoneNumber');
g3cm('send', 'init');
</script>
<script>
function getParameterByName(name) {
name = name.replace(/[\[]/, "\\[").replace(/[\]]/, "\\]");
var regex = new RegExp("[\\?&]" + name + "=([^&#]*)"),
results = regex.exec(location.search);
return results == null ? "" : decodeURIComponent(results[1].replace(/\+/g, " "));
}
$(document).ready(function(){
var phoneNumber = getParameterByName("phoneNumber");
$('#phoneNumber').val(phoneNumber);
});
</script>
<script src="https://api.connectstreams.com/js/connectme-v3.min.js" async="async"></script>
</body>
</html>