Geisinger Health Plan - Log In or Sign Up (2024)

'; InstaMed.launchInContext(); } else { Ext.isSecure = /^https/i.test(window.location.protocol);InstaMed.isNativeApplication = false;InstaMed.isConsumerApp = false;InstaMed.TitleBarMargins = '17 0 0 0';InstaMed.isMobile = true;InstaMed.isResponsive = true;InstaMed.isInContextMode = false;InstaMed.passedInMetaDataToken = '';InstaMed.isInAccessibilityMode = false;InstaMed.userAgentParameter = '';InstaMed.logoutPage = '../../Form/PaymentPortal/Logout?id=GQO.FACETSGRP';InstaMed.isLightWeightMode = false;InstaMed.isReturnUrlUpdateParent = false;InstaMed.isClientSidePostData = false;InstaMed.isDesktop = false;InstaMed.isTablet = false;InstaMed.isDesktopOrTablet = false;InstaMed.isMobileOrTablet = true;InstaMed.isLoggedIn = false;InstaMed.useHistory = false;InstaMed.hasReturnUrl = false;InstaMed.hasCancelUrl = false;InstaMed.isNewRequiredFeild = true;InstaMed.browserTabID = 'A676E3BD6D764950A4579AFF98120148';InstaMed.sessionTimeoutUrl = '../../Form/PaymentPortal/Logout?id=GQO.FACETSGRP';InstaMed.page = 'Form/PaymentPortal/DualLoginAndSignUp';Ext.SSL_SECURE_URL = Ext.isSecure && Ext.isIE ? 'javascript:""' : 'about:blank';Ext.BLANK_IMAGE_URL = 'https://cdn.instamed.com/V_2024_May/Content/Images/General/BlankImage.gif';InstaMed.UniqueClientID = '255786ee4df04ad6885e16902970ab40';Ext.scopeResetCSS=true;InstaMed.contentUrl = 'https://cdn.instamed.com/V_2024_May/';var webPropertyId = 'UA-16010902-1';InstaMed.doIdleLogout = true;InstaMed.isSSO = false;InstaMed.isSelfService = false;LogoutTimer.init();var myMask = null;InstaMed.errorMessageSummaryTitle = 'Please correct the following errors';InstaMed.requiredErrorLabel = 'Required';Ext.ns('Ext.app.REMOTING_API');Ext.app.REMOTING_API = { "id": null, "url": "../../api/PaymentPortal/DualLoginAndSignUp", "type": "remoting", "namespace": null, "actions": { "GridController": [ { "name": "exportDataToFile", "len": 1 }, { "name": "saveColumnSortConfiguration", "len": 1 }, { "name": "saveColumnConfiguration", "len": 1 }, { "name": "updateCharts", "len": 1 }, { "name": "export", "formHandler": true, "len": 1 } ], "PatientPortalLoginController": [ { "name": "checkSession", "len": 1 }, { "name": "changeLanguage", "len": 1 }, { "name": "showBiometricLogin", "len": 1 }, { "name": "authenticateBiometricInfo", "len": 1 }, { "name": "closeAppBanner", "len": 1 }, { "name": "verifyTextEnrollment", "len": 1 }, { "name": "navigateAfterLogin", "len": 1 }, { "name": "navigateFromEStatement", "len": 1 }, { "name": "forgotPassword", "len": 1 }, { "name": "submit", "len": 1 }, { "name": "deleteBiometricInfo", "len": 1 }, { "name": "navigateBackFromTwoFactor", "len": 1 }, { "name": "patientMatchSubmit", "len": 1 }, { "name": "skipTextEnrollment", "len": 1 }, { "name": "authenticateTwoFactor", "len": 1 }, { "name": "redirectToLogin", "len": 1 }, { "name": "getBackButtonOverride", "len": 1 }, { "name": "patientPortalNavigateBack", "len": 1 }, { "name": "saveEStatementPreference", "len": 1 }, { "name": "canUserResetPassword", "len": 3 }, { "name": "redirectToLoginEmailForm", "len": 1 }, { "name": "logout", "len": 1 }, { "name": "sendMobilePhoneNumberConfirmationCode", "len": 1 }, { "name": "navigateTo", "len": 1 }, { "name": "patientPortalHeaderBack", "len": 1 }, { "name": "registerUserBiometricInfo", "len": 1 }, { "name": "dualLogin", "len": 1 } ], "PushNotificationController": [ { "name": "navigateByPushNotification", "len": 1 } ], "SignUpController": [ { "name": "navigateFromSignUp", "len": 0 }, { "name": "completeSignUp", "len": 1 }, { "name": "redirectToSignUpForm", "len": 1 }, { "name": "redirectToSignUp", "len": 1 }, { "name": "sendAccountCreatedEvent", "len": 1 }, { "name": "signUp", "len": 1 }, { "name": "isEnterPayeeManuallyFlow", "len": 0 }, { "name": "verifyTextEnrollment", "len": 1 }, { "name": "dualSignUp", "len": 1 }, { "name": "isDigitalPayoutFlow", "len": 0 }, { "name": "skipTextEnrollment", "len": 1 }, { "name": "isPatientMatchFlow", "len": 0 } ], "ResetPasswordController": [ { "name": "changePassword", "len": 1 }, { "name": "navigateFromEnterCode", "len": 1 }, { "name": "requestPasswordReset", "len": 1 }, { "name": "validateAnswer", "len": 3 }, { "name": "isDualLoginSignUpFlow", "len": 0 }, { "name": "sendResetText", "len": 1 }, { "name": "submit", "len": 1 }, { "name": "resendPasswordResetCode", "len": 1 }, { "name": "getUserId", "len": 0 }, { "name": "sendEmail", "len": 2 }, { "name": "navigateFromSelectMethodForm", "len": 1 }, { "name": "getUserInitials", "len": 1 }, { "name": "pPPResetPassword", "len": 1 }, { "name": "generateResetCode", "len": 0 }, { "name": "sendResetEmail", "len": 1 }, { "name": "navigateFromForgotPassword", "len": 1 } ], "PaymentActionController": [ { "name": "selectLineItem", "len": 1 }, { "name": "viewTransaction", "len": 1 }, { "name": "getNextScheduledTransaction", "len": 1 }, { "name": "getSystemWideDefault", "len": 1 }, { "name": "displayPatientInformationMutliAccount", "len": 3 }, { "name": "getAuthorization", "len": 3 }, { "name": "getVirtualCardEntityID", "len": 1 }, { "name": "getPaymentPlanStatus", "len": 1 }, { "name": "getDisclaimer", "len": 1 }, { "name": "closeSSOReceipt", "len": 1 }, { "name": "voidTransactionFromHistory", "len": 1 }, { "name": "canReturnEcheck", "len": 1 }, { "name": "eCheckRefundTransactionFromHistory", "len": 1 }, { "name": "getBasePaymentTransaction", "len": 2 }, { "name": "returnToProfile", "len": 1 }, { "name": "viewReceiptByData", "len": 5 }, { "name": "canAdjustEcheck", "len": 1 }, { "name": "cancel", "len": 1 }, { "name": "doReturnEcheck", "len": 1 }, { "name": "getNumberOfPaymentsRemaining", "len": 1 }, { "name": "printAll", "len": 1 }, { "name": "emailReceipt", "len": 1 }, { "name": "getReceiptConfigurationList", "len": 1 }, { "name": "downloadReceipt", "len": 1 }, { "name": "downloadCheckImage", "len": 1 }, { "name": "cancelVirtualCard", "len": 1 }, { "name": "downloadCouponImage", "len": 1 }, { "name": "voidTransaction", "len": 1 }, { "name": "viewCheckImage", "len": 1 }, { "name": "eCheckReturn", "len": 1 }, { "name": "populateReceiptByData", "len": 5 }, { "name": "getPayeeName", "len": 3 }, { "name": "viewRefund", "len": 1 }, { "name": "creditCardRefundTransaction", "len": 2 }, { "name": "getPaymentPlan", "len": 1 }, { "name": "emailAllReceipts", "len": 1 }, { "name": "sendEmailReceipt", "len": 3 }, { "name": "canRefund", "len": 1 }, { "name": "eCheckRefundTransaction", "len": 2 }, { "name": "getBalanceRemaining", "len": 1 }, { "name": "collectNow", "len": 1 }, { "name": "eCheckAdjustment", "len": 1 }, { "name": "viewReceiptForTransaction", "len": 5 }, { "name": "viewVoid", "len": 1 }, { "name": "returnCodes", "len": 1 }, { "name": "canVoid", "len": 2 }, { "name": "populateReceipt", "len": 3 }, { "name": "displayMultiARLine", "len": 8 }, { "name": "copyPrimaryToSecondaryTransactionFieldsCommon", "len": 2 }, { "name": "creditCardRefundTransactionFromHistory", "len": 1 }, { "name": "doeCheckAdjustment", "len": 1 }, { "name": "viewReceipt", "len": 1 }, { "name": "getTransactionByData", "len": 2 }, { "name": "multiARRefundTransaction", "len": 1 }, { "name": "getTransaction", "len": 1 }, { "name": "getMultipleAccountReceiptText", "len": 3 } ], "IdleTimerController": [ { "name": "setRemainingIdleTime", "len": 0 }, { "name": "submit", "len": 1 }, { "name": "getRemainingIdleTime", "len": 1 } ], "TextMessageEnrollmentController": [ { "name": "resendEnrollmentText", "len": 1 }, { "name": "updateMobilePhoneNumberFromPopUp", "len": 1 }, { "name": "updateMobilePhoneNumber", "len": 1 }, { "name": "verifyTextEnrollment", "len": 1 }, { "name": "enableTwoStepVerification", "len": 1 }, { "name": "updateUserTextCommPreference", "len": 1 }, { "name": "sendEnrollmentText", "len": 1 }, { "name": "skipTextEnrollment", "len": 1 } ], "QuickPaySignUpController": [ { "name": "signUp", "len": 1 }, { "name": "skip", "len": 1 } ], "PaymentReceiptController": [ { "name": "redirectToSignUp", "len": 1 }, { "name": "goToSignUpOrLogin", "len": 1 }, { "name": "goToReceipt", "len": 1 } ] }, "descriptor": "Ext.app.REMOTING_API"};Ext.app.REMOTING_API.maxRetries = 0;Ext.app.REMOTING_API.timeout = 300 * 1000;Ext.app.REMOTING_API.enableBuffer = false;Ext.Direct.addProvider(Ext.app.REMOTING_API);Ext.app.REMOTING_API.requestKey = 'EEB19ADE9B3FDCC9FAC5793DB7CF1A7A882E0CFEE8A4E32C5B4F964DE48FEC05';Ext.app.REMOTING_API.alias = 'GQO.FACETSGRP';Ext.app.REMOTING_API.corporateID = '';Ext.app.REMOTING_API.token = '';function headerPatientPortalBack() { var nav = InstaMed.getNavigationView(); if(!Ext.Msg.isHidden()) { Ext.Msg.close(); } else if(nav.lastForm.length > 1) { nav.back(); } else { PerformAction({}, PatientPortalLoginController.patientPortalHeaderBack); } }Ext.define('Ext.InstaMed.FormPanel',{extend: 'Ext.form.Panel',alias: 'widget.form',config: { defaultSubmitButton: null }});Ext.define('Ext.InstaMed.FormPanel',{extend: 'Ext.form.Panel',alias: 'widget.form',config: { defaultSubmitButton: null }});Ext.define('Ext.InstaMed.FormPanel',{extend: 'Ext.form.Panel',alias: 'widget.form',config: { defaultSubmitButton: null }});InstaMed.pages = new Array();Ext.Date.monthNames = [ 'January', 'February', 'March', 'April', 'May', 'June', 'July', 'August', 'September', 'October', 'November', 'December']Ext.Date.dayNames = [ 'Sunday', 'Monday', 'Tuesday', 'Wednesday', 'Thursday', 'Friday', 'Saturday']InstaMed.pages.push('NavDualLoginSignUp');InstaMed.pages.push('NavLoginPassword');InstaMed.pages.push('NavSignUpForm');InstaMed.pages.push('NavPageIdleTimeoutForm');InstaMed.PageMaximumSequenceNumber=41;Ext.define('MyApp.view.NavigationView',{extend: 'InstaMed.navigation.View',alias: 'widget.mynavigationview',config: { name: 'NavigationView', useLogo: true, configInnerStates:[0], configActiveItem:0, configLastForm:[new Object()], mobilePrimaryActionButtonInTitleBar: false, mobileSecondaryActionButtonInTitleBar: false, navigationBar: false, items: [ {xtype: 'container', name: 'NavDualLoginSignUp', layout: {type: 'vbox', pack: 'start'}, showBackButton: true, showMenuButton: false, scrollable: 'true', id: 'NavDualLoginSignUp', items: [ { xtype: 'panel', dock: 'top', frame: false, scrollable: 'true', id: 'panel', items: [ {xtype: 'container', maxWidth: 1272, layout: {type: 'hbox'}, cls: 'mainContent MainContentWithHeader ', scrollable: null, id: 'container', items: [ {xtype: 'container', flex: 1, scrollable: null, id: 'container_1', items: [ {xtype: 'container', cls: 'col-large-offSet-3 col-medium-offSet-3 col-small-offSet-1 smallTenColumn xsmallTwelveColumn mediumSixColumn largeSixColumn im-form-wrapper', scrollable: null, id: 'container_2', items: [ { xtype: 'form', preventHeader: true, bodyCls: 'mypanel', api: { }, name: 'DualLoginSignUp', itemId: 'DualLoginSignUp', cls: 'im-form-margin-rule', scrollable: null, id: 'DualLoginSignUp', items: [ {xtype: 'errorbox', name: 'ValidationSummary', ui: 'ErrorBox', hidden: true, cls: 'ErrorBox', id: 'ValidationSummary' }, {xtype: 'container', minHeight: 10, scrollable: null, id: 'DualLoginSignUp_container' }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'DualLoginSignUp_container_1', items: [ {xtype: 'spacer', id: 'DualLoginSignUp_spacer' }, {xtype: 'container', html: 'Geisinger Health Plan - Log In or Sign Up (1)', scrollable: null, id: 'DualLoginSignUp_container_2' }, {xtype: 'spacer', id: 'DualLoginSignUp_spacer_1' }] }, {xtype: 'container', minHeight: 36, scrollable: null, id: 'DualLoginSignUp_container_3' }, {xtype: 'container', scrollable: null, id: 'DualLoginSignUp_container_4', items: [ {xtype: 'hiddenfield', fieldLabel: 'DualLoginSignUpSelectedType', label: 'DualLoginSignUpSelectedType', labelSeparator: ' ', value: 'LoginFieldsContainer', required: false, labelWrap: true, errorTarget: 'under', clearable: false, requiredMessage: 'DualLoginSignUpSelectedType is required', autoComplete: 'on', name: 'DualLoginSignUpSelectedType', margin: '', id: 'DualLoginSignUp_DualLoginSignUpSelectedType', listeners: {blur: function(cmp){if(cmp.validate){cmp.validate();}}} }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'DualLoginSignUp_container_5', items: [ {xtype: 'spacer', id: 'DualLoginSignUp_spacer_2' }, {xtype: 'instamedLabelHeading1', html: 'Welcome!', ui: 'headline-font', cls: 'im-font-500 headline-font', id: 'DualLoginSignUp_instamedLabelHeading1' }, {xtype: 'spacer', id: 'DualLoginSignUp_spacer_3' }] }, {xtype: 'container', minHeight: 10, scrollable: null, id: 'DualLoginSignUp_container_6' }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'DualLoginSignUp_container_7', items: [ {xtype: 'spacer', id: 'DualLoginSignUp_spacer_4' }, {xtype: 'label', html: 'Log in to your account to continue.', ui: 'light-subheading-secondary', cls: 'im-font-500 light-subheading-secondary', id: 'DualLoginSignUp_label' }, {xtype: 'spacer', id: 'DualLoginSignUp_spacer_5' }] }, {xtype: 'container', minHeight: 20, scrollable: null, id: 'DualLoginSignUp_container_8' }, {xtype: 'container', name: 'LoginFieldsContainer', scrollable: null, id: 'DualLoginSignUp_LoginFieldsContainer', items: [ {xtype: 'textfield', allowBlank: false, allowOnlyWhitespace: false, maxLength: 200, maxLength: 200, enforceMaxLength: true, minLength: 1, selectOnFocus: true, autoCorrect: false, fieldLabel: 'Email', label: 'Email', fieldStyle: { textTransform:'none' }, component: {"type":"email","pattern":null}, inputType: 'email', labelSeparator: ' ', value: '', required: true, labelWrap: true, labelAlign: 'placeholder', errorTarget: 'under', clearable: false, requiredMessage: 'Email is required', autoComplete: 'on', name: 'LoginEmail', margin: '', fieldStyle: { textTransform:'none' }, id: 'DualLoginSignUp_LoginEmail', listeners: {action: submitOnEnter,blur: function(cmp){if(cmp.validate){cmp.validate();}}} }, {xtype: 'passwordfield', maxLength: 30, maxLength: 30, enforceMaxLength: true, selectOnFocus: true, autoCorrect: false, fieldLabel: 'Password', label: 'Password', fieldStyle: { textTransform:'none' }, hidden: true, labelSeparator: ' ', inputType: 'password', required: false, labelWrap: true, labelAlign: 'placeholder', errorTarget: 'under', clearable: false, requiredMessage: 'Password is required', autoComplete: 'on', name: 'LoginPassword', margin: '', fieldStyle: { textTransform:'none' }, id: 'DualLoginSignUp_LoginPassword', listeners: {action: submitOnEnter,blur: function(cmp){if(cmp.validate){cmp.validate();}},painted: function(){this.inputElement.addListener('animationstart',function(){InstaMed.get('LoginPassword').setLabelInPlaceholder(false);})}}, revealable: true }] }, {xtype: 'container', minHeight: 12, scrollable: null, id: 'DualLoginSignUp_container_9' }] }, {xtype: 'container', name: 'LoginButtonsContainer', layout: {type: 'vbox'}, scrollable: null, id: 'DualLoginSignUp_LoginButtonsContainer', items: [ {xtype: 'button', text: 'Next', name: 'btnNext', ui: 'action', margin: '', ariaRole: 'button', cls: 'im-full-width-button action noprint', id: 'DualLoginSignUp_button_Next', listeners: {tap: function(cmp, newValue, oldValue, eOpts) { myForm = InstaMed.findParentForm(cmp); PerformAction(myForm.getValues(),PatientPortalLoginController.navigateAfterLogin,cmp,undefined,undefined,undefined,undefined,undefined); }} }] }, {xtype: 'container', layout: {type: 'hbox', pack: 'start', align: 'bottom'}, cls: 'buttonContainer', scrollable: null, id: 'DualLoginSignUp_container_10', items: [ {xtype: 'button', text: 'Back', iconCls: 'x-ma ma-arrow-back', ui: 'Initial-Caps', margin: '', hidden: true, ariaRole: 'button', cls: 'Initial-Caps noprint', id: 'DualLoginSignUp_button_Back', listeners: {tap: function(){PerformAction({}, PatientPortalLoginController.patientPortalNavigateBack);}} }, {xtype: 'spacer', id: 'DualLoginSignUp_spacer_6' }, {xtype: 'label', html: '

Don\'t have an account? Sign Up

', ui: 'light-subheading-secondary', cls: 'top-pad-8 light-subheading-secondary', id: 'DualLoginSignUp_label_1' }] }] }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'container_3', items: [ {xtype: 'spacer', id: 'spacer' }, {xtype: 'container', scrollable: null, id: 'container_4', items: [ {xtype: 'container', minHeight: 10, scrollable: null, id: 'container_5' }, {xtype: 'label', html: 'Continue as Guest', ui: 'subheading-primary', hidden: true, cls: 'subheading-primary', id: 'label' }, {xtype: 'label', html: 'Skip to Receipt', name: 'SkipToReceiptButton', ui: 'subheading-primary', hidden: true, cls: 'subheading-primary', id: 'SkipToReceiptButton' }] }, {xtype: 'spacer', id: 'spacer_1' }] }] }] }] }] }, {xtype: 'spacer', flex: 1, id: 'spacer_2' }, {xtype: 'container', layout: {type: 'hbox'}, hidden: false, cls: 'x-panel-footer im-powered-by', scrollable: null, id: 'container_6', items: [ {xtype: 'spacer', id: 'spacer_3' }, {xtype: 'container', maxWidth: 1272, layout: {type: 'hbox'}, cls: 'largeTwelveColumn mediumTwelveColumn ', scrollable: null, id: 'NavDualLoginSignUp_container', items: [ {xtype: 'container', name: 'poweredbylogo', cls: 'hidden hiddenxs hiddensm', scrollable: null, id: 'NavDualLoginSignUp_poweredbylogo' }, {xtype: 'container', cls: 'copyrightContainer hiddenxs hiddensm', scrollable: null, id: 'NavDualLoginSignUp_container_1', items: [ {xtype: 'spacer', cls: 'hiddenmd hiddenlg', id: 'NavDualLoginSignUp_spacer' }, {xtype: 'label', html: '© 2024 InstaMed. All Rights Reserved.', name: 'copyrightFooter', ui: 'body1-primary', cls: 'margin-bottom-10 body1-primary', id: 'NavDualLoginSignUp_copyrightFooter' }, {xtype: 'spacer', cls: 'hiddenmd hiddenlg', id: 'NavDualLoginSignUp_spacer_1' }] }, {xtype: 'spacer', cls: 'hiddenxs hiddensm', id: 'NavDualLoginSignUp_spacer_2' }, {xtype: 'container', cls: 'linkButtonContainer hiddenxs hiddensm', scrollable: null, id: 'NavDualLoginSignUp_container_2', items: [ {xtype: 'button', text: 'Security', iconCls: 'x-ma ma-lock-outline', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavDualLoginSignUp_button_Security', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/security/','open-window');}} }, {xtype: 'button', text: 'Privacy', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavDualLoginSignUp_button_Privacy', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/privacy-statement/','open-window');}} }, {xtype: 'button', text: 'Terms', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavDualLoginSignUp_button_Terms', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/terms-of-use/','open-window');}} }, {xtype: 'button', text: 'Help', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavDualLoginSignUp_button_Help', listeners: {tap: function() { InstaMed.popupNewWindow('../../Form/PaymentPortal/ContactUs?id=GQO.FACETSGRP','open-window');}} }, {xtype: 'button', text: 'English', align: 'right',menu:[{xtype: 'menuitem', text: 'English', handler: function(cmp) { PerformAction({Language:'en'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'en', cls: 'hiddenxs hiddensm', id: 'menuitem_en'},{xtype: 'menuitem', text: 'Español', handler: function(cmp) { PerformAction({Language:'es'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'es', cls: 'hiddenxs hiddensm', id: 'menuitem_es'},{xtype: 'menuitem', text: 'Français', handler: function(cmp) { PerformAction({Language:'fr'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'fr', cls: 'hiddenxs hiddensm', id: 'menuitem_fr'},], name: 'ForeignLanguages', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavDualLoginSignUp_button_ForeignLanguages' }] }, {xtype: 'container', cls: 'hiddenmd hiddenlg', scrollable: null, id: 'NavDualLoginSignUp_container_3', items: [ {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'NavDualLoginSignUp_container_4', items: [ {xtype: 'spacer', id: 'NavDualLoginSignUp_spacer_3' }, {xtype: 'container', name: 'poweredbylogo', cls: 'hidden', scrollable: null, id: 'NavDualLoginSignUp_poweredbylogo_1' }, {xtype: 'spacer', id: 'NavDualLoginSignUp_spacer_4' }] }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'NavDualLoginSignUp_container_5', items: [ {xtype: 'spacer', id: 'NavDualLoginSignUp_spacer_5' }, {xtype: 'container', cls: 'copyrightContainer', scrollable: null, id: 'NavDualLoginSignUp_container_6', items: [ {xtype: 'spacer', cls: 'hiddenmd hiddenlg', id: 'NavDualLoginSignUp_spacer_6' }, {xtype: 'label', html: '© 2024 InstaMed. All Rights Reserved.', name: 'copyrightFooter', ui: 'body1-primary', cls: 'margin-bottom-10 body1-primary', id: 'NavDualLoginSignUp_copyrightFooter_1' }, {xtype: 'spacer', cls: 'hiddenmd hiddenlg', id: 'NavDualLoginSignUp_spacer_7' }] }, {xtype: 'spacer', id: 'NavDualLoginSignUp_spacer_8' }] }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'NavDualLoginSignUp_container_7', items: [ {xtype: 'spacer', id: 'NavDualLoginSignUp_spacer_9' }, {xtype: 'container', cls: 'linkButtonContainer ', scrollable: null, id: 'NavDualLoginSignUp_container_8', items: [ {xtype: 'button', text: 'Security', iconCls: 'x-ma ma-lock-outline', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavDualLoginSignUp_button_Security_1', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/security/','open-window');}} }, {xtype: 'button', text: 'Privacy', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavDualLoginSignUp_button_Privacy_1', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/privacy-statement/','open-window');}} }, {xtype: 'button', text: 'Terms', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavDualLoginSignUp_button_Terms_1', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/terms-of-use/','open-window');}} }, {xtype: 'button', text: 'Help', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavDualLoginSignUp_button_Help_1', listeners: {tap: function() { InstaMed.popupNewWindow('../../Form/PaymentPortal/ContactUs?id=GQO.FACETSGRP','open-window');}} }] }, {xtype: 'spacer', id: 'NavDualLoginSignUp_spacer_10' }] }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'NavDualLoginSignUp_container_9', items: [ {xtype: 'spacer', id: 'NavDualLoginSignUp_spacer_11' }, {xtype: 'container', scrollable: null, id: 'NavDualLoginSignUp_container_10', items: [ {xtype: 'button', text: 'English', align: 'right',menu:[{xtype: 'menuitem', text: 'English', handler: function(cmp) { PerformAction({Language:'en'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'en', cls: 'hiddenmd hiddenlg', id: 'menuitem_en_1'},{xtype: 'menuitem', text: 'Español', handler: function(cmp) { PerformAction({Language:'es'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'es', cls: 'hiddenmd hiddenlg', id: 'menuitem_es_1'},{xtype: 'menuitem', text: 'Français', handler: function(cmp) { PerformAction({Language:'fr'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'fr', cls: 'hiddenmd hiddenlg', id: 'menuitem_fr_1'},], name: 'ForeignLanguages', ui: 'grey', margin: '', hidden: false, ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavDualLoginSignUp_button_ForeignLanguages_1' }] }, {xtype: 'spacer', id: 'NavDualLoginSignUp_spacer_12' }] }] }] }, {xtype: 'spacer', id: 'spacer_4' }] }] }, {xtype: 'container', name: 'NavLoginPassword', layout: {type: 'vbox', pack: 'start'}, showBackButton: true, showMenuButton: false, scrollable: 'true', id: 'NavLoginPassword', items: [ { xtype: 'panel', dock: 'top', frame: false, scrollable: 'true', id: 'panel_1', items: [ {xtype: 'container', maxWidth: 1272, layout: {type: 'hbox'}, cls: 'mainContent MainContentWithHeader ', scrollable: null, id: 'container_7', items: [ {xtype: 'container', flex: 1, scrollable: null, id: 'container_8', items: [ {xtype: 'container', cls: 'col-large-offSet-3 col-medium-offSet-3 col-small-offSet-1 smallTenColumn xsmallTwelveColumn mediumSixColumn largeSixColumn im-form-wrapper', scrollable: null, id: 'container_9', items: [ { xtype: 'form', preventHeader: true, bodyCls: 'mypanel', api: { }, name: 'DualLoginSignUp', itemId: 'DualLoginSignUp', cls: 'im-form-margin-rule', scrollable: null, id: 'DualLoginSignUp_1', items: [ {xtype: 'errorbox', name: 'ValidationSummary', ui: 'ErrorBox', hidden: true, cls: 'ErrorBox', id: 'ValidationSummary_1' }, {xtype: 'container', minHeight: 10, scrollable: null, id: 'DualLoginSignUp_container_11' }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'DualLoginSignUp_container_12', items: [ {xtype: 'spacer', id: 'DualLoginSignUp_spacer_7' }, {xtype: 'container', html: 'Geisinger Health Plan - Log In or Sign Up (2)', scrollable: null, id: 'DualLoginSignUp_container_13' }, {xtype: 'spacer', id: 'DualLoginSignUp_spacer_8' }] }, {xtype: 'container', minHeight: 36, scrollable: null, id: 'DualLoginSignUp_container_14' }, {xtype: 'container', scrollable: null, id: 'DualLoginSignUp_container_15', items: [ {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'DualLoginSignUp_container_16', items: [ {xtype: 'spacer', id: 'DualLoginSignUp_spacer_9' }, {xtype: 'instamedLabelHeading1', html: 'Hi ', name: 'PasswordPageTitle', ui: 'headline-font', cls: 'headline-font', id: 'DualLoginSignUp_PasswordPageTitle' }, {xtype: 'spacer', id: 'DualLoginSignUp_spacer_10' }] }, {xtype: 'container', minHeight: 8, scrollable: null, id: 'DualLoginSignUp_container_17' }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'DualLoginSignUp_container_18', items: [ {xtype: 'spacer', id: 'DualLoginSignUp_spacer_11' }, {xtype: 'button', iconCls: 'md-icon-close', iconAlign: 'right', name: 'Email', ui: 'Grey-Outlined-Rounded', margin: '', ariaRole: 'button', cls: 'margin-bottom-10 Grey-Outlined-Rounded noprint', listeners: {tap: function(cmp, newValue, oldValue, eOpts) { myForm = InstaMed.findParentForm(cmp); PerformAction(myForm.getValues(),PatientPortalLoginController.redirectToLoginEmailForm,cmp,undefined,undefined,undefined,undefined,undefined); }} }, {xtype: 'spacer', id: 'DualLoginSignUp_spacer_12' }] }, {xtype: 'container', name: 'LoginFieldsContainer', scrollable: null, id: 'DualLoginSignUp_LoginFieldsContainer_1', items: [ {xtype: 'textfield', allowBlank: false, allowOnlyWhitespace: false, maxLength: 200, maxLength: 200, enforceMaxLength: true, minLength: 1, selectOnFocus: true, autoCorrect: false, fieldLabel: 'Email', label: 'Email', fieldStyle: { textTransform:'none' }, component: {"type":"email","pattern":null}, inputType: 'email', hidden: true, labelSeparator: ' ', required: true, labelWrap: true, labelAlign: 'placeholder', errorTarget: 'under', clearable: false, requiredMessage: 'Email is required', autoComplete: 'on', name: 'LoginEmail', margin: '', fieldStyle: { textTransform:'none' }, id: 'DualLoginSignUp_LoginEmail_1', listeners: {action: submitOnEnter,blur: function(cmp){if(cmp.validate){cmp.validate();}}} }, {xtype: 'passwordfield', allowBlank: false, allowOnlyWhitespace: false, maxLength: 30, maxLength: 30, enforceMaxLength: true, selectOnFocus: true, autoCorrect: false, fieldLabel: 'Password', label: 'Password', fieldStyle: { textTransform:'none' }, labelSeparator: ' ', inputType: 'password', required: true, labelWrap: true, labelAlign: 'placeholder', errorTarget: 'under', clearable: false, requiredMessage: 'Password is required', autoComplete: 'on', name: 'LoginPassword', margin: '', fieldStyle: { textTransform:'none' }, id: 'DualLoginSignUp_LoginPassword_1', listeners: {painted: function(cmp) { cmp.focus() },action: submitOnEnter,blur: function(cmp){if(cmp.validate){cmp.validate();}}}, revealable: true }] }, {xtype: 'container', minHeight: 6, scrollable: null, id: 'DualLoginSignUp_container_19' }, {xtype: 'hiddenfield', fieldLabel: 'DualLoginSignUpSelectedType', label: 'DualLoginSignUpSelectedType', labelSeparator: ' ', value: 'LoginFieldsContainer', required: true, labelWrap: true, errorTarget: 'under', clearable: false, requiredMessage: 'DualLoginSignUpSelectedType is required', autoComplete: 'on', name: 'DualLoginSignUpSelectedType', margin: '', id: 'DualLoginSignUp_DualLoginSignUpSelectedType_1', listeners: {blur: function(cmp){if(cmp.validate){cmp.validate();}}} }] }, {xtype: 'container', name: 'LoginButtonsContainer', layout: {type: 'vbox'}, scrollable: null, id: 'DualLoginSignUp_LoginButtonsContainer_1', items: [ {xtype: 'button', text: 'Next', name: 'btnNext', ui: 'action', margin: '', ariaRole: 'button', cls: 'im-full-width-button action noprint', id: 'DualLoginSignUp_button_Next_1', listeners: {tap: function(cmp, newValue, oldValue, eOpts) { myForm = InstaMed.findParentForm(cmp); PerformAction(myForm.getValues(),PatientPortalLoginController.dualLogin,cmp,undefined,undefined,undefined,undefined,undefined); }} }] }, {xtype: 'container', layout: {type: 'hbox', pack: 'start', align: 'bottom'}, cls: 'buttonContainer', scrollable: null, id: 'DualLoginSignUp_container_20', items: [ {xtype: 'button', text: 'Back', iconCls: 'x-ma ma-arrow-back', ui: 'Initial-Caps', margin: '', hidden: false, ariaRole: 'button', cls: 'Initial-Caps noprint', id: 'DualLoginSignUp_button_Back_1', listeners: {tap: function(){ var form = InstaMed.getNavigationView(); form.back(); }} }, {xtype: 'spacer', id: 'DualLoginSignUp_spacer_13' }, {xtype: 'label', html: 'Forgot Password?', ui: 'subheading-primary', cls: 'top-pad-8 subheading-primary', id: 'DualLoginSignUp_label_2' }] }] }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'container_10', items: [ {xtype: 'spacer', id: 'spacer_5' }, {xtype: 'container', scrollable: null, id: 'container_11', items: [ {xtype: 'container', minHeight: 10, scrollable: null, id: 'container_12' }, {xtype: 'label', html: 'Continue as Guest', ui: 'subheading-primary', hidden: true, cls: 'subheading-primary', id: 'label_1' }, {xtype: 'label', html: 'Skip to Receipt', name: 'SkipToReceiptButton', ui: 'subheading-primary', hidden: true, cls: 'subheading-primary', id: 'SkipToReceiptButton_1' }] }, {xtype: 'spacer', id: 'spacer_6' }] }] }] }] }] }, {xtype: 'spacer', flex: 1, id: 'spacer_7' }, {xtype: 'container', layout: {type: 'hbox'}, hidden: false, cls: 'x-panel-footer im-powered-by', scrollable: null, id: 'container_13', items: [ {xtype: 'spacer', id: 'spacer_8' }, {xtype: 'container', maxWidth: 1272, layout: {type: 'hbox'}, cls: 'largeTwelveColumn mediumTwelveColumn ', scrollable: null, id: 'NavLoginPassword_container', items: [ {xtype: 'container', name: 'poweredbylogo', cls: 'hidden hiddenxs hiddensm', scrollable: null, id: 'NavLoginPassword_poweredbylogo' }, {xtype: 'container', cls: 'copyrightContainer hiddenxs hiddensm', scrollable: null, id: 'NavLoginPassword_container_1', items: [ {xtype: 'spacer', cls: 'hiddenmd hiddenlg', id: 'NavLoginPassword_spacer' }, {xtype: 'label', html: '© 2024 InstaMed. All Rights Reserved.', name: 'copyrightFooter', ui: 'body1-primary', cls: 'margin-bottom-10 body1-primary', id: 'NavLoginPassword_copyrightFooter' }, {xtype: 'spacer', cls: 'hiddenmd hiddenlg', id: 'NavLoginPassword_spacer_1' }] }, {xtype: 'spacer', cls: 'hiddenxs hiddensm', id: 'NavLoginPassword_spacer_2' }, {xtype: 'container', cls: 'linkButtonContainer hiddenxs hiddensm', scrollable: null, id: 'NavLoginPassword_container_2', items: [ {xtype: 'button', text: 'Security', iconCls: 'x-ma ma-lock-outline', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavLoginPassword_button_Security', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/security/','open-window');}} }, {xtype: 'button', text: 'Privacy', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavLoginPassword_button_Privacy', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/privacy-statement/','open-window');}} }, {xtype: 'button', text: 'Terms', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavLoginPassword_button_Terms', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/terms-of-use/','open-window');}} }, {xtype: 'button', text: 'Help', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavLoginPassword_button_Help', listeners: {tap: function() { InstaMed.popupNewWindow('../../Form/PaymentPortal/ContactUs?id=GQO.FACETSGRP','open-window');}} }, {xtype: 'button', text: 'English', align: 'right',menu:[{xtype: 'menuitem', text: 'English', handler: function(cmp) { PerformAction({Language:'en'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'en', cls: 'hiddenxs hiddensm', id: 'menuitem_en_2'},{xtype: 'menuitem', text: 'Español', handler: function(cmp) { PerformAction({Language:'es'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'es', cls: 'hiddenxs hiddensm', id: 'menuitem_es_2'},{xtype: 'menuitem', text: 'Français', handler: function(cmp) { PerformAction({Language:'fr'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'fr', cls: 'hiddenxs hiddensm', id: 'menuitem_fr_2'},], name: 'ForeignLanguages', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavLoginPassword_button_ForeignLanguages' }] }, {xtype: 'container', cls: 'hiddenmd hiddenlg', scrollable: null, id: 'NavLoginPassword_container_3', items: [ {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'NavLoginPassword_container_4', items: [ {xtype: 'spacer', id: 'NavLoginPassword_spacer_3' }, {xtype: 'container', name: 'poweredbylogo', cls: 'hidden', scrollable: null, id: 'NavLoginPassword_poweredbylogo_1' }, {xtype: 'spacer', id: 'NavLoginPassword_spacer_4' }] }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'NavLoginPassword_container_5', items: [ {xtype: 'spacer', id: 'NavLoginPassword_spacer_5' }, {xtype: 'container', cls: 'copyrightContainer', scrollable: null, id: 'NavLoginPassword_container_6', items: [ {xtype: 'spacer', cls: 'hiddenmd hiddenlg', id: 'NavLoginPassword_spacer_6' }, {xtype: 'label', html: '© 2024 InstaMed. All Rights Reserved.', name: 'copyrightFooter', ui: 'body1-primary', cls: 'margin-bottom-10 body1-primary', id: 'NavLoginPassword_copyrightFooter_1' }, {xtype: 'spacer', cls: 'hiddenmd hiddenlg', id: 'NavLoginPassword_spacer_7' }] }, {xtype: 'spacer', id: 'NavLoginPassword_spacer_8' }] }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'NavLoginPassword_container_7', items: [ {xtype: 'spacer', id: 'NavLoginPassword_spacer_9' }, {xtype: 'container', cls: 'linkButtonContainer ', scrollable: null, id: 'NavLoginPassword_container_8', items: [ {xtype: 'button', text: 'Security', iconCls: 'x-ma ma-lock-outline', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavLoginPassword_button_Security_1', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/security/','open-window');}} }, {xtype: 'button', text: 'Privacy', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavLoginPassword_button_Privacy_1', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/privacy-statement/','open-window');}} }, {xtype: 'button', text: 'Terms', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavLoginPassword_button_Terms_1', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/terms-of-use/','open-window');}} }, {xtype: 'button', text: 'Help', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavLoginPassword_button_Help_1', listeners: {tap: function() { InstaMed.popupNewWindow('../../Form/PaymentPortal/ContactUs?id=GQO.FACETSGRP','open-window');}} }] }, {xtype: 'spacer', id: 'NavLoginPassword_spacer_10' }] }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'NavLoginPassword_container_9', items: [ {xtype: 'spacer', id: 'NavLoginPassword_spacer_11' }, {xtype: 'container', scrollable: null, id: 'NavLoginPassword_container_10', items: [ {xtype: 'button', text: 'English', align: 'right',menu:[{xtype: 'menuitem', text: 'English', handler: function(cmp) { PerformAction({Language:'en'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'en', cls: 'hiddenmd hiddenlg', id: 'menuitem_en_3'},{xtype: 'menuitem', text: 'Español', handler: function(cmp) { PerformAction({Language:'es'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'es', cls: 'hiddenmd hiddenlg', id: 'menuitem_es_3'},{xtype: 'menuitem', text: 'Français', handler: function(cmp) { PerformAction({Language:'fr'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'fr', cls: 'hiddenmd hiddenlg', id: 'menuitem_fr_3'},], name: 'ForeignLanguages', ui: 'grey', margin: '', hidden: false, ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavLoginPassword_button_ForeignLanguages_1' }] }, {xtype: 'spacer', id: 'NavLoginPassword_spacer_12' }] }] }] }, {xtype: 'spacer', id: 'spacer_9' }] }] }, {xtype: 'container', name: 'NavSignUpForm', layout: {type: 'vbox', pack: 'start'}, showBackButton: true, showMenuButton: false, scrollable: 'true', id: 'NavSignUpForm', items: [ { xtype: 'panel', dock: 'top', frame: false, scrollable: 'true', id: 'panel_2', items: [ {xtype: 'container', maxWidth: 1272, layout: {type: 'hbox'}, cls: 'mainContent MainContentWithHeader ', scrollable: null, id: 'container_14', items: [ {xtype: 'container', flex: 1, scrollable: null, id: 'container_15', items: [ {xtype: 'container', cls: 'col-large-offSet-3 col-medium-offSet-3 col-small-offSet-1 smallTenColumn xsmallTwelveColumn mediumSixColumn largeSixColumn im-form-wrapper', scrollable: null, id: 'container_16', items: [ { xtype: 'form', preventHeader: true, bodyCls: 'mypanel', api: { submit: SignUpController.signUp }, name: 'SignUpPage', itemId: 'SignUpPage', cls: 'im-form-margin-rule', id: 'SignUpPage', items: [ {xtype: 'errorbox', name: 'ValidationSummary', ui: 'ErrorBox', hidden: true, cls: 'ErrorBox', id: 'ValidationSummary_2' }, {xtype: 'container', minHeight: 10, scrollable: null, id: 'SignUpPage_container' }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'SignUpPage_container_1', items: [ {xtype: 'spacer', id: 'SignUpPage_spacer' }, {xtype: 'container', html: 'Geisinger Health Plan - Log In or Sign Up (3)', scrollable: null, id: 'SignUpPage_container_2' }, {xtype: 'spacer', id: 'SignUpPage_spacer_1' }] }, {xtype: 'container', minHeight: 36, scrollable: null, id: 'SignUpPage_container_3' }, {xtype: 'container', scrollable: null, id: 'SignUpPage_container_4', items: [ {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'SignUpPage_container_5', items: [ {xtype: 'spacer', id: 'SignUpPage_spacer_2' }, {xtype: 'instamedLabelHeading1', html: 'Sign up', ui: 'headline-font', cls: 'im-font-500 headline-font', id: 'SignUpPage_instamedLabelHeading1' }, {xtype: 'spacer', id: 'SignUpPage_spacer_3' }] }, {xtype: 'container', minHeight: 10, scrollable: null, id: 'SignUpPage_container_6' }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'SignUpPage_container_7', items: [ {xtype: 'spacer', id: 'SignUpPage_spacer_4' }, {xtype: 'label', html: 'Create an account to continue.', ui: 'light-subheading-secondary', cls: 'im-font-500 light-subheading-secondary', id: 'SignUpPage_label' }, {xtype: 'spacer', id: 'SignUpPage_spacer_5' }] }, {xtype: 'container', minHeight: 20, scrollable: null, id: 'SignUpPage_container_8' }] }, {xtype: 'container', layout: {type: 'hbox'}, cls: 'MultipleFieldsContainer', scrollable: null, id: 'SignUpPage_container_9', plugins: 'responsive', responsiveConfig: {'width > 600':{layout : { type : 'hbox'},},'width <= 600':{layout : { type : 'vbox'},},}, items: [ {xtype: 'textfield', allowBlank: false, allowOnlyWhitespace: false, maxLength: 100, maxLength: 100, enforceMaxLength: true, minLength: 1, selectOnFocus: true, autoCorrect: false, fieldLabel: 'First Name', label: 'First Name', labelSeparator: ' ', value: '', required: true, labelWrap: true, labelAlign: 'placeholder', errorTarget: 'under', clearable: false, requiredMessage: 'First Name is required', autoComplete: 'on', name: 'FirstName', flex: 1, margin: '', id: 'SignUpPage_FirstName', listeners: {action: submitOnEnter,blur: function(cmp){if(cmp.validate){cmp.validate();}}} }, {xtype: 'container', width: 24, name: 'FirstNameLastNameSpacer', cls: 'x-spacer', id: 'SignUpPage_FirstNameLastNameSpacer' }, {xtype: 'textfield', allowBlank: false, allowOnlyWhitespace: false, maxLength: 100, maxLength: 100, enforceMaxLength: true, minLength: 1, selectOnFocus: true, autoCorrect: false, fieldLabel: 'Last Name', label: 'Last Name', labelSeparator: ' ', value: '', required: true, labelWrap: true, labelAlign: 'placeholder', errorTarget: 'under', clearable: false, requiredMessage: 'Last Name is required', autoComplete: 'on', name: 'LastName', flex: 1, margin: '', id: 'SignUpPage_LastName', listeners: {action: submitOnEnter,blur: function(cmp){if(cmp.validate){cmp.validate();}}} }] }, {xtype: 'textfield', allowBlank: false, allowOnlyWhitespace: false, maxLength: 80, maxLength: 80, enforceMaxLength: true, minLength: 0, selectOnFocus: true, autoCorrect: false, fieldLabel: 'Email', label: 'Email', component: {"type":"email","pattern":null}, inputType: 'email', labelSeparator: ' ', required: true, labelWrap: true, labelAlign: 'placeholder', errorTarget: 'under', clearable: false, requiredMessage: 'Email is required', autoComplete: 'on', name: 'Email', margin: '', id: 'SignUpPage_Email', listeners: {action: submitOnEnter,blur: function(cmp){if(cmp.validate){cmp.validate();}}} }, {xtype: 'passwordfield', allowBlank: false, allowOnlyWhitespace: false, maxLength: 30, maxLength: 30, enforceMaxLength: true, minLength: 0, selectOnFocus: true, autoCorrect: false, fieldLabel: 'Password', label: 'Password', labelSeparator: ' ', inputType: 'password', required: true, labelWrap: true, labelAlign: 'placeholder', errorTarget: 'under', clearable: false, requiredMessage: 'Password is required', autoComplete: 'on', name: 'Password', margin: '', id: 'SignUpPage_Password', listeners: {change: function() { var listenerArgs = arguments; Ext.Array.each([function(cmp, newValue, oldValue, eOpts){var valueA = newValue;var valueB=null;var targetCMP=null;if(cmp.getName()=='Password'){ targetCMP = InstaMed.get('ConfirmNewPassword'); valueB = targetCMP.getValue();}if(cmp.getName()=='ConfirmNewPassword'){ valueB = InstaMed.get('Password').getValue(); targetCMP=cmp;}if(valueA == valueB){ if(targetCMP.getTriggers().matched) { } else { targetCMP.addTrigger('matched',{cls:'x-ma green-ma-done',xtype:'trigger'}); targetCMP.addCls('im-hide-reveal'); if(targetCMP.getTriggers().failmatched) { targetCMP.removeTrigger('failmatched'); } }}else{ if(targetCMP.getTriggers().failmatched) { } else { targetCMP.addTrigger('failmatched',{cls:'x-ma red-ma-clear',xtype:'trigger'}); targetCMP.removeCls('im-hide-reveal'); } if(targetCMP.getTriggers().matched) { targetCMP.removeTrigger('matched'); }}},function(cmp, newValue, oldValue, eOpts){var conditionsMet=0;if(/[a-z]/.exec(newValue) != null) conditionsMet++;if(/[A-Z]/.exec(newValue) != null) conditionsMet++;if(/[0-9]/.exec(newValue) != null) conditionsMet++;if(/[~!@#$%^&*()_+`={}\[\];':"<>?,.\|]/.exec(newValue) != null) conditionsMet++;if(/[a-z]/.exec(newValue) != null){ InstaMed.get('lowerCaseLetterLabel').addCls('GreenLabel'); InstaMed.get('lowerCaseLetterIcon').addCls('GreenLabel'); InstaMed.get('lowerCaseLetterLabel').removeCls('RedLabel'); InstaMed.get('lowerCaseLetterIcon').removeCls('RedLabel'); InstaMed.get('lowerCaseLetterIcon').setIconCls('x-ma ma-done');}else{ InstaMed.get('lowerCaseLetterIcon').setIconCls('x-ma ma-clear'); if(conditionsMet<3) { InstaMed.get('lowerCaseLetterLabel').addCls('RedLabel'); InstaMed.get('lowerCaseLetterIcon').addCls('RedLabel'); } else { InstaMed.get('lowerCaseLetterLabel').removeCls('RedLabel'); InstaMed.get('lowerCaseLetterIcon').removeCls('RedLabel'); } InstaMed.get('lowerCaseLetterLabel').removeCls('GreenLabel'); InstaMed.get('lowerCaseLetterIcon').removeCls('GreenLabel');}if(/[A-Z]/.exec(newValue) != null){ InstaMed.get('upperCaseLetterLabel').addCls('GreenLabel'); InstaMed.get('upperCaseLetterIcon').addCls('GreenLabel'); InstaMed.get('upperCaseLetterLabel').removeCls('RedLabel'); InstaMed.get('upperCaseLetterIcon').removeCls('RedLabel'); InstaMed.get('upperCaseLetterIcon').setIconCls('x-ma ma-done');}else{ InstaMed.get('upperCaseLetterIcon').setIconCls('x-ma ma-clear'); if(conditionsMet<3) { InstaMed.get('upperCaseLetterLabel').addCls('RedLabel'); InstaMed.get('upperCaseLetterIcon').addCls('RedLabel'); } else { InstaMed.get('upperCaseLetterLabel').removeCls('RedLabel'); InstaMed.get('upperCaseLetterIcon').removeCls('RedLabel'); } InstaMed.get('upperCaseLetterLabel').removeCls('GreenLabel'); InstaMed.get('upperCaseLetterIcon').removeCls('GreenLabel');}if(/[0-9]/.exec(newValue) != null){ InstaMed.get('oneNumberLabel').addCls('GreenLabel'); InstaMed.get('oneNumberIcon').addCls('GreenLabel'); InstaMed.get('oneNumberLabel').removeCls('RedLabel'); InstaMed.get('oneNumberIcon').removeCls('RedLabel'); InstaMed.get('oneNumberIcon').setIconCls('x-ma ma-done');}else{ InstaMed.get('oneNumberIcon').setIconCls('x-ma ma-clear'); if(conditionsMet<3) { InstaMed.get('oneNumberLabel').addCls('RedLabel'); InstaMed.get('oneNumberIcon').addCls('RedLabel'); } else { InstaMed.get('oneNumberLabel').removeCls('RedLabel'); InstaMed.get('oneNumberIcon').removeCls('RedLabel'); } InstaMed.get('oneNumberLabel').removeCls('GreenLabel'); InstaMed.get('oneNumberIcon').removeCls('GreenLabel');}if(/[~!@#$%^&*()_+`={}\[\];':"<>?,.\|]/.exec(newValue) != null){ InstaMed.get('OneSymbolIcon').setIconCls('x-ma ma-done'); InstaMed.get('OneSymbolLabel').addCls('GreenLabel'); InstaMed.get('OneSymbolIcon').addCls('GreenLabel'); InstaMed.get('OneSymbolLabel').removeCls('RedLabel'); InstaMed.get('OneSymbolIcon').removeCls('RedLabel');}else{ InstaMed.get('OneSymbolIcon').setIconCls('x-ma ma-clear'); if(conditionsMet<3) { InstaMed.get('OneSymbolLabel').addCls('RedLabel'); InstaMed.get('OneSymbolIcon').addCls('RedLabel'); } else { InstaMed.get('OneSymbolLabel').removeCls('RedLabel'); InstaMed.get('OneSymbolIcon').removeCls('RedLabel'); } InstaMed.get('OneSymbolLabel').removeCls('GreenLabel'); InstaMed.get('OneSymbolIcon').removeCls('GreenLabel');}if(conditionsMet>2){ InstaMed.get('CharacterTypes').addCls('GreenLabel'); InstaMed.get('CharacterTypes').addCls('GreenLabel'); InstaMed.get('CharacterTypes').removeCls('RedLabel'); InstaMed.get('CharacterTypes').removeCls('RedLabel');}else{ InstaMed.get('CharacterTypes').addCls('RedLabel'); InstaMed.get('CharacterTypes').addCls('RedLabel'); InstaMed.get('CharacterTypes').removeCls('GreenLabel'); InstaMed.get('CharacterTypes').removeCls('GreenLabel');}if(newValue.length>7){ InstaMed.get('8charsIcon').addCls('GreenLabel'); InstaMed.get('8charsLabel').addCls('GreenLabel'); InstaMed.get('8charsIcon').removeCls('RedLabel'); InstaMed.get('8charsLabel').removeCls('RedLabel'); InstaMed.get('8charsIcon').setIconCls('x-ma ma-done');}else{ InstaMed.get('8charsIcon').addCls('RedLabel'); InstaMed.get('8charsLabel').addCls('RedLabel'); InstaMed.get('8charsIcon').removeCls('GreenLabel'); InstaMed.get('8charsLabel').removeCls('GreenLabel'); InstaMed.get('8charsIcon').setIconCls('x-ma ma-clear');}if(conditionsMet>2 && newValue.length>7) { if(cmp.getTriggers().matched) { } else { cmp.addTrigger('matched',{cls:'x-ma green-ma-done',xtype:'trigger'}); cmp.addCls('im-hide-reveal'); }}else { if(cmp.getTriggers().matched) { cmp.removeTrigger('matched',{cls:'x-ma green-ma-done',xtype:'trigger'}); cmp.removeCls('im-hide-reveal'); }}}], function(func) { func.apply(this, listenerArgs); }); },focus: function(cmp, e, eOpts){ InstaMed.get('PasswordVisualizerChecklist').setVisible(true); },focusleave: function(cmp, e, eOpts){ var newValue = cmp.getValue(); var conditionsMet=0; if(/[a-z]/.exec(newValue) != null) conditionsMet++; if(/[A-Z]/.exec(newValue) != null) conditionsMet++; if(/[0-9]/.exec(newValue) != null) conditionsMet++; if(/[~!@#$%^&*()_+`={}\[\];':"<>?,.\|]/.exec(newValue) != null) conditionsMet++; if(conditionsMet>2 && newValue.length>7) InstaMed.get('PasswordVisualizerChecklist').setVisible(false); },action: submitOnEnter,blur: function(cmp){if(cmp.validate){cmp.validate();}},painted: function(){this.inputElement.addListener('animationstart',function(){InstaMed.get('Password').setLabelInPlaceholder(false);})}}, revealable: true }, {xtype: 'container', name: 'PasswordVisualizerChecklist', hidden: true, scrollable: null, id: 'SignUpPage_PasswordVisualizerChecklist', items: [ {xtype: 'label', html: 'Password must:', id: 'SignUpPage_label_1' }, {xtype: 'container', layout: {type: 'float'}, scrollable: null, id: 'SignUpPage_container_10', items: [ {xtype: 'InstaMedTool', iconCls: 'x-ma ma-clear', name: '8charsIcon', cls: 'RedLabel SmallIcon', id: 'SignUpPage_8charsIcon' }, {xtype: 'label', html: 'Contain at least 8 characters', name: '8charsLabel', cls: 'RedLabel', id: 'SignUpPage_8charsLabel' }] }, {xtype: 'label', html: 'Contain at least 3 of the following 4 characters:', name: 'CharacterTypes', cls: 'RedLabel', id: 'SignUpPage_CharacterTypes' }, {xtype: 'container', layout: {type: 'float'}, scrollable: null, id: 'SignUpPage_container_11', items: [ {xtype: 'InstaMedTool', iconCls: 'x-ma ma-clear', name: 'lowerCaseLetterIcon', cls: 'RedLabel SmallIcon', id: 'SignUpPage_lowerCaseLetterIcon' }, {xtype: 'label', html: '1 lowercase letter', name: 'lowerCaseLetterLabel', cls: 'RedLabel', id: 'SignUpPage_lowerCaseLetterLabel' }] }, {xtype: 'container', layout: {type: 'float'}, scrollable: null, id: 'SignUpPage_container_12', items: [ {xtype: 'InstaMedTool', iconCls: 'x-ma ma-clear', name: 'upperCaseLetterIcon', cls: 'RedLabel SmallIcon', id: 'SignUpPage_upperCaseLetterIcon' }, {xtype: 'label', html: '1 uppercase letter', name: 'upperCaseLetterLabel', cls: 'RedLabel', id: 'SignUpPage_upperCaseLetterLabel' }] }, {xtype: 'container', layout: {type: 'float'}, scrollable: null, id: 'SignUpPage_container_13', items: [ {xtype: 'InstaMedTool', iconCls: 'x-ma ma-clear', name: 'oneNumberIcon', cls: 'RedLabel SmallIcon', id: 'SignUpPage_oneNumberIcon' }, {xtype: 'label', html: '1 number', name: 'oneNumberLabel', cls: 'RedLabel', id: 'SignUpPage_oneNumberLabel' }] }, {xtype: 'container', layout: {type: 'float'}, scrollable: null, id: 'SignUpPage_container_14', items: [ {xtype: 'InstaMedTool', iconCls: 'x-ma ma-clear', name: 'OneSymbolIcon', cls: 'RedLabel SmallIcon', id: 'SignUpPage_OneSymbolIcon' }, {xtype: 'label', html: '1 special character', name: 'OneSymbolLabel', cls: 'RedLabel', id: 'SignUpPage_OneSymbolLabel' }] }] }, {xtype: 'passwordfield', allowBlank: false, allowOnlyWhitespace: false, maxLength: 30, maxLength: 30, enforceMaxLength: true, minLength: 0, selectOnFocus: true, autoCorrect: false, fieldLabel: 'Confirm Password', label: 'Confirm Password', labelSeparator: ' ', inputType: 'password', required: true, labelWrap: true, labelAlign: 'placeholder', errorTarget: 'under', clearable: false, requiredMessage: 'Confirm Password is required', autoComplete: 'on', name: 'ConfirmNewPassword', margin: '', id: 'SignUpPage_ConfirmNewPassword', listeners: {change: function(cmp, newValue, oldValue, eOpts){var valueA = newValue;var valueB=null;var targetCMP=null;if(cmp.getName()=='Password'){ targetCMP = InstaMed.get('ConfirmNewPassword'); valueB = targetCMP.getValue();}if(cmp.getName()=='ConfirmNewPassword'){ valueB = InstaMed.get('Password').getValue(); targetCMP=cmp;}if(valueA == valueB){ if(targetCMP.getTriggers().matched) { } else { targetCMP.addTrigger('matched',{cls:'x-ma green-ma-done',xtype:'trigger'}); targetCMP.addCls('im-hide-reveal'); if(targetCMP.getTriggers().failmatched) { targetCMP.removeTrigger('failmatched'); } }}else{ if(targetCMP.getTriggers().failmatched) { } else { targetCMP.addTrigger('failmatched',{cls:'x-ma red-ma-clear',xtype:'trigger'}); targetCMP.removeCls('im-hide-reveal'); } if(targetCMP.getTriggers().matched) { targetCMP.removeTrigger('matched'); }}},action: submitOnEnter,blur: function(cmp){if(cmp.validate){cmp.validate();}},painted: function(){this.inputElement.addListener('animationstart',function(){InstaMed.get('ConfirmNewPassword').setLabelInPlaceholder(false);})}}, revealable: true }, {xtype: 'hiddenfield', fieldLabel: 'PushNotificationToken', label: 'PushNotificationToken', labelSeparator: ' ', required: false, labelWrap: true, errorTarget: 'under', clearable: false, requiredMessage: 'PushNotificationToken is required', autoComplete: 'on', name: 'PushNotificationToken', margin: '', id: 'SignUpPage_PushNotificationToken', listeners: {blur: function(cmp){if(cmp.validate){cmp.validate();}}} }, {xtype: 'container', minHeight: 10, scrollable: null, id: 'SignUpPage_container_15' }, {xtype: 'container', layout: {type: 'vbox'}, scrollable: null, id: 'SignUpPage_container_16', items: [ {xtype: 'button', text: 'Sign Up', name: 'SignUpFormSubmitButton', ui: 'action', margin: '', ariaRole: 'button', cls: 'im-full-width-button action noprint', id: 'SignUpPage_button_SignUp', listeners: {tap: function(cmp, newValue, oldValue, eOpts) { myForm = InstaMed.findParentForm(cmp); PerformAction(myForm.getValues(),SignUpController.signUp,cmp,undefined,undefined,undefined,undefined,undefined); }} }] }, {xtype: 'container', layout: {type: 'hbox', pack: 'start', align: 'bottom'}, cls: 'buttonContainer', scrollable: null, id: 'SignUpPage_container_17', items: [ {xtype: 'button', text: 'Back', iconCls: 'x-ma ma-arrow-back', ui: 'Initial-Caps', margin: '', hidden: false, ariaRole: 'button', cls: 'Initial-Caps noprint', id: 'SignUpPage_button_Back', listeners: {tap: function(){ var form = InstaMed.getNavigationView(); form.back(); }} }, {xtype: 'spacer', id: 'SignUpPage_spacer_6' }, {xtype: 'container', scrollable: null, id: 'SignUpPage_container_18', items: [ {xtype: 'label', html: '

Already have an account? Log in

', ui: 'light-subheading-secondary', cls: 'top-pad-8 light-subheading-secondary', id: 'SignUpPage_label_2' }] }] }] }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'container_17', items: [ {xtype: 'spacer', id: 'spacer_10' }, {xtype: 'container', scrollable: null, id: 'container_18', items: [ {xtype: 'container', minHeight: 10, scrollable: null, id: 'container_19' }, {xtype: 'label', html: 'Continue as Guest', ui: 'subheading-primary', hidden: true, cls: 'subheading-primary', id: 'label_2' }, {xtype: 'label', html: 'Skip to Receipt', name: 'SkipToReceiptButton', ui: 'subheading-primary', hidden: true, cls: 'subheading-primary', id: 'SkipToReceiptButton_2' }] }, {xtype: 'spacer', id: 'spacer_11' }] }] }] }] }] }, {xtype: 'spacer', flex: 1, id: 'spacer_12' }, {xtype: 'container', layout: {type: 'hbox'}, hidden: false, cls: 'x-panel-footer im-powered-by', scrollable: null, id: 'container_20', items: [ {xtype: 'spacer', id: 'spacer_13' }, {xtype: 'container', maxWidth: 1272, layout: {type: 'hbox'}, cls: 'largeTwelveColumn mediumTwelveColumn ', scrollable: null, id: 'NavSignUpForm_container', items: [ {xtype: 'container', name: 'poweredbylogo', cls: 'hidden hiddenxs hiddensm', scrollable: null, id: 'NavSignUpForm_poweredbylogo' }, {xtype: 'container', cls: 'copyrightContainer hiddenxs hiddensm', scrollable: null, id: 'NavSignUpForm_container_1', items: [ {xtype: 'spacer', cls: 'hiddenmd hiddenlg', id: 'NavSignUpForm_spacer' }, {xtype: 'label', html: '© 2024 InstaMed. All Rights Reserved.', name: 'copyrightFooter', ui: 'body1-primary', cls: 'margin-bottom-10 body1-primary', id: 'NavSignUpForm_copyrightFooter' }, {xtype: 'spacer', cls: 'hiddenmd hiddenlg', id: 'NavSignUpForm_spacer_1' }] }, {xtype: 'spacer', cls: 'hiddenxs hiddensm', id: 'NavSignUpForm_spacer_2' }, {xtype: 'container', cls: 'linkButtonContainer hiddenxs hiddensm', scrollable: null, id: 'NavSignUpForm_container_2', items: [ {xtype: 'button', text: 'Security', iconCls: 'x-ma ma-lock-outline', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavSignUpForm_button_Security', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/security/','open-window');}} }, {xtype: 'button', text: 'Privacy', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavSignUpForm_button_Privacy', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/privacy-statement/','open-window');}} }, {xtype: 'button', text: 'Terms', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavSignUpForm_button_Terms', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/terms-of-use/','open-window');}} }, {xtype: 'button', text: 'Help', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavSignUpForm_button_Help', listeners: {tap: function() { InstaMed.popupNewWindow('../../Form/PaymentPortal/ContactUs?id=GQO.FACETSGRP','open-window');}} }, {xtype: 'button', text: 'English', align: 'right',menu:[{xtype: 'menuitem', text: 'English', handler: function(cmp) { PerformAction({Language:'en'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'en', cls: 'hiddenxs hiddensm', id: 'menuitem_en_4'},{xtype: 'menuitem', text: 'Español', handler: function(cmp) { PerformAction({Language:'es'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'es', cls: 'hiddenxs hiddensm', id: 'menuitem_es_4'},{xtype: 'menuitem', text: 'Français', handler: function(cmp) { PerformAction({Language:'fr'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'fr', cls: 'hiddenxs hiddensm', id: 'menuitem_fr_4'},], name: 'ForeignLanguages', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavSignUpForm_button_ForeignLanguages' }] }, {xtype: 'container', cls: 'hiddenmd hiddenlg', scrollable: null, id: 'NavSignUpForm_container_3', items: [ {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'NavSignUpForm_container_4', items: [ {xtype: 'spacer', id: 'NavSignUpForm_spacer_3' }, {xtype: 'container', name: 'poweredbylogo', cls: 'hidden', scrollable: null, id: 'NavSignUpForm_poweredbylogo_1' }, {xtype: 'spacer', id: 'NavSignUpForm_spacer_4' }] }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'NavSignUpForm_container_5', items: [ {xtype: 'spacer', id: 'NavSignUpForm_spacer_5' }, {xtype: 'container', cls: 'copyrightContainer', scrollable: null, id: 'NavSignUpForm_container_6', items: [ {xtype: 'spacer', cls: 'hiddenmd hiddenlg', id: 'NavSignUpForm_spacer_6' }, {xtype: 'label', html: '© 2024 InstaMed. All Rights Reserved.', name: 'copyrightFooter', ui: 'body1-primary', cls: 'margin-bottom-10 body1-primary', id: 'NavSignUpForm_copyrightFooter_1' }, {xtype: 'spacer', cls: 'hiddenmd hiddenlg', id: 'NavSignUpForm_spacer_7' }] }, {xtype: 'spacer', id: 'NavSignUpForm_spacer_8' }] }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'NavSignUpForm_container_7', items: [ {xtype: 'spacer', id: 'NavSignUpForm_spacer_9' }, {xtype: 'container', cls: 'linkButtonContainer ', scrollable: null, id: 'NavSignUpForm_container_8', items: [ {xtype: 'button', text: 'Security', iconCls: 'x-ma ma-lock-outline', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavSignUpForm_button_Security_1', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/security/','open-window');}} }, {xtype: 'button', text: 'Privacy', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavSignUpForm_button_Privacy_1', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/privacy-statement/','open-window');}} }, {xtype: 'button', text: 'Terms', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavSignUpForm_button_Terms_1', listeners: {tap: function() { InstaMed.popupNewWindow('https://www.instamed.com/terms-of-use/','open-window');}} }, {xtype: 'button', text: 'Help', ui: 'grey', margin: '', ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavSignUpForm_button_Help_1', listeners: {tap: function() { InstaMed.popupNewWindow('../../Form/PaymentPortal/ContactUs?id=GQO.FACETSGRP','open-window');}} }] }, {xtype: 'spacer', id: 'NavSignUpForm_spacer_10' }] }, {xtype: 'container', layout: {type: 'hbox', pack: 'center'}, cls: 'x-center-helper', scrollable: null, id: 'NavSignUpForm_container_9', items: [ {xtype: 'spacer', id: 'NavSignUpForm_spacer_11' }, {xtype: 'container', scrollable: null, id: 'NavSignUpForm_container_10', items: [ {xtype: 'button', text: 'English', align: 'right',menu:[{xtype: 'menuitem', text: 'English', handler: function(cmp) { PerformAction({Language:'en'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'en', cls: 'hiddenmd hiddenlg', id: 'menuitem_en_5'},{xtype: 'menuitem', text: 'Español', handler: function(cmp) { PerformAction({Language:'es'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'es', cls: 'hiddenmd hiddenlg', id: 'menuitem_es_5'},{xtype: 'menuitem', text: 'Français', handler: function(cmp) { PerformAction({Language:'fr'}, PatientPortalLoginController.changeLanguage,cmp); }, name: 'fr', cls: 'hiddenmd hiddenlg', id: 'menuitem_fr_5'},], name: 'ForeignLanguages', ui: 'grey', margin: '', hidden: false, ariaRole: 'button', cls: 'x-button-link-style grey noprint', id: 'NavSignUpForm_button_ForeignLanguages_1' }] }, {xtype: 'spacer', id: 'NavSignUpForm_spacer_12' }] }] }] }, {xtype: 'spacer', id: 'spacer_14' }] }] }, { xtype: 'window', title: '

Inactivity Alert

', titleAlign: 'center', itemId: 'NavPageIdleTimeoutForm', flex: 1, defaultFocus: 'button', closable: true, modal: true, draggable: false, constrainHeader: true, constrainTo: 'mainBorderPanel', closeAction: 'hide', name: 'NavPageIdleTimeoutForm', maxWidth: 400, flex: 1, id: 'NavPageIdleTimeoutForm', listeners: {beforeshow: function(){ InstaMed.query("Logout") && InstaMed.query("Logout").setVisible(InstaMed.isLoggedIn); if(!InstaMed.isSSO){ InstaMed.query("IdleTimerNotification") && InstaMed.query("IdleTimerNotification").setHtml && InstaMed.query("IdleTimerNotification").setHtml(InstaMed.isLoggedIn ? "You have been idle for 12 minutes. If you do not select Continue or you make no selection in 3 minutes and 0 seconds, you will be automatically logged out.":"You have been idle for 12 minutes. If you do not select Continue or you make no selection in 3 minutes and 0 seconds, your session will be refreshed and you may lose any unprocessed information."); InstaMed.query("IdleTimerNotification") && InstaMed.query("IdleTimerNotification").setTitle && InstaMed.query("IdleTimerNotification").setTitle(InstaMed.isLoggedIn ? "Automatic Logout":"Inactivity Alert"); } },show: function() { var listenerArgs = arguments; Ext.Array.each([function(cmp) { if (cmp._closable) { cmp.el.dom.querySelector('.x-tool').setAttribute('aria-label', 'Close'); } },function(cmp) { Ext.each(Ext.DomQuery.select('.x-panel-body', Ext.DomQuery.selectNode('.x-window[id=NavPageIdleTimeoutForm]')), function(p) { Ext.get(p.id).scrollTo('top', 0); }); }], function(func) { func.apply(this, listenerArgs); }); }}, items: [ { xtype: 'form', preventHeader: true, bodyCls: 'mypanel', api: { submit: IdleTimerController.submit }, defaultSubmitButton: 'btnContinue', name: 'MyFormPanel', ui: 'flat', itemId: 'MyFormPanel', flex: 1, cls: 'flat', scrollable: null, id: 'MyFormPanel', items: [ {xtype: 'errorbox', name: 'ValidationSummary', ui: 'ErrorBox', flex: 1, hidden: true, cls: 'ErrorBox', id: 'ValidationSummary_10' }, {xtype: 'label', html: 'You have been idle for 12 minutes. If you do not select Continue or you make no selection in 3 minutes and 0 seconds, your session will be refreshed and you may lose any unprocessed information.', name: 'IdleTimerNotification', flex: 1, id: 'MyFormPanel_IdleTimerNotification' }, {xtype: 'container', flex: 1, scrollable: null, id: 'MyFormPanel_container', items: [ {xtype: 'container', layout: {type: 'hbox', pack: 'start', align: 'bottom'}, flex: 1, cls: 'buttonContainer', scrollable: null, id: 'MyFormPanel_container_1', items: [ {xtype: 'spacer', flex: 1, id: 'MyFormPanel_spacer' }, {xtype: 'button', text: 'Logout', name: 'Logout', ui: 'secondary', flex: 1, margin: '', hidden: true, ariaRole: 'button', cls: 'secondary noprint', id: 'MyFormPanel_button_Logout', listeners: {painted: function(cmp) {cmp.el.dom.setAttribute('aria-label', 'Logout');},tap: function() { LogoutTimer.logOut(); }} }, {xtype: 'button', text: 'Continue', name: 'btnContinue', ui: 'secondary', flex: 1, margin: '', ariaRole: 'button', cls: 'secondary noprint', id: 'MyFormPanel_button_Continue', listeners: {painted: function(cmp) {cmp.el.dom.setAttribute('aria-label', 'Continue');},tap: function(cmp, newValue, oldValue, eOpts) {LogoutTimer.resetMainTimer(); myForm = InstaMed.findParentForm(cmp);PerformAction(myForm.getValues(),IdleTimerController.submit,cmp);}} }] }] }] }] }] }});Ext.Loader.setConfig({ enabled: false});Ext.application({ name: 'MyApp', launch: function() { Ext.create('MyApp.view.NavigationView', {fullscreen: true}); }});LogoutTimer && setTimeout(LogoutTimer.reinitiateMainTimer,5000);}

Geisinger Health Plan - Log In or Sign Up (2024)
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