<!-- AVAILABLE data-form VALUES: patient, provider, ask data-repcontact-provider VALUES: yes, no, ask data-fields- VALUES: first, last, email, phone, state, title, company, questions USE sf-hide-after-ask CSS class to set anything to hide after initial question or on thank you page NOTE: Add * at the end of field name to make it required - first*, last*, email*, phone*, etc --> <!-- <div id="SF_embedForm" data-form="ask" data-copy-ask="Let us know who you are" data-campaign-provider="2024 GHK-Cu Launch" data-campaign-patient="2024 GHK-Cu Launch Patients" data-repcontact-provider="ask" data-message-patient="Thank you message for patient form." data-link-patient="https://webdev.empowerpharmacy.com/who-we-serve/patients/" data-linkname-patient="Patient Link" data-copy-patient="Complete the form to get more information about Empower Pharmacy" data-fields-patient="first*,last,email*,phone,state*" data-message-provider="Thank you message for provider form." data-message-repcontact="Thank you! A sales rep will be in contact." data-link-provider="https://webdev.empowerpharmacy.com/who-we-serve/practitioners/" data-linkname-provider="Provider Link" data-copy-provider="Download our guide for your patients to go beyond GLP-1s" data-fields-provider="first*,last*,email,phone*,title,company,state*,questions*" data-phone-format="1 (999) 999-9999"> </div> --> <!-- EXAMPLE - PROVIDER ONLY -------> <!--<div id="SF_embedForm" data-form="provider" data-campaign-provider="2024 GHK-Cu Launch" data-repcontact-provider="yes" data-message-repcontact="Thank you! A sales rep will be in contact." data-link-provider="https://webdev.empowerpharmacy.com/who-we-serve/practitioners/" data-linkname-provider="Provider Link" data-copy-provider=" " data-fields-provider="first,LAST,Email,PHONE,TITLE,cOmpany, state" data-phone-format="1 (999) 999-9999"> </div> --> <!------ EXAMPLE - PATIENT ONLY -------- <div id="SF_embedForm" data-form="patient" data-campaign-patient="2024 Cross-Sell GLP1s Patients" data-message-patient="Thank you message for patient form." data-link-patient="https://webdev.empowerpharmacy.com/who-we-serve/patients/" data-linkname-patient="Patient Link" data-copy-patient="Complete the form to get more information about Empower Pharmacy" data-fields-patient="first,last,Email,PHONE,state" data-phone-format="1 (999) 999-9999"> </div> <!------ EXAMPLE - BOTH FORMS WITH ASK PROMPT --------> <div id="SF_embedForm" data-form="ask" data-copy-ask="Let us know who you are" data-campaign-provider="2025 503A Cardiovascular Health - Providers" data-campaign-patient="2025 503A Cardiovascular Health - Patients" data-repcontact-provider="ask" data-message-patient="Thank you! We're excited about your interest in Empower Pharmacy. We're proud to compound medications that are tailored to patients' specific needs. Talk to your provider about prescribing with us, we look forward to serving you." data-link-patient="https://webdev.empowerpharmacy.com/who-we-serve/patients/getting-started/" data-linkname-patient="Take the next step in your health journey" data-copy-patient="Complete the form to get more information about Empower Pharmacy" data-fields-patient="first*,last*,email*,phone*,state*" data-message-provider="Thank you! Click below to view our Cardiovasular Infographic. We look forward to partnering with you in the future." data-message-repcontact="Thank you! Click below to view our Cardiovasular Infographic. Our team will be in touch shortly to discuss your clinic's needs." data-link-provider="http://go.empowerpharmacy.com/empower-every-heart-infographic" data-linkname-provider="View Cardiovasular Infographic" data-copy-provider="" data-fields-provider="first*,last*,email*,phone*,title*,company*,state*,questions" data-phone-format="1 (999) 999-9999"> </div>