Error from Hubspot Form API Submission on Nursing Request Information Form (NursingRequestInformation.php)

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REQUEST ID: 50af463dac3bdf08 IP ADDRESS: 50.62.176.123

Gateway time-out

The web server reported a gateway time-out error.


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Status Code:504
CURL Error:
DATA:degree=Physician+Assistant&please_select_your_license_=LPN%2FLVN&firstname=Jason&lastname=Sanchez&phone=6613168316&email=Jassan661%40yahoo.com&how_did_you_find_us_=Search+Engine&state=CA&zip=93305&message=I+have+always+been+interested+in+becoming+a+Physician+Assistant.+I+have+been+in+the+heakth+field+for+over+12+years.+In+2007+I+graduated+as+a+Medical+Assistant+in+which+gained+experience+through+employment+with+clinical+laboratory%2C+phlebotomy%2C+wound+care+and+patient+education.+In+2011+I+graduated+as+an+LVN+with+experience+in+all+areas+of+the+job+duties.+Utilizing+my+skills+and+experiences+in+the+health+field%2C+I+also+became+a+Health+Science+instructor+creating+Medical+Assistants+out+of+high+school+seniors.+I+have+an+absolute+passion+for+providing+patient+care+and+knowledge+to+others.+It+has+always+been+my+personal+goal+to+become+a+Physician+Assistant+but+having+to+work+full+time+with+overtime+on+some+occassions+and+family+life+made+it+close+to+impossible+to+continue+my+studies+at+a+full+time+schedule+plus+the+cost+of+the+whole+course.+I+wish+to+learn+more+about+this+opportunity+of+achieving+my+lifes+goal+of+becoming+a+Physicians+Assistant.+Thank+you.%0D%0A%0D%0ASincerely%2C%0D%0AJason+Sanchez&lead_status=New+Lead&lifecyclestage=lead&hs_context=%7B%22hutk%22%3A%223584f2fe63e018be7bbf4aa90ae1e113%22%2C%22ipAddress%22%3A%22108.80.246.25%22%2C%22pageUrl%22%3A%22https%3A%5C%2F%5C%2Fwww.achievetestprep.com%5C%2Frequest-more-information-RN-bridge-program%3F__hssc%3D107512029.2.1566584603842%26__hstc%3D107512029.3584f2fe63e018be7bbf4aa90ae1e113.1566584603837.1566584603837.1566584603837.1%26__hsfp%3D1430299738%26hsCtaTracking%3D08767bb8-04cf-4f53-be09-762bb9949714%257C665f1fef-ab44-4e00-b107-f9e49bc01929%22%2C%22pageName%22%3A%22Request+More+Information+%7C+RN+Bridge+Program+%7C+Achieve+Test+Prep%22%2C%22pageId%22%3A%227715426260%22%7D&general_program_of_interest=Physician+Assistant
108.80.246.25
Tulare, California 93274
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Array ( [degree] => Array ( [label] => Degree of Interest: [column] => 1 [required] => 1 [req_dependant] => None [type] => select [options] => Array ( [LPN/LVN to ASN Bridge (RN)] => LPN/LVN to ASN Bridge (RN) [LPN to BSN Bridge (RN)] => LPN to BSN Bridge (RN) [LPN to Nurse Practitioner] => LPN to Nurse Practitioner [RN or BSN Bridge] => RN or BSN Bridge [RN to BSN] => RN to BSN [Paramedic to RN] => Paramedic to RN [Paramedic to BSN (flight nurse)] => Paramedic to BSN (flight nurse) [EMT to RN] => EMT to RN [Respiratory Therapist to RN] => Respiratory Therapist to RN [Fire & Emergency Management] => Fire & Emergency Management [Fire Science] => Fire Science [Physician Assistant] => Physician Assistant [Respiratory Therapy] => Respiratory Therapy [Nursing - Full RN Program (not an LPN/LVN)] => Nursing - General Degree [Nursing - CNA to RN] => CNA to RN [Nursing - Medical Assistant to RN] => Medical Asst to RN [Healthcare Administration] => Healthcare Administration [Healthcare Management] => Healthcare Management [Other] => Other ) [sf_lead_field] => Initial_Program_of_Interest__c [sf_instructor_field] => [hs_field] => degree [note] => [valid] => 1 [post] => ugl262 [value] => Physician Assistant ) [license] => Array ( [label] => Please select your license. [column] => 1 [required] => 1 [req_dependant] => None [type] => select [options] => Array ( [CNA/CMA] => CNA/CMA [EMT] => EMT [LPN/LVN] => LPN/LVN [Paramedic] => Paramedic [Physician's Assistant] => Physician's Assistant [RN] => RN [Respiratory Therapist] => RT [None of the above] => None ) [sf_lead_field] => License__c [sf_instructor_field] => License__c [hs_field] => please_select_your_license_ [note] => [valid] => 1 [post] => ugl263 [value] => LPN/LVN ) [fname] => Array ( [label] => First Name: [column] => 1 [required] => 1 [req_dependant] => None [type] => text [size] => 25 [sf_lead_field] => First_Name__c [hs_field] => firstname [valid] => 1 [post] => ugl264 [value] => Jason ) [lname] => Array ( [label] => Last Name: [column] => 1 [required] => 1 [req_dependant] => None [type] => text [size] => 25 [sf_lead_field] => Name [hs_field] => lastname [valid] => 1 [post] => ugl265 [value] => Sanchez ) [phone] => Array ( [label] => Phone: [column] => 1 [required] => 1 [req_dependant] => none [type] => phone [size] => 25 [sf_lead_field] => Mobile_Primary__c [hs_field] => phone [note] => [valid] => 1 [post] => ugl266 [value] => 6613168316 ) [aphone] => Array ( [label] => Alternate Phone: [column] => 1 [required] => [req_dependant] => none [type] => phone [size] => 25 [sf_lead_field] => Home_Phone__c [hs_field] => alternate_phone_ [note] => [valid] => 1 [post] => ugl267 [value] => ) [email] => Array ( [label] => Email: [column] => 1 [required] => 1 [req_dependant] => None [type] => email [size] => 25 [sf_lead_field] => Email__c [hs_field] => email [valid] => 1 [post] => ugl268 [value] => Jassan661@yahoo.com ) [find] => Array ( [label] => How did you find us? [column] => 1 [required] => 1 [req_dependant] => None [type] => select [options] => Array ( [Advanced Career Fair] => Advanced Career Fair [Blog/Forum] => Blog/Forum [Email] => Email [Facebook] => Facebook [LinkedIn] => LinkedIn [Online Job Board] => Other Online Job Board [Received postcard in the mail] => Postcard [Received letter in the mail (not postcard)] => Letter - in mail [Referred by Achieve Student] => Referral - Student [Referred by Someone at Work] => Referral - Nursing Home/Work [Referred by Other] => Referral - Unknown person [Search Engine] => Search Engine [Other] => Other/Unknown ) [sf_lead_field] => Lead_Source__c [sf_instructor_field] => [hs_field] => how_did_you_find_us_ [note] => [valid] => 1 [post] => ugl269 [value] => Search Engine ) [state] => Array ( [label] => State/Province [column] => 1 [required] => 1 [req_dependant] => None [type] => select [sf_lead_field] => State__c [hs_field] => state [options] => Array ( [Alabama] => AL [Alaska] => AK [Arizona] => AZ [Arkansas] => AR [California] => CA [Colorado] => CO [Connecticut] => CT [Delaware] => DE [District of Columbia] => DC [Florida] => FL [Georgia] => GA [Hawaii] => HI [Idaho] => ID [Illinois] => IL [Indiana] => IN [Iowa] => IA [Kansas] => KS [Kentucky] => KY [Louisiana] => LA [Maine] => ME [Maryland] => MD [Massachusetts] => MA [Michigan] => MI [Minnesota] => MN [Mississippi] => MS [Missouri] => MO [Montana] => MT [Nebraska] => NE [Nevada] => NV [New Hampshire] => NH [New Jersey] => NJ [New Mexico] => NM [New York] => NY [North Carolina] => NC [North Dakota] => ND [Ohio] => OH [Oklahoma] => OK [Oregon] => OR [Pennsylvania] => PA [Rhode Island] => RI [South Carolina] => SC [South Dakota] => SD [Tennessee] => TN [Texas] => TX [Utah] => UT [Vermont] => VT [Virginia] => VA [Washington] => WA [West Virginia] => WV [Wisconsin] => WI [Wyoming] => WY ) [valid] => 1 [post] => ugl270 [value] => CA ) [zip] => Array ( [label] => Zip Code [column] => 1 [required] => 1 [req_dependant] => None [type] => zip [sf_lead_field] => Zip_Code__c [hs_field] => zip [valid] => 1 [post] => ugl271 [value] => 93305 ) [comments] => Array ( [label] => Comments or questions: [column] => [required] => [req_dependant] => None [type] => textarea [sf_lead_field] => Web_Form_Comments__c [hs_field] => message [note] => [valid] => 1 [post] => ugl272 [value] => I have always been interested in becoming a Physician Assistant. I have been in the heakth field for over 12 years. In 2007 I graduated as a Medical Assistant in which gained experience through employment with clinical laboratory, phlebotomy, wound care and patient education. In 2011 I graduated as an LVN with experience in all areas of the job duties. Utilizing my skills and experiences in the health field, I also became a Health Science instructor creating Medical Assistants out of high school seniors. I have an absolute passion for providing patient care and knowledge to others. It has always been my personal goal to become a Physician Assistant but having to work full time with overtime on some occassions and family life made it close to impossible to continue my studies at a full time schedule plus the cost of the whole course. I wish to learn more about this opportunity of achieving my lifes goal of becoming a Physicians Assistant. Thank you. Sincerely, Jason Sanchez ) )