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

Response: Server error

Our website provider is having
trouble loading this page

They're working on resolving the issue. Thank you for your patience.

In the meantime, you can refresh this page or go back to the previous page.

REQUEST ID: 51bf0df34a50df10 IP ADDRESS: 50.62.176.123

Gateway time-out

The web server reported a gateway time-out error.


Info: url:"https:\/\/forms.hubspot.com\/uploads\/form\/v2\/133275\/140a63df-8007-46f5-9d5c-041b522deb83"; content_type:"text\/html; charset=UTF-8"; http_code:504; header_size:773; request_size:311; filetime:-1; ssl_verify_result:0; redirect_count:0; total_time:5.09784; namelookup_time:0.004199; connect_time:0.005085; pretransfer_time:0.021396; size_upload:893; size_download:9063; speed_download:1778; speed_upload:175; download_content_length:9063; upload_content_length:893; starttransfer_time:0.021462; redirect_time:0; redirect_url:""; primary_ip:"104.16.253.5"; certinfo:[]; primary_port:443; local_ip:"50.62.176.123"; local_port:15747;
Status Code:504
CURL Error:
DATA:degree=Paramedic+to+RN&please_select_your_license_=Paramedic&firstname=starlit&lastname=whitley&phone=8282288375&email=swhitley15%40yahoo.com&how_did_you_find_us_=Search+Engine&state=NC&zip=28601&lead_status=New+Lead&lifecyclestage=lead&hs_context=%7B%22hutk%22%3A%22293637c1702300739dee5cc16e773825%22%2C%22ipAddress%22%3A%2274.254.113.126%22%2C%22pageUrl%22%3A%22https%3A%5C%2F%5C%2Fwww.achievetestprep.com%5C%2Frequest-more-information-RN-bridge-program%3F__hssc%3D107512029.2.1569435245967%26__hstc%3D107512029.293637c1702300739dee5cc16e773825.1569435245966.1569435245966.1569435245966.1%26__hsfp%3D1297386985%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=Paramedic+to+RN%2FBSN
74.254.113.126
Conover, North Carolina 28613
Form Title: Nursing Request Information
File Name: NursingRequestInformation.php
Session ID: gt9kt6sc6bbnskll4v0sbrjv32
Form ID: b2ddc35b1f271eee4f204f6b51cc06f1
Key: eyJBIjoiOG42ZDRlIiwiQiI6ImF0YzBuczMiLCJDIjoiOGx1MHN3IiwiRCI6IjFkbW44N3YiLCJFIjoibHlkYjNmIiwiRiI6Im1wMXA4MSJ9
Mozilla/5.0 (Windows NT 6.1; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/77.0.3865.90 Safari/537.36
PHP_SELF: /forms/Views/NursingRequestInformation.php
SERVER_ADDR: 23.229.210.163
SERVER_NAME: www2.achievetestprep.com
SERVER_SOFTWARE: Apache
SERVER_PROTOCOL: HTTP/2.0
REQUEST_METHOD: POST
REQUEST_TIME: 1569436070
REQUEST_TIME_FLOAT: 1569436070.389
DOCUMENT_ROOT: /home/atphosting/public_html/achievetestprep.com
HTTP_ACCEPT: */*
HTTP_ACCEPT_ENCODING: gzip, deflate, br
HTTP_ACCEPT_LANGUAGE: en-US,en;q=0.9
HTTP_HOST: www2.achievetestprep.com
HTTP_REFERER: https://www2.achievetestprep.com/forms/Views/NursingRequestInformation.php?current_url=https%3A%2F%2Fwww.achievetestprep.com%2Frequest-more-information-RN-bridge-program%3F__hssc%3D107512029.2.1569435245967%26__hstc%3D107512029.293637c1702300739dee5cc16e773825.1569435245966.1569435245966.1569435245966.1%26__hsfp%3D1297386985%26hsCtaTracking%3D08767bb8-04cf-4f53-be09-762bb9949714%257C665f1fef-ab44-4e00-b107-f9e49bc01929&page_title=Request%20More%20Information%20%7C%20RN%20Bridge%20Program%20%7C%20Achieve%20Test%20Prep&page_id=7715426260&__hssc=107512029.2.1569435245967&__hstc=107512029.293637c1702300739dee5cc16e773825.1569435245966.1569435245966.1569435245966.1&__hsfp=1297386985&hsCtaTracking=08767bb8-04cf-4f53-be09-762bb9949714%7C665f1fef-ab44-4e00-b107-f9e49bc01929
HTTP_USER_AGENT: Mozilla/5.0 (Windows NT 6.1; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/77.0.3865.90 Safari/537.36
HTTPS: on
REMOTE_ADDR: 74.254.113.126
REMOTE_PORT: 14045
SCRIPT_FILENAME: /home/atphosting/public_html/achievetestprep.com/forms/Views/NursingRequestInformation.php
SERVER_ADMIN: webmaster@www2.achievetestprep.com
SERVER_PORT: 443
SCRIPT_NAME: /forms/Views/NursingRequestInformation.php
REQUEST_URI: /forms/Views/NursingRequestInformation.php
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] => xif573 [value] => Paramedic to RN ) [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] => xif574 [value] => Paramedic ) [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] => xif575 [value] => starlit ) [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] => xif576 [value] => whitley ) [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] => xif577 [value] => 8282288375 ) [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] => xif578 [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] => xif579 [value] => swhitley15@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] => xif580 [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] => xif581 [value] => NC ) [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] => xif582 [value] => 28601 ) [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] => xif583 [value] => ) )