healthchecks/templates/front/remove_check_modal.html

<div id="remove-check-modal" class="modal">
    <div class="modal-dialog">
        <form action="{% url 'hc-remove-check' check.code %}" method="post">
            {% csrf_token %}
            <div class="modal-content">
                <div class="modal-header">
                    <button type="button" class="close" data-dismiss="modal">&times;</button>
                    <h4>Remove Check <span class="remove-check-name">{{ check.name_then_code }}</span></h4>
                </div>
                <div class="modal-body">
                    <p>You are about to remove check
                        <strong class="remove-check-name">{{ check.name_then_code }}</strong>.
                    </p>
                    <p>Once it's gone there is no "undo" and you cannot get
                    the old ping URL back.</p>
                    <p>Are you sure?</p>
                </div>
                <div class="modal-footer">
                    <button type="button" class="btn btn-default" data-dismiss="modal">Cancel</button>
                    <button type="submit" class="btn btn-danger">Remove</button>
                </div>
            </div>
        </form>
    </div>
</div>