:root
{
    /* Brand colors: update these first when matching a client website. */
    --patient-brand: #0d4ba0;
    --patient-brand-dark: #081031;
    --patient-brand-heading: #081031;
    --patient-brand-section-heading: #0d4ba0;
    --patient-brand-section-accent: #1678be;
    --patient-brand-soft: #eaf7fc;
    --patient-brand-soft-hover: #f3fbfe;
    --patient-brand-soft-section: #eaf7fc;

    /* Text colors. */
    --patient-text: #081031;
    --patient-text-input: #14204b;
    --patient-text-muted: #6c6b82;
    --patient-text-subtle: #6c6b82;
    --patient-text-eyebrow: #0d4ba0;
    --patient-text-link-hover: #1678be;
    --patient-text-on-brand: #fff;

    /* Surfaces and borders. */
    --patient-surface: #fff;
    --patient-surface-muted: #f2f9ff;
    --patient-border: #b8e7f7;
    --patient-border-control: #b8e7f7;
    --patient-border-control-hover: #1678be;
    --patient-border-link: #b8e7f7;
    --patient-border-link-hover: #26a9e1;
    --patient-border-section: #b8e7f7;
    --patient-link-arrow: #1678be;

    /* Validation and interaction colors. */
    --patient-required: #b53d3d;
    --patient-required-text: #6f5656;
    --patient-focus-ring: rgba(46, 113, 128, .16);

    /* Shadows and image overlay. */
    --patient-shadow: rgba(32, 64, 74, .08);
    --patient-shadow-hover: rgba(32, 64, 74, .1);
    --patient-shadow-button: rgba(32, 64, 74, .2);
    --patient-image-overlay: rgba(20, 66, 77, .08);

    /* Paper-form callout colors. */
    --patient-paper-background: #fff9e9;
    --patient-paper-border: #e7d6a5;
    --patient-paper-icon-background: #f4e7bd;
    --patient-paper-icon: #745f26;
    --patient-paper-heading: #5f4d20;
    --patient-paper-text: #715f33;
}

.title
{
        font-size:x-large;
        text-align:center;
        padding-bottom:15px;
}  
.subtitle
{
        font-size:large;
        text-align:center;
      
}  
    .Table
    {
        margin:0 auto;
        display:inline-block;
        text-align:center;
    }
	
    .Table, .Table *
    {
		-webkit-box-sizing: content-box !important; 
		 box-sizing: content-box !important;
    }
	

    .Row
    {
        display:table-row;
        margin:0 auto;
        text-align:center;
    }
    .RowGray
    {
        background-color:#ccc;
        display:table-row;
        margin:0 auto;
        text-align:center;
    }
    .Cell
    {
        display:block;

        margin:0 auto;

        text-align:left;
        padding-left: 10px;
        padding-right: 15px;
        padding-top:2px;
        padding-bottom:2px;
        float:left; 
        box-sizing: border-box; 
        width:250px;
    }
    .Cell input, .Cell select
    {
        width:100%;    
        background-color:#F2F2F2;
        border-radius:5px;		
		height: 40px;
		color: #000;
           
    }
    .requiredinput
    {
        border-right-color:#FF0000;    
        border-right-style:solid;
		box-sizing: border-box;
    }
    .requiredselect
    {
        border-right-color:#FF0000;    
        border-right-style:solid;
        border-right-width:2px;
		box-sizing: border-box;

    }

    .InsuranceCell
    {
        display:block;

        margin:0 auto;

        text-align:left;
        padding-left: 10px;
        padding-right: 15px;
        padding-top:2px;
        padding-bottom:2px;
        float:left; 
        box-sizing: border-box; 
        width:100%;
		max-width:500px;
    }

    .InsuranceCell input, .InsuranceCell select
    {
        width:100%;    
        background-color:#F2F2F2;
        border-radius:5px;         
		height: 40px;
		color: #000;           
    }
    .InsuranceSubmitButton
    {
        font-weight:bold;
        max-width:250px;    
    }
    .DilationCell
    {
        display:block;

        margin:0 auto;

        text-align:left;
        padding-left: 10px;
        padding-right: 15px;
        padding-top:2px;
        padding-bottom:2px;
        float:left; 
        box-sizing: border-box; 
        width:100%;
		max-width:500px;
    }
    .DilationCell input, .DilationCell select
    {
        width:100%;    
        background-color:#F2F2F2;
        border-radius:5px;         
		height: 40px;
		color: #000;  
    }
    .DilationSubmitButton
    {
        font-weight:bold;
        max-width:275px;    
    }
    
    .HealthHistoryCell
    {
        display:block;

        margin:0 auto;

        text-align:left;
        padding-left: 10px;
        padding-right: 15px;
        padding-top:2px;
        padding-bottom:2px;
        float:left; 
        box-sizing: border-box; 
        max-width:500px;
        width:100%;
    }
    .HealthHistoryCell input, .HealthHistoryCell select, .HealthHistoryCell textarea
    {
        width:100%;    
        background-color:#F2F2F2;
        border-radius:5px;           
    }
    .HealthHistorySubmitButton
    {
        font-weight:bold;
        max-width:275px;    
    }

    .HealthHistory3Cells
    {
        display:block;

        margin:0 auto;

        text-align:left;
        padding-left: 0px;
        padding-right: 15px;
        padding-top:2px;
        padding-bottom:2px;
        float:left; 
        box-sizing: border-box; 
        width:145px;
    }
    .HealthHistory2Cells
    {
        display:block;

        margin:0 auto;

        text-align:left;
        padding-left: 0px;
        padding-right: 15px;
        padding-top:2px;
        padding-bottom:2px;
        float:left; 
        box-sizing: border-box; 
        width:230px;
    }     

    .FinancialPolicyCell
    {
        display:block;

        margin:0 auto;

        text-align:left;
        padding-left: 10px;
        padding-right: 15px;
        padding-top:2px;
        padding-bottom:2px;
        float:left; 
        box-sizing: border-box; 
        width:100%;
		max-width:500px;
    }
    .FinancialPolicyCell input, .FinancialPolicyCell select
    {
        width:100%;    
        background-color:#F2F2F2;
        border-radius:5px;           
    }
    .FinancialPolicyIRPCell 
    {
        display:block;

        margin:0 auto;

        text-align:left;
        padding-left: 0px;
        padding-right: 10px;
        padding-top:2px;
        padding-bottom:2px;
        float:left; 
        box-sizing: border-box;  
    }
    .FinancialPolicyIRPCell input, .FinancialPolicyIRPCell select
    {
        width:50px;    
        background-color:#F2F2F2;
        border-radius:5px;           
    }

    .FinancialPolicySubmitButton
    {
        font-weight:bold;
        max-width:275px;    
    }

/*AuthorizationDisclose begin*/
    .AuthorizationDiscloseCell
    {
        display:block;

        margin:0 auto;

        text-align:left;
        padding-left: 10px;
        padding-right: 15px;
        padding-top:2px;
        padding-bottom:2px;
        float:left; 
        box-sizing: border-box; 
        width:100%;
		max-width:500px;
    }
    .AuthorizationDiscloseCell input, .AuthorizationDiscloseCell select
    {
        width:100%;    
        background-color:#F2F2F2;
        border-radius:5px;           
    }
    .AuthorizationDiscloseIRPCell 
    {
        display:block;

        margin:0 auto;

        text-align:left;
        padding-left: 0px;
        padding-right: 0px;
        padding-top:2px;
        padding-bottom:2px;
        float:left; 
        box-sizing: border-box; 
        width:210px;  
    }
    .AuthorizationDiscloseIRPCell input, .AuthorizationDiscloseIRPCell select
    {
        width:50px;    
        background-color:#F2F2F2;
        border-radius:5px;           
    }

    .AuthorizationDiscloseSubmitButton
    {
        font-weight:bold;
        max-width:275px;    
    }
/*AuthorizationDisclose End*/

/*AcknowledgementPrivacy Begin*/
    .AcknowledgementPrivacyCell
    {
        display:block;

        margin:0 auto;

        text-align:left;
        padding-left: 10px;
        padding-right: 15px;
        padding-top:2px;
        padding-bottom:2px;
        float:left; 
        box-sizing: border-box; 
        width:100%;
		max-width:500px;
    }
    .AcknowledgementPrivacyCell input, .AcknowledgementPrivacyCell select
    {
        width:100%;    
        background-color:#F2F2F2;
        border-radius:5px;           
    }
    .AcknowledgementPrivacyIRPCell 
    {
        display:block;

        margin:0 auto;

        text-align:left;
        padding-left: 0px;
        padding-right: 0px;
        padding-top:2px;
        padding-bottom:2px;
        float:left; 
        box-sizing: border-box; 
        width:210px;  
    }
    .AcknowledgementPrivacyIRPCell input, .AcknowledgementPrivacyIRPCell select
    {
        width:50px;    
        background-color:#F2F2F2;
        border-radius:5px;           
    }

    .AcknowledgementPrivacySubmitButton
    {
        font-weight:bold;
        max-width:275px;    
    }
/*AcknowledgementPrivacy legend*/

/*ConsentTreatMinor Begin*/
    .ConsentTreatMinorCell
    {
        display:block;

        margin:0 auto;

        text-align:left;
        padding-left: 10px;
        padding-right: 15px;
        padding-top:2px;
        padding-bottom:2px;
        float:left; 
        box-sizing: border-box; 
        width:100%;
		max-width:500px;
    }
    .ConsentTreatMinorCell input, .ConsentTreatMinorCell select
    {
        width:100%;    
        background-color:#F2F2F2;
        border-radius:5px;           
    }
    .ConsentTreatMinorIRPCell 
    {
        display:block;

        margin:0 auto;

        text-align:left;
        padding-left: 0px;
        padding-right: 0px;
        padding-top:2px;
        padding-bottom:2px;
        float:left; 
        box-sizing: border-box; 
        width:210px;  
    }
    .ConsentTreatMinorIRPCell input, .ConsentTreatMinorIRPCell select
    {
        width:50px;    
        background-color:#F2F2F2;
        border-radius:5px;           
    }

    .ConsentTreatMinorSubmitButton
    {
        font-weight:bold;
        max-width:275px;    
    }
/*ConsentTreatMinor End*/

   .checkbox input
    {    
       width:25px;
    }
    .smalltextbox
    {    
       width:45px;
    }

.PatientFormsMenu
{
    width:90%;
    max-width:1050px;
    margin:0 auto;
    padding:24px;
    border:1px solid var(--patient-border);
    border-radius:16px;
    background:var(--patient-surface-muted);
    box-shadow:0 8px 24px var(--patient-shadow);
    box-sizing:border-box;
    text-align:left;
	display: block;
}

.PatientFormsMenuHeader
{
    margin-bottom:18px;
}

.PatientFormsMenuEyebrow
{
    display:block;
    margin-bottom:4px;
    color:var(--patient-text-eyebrow);
    font-size:12px;
    font-weight:bold;
    letter-spacing:1.5px;
    text-transform:uppercase;
}

.PatientFormsMenuTitle
{
    display:block;
    color:var(--patient-brand-heading);
    font-size:24px;
    font-weight:bold;
    line-height:1.25;
}

.PatientFormsMenuToggleControl,
.PatientFormsMenuToggle
{
    display:none;
}

.PatientFormsMenuLinks
{
    display:grid;
    grid-template-columns:repeat(auto-fit, minmax(210px, 1fr));
    gap:10px;
}

.PatientFormsMenuLinks .NoneActiveFormLink,
.PatientFormsMenuLinks .ActiveFormLink
{
    position:relative;
    display:flex;
    align-items:center;
    min-height:50px;
    padding:10px 38px 10px 14px;
    border:1px solid var(--patient-border-link);
    border-radius:9px;
    background:var(--patient-surface);
    box-sizing:border-box;
    color:var(--patient-text);
    font-size:14px;
    font-weight:bold;
    line-height:1.3;
    text-decoration:none;
    transition:background-color .15s ease, border-color .15s ease, box-shadow .15s ease, color .15s ease;
}

.PatientFormsMenuLinks .NoneActiveFormLink:after,
.PatientFormsMenuLinks .ActiveFormLink:after
{
    position:absolute;
    right:14px;
    content:"\2192";
    color:var(--patient-link-arrow);
    font-size:18px;
    line-height:1;
}

.PatientFormsMenuLinks .NoneActiveFormLink:hover,
.PatientFormsMenuLinks .NoneActiveFormLink:focus
{
    border-color:var(--patient-border-link-hover);
    background:var(--patient-brand-soft-hover);
    box-shadow:0 3px 10px var(--patient-shadow-hover);
    color:var(--patient-text-link-hover);
    text-decoration:none;
}

.PatientFormsMenuLinks .ActiveFormLink,
.PatientFormsMenuLinks .ActiveFormLink:hover,
.PatientFormsMenuLinks .ActiveFormLink:focus
{
    border-color:var(--patient-brand);
    background:var(--patient-brand);
    color:var(--patient-text-on-brand);
    text-decoration:none;
}

.PatientFormsMenuLinks .ActiveFormLink:after
{
    color:var(--patient-text-on-brand);
    content:"\2713";
}

.PatientFormsLanding
{
    display:grid;
    grid-template-columns:minmax(260px, .9fr) minmax(360px, 1.1fr);
    width:90vw;
    max-width:1050px;
    margin:0 auto 70px;
    overflow:hidden;
    border:1px solid var(--patient-border);
    border-radius:16px;
    background:var(--patient-surface);
    box-shadow:0 8px 24px var(--patient-shadow);
    box-sizing:border-box;
    text-align:left;
}

.PatientFormsLandingImage
{
    min-height:440px;
    background-image:linear-gradient(var(--patient-image-overlay), var(--patient-image-overlay)), url("/patientforms/forms.jpg");
    background-position:center;
    background-size:cover;
}

.PatientFormsLandingContent
{
    padding:42px;
    box-sizing:border-box;
}

.PatientFormsLandingEyebrow
{
    display:block;
    margin-bottom:8px;
    color:var(--patient-text-eyebrow);
    font-size:12px;
    font-weight:bold;
    letter-spacing:1.5px;
    text-transform:uppercase;
}

.PatientFormsLanding h1
{
    margin:0 0 14px;
    color:var(--patient-brand-heading);
    font-size:30px;
    line-height:1.2;
}

.PatientFormsLandingContent > p
{
    margin:0 0 28px;
    color:var(--patient-text-muted);
    font-size:16px;
    line-height:1.6;
}

.PatientFormsLandingSteps
{
    display:grid;
    gap:12px;
    margin-bottom:28px;
}

.PatientFormsLandingStep
{
    display:flex;
    align-items:center;
    gap:12px;
}

.PatientFormsLandingStep > span
{
    display:flex;
    align-items:center;
    justify-content:center;
    flex:0 0 32px;
    width:32px;
    height:32px;
    border-radius:50%;
    background:var(--patient-brand-soft);
    color:var(--patient-brand);
    font-size:14px;
    font-weight:bold;
}

.PatientFormsLandingStep strong,
.PatientFormsLandingStep small
{
    display:block;
}

.PatientFormsLandingStep strong
{
    margin-bottom:2px;
    color:var(--patient-text);
    font-size:14px;
}

.PatientFormsLandingStep small
{
    color:var(--patient-text-subtle);
    font-size:13px;
    line-height:1.4;
}

.PatientFormsPaperCallout
{
    display:flex;
    gap:14px;
    padding:18px;
    border:1px solid var(--patient-paper-border);
    border-radius:10px;
    background:var(--patient-paper-background);
    box-sizing:border-box;
}

.PatientFormsPaperIcon
{
    display:flex;
    align-items:center;
    justify-content:center;
    flex:0 0 38px;
    width:38px;
    height:38px;
    border-radius:8px;
    background:var(--patient-paper-icon-background);
    color:var(--patient-paper-icon);
    font-size:22px;
}

.PatientFormsPaperCallout strong
{
    display:block;
    margin-bottom:4px;
    color:var(--patient-paper-heading);
    font-size:15px;
}

.PatientFormsPaperCallout p
{
    margin:0;
    color:var(--patient-paper-text);
    font-size:13px;
    line-height:1.5;
}

.PatientFormPage
{
    width:90vw;
    max-width:820px;
    margin:0 auto 70px;
    text-align:left;
}

.PatientForm
{
    overflow:hidden;
    border:1px solid var(--patient-border);
    border-radius:16px;
    background:var(--patient-surface);
    box-shadow:0 8px 24px var(--patient-shadow);
	padding: 0px;
}

.PatientFormHeader
{
    padding:32px 36px 26px;
    border-bottom:1px solid var(--patient-border);
    background:var(--patient-surface-muted);
}

.PatientFormEyebrow
{
    display:block;
    margin-bottom:6px;
    color:var(--patient-text-eyebrow);
    font-size:12px;
    font-weight:bold;
    letter-spacing:1.5px;
    text-transform:uppercase;
}

.PatientFormHeader h1
{
    margin:0 0 8px;
    color:var(--patient-brand-heading);
    font-size:30px;
    line-height:1.2;
}

.PatientFormHeader p
{
    max-width:620px;
    margin:0;
    color:var(--patient-text-muted);
    font-size:14px;
    line-height:1.55;
}

.PatientFormRequiredLegend
{
    display:block;
    margin-top:14px;
    color:var(--patient-required-text);
    font-size:12px;
    font-weight:bold;
}

.PatientFormRequiredLegend span
{
    color:var(--patient-required);
}

.PatientForm .PatientFormGrid
{
    display:grid;
    width:auto;
    margin:0;
    padding:30px 36px 12px;
    text-align:left;
}

.PatientFormSectionHeader
{
    position:relative;
    margin:10px 0 20px;
    padding:5px 16px 5px 20px;
    border:1px solid var(--patient-border-section);
    border-radius:9px;
    background:var(--patient-brand-soft-section);
    box-shadow:inset 4px 0 0 var(--patient-brand-section-accent);
    box-sizing:border-box;
}

.PatientFormSectionHeader:first-child
{
    margin-top:0;
}

.PatientFormSectionHeader h2
{
    margin:0 0 3px;
    color:var(--patient-brand-section-heading);
    font-size:19px;
    line-height:1.3;
}

.PatientFormSectionHeader p
{
    margin:0;
    color:var(--patient-text-subtle);
    font-size:13px;
    line-height:1.45;
}

.PatientForm .PatientFormGrid > .Row
{
    display:grid;
    grid-template-columns:repeat(2, minmax(0, 1fr));
    gap:18px 22px;
    width:100%;
    margin-bottom:18px;
    text-align:left;
}

.PatientFormPageWide
{
    max-width:1000px;
}

.PatientForm .PatientFormGrid > .PatientFormSection
{
    display:grid;
}

.PatientForm .PatientFormGrid > .PatientFormSection > .Row
{
    display:grid;
    grid-template-columns:repeat(2, minmax(0, 1fr));
    gap:18px 22px;
    width:100%;
    margin-bottom:18px;
    text-align:left;
}

.PatientForm .PatientFormGrid > .PatientFormSection > .Row > .Cell
{
    float:none;
    width:auto;
    margin:0;
    padding:0;
    text-align:left;
}

.PatientForm .PatientFormGrid > .PatientFormSection > .Row > .Cell > div:first-child
{
    margin-bottom:6px;
    color:var(--patient-text);
    font-size:16px;
    font-weight:bold;
    line-height:1.35;
}

.PatientForm .PatientFormGrid > .PatientFormSection > .Row > .Cell:has(.requiredinput) > div:first-child:after,
.PatientForm .PatientFormGrid > .PatientFormSection > .Row > .Cell:has(.requiredselect) > div:first-child:after
{
    margin-left:3px;
    content:"*";
    color:var(--patient-required);
}

.PatientForm .PatientFormGrid > .Row > .PatientFormFieldFull
{
    grid-column:1 / -1;
}

.PatientForm .PatientFormGrid > .PatientFormSection > .Row > .PatientFormFieldFull
{
    grid-column:1 / -1;
}

.PatientForm .PatientFormGrid > .Row > .Cell
{
    float:none;
    width:auto;
    margin:0;
    padding:0;
    text-align:left;
}

.PatientForm .PatientFormGrid > .Row > .Cell > div:first-child
{
    margin-bottom:6px;
    color:var(--patient-text);
    font-size:16px;
    font-weight:bold;
    line-height:1.35;
}

.PatientForm .PatientFormGrid > .Row > .Cell:has(.requiredinput) > div:first-child:after,
.PatientForm .PatientFormGrid > .Row > .Cell:has(.requiredselect) > div:first-child:after
{
    margin-left:3px;
    content:"*";
    color:var(--patient-required);
}

.PatientForm .PatientFormGrid input[type="text"],
.PatientForm .PatientFormGrid input[type="email"],
.PatientForm .PatientFormGrid input[type="tel"],
.PatientForm .PatientFormGrid select,
.PatientForm .PatientFormGrid textarea
{
    width:100%;
    height:46px;
    margin:0;
    padding:9px 11px;
    border:1px solid var(--patient-border-control);
    border-radius:7px;
    outline:none;
    background:var(--patient-surface);
    box-shadow:none;
    box-sizing:border-box !important;
    color:var(--patient-text-input);
    font-family:inherit;
    font-size:15px;
    transition:border-color .15s ease, box-shadow .15s ease;
}

.PatientForm .PatientFormGrid textarea
{
    min-height:110px;
    resize:vertical;
}

.PatientForm .PatientFormGrid input[type="text"]:hover,
.PatientForm .PatientFormGrid input[type="email"]:hover,
.PatientForm .PatientFormGrid input[type="tel"]:hover,
.PatientForm .PatientFormGrid select:hover,
.PatientForm .PatientFormGrid textarea:hover
{
    border-color:var(--patient-border-control-hover);
}

.PatientForm .PatientFormGrid input[type="text"]:focus,
.PatientForm .PatientFormGrid input[type="email"]:focus,
.PatientForm .PatientFormGrid input[type="tel"]:focus,
.PatientForm .PatientFormGrid select:focus,
.PatientForm .PatientFormGrid textarea:focus
{
    border-color:var(--patient-brand);
    box-shadow:0 0 0 3px var(--patient-focus-ring);
}

.PatientForm .PatientFormGrid .requiredinput,
.PatientForm .PatientFormGrid .requiredselect
{
    border-right:3px solid var(--patient-required);
}

.PatientForm .PatientFormGrid input[type="date"]
{
    display:block;
    width:100%;
    min-width:0;
    max-width:100%;
    inline-size:100%;
    min-inline-size:0;
    max-inline-size:100%;
    height:46px;
    margin:0;
    padding:9px 11px;
    border:1px solid var(--patient-border-control);
    border-right:3px solid var(--patient-required);
    border-radius:7px;
    outline:none;
    background:var(--patient-surface);
    box-shadow:none;
    box-sizing:border-box !important;
    color:var(--patient-text-input);
    color-scheme:light;
    cursor:pointer;
    font-family:inherit;
    font-size:15px;
    transition:border-color .15s ease, box-shadow .15s ease;
}

.PatientForm .PatientFormGrid input[type="date"]:hover
{
    border-color:var(--patient-border-control-hover);
    border-right-color:var(--patient-required);
}

.PatientForm .PatientFormGrid input[type="date"]:focus
{
    border-color:var(--patient-brand);
    border-right-color:var(--patient-required);
    box-shadow:0 0 0 3px var(--patient-focus-ring);
}

.PatientFormDateRange
{
    display:grid;
    grid-template-columns:repeat(2, minmax(0, 1fr));
    gap:18px 22px;
    min-width:0;
    max-width:100%;
}

.PatientFormDateRange > div
{
    min-width:0;
    max-width:100%;
}

.PatientFormDateRange span
{
    display:block;
    margin-bottom:6px;
    color:var(--patient-text-subtle);
    font-size:13px;
    font-weight:bold;
}

.PatientFormConsentCard
{
    margin:0 0 22px;
    overflow:hidden;
    border:1px solid var(--patient-border);
    border-radius:11px;
    background:var(--patient-surface);
    box-shadow:0 4px 14px var(--patient-shadow);
}

.PatientFormConsentContent
{
    padding:22px 22px 18px;
}

.PatientFormConsentEyebrow
{
    display:block;
    margin-bottom:5px;
    color:var(--patient-text-eyebrow);
    font-size:11px;
    font-weight:bold;
    letter-spacing:1.2px;
    text-transform:uppercase;
}

.PatientFormConsentContent h3
{
    margin:0 0 10px;
    color:var(--patient-brand-section-heading);
    font-size:21px;
    line-height:1.3;
}

.PatientFormConsentContent p,
.PatientFormConsentContent li
{
    color:var(--patient-text-muted);
    font-size:14px;
    line-height:1.55;
}

.PatientFormConsentContent p
{
    margin:0 0 12px;
}

.PatientFormConsentContent ol,
.PatientFormConsentContent ul
{
    margin:0 0 14px;
    padding-left:24px;
}

.PatientFormConsentContent li
{
    margin-bottom:5px;
}

.PatientFormNotice
{
    margin-bottom:0 !important;
    padding:12px 14px;
    border-left:4px solid var(--patient-brand-section-accent);
    border-radius:6px;
    background:var(--patient-brand-soft-section);
    color:var(--patient-text) !important;
}

.PatientFormConsentChoice
{
    float:none;
    width:auto;
    max-width:none;
    margin:0;
    padding:18px 22px 22px;
    border-top:1px solid var(--patient-border);
    background:var(--patient-surface-muted);
    box-sizing:border-box !important;
    text-align:left;
}

.PatientFormConsentChoice > div:first-child
{
    margin-bottom:6px;
    color:var(--patient-text);
    font-size:16px;
    font-weight:bold;
    line-height:1.35;
}

.PatientFormConsentChoice:has(.requiredinput) > div:first-child:after,
.PatientFormConsentChoice:has(.requiredselect) > div:first-child:after
{
    margin-left:3px;
    content:"*";
    color:var(--patient-required);
}

.PatientFormConsentChoice select
{
    width:100%;
    height:46px;
    margin:0;
    padding:9px 11px;
    border:1px solid var(--patient-border-control);
    border-right:3px solid var(--patient-required);
    border-radius:7px;
    outline:none;
    background:var(--patient-surface);
    box-shadow:none;
    box-sizing:border-box !important;
    color:var(--patient-text-input);
    font-family:inherit;
    font-size:15px;
    transition:border-color .15s ease, box-shadow .15s ease;
}

.PatientFormConsentChoice select:hover
{
    border-color:var(--patient-border-control-hover);
    border-right-color:var(--patient-required);
}

.PatientFormConsentChoice select:focus
{
    border-color:var(--patient-brand);
    border-right-color:var(--patient-required);
    box-shadow:0 0 0 3px var(--patient-focus-ring);
}

.PatientFormPolicyCard
{
    margin-bottom:22px;
}

.PatientFormPolicyInitials
{
    display:grid;
    grid-template-columns:minmax(0, 1fr) 120px;
    align-items:center;
    gap:18px;
    float:none;
    width:auto;
    margin:0;
    padding:16px 22px 18px;
    border-top:1px solid var(--patient-border);
    background:var(--patient-brand-soft-section);
    box-sizing:border-box !important;
    text-align:left;
}

.PatientFormPolicyInitials > div:first-child
{
    margin:0;
    color:var(--patient-text);
    font-size:15px;
    font-weight:bold;
    line-height:1.35;
}

.PatientFormPolicyInitials > div:first-child:after
{
    margin-left:3px;
    content:"*";
    color:var(--patient-required);
}

.PatientFormPolicyInitials input[type="text"]
{
    text-align:center;
}

.PatientFormPolicyCardTextOnly
{
    background:var(--patient-surface-muted);
}

.PatientFormOptional
{
    color:var(--patient-text-subtle);
    font-size:12px;
    font-weight:normal;
}

.PatientFormFieldHelp
{
    display:block;
    margin-top:6px;
    color:var(--patient-text-subtle);
    font-size:12px;
    line-height:1.45;
}

.PatientFormScreeningList
{
    display:grid;
    grid-template-columns:repeat(2, minmax(0, 1fr));
    gap:14px;
    margin-bottom:22px;
}

.PatientFormScreeningQuestion
{
    display:grid;
    grid-template-columns:minmax(0, 1fr) 110px;
    align-items:center;
    gap:14px;
    padding:14px 16px;
    border:1px solid var(--patient-border);
    border-radius:9px;
    background:var(--patient-surface-muted);
    box-sizing:border-box !important;
}

.PatientFormScreeningQuestion > div:first-child
{
    color:var(--patient-text);
    font-size:15px;
    font-weight:bold;
    line-height:1.4;
}

.PatientFormScreeningQuestion > div:first-child:after
{
    margin-left:3px;
    content:"*";
    color:var(--patient-required);
}

.PatientFormScreeningQuestionWide
{
    grid-column:1 / -1;
}

.PatientFormScreeningNotice
{
    margin:0 0 22px;
    padding:14px 16px;
    border-left:4px solid var(--patient-required);
    border-radius:7px;
    background:var(--patient-paper-background);
    color:var(--patient-paper-text);
    font-size:14px;
    line-height:1.55;
}

.PatientFormScreeningNotice strong
{
    display:block;
    color:var(--patient-paper-heading);
}

.PatientFormRefillNotice
{
    margin:0 0 22px;
    padding:14px 16px;
    border-left:4px solid var(--patient-brand-section-accent);
    border-radius:7px;
    background:var(--patient-brand-soft-section);
    color:var(--patient-text);
    font-size:14px;
    line-height:1.55;
}

.PatientFormSurveyList
{
    display:grid;
    gap:14px;
    margin-bottom:22px;
}

.PatientFormSurveyQuestion
{
    padding:16px 18px;
    border:1px solid var(--patient-border);
    border-radius:10px;
    background:var(--patient-surface-muted);
    box-sizing:border-box !important;
}

.PatientFormSurveyQuestionOptional
{
    background:var(--patient-surface);
}

.PatientFormSurveyQuestion h3
{
    margin:0 0 12px;
    color:var(--patient-text);
    font-size:16px;
    line-height:1.4;
}

.PatientFormSurveyQuestion:not(.PatientFormSurveyQuestionOptional) h3:after
{
    margin-left:3px;
    content:"*";
    color:var(--patient-required);
}

.PatientFormSurveyChoices
{
    width:100%;
    border-collapse:separate;
    border-spacing:6px 0;
}

.PatientFormSurveyChoices td
{
    width:25%;
    padding:0;
}

.PatientFormSurveyChoices input[type="radio"]
{
    position:absolute;
    opacity:0;
}

.PatientFormSurveyChoices label
{
    display:block;
    min-height:42px;
    padding:10px 8px;
    border:1px solid var(--patient-border-control);
    border-radius:7px;
    background:var(--patient-surface);
    box-sizing:border-box !important;
    color:var(--patient-text);
    cursor:pointer;
    font-size:13px;
    font-weight:bold;
    line-height:1.35;
    text-align:center;
}

.PatientFormSurveyChoices input[type="radio"]:checked + label
{
    border-color:var(--patient-brand);
    background:var(--patient-brand);
    color:var(--patient-text-on-brand);
}

.PatientFormSurveyChoices input[type="radio"]:focus + label
{
    border-color:var(--patient-brand);
    box-shadow:0 0 0 3px var(--patient-focus-ring);
}

.PatientFormSurveyYesNoList
{
    grid-template-columns:repeat(2, minmax(0, 1fr));
}

.PatientFormSurveyChoicesShort td
{
    width:50%;
}

.PatientFormMinorConsentCard
{
    background:var(--patient-surface-muted);
}

.PatientFormMinorConsentCard .PatientFormConsentContent
{
    padding:24px 24px 20px;
}

.PatientFormMinorConsentCard .PatientFormMinorConsentPending
{
    margin-top:14px;
    padding:12px 14px;
    border-left:4px solid var(--patient-brand-section-accent);
    border-radius:6px;
    background:var(--patient-brand-soft-section);
}

.PatientFormMinorConsentCard .PatientFormMinorConsentPending p
{
    margin:0;
    color:var(--patient-text);
}

.PatientFormMinorConsentCard:has([id$="divOfficeInfo"]) .PatientFormMinorConsentPending
{
    display:none;
}

.PatientFormPrivacyNoticeCard
{
    margin-bottom:22px;
}

.PatientFormDisclosureDetails
{
    display:grid;
    gap:16px;
}

.PatientFormDisclosureCard
{
    margin:0;
}

.PatientFormDisclosureAddress
{
    color:var(--patient-text-muted);
    font-size:14px;
    font-style:normal;
    line-height:1.65;
}

.PatientFormDisclosureFinePrint
{
    padding:12px 14px;
    border:1px solid var(--patient-border);
    border-radius:6px;
    background:var(--patient-surface-muted);
    font-size:13px !important;
}

.PatientFormDisclosurePending
{
    margin-bottom:22px;
    padding:14px 16px;
    border-left:4px solid var(--patient-brand-section-accent);
    border-radius:6px;
    background:var(--patient-brand-soft-section);
}

.PatientFormDisclosurePending p
{
    margin:0;
    color:var(--patient-text);
    font-size:14px;
    line-height:1.55;
}

.PatientFormGrid:has([id$="divOfficeInfo"]) > .PatientFormDisclosurePending
{
    display:none;
}

.PatientFormHealthHistory > .Row
{
    display:block !important;
}

.PatientFormHealthField
{
    float:none;
    width:100%;
    max-width:none;
    margin:0;
    padding:0;
    box-sizing:border-box !important;
    text-align:left;
}

.PatientFormHealthField > div:first-child,
.PatientFormHealthIntro
{
    margin-bottom:6px;
    color:var(--patient-text);
    font-size:16px;
    font-weight:bold;
    line-height:1.35;
}

.PatientFormHealthField:has(.requiredinput) > div:first-child:after,
.PatientFormHealthField:has(.requiredselect) > div:first-child:after
{
    margin-left:3px;
    content:"*";
    color:var(--patient-required);
}

.PatientFormHealthHistory .PatientFormHealthField input[type="text"],
.PatientFormHealthHistory .PatientFormHealthField input[type="date"],
.PatientFormHealthHistory .PatientFormHealthField select,
.PatientFormHealthHistory .PatientFormHealthField textarea
{
    width:100%;
    margin:0;
    padding:9px 11px;
    border:1px solid var(--patient-border-control);
    border-radius:7px;
    outline:none;
    background:var(--patient-surface);
    box-shadow:none;
    box-sizing:border-box !important;
    color:var(--patient-text-input);
    font-family:inherit;
    font-size:15px;
    transition:border-color .15s ease, box-shadow .15s ease;
}

.PatientFormHealthHistory .PatientFormHealthField input[type="text"],
.PatientFormHealthHistory .PatientFormHealthField input[type="date"],
.PatientFormHealthHistory .PatientFormHealthField select
{
    height:46px;
}

.PatientFormHealthHistory .PatientFormHealthField textarea
{
    min-height:115px;
    resize:vertical;
}

.PatientFormHealthHistory .PatientFormHealthField .requiredinput,
.PatientFormHealthHistory .PatientFormHealthField .requiredselect
{
    border-right:3px solid var(--patient-required);
}

.PatientFormHealthHistory .PatientFormHealthField input:hover,
.PatientFormHealthHistory .PatientFormHealthField select:hover,
.PatientFormHealthHistory .PatientFormHealthField textarea:hover
{
    border-color:var(--patient-border-control-hover);
}

.PatientFormHealthHistory .PatientFormHealthField input:focus,
.PatientFormHealthHistory .PatientFormHealthField select:focus,
.PatientFormHealthHistory .PatientFormHealthField textarea:focus
{
    border-color:var(--patient-brand);
    box-shadow:0 0 0 3px var(--patient-focus-ring);
}

.PatientFormHealthMatrix,
.PatientFormReviewSystems
{
    float:none;
    width:100%;
    max-width:none;
    margin:0;
    padding:0;
    box-sizing:border-box !important;
    text-align:left;
}

.PatientFormHealthMatrix > div:not(.PatientFormHealthIntro)
{
    margin-bottom:20px;
}

.PatientFormHealthMatrix .Table
{
    display:grid;
    width:100%;
    overflow:hidden;
    border:1px solid var(--patient-border);
    border-radius:10px;
    background:var(--patient-surface);
    box-sizing:border-box !important;
    text-align:left;
}

.PatientFormHealthMatrix .Table > .Row,
.PatientFormHealthMatrix .Table > .RowGray
{
    display:grid;
    grid-template-columns:minmax(190px, 1.4fr) minmax(150px, 1fr) minmax(180px, 1.2fr);
    align-items:center;
    margin:0;
    border-bottom:1px solid var(--patient-border);
    background:var(--patient-surface);
    text-align:left;
}

.PatientFormHealthMatrix .Table > .RowGray
{
    background:var(--patient-surface-muted);
}

.PatientFormHealthMatrix .Table > .Row:last-child,
.PatientFormHealthMatrix .Table > .RowGray:last-child
{
    border-bottom:0;
}

.PatientFormHealthMatrix .HealthHistory2Cells,
.PatientFormHealthMatrix .HealthHistory3Cells
{
    float:none;
    width:auto;
    max-width:none;
    margin:0;
    padding:11px 13px;
    box-sizing:border-box !important;
    color:var(--patient-text);
    text-align:left;
}

.PatientFormHealthMatrix .HealthHistory2Cells:first-child
{
    grid-column:span 2;
}

.PatientFormHealthMatrix .Table > .Row:first-child,
.PatientFormHealthMatrix .Table > .RowGray:first-child
{
    background:var(--patient-brand-soft-section);
}

.PatientFormHealthMatrix select,
.PatientFormHealthMatrix input[type="text"]
{
    width:100%;
    height:40px;
    padding:7px 9px;
    border:1px solid var(--patient-border-control);
    border-radius:6px;
    background:var(--patient-surface);
    box-sizing:border-box !important;
    color:var(--patient-text-input);
    font-size:14px;
}

.PatientFormHealthMatrix .requiredselect
{
    border-right:3px solid var(--patient-required);
}

.PatientFormReviewSystems > div:not(.PatientFormHealthIntro) > .Table
{
    display:grid;
    grid-template-columns:repeat(2, minmax(0, 1fr));
    gap:14px;
    width:100%;
    box-sizing:border-box !important;
    text-align:left;
}

.PatientFormReviewSystems .Table > .Row
{
    display:contents;
}

.PatientFormReviewSystems .HealthHistory2Cells
{
    float:none;
    width:auto;
    margin:0;
    padding:16px;
    border:1px solid var(--patient-border);
    border-radius:9px;
    background:var(--patient-surface-muted);
    box-sizing:border-box !important;
    color:var(--patient-text);
    font-size:14px;
    line-height:1.75;
    text-align:left;
}

.PatientFormReviewSystems .HealthHistory2Cells:has(> b)
{
    padding:10px 14px;
    background:var(--patient-brand-soft-section);
    color:var(--patient-brand-section-heading);
    font-size:16px;
}

.PatientFormReviewSystems .HealthHistory2Cells input[type="checkbox"]
{
    width:18px;
    height:18px;
    margin:0 8px 0 0;
    vertical-align:middle;
    accent-color:var(--patient-brand);
}

.PatientFormReviewSystems .HealthHistory2Cells input[type="text"]
{
    width:100%;
    height:38px;
    margin:5px 0 2px;
    padding:7px 9px;
    border:1px solid var(--patient-border-control);
    border-radius:6px;
    background:var(--patient-surface);
    box-sizing:border-box !important;
    color:var(--patient-text-input);
}

.PatientForm .PatientFormGrid > .Row > .PatientFormSecurity
{
    grid-column:1 / -1;
    float:none;
    width:auto;
    max-width:none;
    margin:6px 0 0;
    padding:20px;
    border:1px solid var(--patient-border);
    border-radius:10px;
    background:var(--patient-surface-muted);
    box-sizing:border-box !important;
    color:var(--patient-text);
}

.PatientForm .PatientFormSecurity input[type="text"]
{
    max-width:190px;
    margin-top:4px;
}

.PatientForm .PatientFormGrid > .PatientFormSecurityRow:not(:has(img))
{
    display:none !important;
}

.PatientForm .PatientFormActions
{
    display:block;
    width:auto;
    margin:0;
    padding:4px 36px 36px;
    text-align:right;
}

.PatientForm .PatientFormActions .Row,
.PatientForm .PatientFormActions .Cell
{
    display:block;
    float:none;
    width:auto;
    margin:0;
    padding:0;
    text-align:right;
}

.PatientForm .PatientFormActions .PatientFormSubmit
{
    width:auto;
    min-width:250px;
    min-height:48px;
    padding:12px 24px;
    border:1px solid var(--patient-brand);
    border-radius:8px;
    background:var(--patient-brand);
    color:var(--patient-text-on-brand);
    cursor:pointer;
    box-sizing:border-box !important;
    font-family:inherit;
    font-size:14px;
    font-weight:bold;
    transition:background-color .15s ease, box-shadow .15s ease, transform .15s ease;
}

.PatientForm .PatientFormActions .PatientFormSubmit:hover,
.PatientForm .PatientFormActions .PatientFormSubmit:focus
{
    background:var(--patient-brand-dark);
    color:var(--patient-text-on-brand);
    box-shadow:0 4px 12px var(--patient-shadow-button);
}

.PatientForm .PatientFormActions .PatientFormSubmit:active
{
    transform:translateY(1px);
}

.PatientFormConfirmation
{
    min-height:320px;
    padding:50px 36px;
    box-sizing:border-box;
    text-align:center;
}

.PatientFormConfirmation > div
{
    max-width:520px;
    margin:0 auto;
}

.PatientFormConfirmationIcon
{
    display:flex;
    align-items:center;
    justify-content:center;
    width:58px;
    height:58px;
    margin:0 auto 18px;
    border-radius:50%;
    background:var(--patient-brand-soft);
    color:var(--patient-brand);
    font-size:28px;
    font-weight:bold;
}

.PatientFormConfirmation h1
{
    margin:0 0 10px;
    color:var(--patient-brand-heading);
    font-size:28px;
    line-height:1.25;
}

.PatientFormConfirmation p
{
    margin:0;
    color:var(--patient-text-muted);
    font-size:15px;
    line-height:1.6;
}

    .MenuNext1
    {
        display:block;

        margin:0 auto;

        text-align:center;
        padding-left: 10px;
        padding-right: 15px;
        padding-top:2px;
        padding-bottom:10px;
        float:center; 
        box-sizing: border-box; 
		max-width:715px;
        color:red;
        font-size: 30px;
        
    }
	
	
    .ConsultationsCell
    {
        display:block;

        margin:0 auto;

        text-align:left;
        padding-left: 10px;
        padding-right: 15px;
        padding-top:2px;
        padding-bottom:2px;
        float:left; 
        box-sizing:border-box; 
        width:500px;
        font-weight:bold;
    }
    .ConsultationsCell input
    {            
        background-color:#F2F2F2;
        border-radius:5px;
		height: 40px;
		color: #000;
    }
    .ConsultationsCell select
    {
        width:100%;    
        background-color:#F2F2F2;
        border-radius:8px;
                height:27px;             
    }
    .ConsultationsIRPCell 
    {
        display:block;

        margin:0 auto;

        text-align:left;
        padding-left: 0px;
        padding-right: 0px;
        padding-top:2px;
        padding-bottom:2px;
        float:left; 
        box-sizing: border-box; 
        width:210px;  
    }
    .ConsultationsIRPCell input, .ConsultationsIRPCell select
    {
        width:50px;    
        background-color:#F2F2F2;
        border-radius:5px;   
      
    }

    .ConsultationsSubmitButton
    {
        font-weight:bold;
        max-width:275px;    
    }
	
        .requiredinputShort
    {
        border-right-color:#FF0000;    
        border-right-style:solid;
        width:190px;
    }
    .csstextarea
    {
            width:100%;

        background-color:#F2F2F2;
        border-radius:5px;
        
    }
	
	.DilationUL
	{
		list-style-type: square;		
		list-style-position: outside;
		
	}
	
	.DilationUL li
	{
		margin-left:20px;		
	}
	
	.DilationULNumbers
	{	
		list-style-type: decimal;	
		list-style-position: outside;
		
	}
	
	.DilationULNumbers li
	{
		margin-left:20px;		
	}

@media only screen and (max-width: 725px) {
	
	.PatientForm .PatientFormGrid input[type="date"]
	{
		width:90%;
		max-width:90%;
		inline-size:90%;
		max-inline-size:90%;
	}
    
    .PatientFormsMenu
    {
        padding:18px;
    }

    .PatientFormsMenuHeader
    {
        margin-bottom:14px;
    }

    .PatientFormsMenuDisclosure
    {
        position:relative;
        display:block;
    }

    .PatientFormsMenuToggleControl
    {
        position:absolute;
        z-index:2;
        top:0;
        left:0;
        display:block;
        width:100%;
        height:48px;
        margin:0;
        opacity:0;
        cursor:pointer;
    }

    .PatientFormsMenuToggle
    {
        position:relative;
        display:flex;
        align-items:center;
        min-height:48px;
        padding:10px 44px 10px 15px;
        border:1px solid var(--patient-brand);
        border-radius:9px;
        background:var(--patient-brand);
        box-sizing:border-box;
        color:var(--patient-text-on-brand);
        cursor:pointer;
        font-size:15px;
        font-weight:bold;
        line-height:1.3;
        list-style:none;
    }

    .PatientFormsMenuToggle:after
    {
        position:absolute;
        right:16px;
        content:"+";
        font-size:24px;
        font-weight:normal;
        line-height:1;
    }

    .PatientFormsMenuToggleControl:checked + .PatientFormsMenuToggle:after
    {
        content:"\2212";
    }

    .PatientFormsMenuToggle:hover,
    .PatientFormsMenuToggleControl:focus + .PatientFormsMenuToggle
    {
        background:var(--patient-brand-dark);
        box-shadow:0 0 0 3px var(--patient-focus-ring);
        outline:none;
    }

    .PatientFormsMenuLinks
    {
        display:none;
        grid-template-columns:1fr;
        margin-top:12px;
    }

    .PatientFormsMenuToggleControl:checked ~ .PatientFormsMenuLinks
    {
        display:grid;
    }

    .PatientFormsLanding
    {
        grid-template-columns:1fr;
        width:90vw;
        margin-bottom:40px;
    }

    .PatientFormsLandingImage
    {
        min-height:220px;
    }

    .PatientFormsLandingContent
    {
        padding:26px 22px;
    }

    .PatientFormsLanding h1
    {
        font-size:25px;
    }

    .PatientFormPage
    {
        width:90vw;
        margin-bottom:40px;
    }

    .PatientFormHeader
    {
        padding:26px 22px 22px;
    }

    .PatientFormHeader h1
    {
        font-size:25px;
    }

    .PatientForm .PatientFormGrid
    {
        padding:24px 22px 8px;
    }

    .PatientForm .PatientFormGrid > .Row
    {
        grid-template-columns:1fr;
        gap:16px;
        margin-bottom:16px;
    }

    .PatientForm .PatientFormGrid > .PatientFormSection > .Row
    {
        grid-template-columns:1fr;
        gap:16px;
        margin-bottom:16px;
    }

    .PatientFormDateRange
    {
        grid-template-columns:1fr;
        gap:14px;
    }

    .PatientFormConsentContent
    {
        padding:20px 18px 16px;
    }

    .PatientFormConsentChoice
    {
        padding:16px 18px 20px;
    }

    .PatientFormPolicyInitials
    {
        grid-template-columns:1fr;
        gap:8px;
        padding:16px 18px 20px;
    }

    .PatientFormPolicyInitials input[type="text"]
    {
        text-align:left;
    }

    .PatientFormMinorConsentCard .PatientFormConsentContent
    {
        padding:20px 18px 16px;
    }

    .PatientFormScreeningList
    {
        grid-template-columns:1fr;
        gap:10px;
    }

    .PatientFormScreeningQuestion,
    .PatientFormScreeningQuestionWide
    {
        grid-column:auto;
        grid-template-columns:1fr;
        gap:8px;
        padding:14px;
    }

    .PatientFormSurveyYesNoList
    {
        grid-template-columns:1fr;
    }

    .PatientFormSurveyChoices
    {
        display:block;
        border-spacing:0;
    }

    .PatientFormSurveyChoices tbody
    {
        display:block;
        width:100%;
    }

    .PatientFormSurveyChoices tr
    {
        display:grid;
        grid-template-columns:repeat(2, minmax(0, 1fr));
        gap:8px;
        width:100%;
    }

    .PatientFormSurveyChoices td,
    .PatientFormSurveyChoicesShort td
    {
        display:block;
        width:auto;
    }

    .PatientFormHealthMatrix .Table > .Row,
    .PatientFormHealthMatrix .Table > .RowGray
    {
        grid-template-columns:1fr;
        padding:10px 0;
    }

    .PatientFormHealthMatrix .HealthHistory2Cells:first-child
    {
        grid-column:auto;
        font-weight:bold;
    }

    .PatientFormHealthMatrix .Table > .Row:first-child,
    .PatientFormHealthMatrix .Table > .RowGray:first-child
    {
        display:none;
    }

    .PatientFormHealthMatrix .HealthHistory2Cells,
    .PatientFormHealthMatrix .HealthHistory3Cells
    {
        padding:5px 12px;
    }

    .PatientFormFamilyStatus:before,
    .PatientFormFamilyRelationship:before
    {
        display:block;
        margin-bottom:4px;
        color:var(--patient-text-subtle);
        font-size:12px;
        font-weight:bold;
        letter-spacing:.8px;
        text-transform:uppercase;
    }

    .PatientFormFamilyStatus:before
    {
        content:"Family Member";
    }

    .PatientFormFamilyRelationship:before
    {
        content:"Relationship";
    }

    .PatientFormReviewSystems > div:not(.PatientFormHealthIntro) > .Table
    {
        grid-template-columns:1fr;
        gap:10px;
    }

    .PatientFormReviewSystems .Table > .PatientFormReviewHeadings
    {
        display:none;
    }

    .PatientFormSectionHeader
    {
        margin:10px 0 18px;
        padding:5px 14px 5px 18px;
    }

    .PatientFormSectionHeader h2
    {
        font-size:18px;
    }

    .PatientForm .PatientFormActions
    {
        padding:4px 22px 26px;
    }

    .PatientForm .PatientFormActions .PatientFormSubmit
    {
        width:100%;
        min-width:0;
    }

    .PatientFormConfirmation
    {
        min-height:260px;
        padding:40px 22px;
    }

}
	
	
	
	
	
.ContactOrder_OuterDiv 
{
	width:95%;
    max-width:500px;
	margin: 0 auto;
    font-size:18px;
}
.ContactOrder_title
{
        font-size:x-large;
        text-align:left;
        font-weight:bold;
}   

.ContactOrder_subtitle    
{
        font-size:medium;
        text-align:left;
        padding-top:5px;
		display:inline-block;
}

.ContactOrder_requiredtext
{
        font-size:medium;
        text-align:left;
        color:red;
        padding-top:5px;
}

.ContactOrder_Table
{
    text-align:left;
        margin-top:20px;
}

.ContactOrder_Row
{
	width:100%;
    text-align:left;
}


.ContactOrder_TextBox
{
	width:100%;
	max-width:400px;
}



.ContactOrder_Cell_1
{
	display:inline-block;
    text-align:left;
    padding-left: 15px;
    padding-right: 5px;
    padding-bottom:2px;
    box-sizing:border-box; 
    font-weight:bold;
}

.ContactOrder_Cell_2
{
	display:inline-block;
    text-align:left;
    padding-left: 0px;
    padding-right: 15px;
    padding-bottom:2px;
    box-sizing:border-box; 
    font-weight:bold;
}

.ContactOrder_Cell_3
{
	width:100%;
    text-align:left;
    padding-left: 35px;
    padding-right: 15px;
    padding-bottom:2px;
    box-sizing:border-box; 
}

.ContactOrder_Section    
{
        font-size:large;
        text-align:left;
        margin-top:15px;
        margin-bottom:10px;
        border-bottom: 1px solid black;
}
.ContactOrder_Requiredspan
{
    color:red;
}

.ContactOrder_SubmitDiv
{
	text-align:center;
}



.PatientFormReviewSystems .PatientFormReviewOptions:before
{
    display:block;
    margin:-16px -16px 14px;
    padding:10px 14px;
    border-bottom:1px solid var(--patient-border);
    border-radius:9px 9px 0 0;
    background:var(--patient-brand-soft-section);
    color:var(--patient-brand-section-heading);
    content:attr(data-section);
    font-size:18px;
    font-weight:bold;
    line-height:1.4;
}

	
@media only screen and (max-width: 570px) {

    .Table
    {
        width:275px;
		margin:0 auto;
    }
	
	.HealthHistory3Cells
	{
		width:100%;
	}
	
	.HealthHistory3CellsSmall
	{
		width:45%;
		box-sizing: border-box !important;
	}
	
	.InsuranceCell
	{
		padding-left:0px;
		padding-right:0px;
	}
	
	.HealthHistoryCell
	{
		padding-left:0px;
		padding-right:0px;
	}
	
	.DilationCell
	{
		padding-left:0px;
		padding-right:0px;
	}
	
	.FinancialPolicyCell
	{
		padding-left:0px;
		padding-right:0px;
	}
	
	.ConsentTreatMinorCell
	{
		padding-left:0px;
		padding-right:0px;
	}
	
	.AcknowledgementPrivacyCell
	{
		padding-left:0px;
		padding-right:0px;
	}
	
	.AuthorizationDiscloseCell
	{
		padding-left:0px;
		padding-right:0px;
	}
	
	.ConsultationsCell
	{
		padding-left:0px;
		padding-right:0px;
        width:275px;
	}
	
	.subtitle
	{
		width:70%;		  
		margin:0 auto;
	}  
	
	.ConsultationsDateBox
	{
		width:90px;
	}
}




.form-security-trap-wrap {
  position: absolute !important;
  width: 1px !important;
  height: 1px !important;
  padding: 0 !important;
  margin: -1px !important;
  overflow: hidden !important;
  clip: rect(0, 0, 0, 0) !important;
  clip-path: inset(50%) !important;
  white-space: nowrap !important;
  border: 0 !important;
  opacity: 0 !important;
  pointer-events: none !important;
}

.quote-bot-trap, .form-security-trap-wrap .form-security-trap,
.form-security-trap {
  position: absolute !important;
  left: -9999px !important;
  width: 1px !important;
  height: 1px !important;
  padding: 0 !important;
  margin: 0 !important;
  overflow: hidden !important;
  opacity: 0 !important;
  border: 0 !important;
  background: transparent !important;
}

.quote-captcha-error {
  display: block;
  margin: 0.35rem 0 0.75rem;
}