/** DO NOT MODIFY THIS FILE. All code here are generated by MachForm Theme Editor **/

#main_body h1 a
{
background-image: url('https://forms.citushealth.comimages/form_resources/machform.png');
background-repeat: no-repeat;
height: 40px;
}

html
{
background-image: url('https://forms.citushealth.comimages/form_resources/grey-mild.png');
background-repeat: repeat;
}

#main_body h1
{
background-color: #525252;
background-image: none;
}

#form_container
{
background-color: #ffffff!important;
border-width: 0px;
border-style: solid!important;
border-color: #CCCCCC!important;
}

#main_body form li.highlighted,#main_body .matrix tbody tr:hover td,#machform_review_table tr.alt
{
background-color: #FFF7C0;
}

#main_body form .guidelines
{
background-color: #F5F5F5;
border-width: 1px;
border-style: solid;
border-color: #CCCCCC;
}

#main_body form .guidelines small
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 80%;
color: #444444;
}

#main_body input.text,#main_body input.file,#main_body textarea.textarea,#main_body select.select,#main_body input.checkbox,#main_body input.radio
{
background-color: #FBFBFB;
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 100%;
color: #666666;
}

#machform_review_table td.mf_review_value
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 100%;
color: #444444;
}

#main_body .form_description h2,#main_body .form_success h2
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 160%;
color: #444444;
}

#main_body .form_description p,#main_body form ul.payment_list_items li
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 95%;
color: #444444;
}

#main_body form li span.ap_tp_text
{
color: #444444;
}

#main_body form li label.description,#main_body form li span.description,#main_body .matrix caption,#main_body .matrix td.first_col,#main_body form li.total_payment span,#machform_review_table td.mf_review_label
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 700;
font-style: normal;
font-size: 95%;
color: #444444;
}

#main_body form li span label,#main_body label.choice,#main_body .matrix th,#main_body form li span.symbol,.mf_sigpad_clear,#main_body form li div label,#main_body form li div span.label
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
color: #444444;
}

#main_body form .section_break h3,#main_body form .media h3,#machform_review_table td .mf_section_title
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 110%;
color: #444444;
}

#main_body form .section_break p,#main_body form .media p,#machform_review_table td .mf_section_content
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 85%;
color: #444444;
}

#main_body form li.section_break
{
border-top-width: 1px;
border-top-style: dotted;
border-top-color: #CCCCCC;
}



/** Advanced CSS **/

/** DO NOT MODIFY THIS FILE. All code here are generated by MachForm Theme Editor **/

#main_body h1 a
{
background-image: url('https://portal.citushealth.com/machform/Upload/images/form_resources/machform.png');
background-repeat: no-repeat;
height: 40px;
}

html
{
background-image: url('https://portal.citushealth.com/machform/Upload/images/form_resources/grey-mild.png');
background-repeat: repeat;
}

#main_body h1
{
background-color: #525252;
background-image: none;
}

#form_container
{
background-color: #ffffff!important;
border-width: 0px;
border-style: solid!important;
border-color: #CCCCCC!important;
}

#main_body form li.highlighted,#main_body .matrix tbody tr:hover td,#machform_review_table tr.alt
{
background-color: #FFF7C0;
}

#main_body form .guidelines
{
background-color: #F5F5F5;
border-width: 1px;
border-style: solid;
border-color: #CCCCCC;
}

#main_body form .guidelines small
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 80%;
color: #444444;
}

#main_body input.text,#main_body input.file,#main_body textarea.textarea,#main_body select.select,#main_body input.checkbox,#main_body input.radio
{
background-color: #FBFBFB;
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 100%;
color: #666666;
}

#machform_review_table td.mf_review_value
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 100%;
color: #444444;
}

#main_body .form_description h2,#main_body .form_success h2
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 160%;
color: #444444;
}

#main_body .form_description p,#main_body form ul.payment_list_items li
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 95%;
color: #444444;
}

#main_body form li span.ap_tp_text
{
color: #444444;
}

#main_body form li label.description,#main_body form li span.description,#main_body .matrix caption,#main_body .matrix td.first_col,#main_body form li.total_payment span,#machform_review_table td.mf_review_label
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 700;
font-style: normal;
font-size: 95%;
color: #444444;
}

#main_body form li span label,#main_body label.choice,#main_body .matrix th,#main_body form li span.symbol,.mf_sigpad_clear,#main_body form li div label,#main_body form li div span.label
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
color: #444444;
}

#main_body form .section_break h3,#main_body form .media h3,#machform_review_table td .mf_section_title
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 110%;
color: #444444;
}

#main_body form .section_break p,#main_body form .media p,#machform_review_table td .mf_section_content
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 85%;
color: #444444;
}

#main_body form li.section_break
{
border-top-width: 1px;
border-top-style: dotted;
border-top-color: #CCCCCC;
}



/** Advanced CSS **/

/** DO NOT MODIFY THIS FILE. All code here are generated by MachForm Theme Editor **/

#main_body h1 a
{
background-image: url('https://portal.citushealth.com/machform/Upload/images/form_resources/machform.png');
background-repeat: no-repeat;
height: 40px;
}

html
{
background-image: url('https://portal.citushealth.com/machform/Upload/images/form_resources/grey-mild.png');
background-repeat: repeat;
}

#main_body h1
{
background-color: #525252;
background-image: none;
}

#form_container
{
background-color: #ffffff!important;
border-width: 0px;
border-style: solid!important;
border-color: #CCCCCC!important;
}

#main_body form li.highlighted,#main_body .matrix tbody tr:hover td,#machform_review_table tr.alt
{
background-color: #FFF7C0;
}

#main_body form .guidelines
{
background-color: #F5F5F5;
border-width: 1px;
border-style: solid;
border-color: #CCCCCC;
}

#main_body form .guidelines small
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 80%;
color: #444444;
}

#main_body input.text,#main_body input.file,#main_body textarea.textarea,#main_body select.select,#main_body input.checkbox,#main_body input.radio
{
background-color: #FBFBFB;
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 100%;
color: #666666;
}

#machform_review_table td.mf_review_value
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 100%;
color: #444444;
}

#main_body .form_description h2,#main_body .form_success h2
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 160%;
color: #444444;
}

#main_body .form_description p,#main_body form ul.payment_list_items li
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 95%;
color: #444444;
}

#main_body form li span.ap_tp_text
{
color: #444444;
}

#main_body form li label.description,#main_body form li span.description,#main_body .matrix caption,#main_body .matrix td.first_col,#main_body form li.total_payment span,#machform_review_table td.mf_review_label
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 700;
font-style: normal;
font-size: 95%;
color: #444444;
  
}
#main_body label.choice
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
color: #444444;
display:block!important;
}


#main_body form li span label,#main_body .matrix th,#main_body form li span.symbol,.mf_sigpad_clear,#main_body form li div label,#main_body form li div span.label
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
color: #444444;
display:none!important;
}

#main_body form .section_break h3,#main_body form .media h3,#machform_review_table td .mf_section_title
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 110%;
color: #444444;
}

#main_body form .section_break p,#main_body form .media p,#machform_review_table td .mf_section_content
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 85%;
color: #444444;
}

#main_body form li.section_break
{
border-top-width: 1px;
border-top-style: dotted;
border-top-color: #CCCCCC;
}



/** Advanced CSS **/

/** DO NOT MODIFY THIS FILE. All code here are generated by MachForm Theme Editor **/

#main_body h1 a
{
background-image: url('https://portal.citushealth.com/machform/Upload/images/form_resources/machform.png');
background-repeat: no-repeat;
height: 40px;
}

html
{
background-image: url('https://portal.citushealth.com/machform/Upload/images/form_resources/grey-mild.png');
background-repeat: repeat;
}

#main_body h1
{
background-color: #525252;
background-image: none;
}

#form_container
{
background-color: #ffffff!important;
border-width: 0px;
border-style: solid!important;
border-color: #CCCCCC!important;
}

#main_body form li.highlighted,#main_body .matrix tbody tr:hover td,#machform_review_table tr.alt
{
background-color: #FFF7C0;
}

#main_body form .guidelines
{
background-color: #F5F5F5;
border-width: 1px;
border-style: solid;
border-color: #CCCCCC;
}

#main_body form .guidelines small
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 80%;
color: #444444;
}

#main_body input.text,#main_body input.file,#main_body textarea.textarea,#main_body select.select,#main_body input.checkbox,#main_body input.radio
{
background-color: #FBFBFB;
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 100%;
color: #666666;
}

#machform_review_table td.mf_review_value
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 100%;
color: #444444;
}

#main_body .form_description h2,#main_body .form_success h2
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 160%;
color: #444444;
}

#main_body .form_description p,#main_body form ul.payment_list_items li
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 95%;
color: #444444;
}

#main_body form li span.ap_tp_text
{
color: #444444;
}

#main_body form li label.description,#main_body form li span.description,#main_body .matrix caption,#main_body .matrix td.first_col,#main_body form li.total_payment span,#machform_review_table td.mf_review_label
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 700;
font-style: normal;
font-size: 95%;
color: #444444;
}

#main_body form li span label,#main_body label.choice,#main_body .matrix th,#main_body form li span.symbol,.mf_sigpad_clear,#main_body form li div label,#main_body form li div span.label
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
color: #444444;
}

#main_body form .section_break h3,#main_body form .media h3,#machform_review_table td .mf_section_title
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 110%;
color: #444444;
}

#main_body form .section_break p,#main_body form .media p,#machform_review_table td .mf_section_content
{
font-family: 'Lucida Grande','Lucida Grande',Tahoma,Arial,sans-serif;
font-weight: 400;
font-style: normal;
font-size: 85%;
color: #444444;
}

#main_body form li.section_break
{
border-top-width: 1px;
border-top-style: dotted;
border-top-color: #CCCCCC;
}



/** Advanced CSS **/

@font-face {
  font-family: DINOT-bold;
  src: url(https://static1.squarespace.com/static/58d944d2ebbd1aac620cfead/t/60a41a7cc996a914d3c022ce/1621367420199/DINOT-Bold.woff2);
}

@font-face {
  font-family: DINOT;
  src: url(https://static1.squarespace.com/static/58d944d2ebbd1aac620cfead/t/60a420274dcb02030bf901d8/1621368871035/DINOT.woff2);
}

li#li_211 {
    padding-top: 10px !important;
}

#main_body h1 a {
    background-size: contain !important;
    background-position: center;
}


#main_body form li span.description {
    margin-bottom: 10px;
    display: block;
    line-height: 1em !important;
}

#main_body form .section_break h3, #main_body form .media h3 {
    font-size: 1.5em !important;
}


.text.medium {
    width: 100% !important;
}


form.appnitro {
    margin: 0px 20px 0;

}

#main_body textarea.textarea {
    max-width: 100% !important;
    width: 100%;
}

#main_body form li.vfooter {
    position: fixed;
    bottom: 0;
    background: #50bcff;
    color: white;
    left: 0;
    width: 100% !important;
    right: 0;
    padding: 8px 9px 1px !important;
    margin: 0;
    z-index: 99999;   
}

.vfooter p {
    color: white !important;
    font-size: .95em !important;
}

.details {
    padding: 10px 20px 10px !important;
}

#main_body form li.section_break.orange {
    background: #50bcff;
    color: white;
    padding: 20px 20px 15px 20px !important;
    margin-right: 0 !important;
    width: 100% !important;
}

.orange p, .orange h3, .orange p {
    color: white !important;
}

.orange p, .orange p a {
    color: white !important;
}

#main_body form li.section_break.blue {
    background: #0077bc;
    color: white;
    padding: 24px 20px 16px 19px !important;
    margin-right: 0 !im
    margin-right: 0 !important;
    width: 100% !important;
}

#main_body form li.section_break.blue h3 {
        font-size: 2em !important;
       text-align: center;
}

#li_211 p {
    text-align: center !important;
    font-size: 1.3em !important;
}

.blue p, .blue h3 {
    color: white !important;
}

#main_body h1 {
	display: block !important;
}

#main_body h1 {
    background-color: white;
    background-image: none;
}

#main_body h1 a {
   background-size: 100%;
   /* height: 120px; */
}

#main_body form li {
    margin-bottom: 16px;
}

#main_body {
    font-family:'DINOT', sans-serif;
    margin: 0px 0 0px;
}

.appnitro {
    font-family:'DINOT', sans-serif;
    margin: 0px 0 0px;
}

#main_body form li.section_break {
    border-top-style: none;
    padding-top: 30px;
}


#main_body input.text, #main_body textarea.textarea, .mf_sig_wrapper {
    border: none;
    box-shadow: 0 0 0 1px rgb(0 0 0 / 20%) inset !important;
    padding: 10px 0 6px 6px;
    margin: 6px 0 0;
}


#main_body form .section_break p, #main_body form .media p, #machform_review_table td .mf_section_content, #main_body textarea.textarea {
  font-family: 'DINOT', sans-serif !important;
}


#submit_form, .uploadifive-button, input, #main_body form .section_break h3, #main_body form .media h3, #machform_review_table td .mf_section_title {
    font-family: 'DINOT-bold', sans-serif !important;
        font-weight: 500 !important;
height: 30px !important;
    font-size: 16px !important;

}

#main_body form li label.description, #main_body form li span.description, #main_body .matrix caption, #main_body .matrix td.first_col, #main_body form li.total_payment span, #machform_review_table td.mf_review_label {
    font-family: 'DINOT-bold', sans-serif;
    font-weight: 500 !important;
}

#main_body form li span label, #main_body label.choice, #main_body .matrix th, #main_body form li span.symbol, .mf_sigpad_clear, #main_body form li div label, #main_body form li div span.label {
    font-family: 'DINOT', sans-serif;
}

#main_body form .guidelines {
    display: none;
}

#form_container {
    max-width: 840px;
    width: 100%;
    /* padding-top: 40px; */
}

#main_body form ul li#li_buttons {
    margin-bottom: 60px !important;
}

.appnitro li {
    width: 100%;
-moz-box-sizing: border-box;
-webkit-box-sizing: border-box;
box-sizing: border-box;
}

.mf_sig_wrapper {
-moz-box-sizing: border-box;
-webkit-box-sizing: border-box;
box-sizing: border-box;
max-width: 98%;
border: none !important;
}

canvas#mf_canvas_pad_67 {
    max-width: 100%;
}

#main_body input.button_text, #main_body .button_text, #submit_form {
     padding: 10px 40px 12px 40px;
    font-weight: 600;
    color: #fff;
    font-size: 18px !important;
    background: #9d2872 !important;
    box-shadow: inherit;
    border-radius: 50px;
    -webkit-transition: all 0.3s ease-out 0s;
    -moz-transition: all 0.3s ease-out 0s;
    -ms-transition: all 0.3s ease-out 0s;
    -o-transition: all 0.3s ease-out 0s;
    transition: all 0.3s ease-out 0s;
    white-space: inherit;
    border: 2px solid #fff;
    text-shadow: none;
    font-family: 'DINOT' !important;
}

#main_body input.button_text:hover , #main_body .button_text:hover {
     padding: 10px 40px 12px 40px;
    font-weight: 600;
      box-shadow: inherit;
    border-radius: 50px;
    -webkit-transition: all 0.3s ease-out 0s;
    -moz-transition: all 0.3s ease-out 0s;
    -ms-transition: all 0.3s ease-out 0s;
    -o-transition: all 0.3s ease-out 0s;
    transition: all 0.3s ease-out 0s;
    white-space: inherit;
    text-shadow: none;
    font-family: 'DINOT' !important;
    box-shadow: inherit; 
    background:#FFFFFF !important; 
    color: #9d2872 !important; 
    border: 2px solid #9d2872; 
}


#main_body input.button_text:focus , #main_body .button_text:focus {
     padding: 10px 40px 12px 40px;
    font-weight: 600;
    color: #fff;
    background: #50bcff !important;
    box-shadow: inherit;
    border-radius: 50px;
    -webkit-transition: all 0.3s ease-out 0s;
    -moz-transition: all 0.3s ease-out 0s;
    -ms-transition: all 0.3s ease-out 0s;
    -o-transition: all 0.3s ease-out 0s;
    transition: all 0.3s ease-out 0s;
    white-space: inherit;
    border: 2px solid #50bcff;
    text-shadow: none;
    font-family: 'DINOT';
}


.uploadifive-button, .uploadifive-button:focus {
        padding: 10px 40px 12px 40px;
    font-weight: 600;
    color: #fff;
    background: #9d2872 !important;
    box-shadow: inherit;
    border-radius: 50px;
    -webkit-transition: all 0.3s ease-out 0s;
    -moz-transition: all 0.3s ease-out 0s;
    -ms-transition: all 0.3s ease-out 0s;
    -o-transition: all 0.3s ease-out 0s;
    transition: all 0.3s ease-out 0s;
    white-space: inherit;
    border: 2px solid #9d2872;
    text-shadow: none;
    font-family: 'DINOT' !important;
    margin-top: 10px !important;
font-size: 16px !important;
}

.uploadifive-button:hover {
  padding: 10px 40px 12px 40px;
    font-weight: 600;
    box-shadow: inherit;
    border-radius: 50px;
    -webkit-transition: all 0.3s ease-out 0s;
    -moz-transition: all 0.3s ease-out 0s;
    -ms-transition: all 0.3s ease-out 0s;
    -o-transition: all 0.3s ease-out 0s;
    transition: all 0.3s ease-out 0s;
    white-space: inherit;
    text-shadow: none;
    font-family: 'DINOT' !important;
    box-shadow: inherit; 
    background: #FFFFFF !important; 
    color: #9d2872 !important; 
    border: 2px solid #9d2872;
}

#form_container {
    border-style: none !important;
    box-shadow: 0 0 0px rgba(0, 0, 0, 0) !important;
}

#main_body form li.section_break {
    padding-top: 0px;
}

#main_body .form_description{
display:none;
}
#main_body .form_description[class]{
display:none;
}

#main_body .custom-width-text {

}

#main_body #li_buttons{
text-align : center;
}

#main_body #submit_form1{
width : 250px !important;
height : 40px!important;
font-size: 16px !important;
}

.no_guidelines form li{
width :100% !important;
}

#main_body form li.column_2{
width :50% !important;
}

@media only screen and (max-width: 767px) {

	#main_body form li.column_2 {
    	min-width: 100% !important;
	}

}

#main_body form li:not(.media_video) span input {
    width: 80%;
    display: inline-block;
}

#main_body form li:not(.media_video) span{
 width: 30%;

}

#main_body form li:not(.media_video) span#calendar_41 {
    width: 5%;
}

#main_body form li:not(.media_video) span#calendar_41 img {
    position: relative;
    top: 10px;
}

#main_body select.select {
    border: none !important;
}

#element_43_1.element.checkbox {
    width: 2% !important;
    display: flex !important;
    flex-direction: row;
    flex-wrap: wrap;
    align-content: flex-start;
    justify-content: space-evenly;
    align-items: center;
vertical-align: middle;
  margin-right: 5px; 
}

#element_43_1.element.checkbox + label {
    display: inline-flex;
    align-items: center;
}