.elementor-4923 .elementor-element.elementor-element-dcf1617:not(.elementor-motion-effects-element-type-background), .elementor-4923 .elementor-element.elementor-element-dcf1617 > .elementor-motion-effects-container > .elementor-motion-effects-layer{background-color:#F5F6F8;}.elementor-4923 .elementor-element.elementor-element-dcf1617 > .elementor-container{min-height:414px;}.elementor-4923 .elementor-element.elementor-element-dcf1617 > .elementor-background-overlay{opacity:0.5;transition:background 0.3s, border-radius 0.3s, opacity 0.3s;}.elementor-4923 .elementor-element.elementor-element-dcf1617{transition:background 0.3s, border 0.3s, border-radius 0.3s, box-shadow 0.3s;margin-top:0px;margin-bottom:0px;padding:50px 0px 0px 0px;}.elementor-4923 .elementor-element.elementor-element-eb23c13 > .elementor-element-populated{margin:0px 0px 0px 0px;--e-column-margin-right:0px;--e-column-margin-left:0px;padding:0px 0px 0px 0px;}.elementor-4923 .elementor-element.elementor-element-96f31c6{width:var( --container-widget-width, 100% );max-width:100%;--container-widget-width:100%;--container-widget-flex-grow:0;}.elementor-4923 .elementor-element.elementor-element-96f31c6 > .elementor-widget-container{margin:0px 0px 0px 0px;padding:0px 0px 0px 0px;}/* Start custom CSS for shortcode, class: .elementor-element-96f31c6 */form#gform_26 label.gfield_label{
    margin-bottom:2px !important;
} 

form#gform_26,h1,h2,h3,h4,span,p,label,input,select{
    font-family: "Inter", sans-serif !important;
    font-size: 14px
}

form#gform_26 input,
form#gform_26 select{
    border-radius: 5px;
    border: 1px solid #D1D5DB; 
    background: white
}
form#gform_26 select{
    padding:12px 8px;
}
 
 
form#gform_26 input[type="radio"],
form#gform_26 input input[type="checkbox"]{
    border-radius: 5px;
    border: 1px solid #D1D5DB; 
    width: 16px !important;
    height: 16px !important; 
}
/* Hide the native radio button */

#field_26_55,
#field_26_56 {
    position: relative;
} 

/*radio*/
#field_26_55 input[type="radio"],
#field_26_56 input[type="checkbox"]{
    position: absolute;
    opacity: 0;
    width: 0;
    height: 0;
}

/* Style the label to look like a radio button */
#field_26_55 label,
#field_26_56 label{
    position: relative;
    padding-left: 30px;
    cursor: pointer;
    display: inline-block;
}

/* Custom radio button appearance */
#field_26_55 label::before{
    content: '';
    position: absolute;
    left: 0;
    top: 5px;
    width: 16px;
    height: 16px; 
    border: 2px solid white;
    background: transparent;
    border-radius: 50%;
    transition: background 0.3s, border-color 0.3s;
}

/* Custom checkbox appearance */
#field_26_56 label::before {
    content: '';
    position: absolute;
    left: 0;
    top: 5px;
    width: 16px;
    height: 16px;
    border: 2px solid white;
    background: transparent;
    transition: background 0.3s, border-color 0.3s;
}

/* Style for checked state */
#field_26_55 input[type="radio"]:checked + label::before { 
    border: 5px solid white;
}

/* Inner circle for checked state */
#field_26_55 input[type="radio"]:checked + label::after {
    content: '';
    position: absolute;
    left: 5px;
    top: 5px;
    width: 10px;
    height: 10px; 
    border-radius: 50%;
}

/* Style for checked state */
#field_26_56 input[type="checkbox"]:checked + label::before {
    background: white;
    border-color: white;
}

/* Checkmark for checked state */
#field_26_56 input[type="checkbox"]:checked + label::after {
    content: '';
    position: absolute;
    left: 6px;
    top: 5px;
    width: 6px;
    height: 12px;
    border: solid black;
    border-width: 0 2px 2px 0;
    transform: rotate(45deg);
}


.health-insurance{
    /*background:#141F42;*/
    color: white;
}
div#field_26_150{
    width: 100% !important;
    display: flex !important;
    flex-direction: row !important;
    justify-content: space-between !important; 
    background-image: linear-gradient(90deg, #141F42 50%, #80818C 50%);
}

div#field_26_145 {
    width: 100%;
    padding: 37px 37px 37px 0;
    display: flex;
    flex-direction: column;
    row-gap: 10px;
}

div#field_26_145 h1{
    color:white;
    font-size: 50px;
}

div#field_26_145 h1
{
    color:white;
    font-size: 50px;
    font-weight: 800;
}
div#field_26_145 #label
{
    color:white;
    font-size: 50px;
    font-weight: 300;
}

div#field_26_147 {
    width: 100%;
    padding: 37px 0 37px 37px;
    background: #80818C;
    row-gap: 13px;
    color: white;
    display: flex;
    flex-direction: column;
}
 
div#field_26_155 {
    display: flex;
    width: 100%;
    justify-content: space-between; 
}

.state, .insurance-plan{
    width: 100%;
}
.insurance-plan{
    margin-left: 23px;
}



/*body form white BG*/

/*div#field_26_159 { */
/*    margin-right: auto;*/
/*    margin-left: auto;*/
/*    position: relative;*/
/*    max-width: 1140px; */
/*}*/

fieldset label{
    font-size: 14px;
}

div#input_26_56{
    display:flex;
    flex-direction: column;
    justify-items: center;
}


div#field_26_162{
    display: flex;
    width: 100%;
    justify-content: space-between;
}
div#field_26_164{
    display: flex;
    width: 60%;
    justify-content: space-between;
}
div#field_26_104 {
    width: 60%;
}
fieldset#field_26_61 {
    width: 100%;
}

div#gfield_consent_description_26_61,
div#gfield_consent_description_26_64,
div#gfield_consent_description_26_65,
div#gfield_consent_description_26_66,
div#gfield_consent_description_26_105{
    background: #E2E8F0;
    border: 2px solid #D1D5DB;
    
}
div#field_26_14,
div#field_26_15,
div#field_26_21,
div#field_26_26{
    width: 100%;
}

div#field_26_15,
div#field_26_26{
    margin-left: 23px;
}


input.gform_previous_button{ 
    padding:15px 22px !important;
    border: none  !important;
    background: #E5E7EB  !important;
    color:#878B93  !important;
}
input.gform_button,
input.gform_next_button { 
    padding:15px 22px !important;
    border: none  !important;
    background: #141F42  !important;
    color:#fff  !important;
}



.form-header-container {
    width: 100% !important;
    display: flex !important;
    flex-direction: row !important;
    justify-content: space-between !important;
    margin-right: auto;
    margin-left: auto;
    position: relative;
    max-width: 1140px; 
}

.gform_footer{  
    margin-right: auto !important;
    margin-left: auto !important;
    position: relative !important;
    max-width: 1140px !important;
    width: 100% !important; 
}

p.gform_required_legend {
    display: none;
}
textarea#input_26_121 {
    border-radius: 5px;
    border: 1px solid #D1D5DB;
    background: #F9F9F9;
    height: 125px;
}


/* Responsive styles for screens below 768px */
@media (max-width: 768px) {
    .form-header-container {
        flex-direction: column !important; 
    }
 div#field_26_150 { 
    flex-direction: column !important;
    justify-content: space-between !important;
    background-image: linear-gradient(180deg, #141F42 50%, #80818C 50%);
}
div#field_26_147 {
    padding: 0;
}
div#field_26_147 {
    padding:20px;
}
div.form-header-container{
    padding:0;
}
div#field_26_145{
    padding:20px;
}
div#field_26_159 {
    padding:20px;
}
.gform_footer{  
    padding: 20px 20px  120px 20px !important;
}
}


/*button select all*/
button#button_129_select_all {
    background: #fff;
    border: 1px solid #ccc;
    padding: 10px 20px;
    border-radius: 5px;
}

/*progressbar*/

div#gf_progressbar_wrapper_26 { 
    margin-right: auto;
    margin-left: auto;
    position: relative;
    max-width: 1140px;
}
.gf_progressbar_percentage{
    background: #141F42 !important;
}
 
 
 
 /*pagefooter*/
 
 .gform_page_footer.top_label {
    max-width: 1140px;
    margin-left: auto !important;
    position: relatiive;
    margin-right: auto !important;
}
.date-today {
    margin-top: -37px;
    margin-left: -10px;
}
.date-today #date-today-signature,
.date-today #date-today-consent{
    border-radius: 5px; 
    background: none;
    border: none;
    width: 20%;
    margin-top: -20px;
}
 
#gform_page_26_2,
#gform_page_26_3{
    margin-right: auto;
    margin-left: auto;
    position: relative;
    max-width: 1140px;
}


 
/*#gform_page_26_1 .gform_page_footer.top_label*/
/*,#gform_page_26_2 .gform_page_footer.top_label{*/
/*    display: block !important;*/
/*}*/
 
/*.gform_page_footer.top_label {*/
/*    display: none;*/
/*}*//* End custom CSS */