@charset "utf-8";
/* CSS Document */



.asterisk{
	color: red;
	font-weight: bold;
	font-size: 14px;
}

#contentRight{
	background-color:#d7d7d7;
	padding: 5px;
	border:1px dashed #666666;
}

ol.forms{
	list-style-position:inside;
	position:relative;
	left:-15px;
	font-weight:bold;
}

ol.forms li{
	margin-bottom:12px;
	font-size:13px;
	text-align:left;
	width:auto;
}

li.current{
	list-style-type:square;
}

li.finished{
	list-style-image:url(images/list-checkmark.gif);
	color:#666666;
}

p.disclaimer{
	font-weight:bold;
	text-align:justify;
	display:block;
}

p.form{
	margin:0px 0px 15px 0px;
	padding:0px 0px 0px 0px;
	float:none;
	text-align:justify;
	position:relative;
	display:block;
	}

#formcontainer	{
	width:100%;
	max-width:850px;
	height:auto;
	display:block;
	position:relative;
	padding:0;
	margin-top:15px auto 0 auto;
	text-align:left;
	float:left;
				}

#formcontainer ol li{
	margin-bottom:12px;
	font-size:13px;
	clear:both;
	}
	
#formcontainer ol li label{
	padding:none;
	}	

.clearfix	{
	display: inline-block;
	padding:5px 0px 5px 0px;
			}		
			
label	{
	float:left;
	text-align:right;
	margin-right:5px;
	font-size:13px;
	color:#000000;
		}
		
input	{
	vertical-align:bottom;
	font-size:11px;
	padding:1px;
	font-family:Arial, Helvetica, sans-serif;
	}

textbox{
	border:1px solid #000000;
	}

textarea{
	overflow:hidden;
	scroll-y:hidden;
	}

table.checkboxes tr td {
	text-align:right;
	}
	
	
	
	
.healthInsuranceInfo{float:left; width:100%; border:3px solid #c3c3c3; background:url(images/form_bg.gif) repeat-x 0 0; overflow:hidden; padding:10px 0 20px}
.healthInsuranceInfo .clearfix{float:left; width:95.5%; padding:10px 20px 0}
.healthInsuranceInfo .line{border-bottom:1px solid #c3c3c3; padding-bottom:20px; margin-bottom:10px; display:inline}
.healthInsuranceInfo .clearfix label{float:left; width:200px; padding:4px 20px 0 0; color:#333; font-size:14px; text-align:right}
.healthInsuranceInfo .clearfix label.yes_no{float:left; width:50px; padding:4px 20px 0 0; color:#333; font-size:13px; text-align:left}
.healthInsuranceInfo .clearfix label.card{float:left; width:auto; padding:4px 10px 0 0; color:#333; font-size:13px; text-align:left}
.healthInsuranceInfo .clearfix input{float:left; width:200px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; margin:0}
.healthInsuranceInfo .clearfix input.mm{float:left; width:50px; padding:6px 0; text-align:center; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}
.healthInsuranceInfo .clearfix input.dd{float:left; width:50px; padding:6px 0; text-align:center; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}
.healthInsuranceInfo .clearfix input.yy{float:left; width:86px; padding:6px 0; text-align:center; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}
.healthInsuranceInfo .clearfix input.name{float:left; width:89px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}

.healthInsuranceInfo .clearfix input.add{float:left; width:572px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px;}
.healthInsuranceInfo .clearfix input.radio{float:left; width:auto; padding:0; background:none; border:none; margin:6px 7px 0 0; height:14px}
/* #middle{float:left;} */
.healthInsuranceInfo p{float:left; width:95%; margin:0; padding:10px 0 10px 2%}
.healthInsuranceInfo .clearfix input.btn{float:left; width:151px; padding:0px 0 10px; margin:20px 10px 0px 0; display:inline; line-height:18px; color:#fff; height:40px; background: url(images/submit_btn.gif) no-repeat 0 0; border:none; font-size:14px; cursor:pointer}


.newPatientform{float:left; width:100%; border:3px solid #c3c3c3; background:url(images/form_bg.gif) repeat-x 0 0; overflow:hidden; padding:10px 0 20px}
.newPatientform .clearfix{float:left; width:95.5%; padding:10px 20px 0}
.newPatientform .clearfix label{float:left; width:200px; padding:4px 20px 0 0; color:#333; font-size:14px; text-align:right}
.newPatientform .clearfix label.full{float:left; width:100%; padding:4px 20px 0 0; color:#333; font-size:14px; text-align:left}
.newPatientform .clearfix label.full_u{float:left; width:100%; padding:4px 20px 10px 0; color:#333; font-size:14px; text-align:left; font-weight:bold}
.newPatientform .clearfix label.name_f{float:left; width:70px; padding:4px 10px 0 0; color:#333; font-size:14px; text-align:right;}
.newPatientform .clearfix label.yes_no{float:left; width:50px; padding:4px 20px 0 0; color:#333; font-size:13px; text-align:left}
.newPatientform .clearfix label.card{float:left; width:auto; padding:4px 10px 0 0; color:#333; font-size:13px; text-align:left}
.newPatientform .clearfix input{float:left; width:200px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; margin:0}
.newPatientform .clearfix input.add{float:left; width:572px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px;}
.newPatientform .clearfix input.name_t{float:left; width:172px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; margin:0; display:inline}
.newPatientform .clearfix input.full{float:left; width:525px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; margin-top:5px;}
.newPatientform .clearfix input.radio{float:left; width:auto; padding:0; background:none; border:none; margin:6px 7px 0 0; height:14px}
.newPatientform .clearfix input.mm{float:left; width:50px; padding:6px 0; text-align:center; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}
.newPatientform .clearfix input.dd{float:left; width:50px; padding:6px 0; text-align:center; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}
.newPatientform .clearfix input.yy{float:left; width:86px; padding:6px 0; text-align:center; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}
.newPatientform .clearfix input.name{float:left; width:89px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}
.newPatientform .clearfix textarea{float:left; width:570px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; height:150px; font-family:Arial, Helvetica, sans-serif}
.newPatientform p{float:left; width:95%; margin:0; padding:10px 0 10px 2%}
.newPatientform .clearfix input.btn{float:left; width:151px; padding:0px 0 10px; margin:20px 10px 0px 0; display:inline; line-height:18px; color:#fff; height:40px; background: url(images/submit_btn.gif) no-repeat 0 0; border:none; font-size:14px; cursor:pointer}

.noticeOfPrivacyPractices{float:left; width:100%; border:3px solid #c3c3c3; background:url(images/form_bg.gif) repeat-x 0 0; overflow:hidden; padding:10px 0 20px}
.noticeOfPrivacyPractices .clearfix{float:left; width:92.5%; padding:10px 20px 0}
.noticeOfPrivacyPractices .clearfix label{float:left; width:200px; padding:4px 20px 0 0; color:#686868; font-size:14px; text-align:right}
.noticeOfPrivacyPractices .clearfix label.full{float:left; width:100%; padding:4px 20px 0 0; color:#686868; font-size:14px; text-align:left; padding-bottom:10px}
.noticeOfPrivacyPractices .clearfix input{float:left; width:200px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; margin:0}
.noticeOfPrivacyPractices .clearfix input.full{float:left; width:305px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; margin-left:10px; display:inline}
.noticeOfPrivacyPractices p{float:left; width:95%; margin:0; padding:10px 0 10px 2%}
.noticeOfPrivacyPractices .clearfix input.btn{float:left; width:151px; padding:0px 0 10px; margin:20px 10px 0px 0; display:inline; line-height:18px; color:#fff; height:40px; background: url(images/submit_btn.gif) no-repeat 0 0; border:none; font-size:14px; cursor:pointer}
.noticeOfPrivacyPractices .clearfix input.mm{float:left; width:50px; padding:6px 0; text-align:center; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}
.noticeOfPrivacyPractices .clearfix input.dd{float:left; width:50px; padding:6px 0; text-align:center; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}
.noticeOfPrivacyPractices .clearfix input.yy{float:left; width:86px; padding:6px 0; text-align:center; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}
.noticeOfPrivacyPractices .clearfix input.name{float:left; width:89px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}


.newPatientQuestionaire{float:left; width:100%; border:3px solid #c3c3c3; background:url(images/form_bg.gif) repeat-x 0 0; overflow:hidden; padding:10px 0 20px}
.newPatientQuestionaire .clearfix{float:left; width:95.5%; padding:10px 20px 0}
.newPatientQuestionaire .line{border-bottom:1px solid #c3c3c3; padding-bottom:20px; margin-bottom:10px; display:inline; float:left; width:100%}
.newPatientQuestionaire .clearfix label{float:left; width:200px; padding:4px 20px 0 0; color:#333; font-size:14px; text-align:right}
.newPatientQuestionaire .order label{color:#333333!important;}
.newPatientQuestionaire .clearfix label.full{float:left; width:100%; padding:4px 20px 0 0; color:#333; font-size:14px; text-align:left; padding-bottom:10px}
.newPatientQuestionaire .clearfix label.age{float:left; width:auto; padding:4px 5px 0; color:#333; font-size:14px; text-align:left;}
.newPatientQuestionaire .clearfix label.name_f{float:left; width:65px; padding:4px 5px 0 0; color:#333; font-size:14px; text-align:right;}
.newPatientQuestionaire .clearfix label.name_phone{float:left; width:50px; padding:4px 5px 0 0; color:#333; font-size:14px; text-align:right;}
.newPatientQuestionaire .clearfix label.name_fax{float:left; width:35px; padding:4px 5px 0 0; color:#333; font-size:14px; text-align:right;}
.newPatientQuestionaire .clearfix label.name_cm{float:left; width:120px; padding:4px 5px 0 0; color:#333; font-size:14px; text-align:right;}
.newPatientQuestionaire .clearfix label.name_pha{float:left; width:170px; padding:4px 5px 0 20px; color:#333; font-size:14px; text-align:right;}
.newPatientQuestionaire .clearfix input{float:left; width:200px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; margin:0}
.newPatientQuestionaire .clearfix input.full{float:left; width:305px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; margin-left:10px; display:inline}
.newPatientQuestionaire .clearfix input.name_t{float:left; width:120px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; margin:0; display:inline}
.newPatientQuestionaire .clearfix input.name_n{float:left; width:120px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; margin:0; display:inline}
.newPatientQuestionaire .clearfix input.name_add{float:left; width:145px; padding:6px 5px; margin-right:6px; background:#fff; border:1px solid #cecece; font-size:14px; margin:0; display:inline}
.newPatientQuestionaire .clearfix input.name_age{float:left; width:50px; padding:2px 5px; background:#fff; border:1px solid #cecece; font-size:12px; margin:0; display:inline}
.newPatientQuestionaire .clearfix input.name_age_b{float:left; width:220px; padding:2px 5px; background:#fff; border:1px solid #cecece; font-size:12px; margin:0; display:inline}
.newPatientQuestionaire .clearfix input.checkbox{float:none; width:auto; padding:0; background:none; border:none; margin:0 7px 0 0; height:14px}
.newPatientQuestionaire .clearfix input.radio{float:none; width:auto; padding:0; background:none; border:none; margin:0 7px 0 0; height:14px}
.newPatientQuestionaire .clearfix input.last{ float:none; width:auto; display:inline; background:#fff; border:1px solid #cecece; font-size:14px; margin:0; padding:2px 5px; vertical-align:middle}
.newPatientQuestionaire .clearfix input.mm{float:left; width:50px; padding:6px 0; text-align:center; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}
.newPatientQuestionaire .clearfix input.dd{float:left; width:50px; padding:6px 0; text-align:center; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}
.newPatientQuestionaire .clearfix input.yy{float:left; width:86px; padding:6px 0; text-align:center; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}
.newPatientQuestionaire .clearfix input.name{float:left; width:89px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}

.newPatientQuestionaire .clearfix textarea{float:left; width:570px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; height:150px; font-family:Arial, Helvetica, sans-serif}
.newPatientQuestionaire .clearfix .textare2{float:left; width:315px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; height:85px; font-family:Arial, Helvetica, sans-serif}
.newPatientQuestionaire .clearfix textarea.text{float:left; width:120px; padding:3px 5px; background:#fff; border:1px solid #cecece; font-size:14px; height:40px; font-family:Arial, Helvetica, sans-serif}
.newPatientQuestionaire .clearfix .textare{float:left; width:315px; padding:6px 5px; background:#fff; border:1px solid #cecece; font-size:14px; height:120px; font-family:Arial, Helvetica, sans-serif}
.newPatientQuestionaire .clearfix ol li input{ float:none; width:auto; display:inline; background:#fff; border:1px solid #cecece; font-size:14px; margin:0; padding:2px 5px; vertical-align:middle}
.newPatientQuestionaire .clearfix ol li label{float:none; width:auto; display:inline; padding:0; color:#333; font-size:14px; text-align:inherit}
.newPatientQuestionaire p{float:left; width:95%; margin:0; padding:10px 0 10px 2%}
.newPatientQuestionaire .clearfix input.btn{float:left; width:151px; padding:0px 0 10px; margin:20px 10px 0px 0; display:inline; line-height:18px; color:#fff; height:40px; background: url(images/submit_btn.gif) no-repeat 0 0; border:none; font-size:14px; cursor:pointer}


.SIGNATURE{float:left; padding:10px 20px 0; width:95.5%;}
.SIGNATURE .col1{float:left; width:450px;}
.SIGNATURE .col2{float:left; width:350px;}
.SIGNATURE .col2 label{float:left; width:100%; text-align:left; padding-bottom:5px; color:#333; font-size:14px;}
.SIGNATURE .col2 input.mm{float:left; width:50px; padding:6px 0; text-align:center; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}
.SIGNATURE .col2 input.dd{float:left; width:50px; padding:6px 0; text-align:center; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}
.SIGNATURE .col2 input.yy{float:left; width:86px; padding:6px 0; text-align:center; background:#fff; border:1px solid #cecece; font-size:14px; margin:0 10px 0 0; display:inline}
.SIGNATURE .col1 label{float:left; width:200px; padding:4px 20px 0 0; color:#333; font-size:14px; text-align:right}
.SIGNATURE textarea{float:left; width:190px; padding:30px 5px 10px; background:#fff; border:1px solid #cecece; font-size:14px; height:65px; font-family:Arial, Helvetica, sans-serif}