.Form_formWrapper__ChrEQ{padding-top:2.5rem}.Form_formWrapper__ChrEQ nucleus-form::part(submit-button){display:none}.Form_formWrapper__ChrEQ .Form_tableHeading__owpaV{margin-bottom:0;padding-top:1rem}.Form_formWrapper__ChrEQ .Form_serverErrorContainer__PRV9d{color:var(--nt-color-notification-high);border-top:.125rem solid var(--nt-color-notification-high);border-bottom:.125rem solid var(--nt-color-notification-high);font-size:1.125rem;width:100%;padding:1.875rem 0 1.875rem .625rem;margin-bottom:1.25rem}.Form_formWrapper__ChrEQ .Form_subHeadingCopy__klHSr{padding-bottom:3.25rem}.Form_formWrapper__ChrEQ .Form_requiredLabel__hZdmA{font-size:var(--nt-size-font-xl);font-weight:var(--nt-font-weight-regular);line-height:var(--nt-font-line-height-comfortable)}@media(min-width:1200px){.Form_formWrapper__ChrEQ .Form_requiredLabel__hZdmA{font-size:var(--nt-size-font-2xl)}}.Form_formWrapper__ChrEQ .Form_requiredIcon__cvRyv{margin-right:.25rem;color:var(--nt-color-accent-secondary-2)}.Form_formWrapper__ChrEQ .Form_formHeading__Wn8b5>span{margin-right:.25rem;color:var(--nt-color-accent-secondary-2)!important}.Form_formWrapper__ChrEQ .Form_formHeading__Wn8b5 h4{font-weight:700;color:var(--nt-color-action-primary-active)!important;line-height:2.25rem;font-size:1.625rem}.Form_formWrapper__ChrEQ .Form_headingfontSize__b_DnV{font-size:1.3rem;margin-bottom:.3rem}.Form_formWrapper__ChrEQ .Form_inlineGroupStyle__IdqqP{display:flex;flex-wrap:wrap;gap:32px}.Form_formWrapper__ChrEQ .Form_colCount__Q7bmE{-moz-column-count:2;column-count:2;padding-left:0}@media(max-width:1199px){.Form_formWrapper__ChrEQ .Form_colCount__Q7bmE{-moz-column-count:1;column-count:1;padding-left:0}}.Form_formWrapper__ChrEQ .Form_colCount__Q7bmE .Form_textCheckboxWrapper__TXGKg{padding-left:.2rem}.Form_formWrapper__ChrEQ .Form_colCount__Q7bmE .Form_textCheckboxWrapper__TXGKg:nth-child(5) .Form_textCheckbox__sfBnM{margin-bottom:1.75rem}@media(max-width:1199px){.Form_formWrapper__ChrEQ .Form_colCount__Q7bmE .Form_textCheckboxWrapper__TXGKg:nth-child(5) .Form_textCheckbox__sfBnM{margin-bottom:0}.Form_formWrapper__ChrEQ .Form_colCount__Q7bmE .Form_textCheckboxWrapper__TXGKg:nth-child(n){margin-top:-2rem}.Form_formWrapper__ChrEQ .Form_colCount__Q7bmE .Form_textCheckboxWrapper__TXGKg:first-child{margin-top:0}}.Form_formWrapper__ChrEQ .Form_cancelButton__i77Nv{display:inline;padding-left:2rem}.Form_variation_ReferDentistForm__21EEX .Form_radioButtonsWrapper__DQbVW{display:flex;flex-wrap:wrap;gap:32px}.Form_formWrapper__ChrEQ[data-testid=si-referral-form-wrapper] .Form_textCheckboxWrapper__TXGKg{padding-left:.9375rem}.Form_agentFormContainer__DX3ug{display:flex}@media(max-width:767px){.Form_agentFormContainer__DX3ug{flex-direction:column-reverse}}@media(min-width:768px){.Form_agentFormContainer__DX3ug{padding-right:0}}.Form_formLeftContainer__IC4pD{flex-basis:60%}@media(max-width:767px){.Form_formLeftContainer__IC4pD{flex:1 1}}.Form_sideBarContainer__VZkc8{flex-basis:40%;width:100%;height:100%;padding:5%;background-color:var(--nt-color-notification-low-bg);border-top-left-radius:6.25rem;margin-left:5%;align-items:center;text-align:center}@media(max-width:767px){.Form_sideBarContainer__VZkc8{flex:1 1;margin-left:0;margin-bottom:2rem;padding-top:15%}}.Form_headingSection__QsgOz{padding-top:2rem;padding-bottom:1.5rem}.Form_headingSection__QsgOz h2{color:var(--nt-color-humana-green-dark);font-weight:var(--nt-font-weight-light);margin-bottom:1rem}.Form_headingSection__QsgOz p{color:var(--nt-color-font-primary)}.Form_featuresList__CQJk6{position:relative}.Form_featureItem__Ba1Rx{position:relative;padding:1rem 1rem 2.5rem;margin-bottom:1rem;border-bottom:1px solid #c8c8c8}.Form_featureItem__Ba1Rx h3{color:var(--nt-color-humana-green-dark);font-weight:var(--nt-font-weight-bold)}.Form_featureItem__Ba1Rx p{color:var(--nt-color-font-primary)}.Form_featureItem__Ba1Rx .Form_hideDescription__ndMux{display:none}.Form_featureItem__Ba1Rx:last-child{border-bottom:none;margin-bottom:0;padding-bottom:2rem}