.copay-register .left-col h2{position:relative;padding-right:100px}
.copay-register .left-col h2:after{content:'';position:absolute;background-image:url(../img/cta-card.png);background-size:90px 72px;top:0;right:0;display:inline-block;width:90px;height:72px}
@media print,(-webkit-min-device-pixel-ratio:1.25),(-o-min-device-pixel-ratio:5 / 4),(min-resolution:120dppx){.copay-register .left-col h2:after{background-image:url(../img/cta-card-2x.png);background-size:90px 72px}
}
.unsubscribe .button{margin-top:1em}
.form .required-text{font-size:11px;font-size:.6875rem}
.form .errorMsg{font-size:12px;font-size:.75rem;color:red}
.form .errorMsg[style*=inline]{display:block!important}
.request-info .form .box .support,.support-registration .form .box .request{display:none}
.form .box{width:100%;background-color:#f8f8f8;padding:15px;text-align:left;color:#666}
.form .box h4{font-family:'Gotham 4r','Gotham A','Gotham B';font-weight:400;font-style:normal;color:#83389b;margin-top:0}
.request-info .form .box{margin-top:20px}
.support-registration .form .box{margin-top:278px}
.support-registration .form .box:before{content:'';position:absolute;background-image:url(../img/sp-wheel.png);background-size:309px 268px;left:0;top:-278px;display:inline-block;width:100%;height:268px;background-position:center bottom}
.form .box.signup_form_wrapper_co_pay:before,.form .box:before{display:none}
@media print,(-webkit-min-device-pixel-ratio:1.25),(-o-min-device-pixel-ratio:5 / 4),(min-resolution:120dppx){.support-registration .form .box:before{background-image:url(../img/sp-wheel-2x.png);background-size:309px 268px}
}
.form .box .inner-white{background-color:#fff;padding:15px;margin-top:1em}
.form .box .inner-white+.inner-white{margin-top:0}
.form .box .inner-white.expand-trigger{position:relative;padding-right:84px;margin-top:3em}
.form .box .inner-white.expand-trigger .label_checkbox{margin-top:0}
.form .box .inner-white.expand-trigger:after{content:'';position:absolute;background-image:url(../img/cta-card.png);background-size:90px auto;background-position:0 0;width:90px;height:72px;top:0;right:-12px;left:auto}
@media print,(-webkit-min-device-pixel-ratio:1.25),(-o-min-device-pixel-ratio:5 / 4),(min-resolution:120dppx){.form .box .inner-white.expand-trigger:after{background-image:url(../img/cta-card-2x.png);background-size:90px auto}
}
.form .field{width:100%}
.form label{display:block;margin-top:1em}
.form label.label_check{display:inline-block;font-family:'Gotham 5r','Gotham A','Gotham B';font-weight:500;font-style:normal}
.form label.label_check+label{margin-left:10px}
.form input[type=text]+input[type=text],.form input[type=email]+input[type=text],.form select+select{margin-left:1.976284585%}
.form input[type=text],.form input[type=email]{width:100%;height:38px;padding:5px;border:1px solid #ece4ee}
.form input[type=text].phone3,.form input[type=email].phone3{width:27.6679841897%}
.form input[type=text].phone4,.form input[type=email].phone4{width:40.7114624506%}
.form input[type=text].error,.form input[type=email].error{border-color:red}
.form select{width:100%;height:38px;padding:5px;border:1px solid #ece4ee;min-width:70px}
.form select.dateMD{width:27.6679841897%}
.form select.dateY{width:40.7114624506%}
.bv_8 .form select.dateY{width:34.7826086957%}
.form select.error{border-color:red}
.form .label_check{background-image:url(../img/sprites/form.png);background-position:0 -138px;background-size:24px;background-repeat:no-repeat;padding-left:20px;line-height:19px;margin-top:0}
@media print,(-webkit-min-device-pixel-ratio:1.25),(-o-min-device-pixel-ratio:5 / 4),(min-resolution:120dppx){.form .label_check{background-image:url(../img/sprites/form-x2.png);background-position:0 -136px;background-size:22px;background-repeat:no-repeat}
}
.form .label_check.c_on{background-image:url(../img/sprites/form.png);background-position:0 -207px;background-size:24px;background-repeat:no-repeat}
@media print,(-webkit-min-device-pixel-ratio:1.25),(-o-min-device-pixel-ratio:5 / 4),(min-resolution:120dppx){.form .label_check.c_on{background-image:url(../img/sprites/form-x2.png);background-position:0 -204px;background-size:22px;background-repeat:no-repeat}
}
.form .label_check.error{background-image:url(../img/sprites/form.png);background-position:0 -69px;background-size:24px;background-repeat:no-repeat}
@media print,(-webkit-min-device-pixel-ratio:1.25),(-o-min-device-pixel-ratio:5 / 4),(min-resolution:120dppx){.form .label_check.error{background-image:url(../img/sprites/form-x2.png);background-position:0 0;background-size:22px;background-repeat:no-repeat}
}
.form .label_checkbox{background-image:url(../img/sprites/form.png);background-position:0 -350px;background-size:24px;background-repeat:no-repeat;padding:5px 0 0 25px;min-height:24px}
@media print,(-webkit-min-device-pixel-ratio:1.25),(-o-min-device-pixel-ratio:5 / 4),(min-resolution:120dppx){.form .label_checkbox{background-image:url(../img/sprites/form-x2.png);background-position:0 -344px;background-size:22px;background-repeat:no-repeat}
}
.form .label_checkbox.c_on{background-image:url(../img/sprites/form.png);background-position:0 -424px;background-size:24px;background-repeat:no-repeat}
@media print,(-webkit-min-device-pixel-ratio:1.25),(-o-min-device-pixel-ratio:5 / 4),(min-resolution:120dppx){.form .label_checkbox.c_on{background-image:url(../img/sprites/form-x2.png);background-position:0 -416px;background-size:22px;background-repeat:no-repeat}
}
.form .label_checkbox.error{background-image:url(../img/sprites/form.png);background-position:0 -276px;background-size:24px;background-repeat:no-repeat}
@media print,(-webkit-min-device-pixel-ratio:1.25),(-o-min-device-pixel-ratio:5 / 4),(min-resolution:120dppx){.form .label_checkbox.error{background-image:url(../img/sprites/form-x2.png);background-position:0 -272px;background-size:22px;background-repeat:no-repeat}
}
.form .label_check input,.form .label_checkbox input{position:absolute;left:-9999px}
.form .error .label_check{background-image:url(../img/sprites/form.png);background-position:0 -69px;background-size:24px;background-repeat:no-repeat}
@media print,(-webkit-min-device-pixel-ratio:1.25),(-o-min-device-pixel-ratio:5 / 4),(min-resolution:120dppx){.form .error .label_check{background-image:url(../img/sprites/form-x2.png);background-position:0 0;background-size:22px;background-repeat:no-repeat}
}
.form .error .label_check.c_on{background-image:url(../img/sprites/form.png);background-position:0 0;background-size:24px;background-repeat:no-repeat}
@media print,(-webkit-min-device-pixel-ratio:1.25),(-o-min-device-pixel-ratio:5 / 4),(min-resolution:120dppx){.form .error .label_check.c_on{background-image:url(../img/sprites/form-x2.png);background-position:0 -68px;background-size:22px;background-repeat:no-repeat}
}
.form .error .label_checkbox{background-image:url(../img/sprites/form.png);background-position:0 -276px;background-size:24px;background-repeat:no-repeat}
@media print,(-webkit-min-device-pixel-ratio:1.25),(-o-min-device-pixel-ratio:5 / 4),(min-resolution:120dppx){.form .error .label_checkbox{background-image:url(../img/sprites/form-x2.png);background-position:0 -272px;background-size:22px;background-repeat:no-repeat}
}
.form .agree,.form .copay_agree{position:relative;padding:5px 0 0 25px}
.form .agree .label_checkbox,.form .copay_agree .label_checkbox{position:absolute;top:0;left:0;width:24px;height:24px}
#qRegSupport .checkbox{padding-top:26px;background:url(../img/logo-onward.svg) 25px top no-repeat;background-size:125px 21px}
.s_no_svg #qRegSupport .checkbox{background-image:url(../img/logo-onward.png)}
#qRegSupport .checkbox label{margin:0}
#checkInPhone,#journeyGoForwardFollowUp,#journeyInsuranceApproval,#journeyRequestDenied{display:none;margin:30px 0 30px 25px}
#journeyInsuranceApproval .label_check,#journeyRequestDenied .label_check{min-height:26px;padding-top:3px}
#checkInPhone input[type=text],#checkInPhone select,#journeyGoForwardFollowUp input[type=text],#journeyGoForwardFollowUp select,.form .copayElegibleQuestions input[type=text],.form .copayElegibleQuestions select{margin-left:5px}
#checkInPhone input[type=text]:first-child,#checkInPhone select:first-child,#journeyGoForwardFollowUp input[type=text]:first-child,#journeyGoForwardFollowUp select:first-child,.form .copayElegibleQuestions input[type=text]:first-child,.form .copayElegibleQuestions select:first-child{margin-left:0}
#checkInPhone input[type=text].dateMD,#checkInPhone input[type=text].phone3,#checkInPhone select.dateMD,#checkInPhone select.phone3,#journeyGoForwardFollowUp input[type=text].dateMD,#journeyGoForwardFollowUp input[type=text].phone3,#journeyGoForwardFollowUp select.dateMD,#journeyGoForwardFollowUp select.phone3,.form .copayElegibleQuestions input[type=text].dateMD,.form .copayElegibleQuestions input[type=text].phone3,.form .copayElegibleQuestions select.dateMD,.form .copayElegibleQuestions select.phone3{width:28%!important}
#checkInPhone input[type=text].dateY,#checkInPhone input[type=text].phone4,#checkInPhone select.dateY,#checkInPhone select.phone4,#journeyGoForwardFollowUp input[type=text].dateY,#journeyGoForwardFollowUp input[type=text].phone4,#journeyGoForwardFollowUp select.dateY,#journeyGoForwardFollowUp select.phone4,.form .copayElegibleQuestions input[type=text].dateY,.form .copayElegibleQuestions input[type=text].phone4,.form .copayElegibleQuestions select.dateY,.form .copayElegibleQuestions select.phone4{width:32%!important}
.form .journey label.label_check{display:block;width:auto;height:auto;line-height:1.2em;margin:8px 0 0}
.form .journey label.label_check:first-child{margin-top:0}
.form .journey label.label_check .step{display:inline-block;height:26px;line-height:26px}
.form .journey .desc{color:#666;line-height:1.2em;margin:10px 0 30px}
.form .radioList.onecol label.label_check{display:block;margin-top:8px}
.form .radioList.onecol label.label_check:first-child{margin-top:0}
.form .radioList.mobile-onecol label.label_check{display:block;margin-top:8px;margin-left:0}
.form .radioList.mobile-onecol label.label_check:first-child{margin-top:0}
.form .radioList.twocol label.label_check{width:90%;margin-top:8px}
.form .radioList.twocol label.label_check:first-child{margin-top:0}
.form .radioList.twocol label.label_check+label{margin-left:0}
@media only screen and (min-width:48em){.copay-register .left-col{padding-bottom:36px}
.copay-register .left-col h2{padding-right:140px;min-height:67px}
.copay-register .left-col h2:after{content:'';position:absolute;background-image:url(../img/d-cta-card.png);background-size:132px 106px;top:-22px;right:0;display:inline-block;width:132px;height:106px}
}
@media only screen and (min-width:48em) and (-webkit-min-device-pixel-ratio:1.25),only screen and (min-width:48em) and (-o-min-device-pixel-ratio:5 / 4),only screen and (min-width:48em) and (min-resolution:120dppx){.copay-register .left-col h2:after{background-image:url(../img/d-cta-card-2x.png);background-size:132px 106px}
}
@media only screen and (min-width:48em){.support-registration .left-col h2+h3,.support-registration .left-col h2+h3+p,.support-registration .left-col h2+h3+p+p{padding-right:305px}
.form .required-text{font-size:12px;font-size:.75rem}
.form .errorMsg{font-size:13px;font-size:.8125rem}
.form .box{padding:25px}
.form .box h4{font-size:17px;font-size:1.0625rem}
.request-info .form .box,.support-registration .form .box{margin-top:62px}
.support-registration .form .box:before{background-image:url(../img/d-sp-wheel.png);background-size:324px 281px;left:inherit;right:0;top:-325px;width:324px;height:281px;background-position:left top;z-index:-1}
}
@media only screen and (min-width:48em) and (-webkit-min-device-pixel-ratio:1.25),only screen and (min-width:48em) and (-o-min-device-pixel-ratio:5 / 4),only screen and (min-width:48em) and (min-resolution:120dppx){.support-registration .form .box:before{background-image:url(../img/d-sp-wheel-2x.png);background-size:324px 281px}
}
@media only screen and (min-width:48em){.form .box .inner-white{padding:15px 25px}
.form .box .inner-white.expand-trigger{padding-right:232px;margin-top:2em}
.form .box .inner-white.expand-trigger:after{background-image:url(../img/d-cta-card.png);background-size:132px 106px;width:132px;height:106px;top:-14px;right:73px}
}
@media only screen and (min-width:48em) and (-webkit-min-device-pixel-ratio:1.25),only screen and (min-width:48em) and (-o-min-device-pixel-ratio:5 / 4),only screen and (min-width:48em) and (min-resolution:120dppx){.form .box .inner-white.expand-trigger:after{background-image:url(../img/d-cta-card-2x.png);background-size:132px 106px}
}
@media only screen and (min-width:48em){.form .field{width:47%}
.form .field.wide{width:100%}
.form .label_check{background-image:url(../img/sprites/d-form.png);background-position:0 -152px;background-size:29px;background-repeat:no-repeat;padding-left:27px;line-height:26px;min-height:26px}
}
@media only screen and (min-width:48em) and (-webkit-min-device-pixel-ratio:1.25),only screen and (min-width:48em) and (-o-min-device-pixel-ratio:5 / 4),only screen and (min-width:48em) and (min-resolution:120dppx){.form .label_check{background-image:url(../img/sprites/d-form-x2.png);background-position:0 -152px;background-size:29px;background-repeat:no-repeat}
}
@media only screen and (min-width:48em){.form .label_check.c_on{background-image:url(../img/sprites/d-form.png);background-position:0 -228px;background-size:29px;background-repeat:no-repeat}
}
@media only screen and (min-width:48em) and (-webkit-min-device-pixel-ratio:1.25),only screen and (min-width:48em) and (-o-min-device-pixel-ratio:5 / 4),only screen and (min-width:48em) and (min-resolution:120dppx){.form .label_check.c_on{background-image:url(../img/sprites/d-form-x2.png);background-position:0 -228px;background-size:29px;background-repeat:no-repeat}
}
@media only screen and (min-width:48em){.form .label_check.error{background-image:url(../img/sprites/d-form.png);background-position:0 -76px;background-size:29px;background-repeat:no-repeat}
}
@media only screen and (min-width:48em) and (-webkit-min-device-pixel-ratio:1.25),only screen and (min-width:48em) and (-o-min-device-pixel-ratio:5 / 4),only screen and (min-width:48em) and (min-resolution:120dppx){.form .label_check.error{background-image:url(../img/sprites/d-form-x2.png);background-position:0 0;background-size:29px;background-repeat:no-repeat}
}
@media only screen and (min-width:48em){.form .label_checkbox{background-image:url(../img/sprites/d-form.png);background-position:0 -383px;background-size:29px;background-repeat:no-repeat;padding:5px 0 0 34px;min-height:29px}
}
@media only screen and (min-width:48em) and (-webkit-min-device-pixel-ratio:1.25),only screen and (min-width:48em) and (-o-min-device-pixel-ratio:5 / 4),only screen and (min-width:48em) and (min-resolution:120dppx){.form .label_checkbox{background-image:url(../img/sprites/d-form-x2.png);background-position:0 -383px;background-size:29px;background-repeat:no-repeat}
}
@media only screen and (min-width:48em){.form .label_checkbox.c_on{background-image:url(../img/sprites/d-form.png);background-position:0 -462px;background-size:29px;background-repeat:no-repeat}
}
@media only screen and (min-width:48em) and (-webkit-min-device-pixel-ratio:1.25),only screen and (min-width:48em) and (-o-min-device-pixel-ratio:5 / 4),only screen and (min-width:48em) and (min-resolution:120dppx){.form .label_checkbox.c_on{background-image:url(../img/sprites/d-form-x2.png);background-position:0 -462px;background-size:29px;background-repeat:no-repeat}
}
@media only screen and (min-width:48em){.form .label_checkbox.error{background-image:url(../img/sprites/d-form.png);background-position:0 -304px;background-size:29px;background-repeat:no-repeat}
}
@media only screen and (min-width:48em) and (-webkit-min-device-pixel-ratio:1.25),only screen and (min-width:48em) and (-o-min-device-pixel-ratio:5 / 4),only screen and (min-width:48em) and (min-resolution:120dppx){.form .label_checkbox.error{background-image:url(../img/sprites/d-form-x2.png);background-position:0 -304px;background-size:29px;background-repeat:no-repeat}
}
@media only screen and (min-width:48em){.form .error .label_check{background-image:url(../img/sprites/d-form.png);background-position:0 -76px;background-size:29px;background-repeat:no-repeat}
}
@media only screen and (min-width:48em) and (-webkit-min-device-pixel-ratio:1.25),only screen and (min-width:48em) and (-o-min-device-pixel-ratio:5 / 4),only screen and (min-width:48em) and (min-resolution:120dppx){.form .error .label_check{background-image:url(../img/sprites/d-form-x2.png);background-position:0 0;background-size:29px;background-repeat:no-repeat}
}
@media only screen and (min-width:48em){.form .error .label_check.c_on{background-image:url(../img/sprites/d-form.png);background-position:0 0;background-size:29px;background-repeat:no-repeat}
}
@media only screen and (min-width:48em) and (-webkit-min-device-pixel-ratio:1.25),only screen and (min-width:48em) and (-o-min-device-pixel-ratio:5 / 4),only screen and (min-width:48em) and (min-resolution:120dppx){.form .error .label_check.c_on{background-image:url(../img/sprites/d-form-x2.png);background-position:0 -76px;background-size:29px;background-repeat:no-repeat}
}
@media only screen and (min-width:48em){.form .error .label_checkbox{background-image:url(../img/sprites/d-form.png);background-position:0 -304px;background-size:29px;background-repeat:no-repeat}
}
@media only screen and (min-width:48em) and (-webkit-min-device-pixel-ratio:1.25),only screen and (min-width:48em) and (-o-min-device-pixel-ratio:5 / 4),only screen and (min-width:48em) and (min-resolution:120dppx){.form .error .label_checkbox{background-image:url(../img/sprites/d-form-x2.png);background-position:0 -304px;background-size:29px;background-repeat:no-repeat}
}
@media only screen and (min-width:48em){.form .agree,.form .copay_agree{padding:5px 0 0 34px}
.form .agree .label_checkbox,.form .copay_agree .label_checkbox{width:29px;height:29px}
.bv_8 .form select.dateY{width:32.4110671937%}
#qRegSupport .checkbox{background-position:34px top}
#checkInPhone,#journeyGoForwardFollowUp,#journeyInsuranceApproval,#journeyRequestDenied{display:none;margin-left:30px}
.form .radioList.mobile-onecol label.label_check{display:inline-block;margin:auto}
.form .radioList.mobile-onecol label.label_check+label,.form .radioList.twocol label.label_check+label{margin-left:10px}
.form .radioList.twocol label.label_check{width:45%}
.form .radioList.twocol label.label_check:first-child+label{margin-top:0}
}
@media only screen and (min-width:62.5em){.bv_8 .form select.dateY{width:102px}
#checkInPhone input[type=text].dateMD,#checkInPhone input[type=text].phone3,#checkInPhone select.dateMD,#checkInPhone select.phone3,#journeyGoForwardFollowUp input[type=text].dateMD,#journeyGoForwardFollowUp input[type=text].phone3,#journeyGoForwardFollowUp select.dateMD,#journeyGoForwardFollowUp select.phone3,.form .copayElegibleQuestions input[type=text].dateMD,.form .copayElegibleQuestions input[type=text].phone3,.form .copayElegibleQuestions select.dateMD,.form .copayElegibleQuestions select.phone3{width:65px!important}
#checkInPhone input[type=text].dateY,#checkInPhone input[type=text].phone4,#checkInPhone select.dateY,#checkInPhone select.phone4,#journeyGoForwardFollowUp input[type=text].dateY,#journeyGoForwardFollowUp input[type=text].phone4,#journeyGoForwardFollowUp select.dateY,#journeyGoForwardFollowUp select.phone4,.form .copayElegibleQuestions input[type=text].dateY,.form .copayElegibleQuestions input[type=text].phone4,.form .copayElegibleQuestions select.dateY,.form .copayElegibleQuestions select.phone4{width:101px!important}
}
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