.PrescriptionForm_sign-up-form-container__dCQvj{position:relative;margin-top:4rem;margin-bottom:6rem}.PrescriptionForm_sign-up-form-container__wrapper__q3Nhy{display:flex;width:100%;justify-content:center;background-color:#071851;overflow:hidden;padding:6rem;border-radius:1.8rem;box-shadow:0 0 0 1px rgba(0,0,0,0),0 0 0 4px rgba(0,0,0,0),0 2px 4px 0 rgba(0,0,0,.18)}.PrescriptionForm_sign-up-form-container__dCQvj label{color:#fff!important}.PrescriptionForm_sign-up-form-container__media__CibC6{position:relative;min-width:50%;min-height:100%}.PrescriptionForm_sign-up-form-container__media-image__nOHsl{position:absolute;top:0;left:0;width:100%;height:100%;object-fit:cover;object-position:center center}.PrescriptionForm_sign-up-form-container__form__MF41A{padding:0;max-width:75rem}.PrescriptionForm_sign-up-form-container__text__vtZy9{font-family:Work Sans;font-weight:400;line-height:1.4;font-size:3rem;margin-bottom:3rem;position:relative;color:#242424;text-align:center}.PrescriptionForm_sign-up-form-container__image__idUcK{position:absolute;top:0;left:0;width:100%;height:100%;object-fit:cover}@media only screen and (max-width:1300px){.PrescriptionForm_sign-up-form-container__wrapper__q3Nhy{column-gap:5rem}.PrescriptionForm_sign-up-form-container__text__vtZy9{font-size:2.2rem}}@media only screen and (max-width:1024px){.PrescriptionForm_sign-up-form-container__dCQvj{margin-bottom:0}.PrescriptionForm_sign-up-form-container__wrapper__q3Nhy{grid-template-columns:repeat(1,1fr);column-gap:2rem;row-gap:3rem;padding:4rem 3rem}.PrescriptionForm_sign-up-form-container__media__CibC6{display:none}.PrescriptionForm_sign-up-form-container__form__MF41A{padding:5rem}}@media only screen and (max-width:540px){.PrescriptionForm_sign-up-form-container__dCQvj{margin-top:0}.PrescriptionForm_sign-up-form-container__wrapper__q3Nhy{box-shadow:none}.PrescriptionForm_sign-up-form-container__text__vtZy9{font-size:1.6rem}.PrescriptionForm_sign-up-form-container__form__MF41A{padding:0}}.PrescriptionForm_sign-up-form__OATr6{position:relative;display:flex;flex-wrap:wrap;padding:0;justify-content:space-between}.PrescriptionForm_sign-up-form__input-error__DO4Hk{color:#d32f2f;font-size:1.6rem}.PrescriptionForm_sign-up-form__form-header__C8YI1{margin-bottom:4rem;display:flex;justify-content:center;flex-direction:column}.PrescriptionForm_sign-up-form__form-title__qkqgO{font-size:6rem;font-family:Work Sans;font-weight:500;text-align:center;color:#fff;line-height:1.2}.PrescriptionForm_sign-up-form__form-text__B0wce{font-size:2rem;font-family:Work Sans;font-weight:400;line-height:1.5;text-align:center;color:#fff;max-width:60rem;margin:3rem auto auto}.PrescriptionForm_sign-up-form__text__m24qR{font-size:1.8rem;display:block;line-height:1.6;margin-bottom:1.4rem}.PrescriptionForm_sign-up-form__text-header__Ya_Yp{font-size:2rem;display:block;line-height:1.8;margin-bottom:1.4rem}.PrescriptionForm_sign-up-form__submit__Ij3JN{color:#071851;border:none;text-decoration:none;cursor:pointer;text-align:center;display:block;width:100%;margin:4rem auto auto;background:#58ffe6;text-transform:uppercase;box-shadow:0 2px 10px rgba(0,0,0,.1);padding:1.5rem 1rem;font-family:Work Sans;font-weight:500;font-size:2rem;border-radius:10px}.PrescriptionForm_sign-up-form__date-picker__7B4E_{width:100%}.PrescriptionForm_sign-up-form__date-picker__7B4E_ input{padding:1.8rem .8rem;font-size:1.4rem}.PrescriptionForm_sign-up-form__date-picker__7B4E_ input:focus{border-color:#2196f3;box-shadow:0 0 5px rgba(0,0,0,.1)}.PrescriptionForm_sign-up-form__date-picker__7B4E_ div{border-radius:0}.PrescriptionForm_sign-up-form__date-picker__7B4E_ button svg{width:2rem;height:2rem}.PrescriptionForm_sign-up-form__input__nmBcb{padding-bottom:3rem}.PrescriptionForm_sign-up-form__radio-label__I_5ZW{margin-bottom:1rem}.PrescriptionForm_sign-up-form__radio-label__I_5ZW span{font-size:1.5rem}.PrescriptionForm_sign-up-form--1__wNg2e .PrescriptionForm_sign-up-form__input__nmBcb{width:100%}.PrescriptionForm_sign-up-form--2__R_ab4 .PrescriptionForm_sign-up-form__input__nmBcb{width:48%}.PrescriptionForm_sign-up-form--2__R_ab4 .PrescriptionForm_sign-up-form__input--textarea__Em60m{width:100%;resize:none}@media only screen and (max-width:1024px){.PrescriptionForm_sign-up-form__OATr6{max-width:none}.PrescriptionForm_sign-up-form-container__title__8iKpD{font-size:2.6rem}.PrescriptionForm_sign-up-form__form-title__qkqgO{font-size:4rem}.PrescriptionForm_sign-up-form__input__nmBcb{padding-bottom:1rem}.PrescriptionForm_sign-up-form--2__R_ab4 .PrescriptionForm_sign-up-form__input--textarea__Em60m,.PrescriptionForm_sign-up-form--2__R_ab4 .PrescriptionForm_sign-up-form__input__nmBcb{width:100%}}@media only screen and (max-width:540px){.PrescriptionForm_sign-up-form__form-header__C8YI1{margin-bottom:2rem}.PrescriptionForm_sign-up-form__form-title__qkqgO{text-align:center}.PrescriptionForm_sign-up-form__form-text__B0wce{font-size:1.6rem;max-width:36rem;margin:2rem auto auto;text-align:center}.PrescriptionForm_sign-up-form__submit__Ij3JN{font-size:1.8rem;margin-top:2rem}}