body{
  background:#eccabb;
}
#form_logo{
  margin: 20px auto;
  display: block;
  z-index: 0;
  postion: relative;
}
input{
  background: transparent;
}
.form_default{
  background: #eccabb;
}
.form_group{
  margin: 2px 0;
}
.bold_text{
  color: #3e4a88;
  font-weight: bold;
  font-size: 120%;
  width: 100%;
  text-align: center;
}
.text_center{
  text-align: center;
  width: 100%;
  display: block;
}
.box{
  padding: 5px;
  box-sizing: border-box;
  border: 1px solid #888;
  border-radius: 10px 10px 0 0;
  z-index: 10;
  position: relative;
  background: #fff;
}
.box_header_purple{
  width: 100%;
  background: #485387;
  color: #d3cd73;
  text-align: center;
  font-size: 175%;
  font-weight: bold;
  margin: -5px -5px 15px;
  padding: 5px;
  border-radius: 10px 10px 0 0;
  font-family: "Times New Roman",Georgia,serif;
}
.box_header_green{
  width: 100%;
  background: #569e89;
  color: #d3cd73;
  text-align: center;
  font-size: 175%;
  font-weight: bold;
  margin: -5px -5px 15px;
  padding: 5px;
  border-radius: 10px 10px 0 0;
  font-family: "Times New Roman",Georgia,serif;
}
.box_number_purple{
  width: 0;
  height: 0;
  border: 30px solid transparent;
  border-bottom-color: #706993;
  top: -42px;
  position: absolute;
  font-size: 300%;
  line-height: 1.65;
  text-indent: -11px;
  z-index: 100;
  font-weight: bold;
  color: #fff;
}
.box_number_purple:after{
  content: '';
	position: absolute;
	left: -30px;
	top: 30px;
	width: 0;
	height: 0;
	border: 30px solid transparent;
	border-top-color: #706993;
  z-index: -1;
}
.box_number_green{
  width: 0;
  height: 0;
  border: 30px solid transparent;
  border-bottom-color: #7ba698;
  top: -42px;
  position: absolute;
  font-size: 300%;
  line-height: 1.65;
  text-indent: -11px;
  z-index: 100;
  font-weight: bold;
  color: #fff;
}
.box_number_green:after{
  content: '';
	position: absolute;
	left: -30px;
	top: 30px;
	width: 0;
	height: 0;
	border: 30px solid transparent;
	border-top-color: #7ba698;
  z-index: -1;
}
.box_half{
  width: 48%;
  margin: 25px 1% 0;
  float: left;
}
.box_full{
  width: 98%;
  float: left;
  margin: 25px 1% 0;
}
.box_group_half{
  width: 48%;
  float: left;
  margin: 0 1%;
}
.box_group_half .box_full{
  width: 100%;
  float: left;
  margin: 25px 0 0;
}
.box_full .box_half{
    margin: 0 1%;
}
.grey_group{
  background: #d7d7d7;
  margin: 5px -5px -5px;
  padding: 5px;
  color: #296954;
  overflow: hidden;
}
.yes_no_half {
  width: 48%;
  margin: 0 1%;
  float: left;
  font-size: 80%;
}
.yes_no_33 {
  width: 31.33%;
  margin: 0 1%;
  float: left;
  font-size: 80%;
}
.yes_no_half .form_group,.yes_no_33 .form_group{
  margin: 0;
}
.random_box{
  margin: 25px 1% 0;
  padding: 5px;
  background: #d7d7d7;
  border: 1px solid #888;
  color: #296954;
  box-sizing: border-box;
}
#top_boxes{
  margin: -145px 0 0 0;
}
.fixed_width{
  width: 325px;
  display: inline-block;
  vertical-align: bottom;
  margin: 0 10px 0 0;
}
#informed_consent{
  font-size: 140%;
  font-weight: bold;
  text-indent: 20px;
  text-align: justify;
}
#final_number{
  text-indent: -6px;
}
.orange_text{
  color: #db808f;
}
.green_text{
  color: #7ba698;
}
.top_grey{
  width: 100%;
  background-color: #485387;
  padding: 5px;
  font-size: 20px;
  text-align: center;
  color: #fff;
  border-radius: 10px 10px 0 0;
  box-sizing: border-box;
}
.bottom_box{
  padding: 5px;
  background: #fff;
}
.bottom_interior_box{
  padding: 5px;
  background: rgb(161, 189, 210);
}
input[name="question_1"]{
  width: 80%;
}
input[name="question_2"]{
  width: 78%;
}
input[name="question_3"],.last_name{
  width: 33%;
}
input[name="question_4"],.first_name{
  width: 32%;
}
input[name="question_5"],.middle_name{
  width: 9%;
}
input[name="question_6"],.pre_name{
  width: 10%;
}
.last_name{
  margin: 0 0 0 40px;
}
.last_name,.first_name,.middle_name,.pre_name,.city_address,.state_address,.zip_address{
  font-size: 75%;
  display: inline-block;
  vertical-align: top;
}
input[name="question_7"]{
  width: 47%;
}
input[name="question_10"]{
  width: 8%;
}
input[name="question_11"]{
  width: 8%;
}
input[name="question_12"]{
  width: 15%;
}
input[name="question_13"]{
  width: 8%;
}
input[name="question_14"]{
  width: 24%;
}
input[name="question_15"]{
  width: 77.5%;
}
input[name="question_16"],.city_address{
  width: 62%;
}
input[name="question_17"],.state_address{
  width: 10%;
}
input[name="question_18"],.zip_address{
  width: 23.5%;
}
input[name="question_20"]{
  width: 10%;
}
input[name="question_21"]{
  width: 26%;
}
input[name="question_22"]{
  width: 10%;
}
input[name="question_23"]{
  width: 23%;
}
input[name="question_24"]{
  width: 10%;
}
input[name="question_25"]{
  width: 26%;
}
input[name="question_26"]{
  width: 10%;
}
input[name="question_27"]{
  width: 24.5%;
}
input[name="question_28"]{
  width: 85%;
}
input[name="question_29"]{
  width: 71.5%;
}
input[name="question_30"]{
  width: 29%;
}
input[name="question_31"]{
  width: 30%;
}
input[name="question_32"]{
  width: 41.5%;
}
input[name="question_33"]{
  width: 49%;
}
input[name="question_34"]{
  width: 54%;
}
input[name="question_35"]{
  width: 77%;
}
input[name="question_36"]{
  width: 78%;
}
input[name="question_37"]{
  width: 70%;
}
input[name="question_38"]{
  width: 67.5%;
}
input[name="question_39"]{
  width: 10%;
}
input[name="question_40"]{
  width: 54.5%;
}
input[name="question_41"]{
  width: 56%;
}
input[name="question_42"]{
  width: 39%;
}
input[name="question_43"]{
  width: 24%;
}
input[name="question_44"]{
  width: 8%;
}
input[name="question_45"]{
  width: 8%;
}
input[name="question_46"]{
  width: 10%;
}
input[name="question_47"]{
  width: 21.5%;
}
input[name="question_48"]{
  width: 72%;
}
input[name="question_49"]{
  width: 70%;
}
input[name="question_50"]{
  width: 67.5%;
}
input[name="question_51"]{
  width: 10%;
}
input[name="question_52"]{
  width: 54.5%;
}
input[name="question_53"]{
  width: 56%;
}
input[name="question_54"]{
  width: 39%;
}
input[name="question_55"]{
  width: 24%;
}
input[name="question_56"]{
  width: 8%;
}
input[name="question_57"]{
  width: 8%;
}
input[name="question_58"]{
  width: 10%;
}
input[name="question_59"]{
  width: 21.5%;
}
input[name="question_60"]{
  width: 72%;
}
input[name="question_61"]{
  width: 77%;
}
input[name="question_62"]{
  width: 85%;
}
input[name="question_63"]{
  width: 8%;
}
input[name="question_64"]{
  width: 25%;
}
input[name="question_65"]{
  width: 10%;
}
input[name="question_66"]{
  width: 27%;
}
input[name="question_67"]{
  width: 10%;
}
input[name="question_68"]{
  width: 10%;
}
input[name="question_69"]{
  width: 15%;
}
input[name="question_70"]{
  width: 39%;
}
input[name="question_71"]{
  width: 25%;
}
input[name="question_72"]{
  width: 8.5%;
}
input[name="question_73"]{
  width: 28%;
}
input[name="question_74"]{
  width: 8.5%;
}
input[name="question_75"]{
  width: 27%;
}
input[name="question_76"]{
  width: 89.5%;
}
input[name="question_77"]{
  width: 8%;
}
input[name="question_78"]{
  width: 21%;
}
input[name="question_79"]{
  width: 8%;
}
input[name="question_80"]{
  width: 8%;
}
input[name="question_81"]{
  width: 21%;
}
input[name="question_82"]{
  width: 77.5%;
}
input[name="question_83"]{
  width: 49%;
}
input[name="question_84"]{
  width: 28%;
}
input[name="question_85"]{
  width: 28%;
}
input[name="question_86"]{
  width: 47.5%;
}
input[name="question_88"]{
  width: 74%;
}
input[name="question_89"]{
  width: 10%;
}
input[name="question_90"]{
  width: 24%;
}
input[name="question_91"]{
  width: 25.5%;
}
input[name="question_94"]{
  width: 78%;
}
input[name="question_96"]{
  width: 70.5%;
}
input[name="question_99"]{
  width: 41%;
}
input[name="question_135"]{
  width: 100%;
}
input[name="question_145"]{
  width: 100%;
}
input[name="question_175"]{
  width: 100%;
}
input[name="question_155"]{
  width: 52%;
}
input[name="question_163"],input[name="question_164"],input[name="question_165"]{
  width: 76%;
}
input[name="question_171"],input[name="question_172"],input[name="question_173"]{
  width: 20%;
}
input[name="question_168"]{
  width: 100%;
}
input[name="question_169"]{
  width: 100%;
}
input[name="question_170"]{
  width: 100%;
}
.signature,.signature_date{
  font-size: 80%;
  display: inline-block;
}
.signature{
  width: 78%;
}
.signature_date{
  width: 19%;
}
#physical_health{
  width: 290px;
  display: inline-block;
  vertical-align: bottom;
}
.street_address{
  font-size: 75%;
  float: right;
  margin: 0 1% 0 0;
}
@media print {
  @page {
    size: letter portrait;
    margin: 0.5cm;
  }
  #page_break {
    width: 100%;
    margin: 0 0 125px;
    clear: both;
    height: 1px;
  }
}