/* ----- Form Structure ----- */

form p {
	padding: 0;
	margin: 0;
	line-height: 1em;
}

.formbox {
	margin: 0 3em 1em 3em;
	padding: 10px;
	background-color: #fdfdfd;
	border: 0px solid #666;
}

.formbox p {
	display: block;
}

.boxb {
	background-color: #fff;
	margin: 12px;
	padding: 5px;
	border: 1px solid #777;
}

.boxb p {
	background-color: #f9f9f9;
	padding: 6px 8px;
	border: 1px solid #999;
}

	
/* ----- Form Styling ----- */

	.required {
		color: #AF3501;
		font-size: 10px;
	}

	.breaker {
	    clear: both;
	}
	
	.errortext {
		margin: 0 3em 1em 3em;
		padding: 2px;
		color: #fff;
		font-size: 1.1em;
		font-style: bold;
		background-color: #cc0000;
	}
	
	
/* ----- Form Elements ----- */
	
	select {
		width: 10em;
		margin: 4px 4px 12px 2px;
	}
	
	.comments textarea {
		width: 440px;
		height: 100px;
		margin: 4px 4px 15px 2px;
	}
	
	.formbox input {
		width: 240px;
		margin: 4px 4px 12px 2px;
	}
	
	.check input {
		width: 1em;
		margin: 0 6px 0 2px;
		padding: 0;
	}
	
	.check {
		line-height: 1.6em;
	}
	
	input.submitbtn {
		width: 130px;
	}

	.zip, .state {
		padding-right: 1em;
		float: left;
		display: inline;
	}
	
	.zip input {
		width: 5em;
	}
	
	input:focus, input.sffocus, textarea:focus, textarea.sffocus, select:focus, select.sffocus {
		border: 1px solid #AF3501;
		margin: 5px 5px 13px 3px;
	}
	
	.check input:focus, .check input.sffocus, .check select:focus, .check select.sffocus {
		border: 1px solid #AF3501;
		width: 1em;
		margin: 0 6px 0 2px;
		padding: 0;
	}
	
	/* ----- Patient Name ----- */
	
	.namediv {
		float: left;
		display: inline;
		position: relative;
	}
	
	.namediv input {
		width: 12em;
		float: none;
	}
	
	.middleinitial input {
		width: 1.9em;
	}
	
	
	/* ----- SSN ----- */
	
	.social {

	}
	
	.ssn1 input {
		width: 2.7em;
		float: left;
		display: inline;
	}
	
	.ssn2 input {
		width: 1.9em;
		float: left;
		display: inline;
	}
	
	.ssn3 input {
		width: 3.5em;
		float: left;
		display: inline;
	}