.LandingPatientInfoForm_container__zRbYh{display:flex;flex-direction:column;gap:var(--spacing-6)}.LandingPatientInfoForm_summaryCard__Y6EDF{background:var(--color-brand-50);border:1px solid var(--border-brand)}.LandingPatientInfoForm_summaryTitle__gATxs{margin-bottom:var(--spacing-4);text-align:center}.LandingPatientInfoForm_summaryDetails__llLdD{display:flex;flex-direction:column;gap:var(--spacing-3)}.LandingPatientInfoForm_summaryItem__2h_1V{justify-content:space-between}.LandingPatientInfoForm_priceDisplay__Xt6EE,.LandingPatientInfoForm_summaryItem__2h_1V{display:flex;align-items:center;gap:var(--spacing-2)}.LandingPatientInfoForm_originalPrice__urfmk{text-decoration:line-through}.LandingPatientInfoForm_formCard__9GZeq{background:var(--surface-secondary)}.LandingPatientInfoForm_form__MGQmY{display:flex;flex-direction:column;gap:var(--spacing-6)}.LandingPatientInfoForm_formHeader__KTwvX{text-align:center;margin-bottom:var(--spacing-4)}.LandingPatientInfoForm_personalInfoSection__zSfqv{margin-bottom:var(--spacing-4)}.LandingPatientInfoForm_inputGrid__o_x8U{display:grid;grid-template-columns:1fr 1fr;grid-gap:var(--spacing-4);gap:var(--spacing-4);@media (max-width:640px){grid-template-columns:1fr}}.LandingPatientInfoForm_phoneSection__Q4IR8{margin-bottom:var(--spacing-4)}.LandingPatientInfoForm_phoneGrid__0coro{display:grid;grid-template-columns:140px 1fr;grid-gap:var(--spacing-4);gap:var(--spacing-4);align-items:end;@media (max-width:640px){grid-template-columns:1fr}}.LandingPatientInfoForm_prefixSelect__NA40i{min-width:120px}.LandingPatientInfoForm_phoneInput___Naob{flex:1 1}.LandingPatientInfoForm_checkboxSection__nclgA{display:flex;flex-direction:column;gap:var(--spacing-4);margin-bottom:var(--spacing-6)}.LandingPatientInfoForm_policyLink__J0brt{color:var(--text-brand);text-decoration:underline;font-weight:var(--font-weight-medium)}.LandingPatientInfoForm_policyLink__J0brt:hover{color:var(--text-accent)}.LandingPatientInfoForm_required__9oiE4{color:var(--color-danger-600);font-weight:var(--font-weight-semibold);margin-left:var(--spacing-1)}.LandingPatientInfoForm_submitButton__CwnFI{min-height:var(--size-lg);font-weight:var(--font-weight-bold);margin-top:var(--spacing-2);text-wrap:wrap}@media (max-width:640px){.LandingPatientInfoForm_container__zRbYh,.LandingPatientInfoForm_form__MGQmY{gap:var(--spacing-4)}.LandingPatientInfoForm_formHeader__KTwvX,.LandingPatientInfoForm_personalInfoSection__zSfqv,.LandingPatientInfoForm_phoneSection__Q4IR8{margin-bottom:var(--spacing-3)}.LandingPatientInfoForm_checkboxSection__nclgA{margin-bottom:var(--spacing-4)}}