:root{--color-primary: #2563eb;--color-primary-hover: #1d4ed8;--color-primary-disabled: #93c5fd;--color-success: #50cd89;--color-error: #f1416c;--color-warning: #ffc700;--color-text: #080808;--color-text-muted: #71717A;--color-border: #e4e6ef;--color-border-error: #f1416c;--color-background: #ffffff;--color-background-alt: #f5f8fa;--color-background-error: #fff5f8;--color-background-success: #f0fdf4;--spacing-xs: .25rem;--spacing-sm: .5rem;--spacing-md: 1rem;--spacing-lg: 1.5rem;--spacing-xl: 2rem;--spacing-2xl: 3rem;--radius-sm: .25rem;--radius-md: .475rem;--radius-lg: .625rem;--radius-xl: .75rem;--radius-full: 9999px;--shadow-sm: 0 1px 2px 0 rgb(0 0 0 / .05);--shadow-md: 0 1px 4px 0 rgb(0 0 0 / .08);--shadow-lg: 0 10px 15px -3px rgb(0 0 0 / .1);--font-sans: "Inter", system-ui, -apple-system, BlinkMacSystemFont, "Segoe UI", sans-serif;--font-size-xs: .75rem;--font-size-sm: .875rem;--font-size-base: 1rem;--font-size-lg: 1.125rem;--font-size-xl: 1.25rem;--font-size-2xl: 1.5rem;--font-size-3xl: 1.875rem}*,*:before,*:after{box-sizing:border-box}*{margin:0;padding:0}html,body{height:100%}body{font-family:var(--font-sans);font-size:var(--font-size-base);line-height:1.5;color:var(--color-text);background-color:var(--color-background);-webkit-font-smoothing:antialiased;-moz-osx-font-smoothing:grayscale}#root{min-height:100vh}.app{min-height:100vh;display:flex;flex-direction:column}.home-screen{flex:1;display:flex;flex-direction:column;align-items:center;justify-content:center;padding:var(--spacing-lg);text-align:center}.home-screen h1{font-size:var(--font-size-3xl);font-weight:700;color:var(--color-primary);margin-bottom:var(--spacing-md)}.home-screen p{color:var(--color-text-muted);max-width:500px;margin-bottom:var(--spacing-md)}.home-hint{margin-top:var(--spacing-xl);font-size:var(--font-size-sm);color:var(--color-text-muted)}.home-hint code{background-color:var(--color-background-alt);padding:var(--spacing-xs) var(--spacing-sm);border-radius:var(--radius-sm);font-family:monospace;color:var(--color-primary)}.demo-links{margin-top:var(--spacing-2xl);padding:var(--spacing-lg);background-color:var(--color-background-alt);border-radius:var(--radius-lg);max-width:500px}.demo-links-title{font-size:var(--font-size-sm);font-weight:600;color:var(--color-text);margin-bottom:var(--spacing-md);text-align:center}.demo-links-grid{display:grid;grid-template-columns:1fr 1fr;gap:var(--spacing-sm)}.demo-link{padding:var(--spacing-sm) var(--spacing-md);background-color:var(--color-background);border:1px solid var(--color-border);border-radius:var(--radius-md);color:var(--color-primary);text-decoration:none;font-size:var(--font-size-sm);text-align:center;transition:all .15s ease}.demo-link:hover{background-color:var(--color-primary);color:#fff;border-color:var(--color-primary)}.patient-form-page{flex:1;min-height:100vh;display:flex;flex-direction:column;background-color:var(--color-background-alt);position:relative}.form-top-banner{width:100%;background-color:var(--color-background);padding:var(--spacing-sm) var(--spacing-xl);display:flex;align-items:center}.ftb-branding{display:flex;align-items:center;gap:var(--spacing-sm)}.ftb-logo{max-height:28px;max-width:120px;object-fit:contain}.ftb-company-name{font-size:var(--font-size-sm);font-weight:700;color:var(--color-text);line-height:1.3}.ftb-practice-name{font-size:var(--font-size-xs);color:var(--color-text-muted)}.ftb-right{display:flex;flex-direction:column;align-items:flex-end;gap:2px;flex-shrink:0}.ftb-patient-label{font-size:var(--font-size-xs);font-weight:600;color:#ffffffa6;text-transform:uppercase;letter-spacing:.08em}.ftb-patient-name{font-size:var(--font-size-base);font-weight:600;color:#fff}.form-container{width:100%;background-color:var(--color-background);min-height:calc(100vh - 65px)}.form-right-panel{max-width:860px;margin:0 auto;padding:0 var(--spacing-lg) var(--spacing-lg);display:flex;flex-direction:column;width:100%}.form-letterhead{display:flex;justify-content:space-between;align-items:flex-start;gap:var(--spacing-lg);padding:var(--spacing-md) 0;border-bottom:1px solid var(--color-border);margin-bottom:var(--spacing-sm)}.flh-company{display:flex;align-items:center;gap:var(--spacing-md)}.flh-logo{height:48px;width:48px;object-fit:contain;flex-shrink:0}.flh-company-details{display:flex;flex-direction:column;gap:2px}.flh-company-name{font-size:var(--font-size-sm);font-weight:700;color:var(--color-text)}.flh-company-details span:not(.flh-company-name){font-size:12px;color:var(--color-text-muted);line-height:1.5}.flh-patient{display:flex;flex-direction:column;align-items:flex-end;gap:2px;flex-shrink:0;text-align:right}.flh-patient-name{font-size:var(--font-size-sm);font-weight:700;color:var(--color-text)}.flh-patient span:not(.flh-patient-name){font-size:12px;color:var(--color-text-muted);line-height:1.5}.form-page-title{font-size:var(--font-size-2xl);font-weight:700;color:var(--color-text);line-height:1.2;padding-top:var(--spacing-sm);margin-bottom:var(--spacing-md)}.form-right-panel>form{background-color:var(--color-background);border-radius:var(--radius-xl);box-shadow:var(--shadow-md);padding:var(--spacing-xl) var(--spacing-2xl);margin-bottom:var(--spacing-xl)}.form-fields-grid{display:grid;grid-template-columns:minmax(0,1fr) minmax(0,1fr);gap:1.25rem var(--spacing-lg);margin-top:var(--spacing-md);align-items:start}.field-col-span-1{grid-column:span 1;min-width:0}.field-col-span-2{grid-column:span 2;min-width:0}.form-field{display:flex;flex-direction:column;gap:var(--spacing-xs);min-width:0}.form-field--inline{flex-direction:row;align-items:center}.form-label{font-size:13px;font-weight:500;color:var(--color-text-muted);display:block;margin-bottom:var(--spacing-xs)}.required-mark{color:var(--color-error);margin-left:var(--spacing-xs)}.form-input{width:100%;min-width:0;min-height:42px;padding:var(--spacing-sm) var(--spacing-md);border:1px solid var(--color-border);border-radius:var(--radius-md);font-size:var(--font-size-base);font-family:inherit;color:var(--color-text);background-color:var(--color-background);transition:border-color .15s ease,box-shadow .15s ease}.form-input:focus{outline:none;border-color:var(--color-primary);box-shadow:0 0 0 3px color-mix(in srgb,var(--color-primary) 15%,transparent)}.form-input:disabled{background-color:var(--color-background-alt);cursor:not-allowed}.form-input--error{border-color:var(--color-border-error)}.form-input--readonly{background-color:var(--color-background-alt);color:var(--color-text-muted);cursor:default}.form-input--error:focus{box-shadow:0 0 0 3px #dc26261a}.form-input:-webkit-autofill,.form-input:-webkit-autofill:hover,.form-input:-webkit-autofill:focus{-webkit-box-shadow:0 0 0px 1000px var(--color-background) inset;box-shadow:0 0 0 1000px var(--color-background) inset;-webkit-text-fill-color:var(--color-text)}.form-textarea{width:100%;padding:var(--spacing-sm) var(--spacing-md);border:1px solid var(--color-border);border-radius:var(--radius-md);font-size:var(--font-size-base);font-family:inherit;resize:vertical;min-height:100px;white-space:pre-wrap;overflow-wrap:anywhere;word-break:break-word;transition:border-color .15s ease,box-shadow .15s ease}.form-textarea--compact{min-height:42px;resize:none;overflow-y:hidden}.form-textarea:focus{outline:none;border-color:var(--color-primary);box-shadow:0 0 0 3px #2563eb1a}.form-textarea:disabled{background-color:var(--color-background-alt);cursor:not-allowed}.form-textarea--error{border-color:var(--color-border-error)}.form-textarea--error:focus{box-shadow:0 0 0 3px #dc26261a}.form-select{width:100%;padding:var(--spacing-sm) var(--spacing-md);border:1px solid var(--color-border);border-radius:var(--radius-md);font-size:var(--font-size-base);font-family:inherit;background-color:var(--color-background);cursor:pointer;transition:border-color .15s ease,box-shadow .15s ease}.form-select:focus{outline:none;border-color:var(--color-primary);box-shadow:0 0 0 3px #2563eb1a}.form-select:disabled{background-color:var(--color-background-alt);cursor:not-allowed}.form-select--error{border-color:var(--color-border-error)}.form-radio-group{display:flex;flex-flow:row wrap;gap:var(--spacing-sm) var(--spacing-lg);padding-top:4px}.form-radio-group--vertical{flex-flow:column nowrap;gap:var(--spacing-sm)}.form-radio-label{display:flex;align-items:center;gap:var(--spacing-sm);cursor:pointer}.form-radio{width:1.125rem;height:1.125rem;cursor:pointer}.form-radio-text{font-size:var(--font-size-base)}.form-checkbox-group{display:flex;flex-flow:row wrap;gap:var(--spacing-sm) var(--spacing-lg);padding-top:4px}.form-checkbox-label{display:flex;align-items:center;gap:var(--spacing-sm);cursor:pointer}.form-checkbox{width:1.125rem;height:1.125rem;cursor:pointer}.form-checkbox-text{font-size:var(--font-size-base)}.form-error{font-size:var(--font-size-sm);color:var(--color-error);margin-top:var(--spacing-xs)}.form-help{font-size:var(--font-size-sm);color:var(--color-text-muted);margin-top:var(--spacing-xs)}.insurance-sections-wrapper{margin-top:var(--spacing-lg)}.insurance-sections-list{display:flex;flex-direction:column;gap:var(--spacing-lg)}.insurance-section-block{border:1px solid var(--color-border);border-radius:var(--radius-lg);overflow:hidden}.insurance-section-header{display:flex;align-items:center;justify-content:space-between;padding:var(--spacing-sm) var(--spacing-md);background-color:var(--color-background-alt);border-bottom:1px solid var(--color-border)}.insurance-section-title{font-size:var(--font-size-sm);font-weight:700;color:var(--color-primary);text-transform:uppercase;letter-spacing:.07em;margin:0}.insurance-section-delete{display:flex;align-items:center;justify-content:center;width:28px;height:28px;border:1px solid var(--color-border);border-radius:var(--radius-md);background:var(--color-background);color:var(--color-text-muted);cursor:pointer;transition:border-color .15s ease,color .15s ease,background-color .15s ease;padding:0}.insurance-section-delete:hover{border-color:var(--color-error);color:var(--color-error);background-color:var(--color-background-error)}.insurance-section-block .form-fields-grid{padding:var(--spacing-md)}.insurance-add-button{display:inline-flex;align-items:center;gap:var(--spacing-xs);margin-top:var(--spacing-md);padding:var(--spacing-sm) var(--spacing-md);border:1px dashed var(--color-primary);border-radius:var(--radius-md);background:transparent;color:var(--color-primary);font-size:var(--font-size-sm);font-weight:500;cursor:pointer;transition:background-color .15s ease}.insurance-add-button:hover{background-color:#eff6ff}.form-section-block{margin-top:var(--spacing-xl);padding-top:var(--spacing-lg);border-top:1px solid var(--color-border)}.form-section-block:first-child{margin-top:0;padding-top:0;border-top:none}.form-section-header--first{padding-top:0!important;margin-top:0!important;border-top:none!important}.image-upload-zone{display:flex;flex-direction:column;align-items:center;justify-content:center;gap:var(--spacing-xs);padding:var(--spacing-lg) var(--spacing-md);border:2px dashed var(--color-border);border-radius:var(--radius-md);background-color:var(--color-background-alt);cursor:pointer;transition:border-color .15s ease,background-color .15s ease}.image-upload-zone:hover{border-color:var(--color-primary);background-color:#eff6ff}.image-upload-zone--error{border-color:var(--color-border-error)}.image-upload-zone--disabled{opacity:.5;cursor:not-allowed}.image-upload-icon{color:var(--color-text-muted)}.image-upload-text{font-size:var(--font-size-base);font-weight:500;color:var(--color-text);margin:0}.image-upload-hint{font-size:var(--font-size-sm);color:var(--color-text-muted);margin:0}.image-upload-hidden-input{display:none}.image-upload-previews{display:flex;flex-wrap:wrap;gap:var(--spacing-sm);margin-top:var(--spacing-sm)}.image-upload-thumb{position:relative;width:96px;display:flex;flex-direction:column;align-items:center;gap:4px}.image-upload-thumb-img{width:96px;height:96px;object-fit:cover;border-radius:var(--radius-md);border:1px solid var(--color-border)}.image-upload-remove{position:absolute;top:4px;right:4px;width:20px;height:20px;border-radius:50%;border:none;background-color:#0000008c;color:#fff;font-size:14px;line-height:1;cursor:pointer;display:flex;align-items:center;justify-content:center;padding:0}.image-upload-remove:hover{background-color:var(--color-error)}.image-upload-thumb-name{font-size:10px;color:var(--color-text-muted);max-width:96px;overflow:hidden;text-overflow:ellipsis;white-space:nowrap;text-align:center}.form-actions{margin-top:var(--spacing-lg);display:flex;justify-content:flex-end;align-items:center;gap:var(--spacing-md);flex-wrap:wrap}.form-submit-button{padding:.625rem var(--spacing-xl);background-color:var(--color-primary);color:#fff;border:none;border-radius:var(--radius-md);font-size:var(--font-size-base);font-weight:600;cursor:pointer;min-width:140px;transition:background-color .15s ease}.form-submit-button:hover:not(:disabled){background-color:var(--color-primary-hover)}.form-submit-button:disabled{background-color:var(--color-primary-disabled);cursor:not-allowed}.form-draft-button{padding:.625rem var(--spacing-xl);background-color:transparent;color:var(--color-primary);border:1px solid var(--color-primary);border-radius:var(--radius-md);font-size:var(--font-size-base);font-weight:600;cursor:pointer;min-width:140px;transition:background-color .15s ease,opacity .15s ease}.form-draft-button:hover:not(:disabled){background-color:var(--color-background-subtle, rgba(0, 0, 0, .04))}.form-draft-button:disabled{opacity:.5;cursor:not-allowed}.form-draft-status{font-size:var(--font-size-sm);color:var(--color-muted, #71717a)}.form-draft-status--error{color:var(--color-error)}.form-submit-error{padding:var(--spacing-md);background-color:var(--color-background-error);border:1px solid var(--color-border-error);border-radius:var(--radius-md);color:var(--color-error);font-size:var(--font-size-sm);margin-bottom:var(--spacing-md)}.loading-screen{flex:1;display:flex;flex-direction:column;align-items:center;justify-content:center;padding:var(--spacing-lg);text-align:center}.loading-spinner{width:2.5rem;height:2.5rem;border:3px solid var(--color-border);border-top-color:var(--color-primary);border-radius:var(--radius-full);animation:spin 1s linear infinite}@keyframes spin{to{transform:rotate(360deg)}}.loading-message{margin-top:var(--spacing-md);color:var(--color-text-muted)}.error-screen{flex:1;display:flex;flex-direction:column;align-items:center;justify-content:center;padding:var(--spacing-lg);text-align:center}.error-icon{font-size:4rem;margin-bottom:var(--spacing-md)}.error-title{font-size:var(--font-size-2xl);font-weight:700;color:var(--color-text);margin-bottom:var(--spacing-sm)}.error-message{color:var(--color-text-muted);max-width:500px;margin-bottom:var(--spacing-md)}.error-hint{font-size:var(--font-size-sm);color:var(--color-text-muted);max-width:500px}.success-screen{flex:1;display:flex;flex-direction:column;align-items:center;justify-content:center;padding:var(--spacing-lg);text-align:center}.success-icon{width:4rem;height:4rem;background-color:var(--color-success);color:#fff;border-radius:var(--radius-full);display:flex;align-items:center;justify-content:center;font-size:var(--font-size-3xl);margin-bottom:var(--spacing-md)}.success-title{font-size:var(--font-size-2xl);font-weight:700;color:var(--color-text);margin-bottom:var(--spacing-sm)}.success-message{color:var(--color-text-muted);max-width:500px;margin-bottom:var(--spacing-md)}.success-detail{color:var(--color-text-muted);font-size:var(--font-size-sm);margin-bottom:var(--spacing-md)}.success-hint{font-size:var(--font-size-sm);color:var(--color-text-muted);max-width:500px}.form-section-header{grid-column:span 2;padding-top:var(--spacing-lg);margin-top:var(--spacing-sm)}.form-section-header:first-child{padding-top:0;margin-top:0}.form-section-title{display:inline-block;font-size:14px;font-weight:700;color:var(--color-primary);letter-spacing:.02em;border-left:3px solid var(--color-primary);padding-left:.625rem;margin:0}.form-instructions{font-size:13px;line-height:1.55;color:#4b5563;margin:0 0 1.25rem;white-space:pre-wrap}.form-section-description{font-size:12.5px;line-height:1.5;color:#4b5563;margin:.5rem 0 1rem;white-space:pre-wrap}.form-footer-text{font-size:12px;line-height:1.5;color:#6b7280;font-style:italic;margin:1.5rem 0 0;white-space:pre-wrap}.form-section-block--internal{background:#fffbeb;border:1px dashed #f59e0b;border-radius:8px;padding:12px 16px;margin-top:1rem}.form-section-internal-badge{display:inline-block;margin-left:.75rem;padding:2px 8px;font-size:10.5px;font-weight:600;color:#92400e;background:#fde68a;border-radius:4px;letter-spacing:.02em;text-transform:uppercase;vertical-align:middle}.preview-readonly-fieldset{border:none;padding:0;margin:0;min-width:0}.preview-readonly-fieldset *{pointer-events:none!important}.preview-readonly-fieldset input,.preview-readonly-fieldset textarea,.preview-readonly-fieldset select,.preview-readonly-fieldset button{opacity:1;cursor:not-allowed}.form-field--internal{position:relative}.form-field--internal:after{content:"Internal";position:absolute;top:-6px;right:0;font-size:9.5px;font-weight:600;color:#92400e;background:#fde68a;padding:1px 6px;border-radius:3px;letter-spacing:.02em;text-transform:uppercase}.form-card-hint{display:flex;align-items:center;gap:var(--spacing-sm);padding:var(--spacing-sm) var(--spacing-md);background-color:#eff6ff;border:1px solid #bfdbfe;border-radius:var(--radius-md);font-size:var(--font-size-sm);color:#1e40af;margin-bottom:var(--spacing-sm)}.form-card-hint-icon{flex-shrink:0;font-size:1rem}.branding-practice{font-size:var(--font-size-sm);color:var(--color-text-muted);margin-top:var(--spacing-xs)}@media (max-width: 768px){.form-top-banner{padding:var(--spacing-xs) var(--spacing-md)}.form-page-title{font-size:var(--font-size-xl)}.form-right-panel{padding:var(--spacing-lg)}.form-right-panel>form{padding:var(--spacing-lg)}.form-fields-grid{grid-template-columns:1fr}.field-col-span-1,.field-col-span-2{grid-column:span 1}.form-letterhead{flex-direction:column;gap:var(--spacing-md)}.flh-patient{align-items:flex-start;text-align:left}.form-actions{flex-direction:column;align-items:stretch;justify-content:stretch}.form-submit-button,.form-draft-button{width:100%;min-width:unset}.form-draft-status{text-align:center}}@media (max-width: 480px){.form-right-panel{padding:var(--spacing-md)}.form-right-panel>form{padding:var(--spacing-md)}.error-title,.success-title{font-size:var(--font-size-xl)}}.signature-pad{position:relative;width:100%;height:180px;border:2px dashed var(--color-border);border-radius:var(--radius-md);background-color:#fff;overflow:hidden;transition:border-color .15s ease}.signature-pad:hover{border-color:var(--color-primary)}.signature-pad--error{border-color:var(--color-border-error)}.signature-pad--disabled{opacity:.5;pointer-events:none}.signature-pad-canvas{width:100%;height:100%;display:block;cursor:crosshair}.signature-pad-placeholder{position:absolute;top:0;right:0;bottom:0;left:0;display:flex;align-items:center;justify-content:center;color:var(--color-text-muted);font-size:var(--font-size-sm);pointer-events:none;-webkit-user-select:none;user-select:none}.signature-pad-actions{display:flex;justify-content:flex-end;margin-top:var(--spacing-xs)}.signature-pad-clear{font-size:var(--font-size-sm);color:var(--color-text-muted);background:none;border:1px solid var(--color-border);border-radius:var(--radius-sm);padding:4px 12px;cursor:pointer;transition:background-color .15s ease,color .15s ease}.signature-pad-clear:hover:not(:disabled){background-color:var(--color-background-alt);color:var(--color-text)}.signature-pad-clear:disabled{opacity:.4;cursor:not-allowed}.signature-pad-tabs{display:inline-flex;gap:4px;padding:4px;margin-bottom:var(--spacing-sm);background:var(--color-background-alt, #f5f8fa);border-radius:999px;width:fit-content}.signature-pad-tab{display:inline-flex;align-items:center;gap:6px;font-size:var(--font-size-sm);font-weight:500;line-height:1;padding:8px 18px;background:transparent;border:none;border-radius:999px;color:var(--color-text-muted);cursor:pointer;transition:background-color .15s ease,color .15s ease,box-shadow .15s ease;-webkit-user-select:none;user-select:none}.signature-pad-tab-icon{flex-shrink:0}.signature-pad-tab:hover:not(:disabled):not(.signature-pad-tab--active){color:var(--color-text)}.signature-pad-tab--active,.signature-pad-tab--active:hover:not(:disabled){background:#fff;color:var(--color-primary);box-shadow:0 1px 2px #0f172a14,0 1px 3px #0f172a0f}.signature-pad-tab:focus-visible{outline:2px solid var(--color-primary);outline-offset:2px}.signature-pad-tab:disabled{opacity:.5;cursor:not-allowed}.form-input--readonly{display:flex;align-items:center;background:var(--color-background-alt, #f5f8fa);color:var(--color-text);cursor:default;-webkit-user-select:none;user-select:none}.signature-pad--upload{display:flex;align-items:center;justify-content:center;cursor:pointer}.signature-pad-upload-label{display:flex;align-items:center;justify-content:center;width:100%;height:100%;padding:var(--spacing-md);color:var(--color-text-muted);font-size:var(--font-size-sm);text-align:center;cursor:pointer}.signature-pad-preview{max-width:100%;max-height:100%;object-fit:contain;display:block}
