.provider-claim-form_formWrapper__mxwBl{display:flex;justify-content:center;gap:2rem;font-family:abc-rom,sans-serif;font-size:1.7rem;line-height:2.4rem}.provider-claim-form_exCssCityInput__jxx_5{margin-bottom:2rem}.provider-claim-form_exCssSubmit__HrScI{max-width:500px}.provider-claim-form_formHeading__2l1gV{font-family:abc-gravity-condensed,abc-gravity-condensed-fallback,sans-serif;font-size:3.6rem;line-height:3.4rem;font-weight:900;text-transform:uppercase;margin-bottom:4rem;text-align:center}.provider-claim-form_sectionWrapper__XNNV3{display:flex;flex-direction:column;gap:2rem}.provider-claim-form_cityStateWrapper__DJyR8{display:flex;justify-content:space-between}@media(max-width:990px){.provider-claim-form_cityStateWrapper__DJyR8{flex-direction:column;gap:1rem}.provider-claim-form_formWrapper__mxwBl{flex-direction:column;align-items:center}.provider-claim-form_sectionWrapper__XNNV3{width:100%}.provider-claim-form_lastSection__GRhN8{margin-bottom:40px}}@media not all and (max-width:990px){.provider-claim-form_formWrapper__mxwBl{flex-wrap:wrap;flex-direction:row}.provider-claim-form_sectionWrapper__XNNV3{width:calc(50% - 7rem);margin:0 3rem}.provider-claim-form_lastSection__GRhN8{margin-bottom:2rem}.provider-claim-form_exCssCityInput__jxx_5{flex:1;margin-right:2rem}}.provider-claim-form_dropdownButton__TkFKj,.provider-claim-form_multiSelectDropdownButton__Q7d7r{border-color:#000;border-radius:0}.phone-number-input_phoneNumberInput__2c7WU{position:relative;border:1px solid #000}.phone-number-input_phoneInput__DKvuz{display:flex;align-items:center;overflow:hidden}.phone-number-input_phoneInput__DKvuz .PhoneInputCountry{position:relative;display:inline-block;width:5.5rem;min-width:5.5rem;padding:1rem;background-color:#fff}.phone-number-input_phoneInput__DKvuz .PhoneInputCountrySelect{position:absolute;top:0;left:0;height:100%;width:100%;z-index:1;border:0;opacity:0;cursor:pointer}.phone-number-input_phoneInput__DKvuz .PhoneInputCountryIconImg{vertical-align:middle}.phone-number-input_phoneInput__DKvuz .PhoneInputCountrySelectArrow{display:none}.phone-number-input_phoneInput__DKvuz .PhoneInputInput{height:5rem;border:none;width:100%;outline:none}.phone-number-input_exCssErrorMessage__lTm0E{margin-left:2rem}
/*# sourceMappingURL=f8758f0a466fa795.css.map*/