.container {
  padding: 7.5vw 18.75vw 10.10417vw;
  position: relative;
  overflow: hidden
}

.container::before {
  content: "";
  position: absolute;
  left: -15.625vw;
  top: -7.29167vw;
  width: 35.88542vw;
  height: 35.88542vw;
  border-radius: 50%;
  opacity: 0.12;
  background: linear-gradient(0deg, #0055D5 0%, #0055D5 100%), #D9D9D9;
  filter: blur(308.75px);
  z-index: -1
}

.container::after {
  content: "";
  position: absolute;
  right: -11.40625vw;
  bottom: -14.58333vw;
  width: 35.88542vw;
  height: 35.88542vw;
  border-radius: 50%;
  opacity: 0.12;
  background: linear-gradient(0deg, #0055D5 0%, #0055D5 100%), #D9D9D9;
  filter: blur(308.75px);
  z-index: -1
}

.container .wrap {
  max-width: 62.5vw;
  margin: 0 auto;
  display: flex;
  flex-direction: column;
  gap: 1.875vw
}

.container .wrap .page-title .t,
.container .wrap .section-title .t {
  color: #071D49;
  font-weight: 500;
  line-height: normal
}

.container .wrap .title-line {
  display: flex;
  align-items: center;
  width: 48.22917vw;
  margin-top: 1.875vw
}

.container .wrap .line-blue {
  flex-shrink: 0;
  width: 2.23958vw;
  height: 2px;
  background: #1673ff
}

.container .wrap .line-gradient {
  flex: 1;
  height: 2px;
  background: linear-gradient(to right, #bfbfbf, rgba(255, 255, 255, 0))
}

.container .wrap .contact-bar {
  display: flex;
  flex-wrap: wrap;
  gap: 1.875vw;
  align-items: center
}

.container .wrap .contact-bar .contact-item {
  display: flex;
  align-items: center;
  gap: .83333vw
}

.container .wrap .contact-bar .contact-item .icon {
  flex-shrink: 0;
  width: 1.875vw;
  height: 1.875vw
}

.container .wrap .contact-bar .contact-item .icon img {
  display: block;
  width: 100%;
  height: auto
}

.container .wrap .contact-bar .contact-item p {
  color: #071D49;
  line-height: 1.5;
  letter-spacing: 1px
}

.container .wrap .content-text {
  color: #696969;
  line-height: 1.5
}

.container .wrap .content-text p {
  margin: 0
}

.container .wrap .content-text p + p {
  margin-top: 1.5em
}

.container .wrap .form-section {
  display: flex;
  flex-direction: column;
  gap: 1.77083vw
}

.container .wrap .form-section .section-title .title-line {
  margin-top: 1.04167vw
}

.container .wrap .report-form {
  display: flex;
  flex-direction: column;
  gap: 2.5vw
}

.container .wrap .form-block {
  display: flex;
  flex-direction: column;
  gap: 1.25vw
}

.container .wrap .form-block .block-title {
  color: #000;
  font-weight: 700;
  line-height: 1.5
}

.container .wrap .form-rows {
  display: flex;
  flex-direction: column;
  gap: 2.1354vw
}

.container .wrap .form-row {
  display: flex;
  gap: 1.25vw;
  width: 100%
}

.container .wrap .form-row-3 .form-item {
  flex: 1;
  min-width: 0
}

.container .wrap .form-row-2 .form-item {
  flex: 1;
  min-width: 0
}

.container .wrap .form-item {
  display: flex;
  flex-direction: column;
  gap: .20833vw;
  width: 100%;
}

.container .wrap .form-item label {
  color: #071D49;
  line-height: 1.5
}

.container .wrap .form-item input[type="text"],
.container .wrap .form-item input[type="email"],
.container .wrap .form-item textarea {
  width: 100%;
  height: 3.125vw;
  padding: .625vw .98958vw;
  border: 1px solid rgba(105, 105, 105, 0.2);
  border-radius: 4px;
  background: #fff;
  color: #071D49;
  font-size: inherit;
  font-family: inherit;
  line-height: 1.5;
  outline: none;
  box-shadow: 0 4px 33.3px 0 rgba(46, 130, 254, 0.06);
  transition: border-color .3s;
  box-sizing: border-box
}

.container .wrap .custom-select {
  position: relative;
  width: 100%
}

.container .wrap .custom-select-trigger {
  position: relative;
  display: flex;
  align-items: center;
  justify-content: space-between;
  width: 100%;
  height: 3.125vw;
  padding: .625vw .98958vw;
  padding-right: 2.08333vw;
  border: 1px solid rgba(105, 105, 105, 0.2);
  border-radius: 4px;
  background: #fff;
  color: #071D49;
  font-size: inherit;
  font-family: inherit;
  line-height: 1.5;
  text-align: left;
  outline: none;
  box-shadow: 0 4px 33.3px 0 rgba(46, 130, 254, 0.06);
  transition: border-color .3s;
  box-sizing: border-box;
  cursor: pointer
}

.container .wrap .custom-select-trigger::after {
  content: "";
  position: absolute;
  right: .98958vw;
  top: 50%;
  width: .625vw;
  height: .41667vw;
  background-image: url("data:image/svg+xml,%3Csvg xmlns='http://www.w3.org/2000/svg' width='12' height='8' viewBox='0 0 12 8' fill='none'%3E%3Cpath d='M1 1.5L6 6.5L11 1.5' stroke='%23696969' stroke-width='1.5' stroke-linecap='round' stroke-linejoin='round'/%3E%3C/svg%3E");
  background-repeat: no-repeat;
  background-position: center;
  background-size: contain;
  transform: translateY(-50%);
  transition: transform .3s;
  pointer-events: none
}

.container .wrap .custom-select.is-open .custom-select-trigger {
  border-color: #1673ff
}

.container .wrap .custom-select.is-open .custom-select-trigger::after {
  transform: translateY(-50%) rotate(180deg)
}

.container .wrap .custom-select-text {
  flex: 1;
  min-width: 0;
  overflow: hidden;
  text-overflow: ellipsis;
  white-space: nowrap
}

.container .wrap .custom-select-text.is-placeholder {
  color: #696969
}

.container .wrap .custom-select-panel {
  display: none;
  position: absolute;
  top: calc(100% + .20833vw);
  left: 0;
  right: 0;
  z-index: 20;
  max-height: 15.625vw;
  overflow-y: auto;
  padding: .52083vw;
  border-radius: .3125vw;
  background: #fff;
  box-shadow: 0 .20833vw 1.25vw rgba(7, 29, 73, 0.12);
  box-sizing: border-box
}

.container .wrap .custom-select.is-open {
  z-index: 30
}

.container .wrap .custom-select.is-open .custom-select-panel {
  display: block
}

.container .wrap .custom-select-option {
  display: flex;
  align-items: center;
  height: 1.875vw;
  padding: 0 .52083vw;
  border-radius: .10417vw;
  color: #071D49;
  font-size: .83333vw;
  line-height: 1.5;
  cursor: pointer;
  transition: background .2s, color .2s
}

.container .wrap .custom-select-option:hover,
.container .wrap .custom-select-option.is-active {
  background: #244290;
  color: #fff
}

.container .wrap .form-item input::placeholder,
.container .wrap .form-item textarea::placeholder {
  color: #696969
}

.container .wrap .form-item input:focus,
.container .wrap .form-item textarea:focus {
  border-color: #1673ff
}

.container .wrap .form-item textarea {
  height: 3.07292vw;
  resize: none;
  min-height: 3.07292vw
}

.container .wrap .form-item textarea.textarea-history {
  border-radius: 12px;
  padding: .83333vw .98958vw;
  box-shadow: none
}

.container .wrap .form-item input.field-dosage {
  height: 3.07292vw;
  padding: .83333vw .98958vw;
  box-shadow: none
}

.container .wrap .form-item textarea.textarea-desc {
  height: 6.25vw;
  min-height: 6.25vw;
  padding: .83333vw .98958vw;
  box-shadow: none
}

.container .wrap .radio-group {
  display: flex;
  align-items: center;
  gap: 1.35417vw;
  margin-top: .52083vw
}

.container .wrap .radio-item,
.container .wrap .checkbox-item {
  display: flex;
  align-items: center;
  gap: .67708vw;
  cursor: pointer
}

.container .wrap .radio-item input,
.container .wrap .checkbox-item input {
  position: absolute;
  opacity: 0;
  width: 0;
  height: 0
}

.container .wrap .radio-box,
.container .wrap .checkbox-box {
  flex-shrink: 0;
  width: 1.5625vw;
  height: 1.5625vw;
  border: 1px solid #e1e1e1;
  border-radius: 4px;
  position: relative;
  transition: all .3s
}

.container .wrap .radio-item input:checked + .radio-box {
  background: #244290;
  border-color: #244290
}

.container .wrap .radio-item input:checked + .radio-box::after {
  content: "";
  position: absolute;
  top: 50%;
  left: 50%;
  width: .625vw;
  height: .41667vw;
  border-left: 2px solid #fff;
  border-bottom: 2px solid #fff;
  transform: translate(-50%, -60%) rotate(-45deg)
}

.container .wrap .checkbox-item input:checked + .checkbox-box {
  background: #244290;
  border-color: #244290
}

.container .wrap .checkbox-item input:checked + .checkbox-box::after {
  content: "";
  position: absolute;
  top: 50%;
  left: 50%;
  width: .625vw;
  height: .41667vw;
  border-left: 2px solid #fff;
  border-bottom: 2px solid #fff;
  transform: translate(-50%, -60%) rotate(-45deg)
}

.container .wrap .upload-box {
  position: relative;
  display: flex;
  align-items: center;
  height: 3.07292vw;
  padding: 0 .98958vw;
  border: 1px solid rgba(105, 105, 105, 0.2);
  border-radius: 4px;
  background: #fff;
  box-shadow: 0 4px 33.3px 0 rgba(46, 130, 254, 0.06);
  box-sizing: border-box
}

.container .wrap .upload-box input[type="file"] {
  position: absolute;
  inset: 0;
  opacity: 0;
  cursor: pointer;
  z-index: 1
}

.container .wrap .upload-box .upload-tip {
  flex: 1;
  color: #696969;
  line-height: 1.5;
  margin: 0;
  pointer-events: none
}

.container .wrap .upload-box .upload-icon {
  flex-shrink: 0;
  width: 1.25vw;
  height: 1.25vw;
  pointer-events: none
}

.container .wrap .upload-box .upload-icon svg {
  display: block;
  width: 100%;
  height: 100%
}

.container .wrap .form-agree {
  margin-top: -.41667vw
}

.container .wrap .field-error {
  color: #e53935;
  line-height: 1.5;
  margin: .20833vw 0 0
}

.container .wrap .submit-btn {
  display: flex;
  align-items: center;
  justify-content: center;
  width: 100%;
  height: 4.84375vw;
  border: none;
  border-radius: 17px;
  background: linear-gradient(to right, #4da7fe, #244290);
  color: #fff;
  font-weight: 500;
  line-height: 1.5;
  cursor: pointer;
  transition: opacity .3s
}

.container .wrap .submit-btn:hover {
  opacity: .9
}

.success-modal {
  position: fixed;
  inset: 0;
  z-index: 9999;
  display: none;
  align-items: center;
  justify-content: center;
  padding: 5vw
}

.success-modal.is-show {
  display: flex
}

body.modal-open {
  overflow: hidden
}

.success-modal-mask {
  position: absolute;
  inset: 0;
  background: rgba(0, 0, 0, 0.45)
}

.success-modal-box {
  position: relative;
  width: 46.875vw;
  max-width: 900px;
  background: #fff;
  border-radius: 1.04167vw;
  box-shadow: 0 .20833vw .65104vw rgba(0, 0, 0, 0.25);
  padding: 5vw 6.5625vw;
  box-sizing: border-box
}

.success-modal-close {
  position: absolute;
  top: 1.45833vw;
  right: 1.45833vw;
  width: 2.08333vw;
  height: 2.08333vw;
  padding: 0;
  border: none;
  background: transparent;
  cursor: pointer
}

.success-modal-close svg {
  display: block;
  width: 100%;
  height: 100%
}

.success-modal-content {
  display: flex;
  flex-direction: column;
  align-items: center;
  gap: 2.60417vw
}

.success-modal-text {
  color: #000;
  line-height: 1.5;
  text-align: center;
  margin: 0
}

.success-modal-btn {
  display: flex;
  align-items: center;
  justify-content: center;
  width: 14.0625vw;
  min-width: 180px;
  height: 4.84375vw;
  border: none;
  border-radius: 17px;
  background: linear-gradient(to right, #4da7fe, #244290);
  color: #fff;
  font-weight: 500;
  line-height: 1.5;
  cursor: pointer;
  transition: opacity .3s
}

.success-modal-btn:hover {
  opacity: .9
}

@media screen and (max-width: 768px) {
  .container {
    padding: 40px 5%;
    padding-bottom: 40px
  }

  .container::before,
  .container::after {
    width: 300px;
    height: 300px;
    opacity: .5
  }

  .container::before {
    left: -100px;
    top: -80px
  }

  .container::after {
    right: -100px;
    bottom: -100px
  }

  .container .wrap {
    max-width: 100%;
    gap: 24px
  }

  .container .wrap .title-line {
    width: 100%;
    margin-top: 12px
  }

  .container .wrap .line-blue {
    width: 30px
  }

  .container .wrap .contact-bar {
    flex-direction: column;
    align-items: flex-start;
    gap: 20px
  }

  .container .wrap .contact-bar .contact-item {
    gap: 12px
  }

  .container .wrap .contact-bar .contact-item .icon {
    width: 24px;
    height: 24px
  }

  .container .wrap .contact-bar .contact-item p {
    font-size: 14px;
    letter-spacing: 0.5px
  }

  .container .wrap .content-text {
    font-size: 14px
  }

  .container .wrap .form-section {
    gap: 24px
  }

  .container .wrap .report-form {
    gap: 32px
  }

  .container .wrap .form-block {
    gap: 16px
  }

  .container .wrap .form-rows {
    gap: 16px
  }

  .container .wrap .form-row {
    flex-direction: column;
    gap: 16px
  }

  .container .wrap .form-item input[type="text"],
  .container .wrap .form-item input[type="email"],
  .container .wrap .form-item textarea {
    height: 48px;
    padding: 10px 14px;
    font-size: 14px
  }

  .container .wrap .custom-select-trigger {
    height: 48px;
    padding: 10px 14px;
    padding-right: 36px;
    font-size: 14px
  }

  .container .wrap .custom-select-trigger::after {
    right: 14px;
    width: 12px;
    height: 8px
  }

  .container .wrap .custom-select-panel {
    top: calc(100% + 4px);
    max-height: 240px;
    padding: 10px;
    border-radius: 6px;
    box-shadow: 0 4px 24px rgba(7, 29, 73, 0.12)
  }

  .container .wrap .custom-select-option {
    height: 36px;
    padding: 0 10px;
    border-radius: 2px;
    font-size: 16px
  }

  .container .wrap .form-item textarea {
    height: 59px;
    min-height: 59px
  }

  .container .wrap .form-item textarea.textarea-history {
    padding: 16px 14px
  }

  .container .wrap .form-item input.field-dosage {
    height: 59px;
    padding: 16px 14px
  }

  .container .wrap .form-item textarea.textarea-desc {
    height: 120px;
    min-height: 120px;
    padding: 16px 14px
  }

  .container .wrap .radio-box,
  .container .wrap .checkbox-box {
    width: 24px;
    height: 24px
  }

  .container .wrap .radio-item input:checked + .radio-box::after,
  .container .wrap .checkbox-item input:checked + .checkbox-box::after {
    width: 10px;
    height: 6px;
    border-left-width: 2px;
    border-bottom-width: 2px;
    transform: translate(-50%, -58%) rotate(-45deg)
  }

  .container .wrap .radio-group {
    gap: 20px;
    margin-top: 8px
  }

  .container .wrap .upload-box {
    height: auto;
    min-height: 48px;
    padding: 12px 14px
  }

  .container .wrap .upload-box .upload-tip {
    font-size: 13px
  }

  .container .wrap .upload-box .upload-icon {
    width: 20px;
    height: 20px
  }

  .container .wrap .field-error {
    font-size: 13px;
    margin-top: 4px
  }

  .success-modal {
    padding: 20px
  }

  .success-modal-box {
    width: 100%;
    border-radius: 16px;
    padding: 48px 24px 32px
  }

  .success-modal-close {
    top: 12px;
    right: 12px;
    width: 32px;
    height: 32px
  }

  .success-modal-content {
    gap: 32px
  }

  .success-modal-text {
    font-size: 20px
  }

  .success-modal-btn {
    width: 180px;
    height: 56px;
    border-radius: 12px;
    font-size: 18px
  }

  .container .wrap .submit-btn {
    height: 56px;
    border-radius: 12px;
    font-size: 18px
  }
}