Referal ModernVet — Modern Vet

body { font-family: "Poppins", sans-serif; margin: 0; font-size: 16px; } .referal-form { margin: 20px 10px; margin-bottom: 0; background-color: #f9e2d5; width: auto; } .referal-form label { display: flex; align-self: center; justify-content: space-between; } .container { margin: 0 auto; padding-left: 60px; padding-right: 60px; } h1 { text-align: center; margin: 0 auto; margin-bottom: 15px; font-size: 30px; } h2 { font-size: 24px; text-transform: uppercase; font-weight: 500; color: #272353; padding-left: 10px; margin-bottom: 0; margin-top: 0; } .referal-top { background-color: #fcc29a; padding: 10px 20px; display: flex; font-weight: bold; color: #272353; margin-bottom: 15px; } .referal-top .rf { display: flex; flex-wrap: wrap; flex-basis: 66%; } .referal-top .rf .date { flex-shrink: 0; justify-content: flex-start; } .referal-top .rf .date input { margin-left: 15px; } .referal-top .rf .ref-department { flex-basis: 100%; flex-shrink: 0; } .referal-top .rf .ref-department span { font-weight: 400; } .referal-top .rf label { flex-basis: 40%; padding-right: 30px; } .referal-header .logo { margin: 0 auto; text-align: center; transform: translateY(-20px); margin-bottom: -5px; } .referal-header .logo svg { width: 220px; } .contacts { font-weight: 500; line-height: 2; padding-left: 15px; border-left: 1px dashed #272353; } b { font-weight: bold; } form { overflow: hidden; } .simple-fields { background-color: #fceee8; color: #272353; } .simple-fields h2 { background-color: #fcc29a; width: 100%; } .simple-fields label { border-bottom: 2px solid #fcc29a; padding-left: 10px; margin: 0; align-items: center; height: 30px; justify-content: flex-start; width: auto; flex-shrink: 0; flex-grow: 1; color: #272353; } .simple-fields label input { color: #272353; margin-left: 15px; border: none; background: transparent; pointer-events: none; outline: none; } .patient-info, .pet-owner, .pet-history, .other-records { display: flex; flex-wrap: wrap; } .pet-history { background-color: transparent; } .pet-history label { height: 48px; border-bottom: none; } .other-records { background-color: transparent; } .other-records label { background-color: transparent; border: none; } .other-records label + textarea { width: 100%; background-color: #fceee8; border: none; outline: none; border-top: 2px solid #fcc29a; border-bottom: none; height: 100px; } .row { width: 100%; display: flex; justify-content: space-between; } label input[name=other-records] { border-bottom: 2px solid #212058; } label + input[type=checkbox], input[type=radio] { width: fit-content; } input[type=text], input[type=tel], input[type=email], textarea { width: auto; padding: 5px; } input[type=submit] { padding: 10px 20px; background-color: #4CAF50; color: #fff; border: none; border-radius: 4px; cursor: pointer; } input[type=submit]:hover { background-color: #45a049; } .referal-instruction { text-align: center; background-color: #fcc29a; padding: 10px 30px; } .referal-instruction h2 { font-weight: bold; } .referal-instruction p { font-size: 11px; font-weight: 500; color: #272353; } .referal-bottom { text-align: center; background-color: #272353; color: #f9e2d5; font-weight: bold; line-height: 2.5; } button { background: #A71D17; box-shadow: 0 0 0 #A71D17; color: #fff; padding: 10px 20px; border: none; border-radius: 4px; font-size: 16px; cursor: pointer; margin: 15px auto; text-align: center; display: block; } button:hover { opacity: 0.8; } input[type=checkbox], input[type=radio] { margin-top: 0; margin-bottom: 0; margin-right: 0; } /* Скрыть оригинальные стили чекбоксов и радиокнопок */ input[type=checkbox], input[type=radio] { appearance: none; -webkit-appearance: none; -moz-appearance: none; width: 20px; height: 20px; border: 2px solid #272353 !important; outline: none; cursor: pointer; } input[type=checkbox]::before, input[type=radio]::before { display: none; } /* Создать стилизованный вид для отмеченных чекбоксов и радиокнопок */ input[type=checkbox]:checked, input[type=radio]:checked { background-color: #272353; } input[type=checkbox]:checked::before, input[type=radio]:checked::before { display: block; } /* Создать стилизованный вид для иконки чекбокса */ input[type=checkbox]::before { content: "✓"; text-align: center; line-height: 20px; font-size: 14px; color: #fff; } input[type=radio]::before { content: "✓"; text-align: center; line-height: 20px; font-size: 14px; color: #fff; } /* Присоединить метку к соответствующему чекбоксу или радиокнопке */ input[type=checkbox]:checked + label, input[type=radio]:checked + label { font-weight: bold; color: #272353; } input[type=date] { position: relative; appearance: none; -webkit-appearance: none; -moz-appearance: none; border: none; background-color: transparent; color: #272353; font-size: 16px; outline: none; } input[type=date]::-webkit-calendar-picker-indicator { position: absolute; top: 0; right: 0; bottom: 0; left: 0; width: auto; height: auto; color: transparent; background: transparent; cursor: pointer; } input[type=date]:focus { outline: none; border: none; } label input[type=file i] { display: none; } .attc-file { position: relative; padding-left: 30px; cursor: pointer; } .attc-file:hover { color: #000; } .attc-file::before { content: ""; width: 22px; height: 22px; position: absolute; top: 0; left: 0; background-image: url("data:image/svg+xml,%3Csvg width='24' height='25' fill='none' xmlns='http://www.w3.org/2000/svg'%3E%3Cpath d='M13.258 5.349L5.156 13.45a4.179 4.179 0 000 5.892 4.179 4.179 0 005.893 0l8.47-8.47a2.579 2.579 0 000-3.683 2.58 2.58 0 00-3.683 0l-8.47 8.47a1.045 1.045 0 000 1.474 1.045 1.045 0 001.473 0l6.997-6.998 1.105 1.105-6.997 6.998a2.58 2.58 0 01-3.683 0 2.58 2.58 0 010-3.683l8.47-8.47a4.179 4.179 0 015.893 0 4.179 4.179 0 010 5.892l-8.47 8.47a5.713 5.713 0 01-8.103 0 5.713 5.713 0 010-8.102l8.102-8.102 1.105 1.105z' fill='%23000' fill-opacity='.87'/%3E%3C/svg%3E"); background-repeat: no-repeat; background-size: contain; } .upload-wrap { display: flex; justify-content: flex-start; align-items: center; background: #272353; box-shadow: 0 0 0 #272353; color: #fff; padding: 10px 20px; border: none; border-radius: 4px; font-size: 16px; cursor: pointer; margin-top: 15px; margin-bottom: 15px; text-align: center; } .topform-list { display: flex; justify-content: flex-start; align-items: flex-start; flex-direction: column; width: 100%; margin-bottom: 20px; } .topform-list .dropdown { display: flex; align-items: center; } .topform-list .dropdown select { border: none; background-color: transparent; outline: none; font-size: 16px; color: #212058; } .topform-list .dropdown select option { background-color: transparent; border: none; box-shadow: none; } .topform-list .dropdown label { padding-right: 0; width: auto; flex-basis: auto; } /* Стили для мобильных устройств */ @media (max-width: 1199px) { .referal-form { margin: 10px; } .referal-form label { align-self: stretch; } .simple-fields label { justify-content: space-between; height: auto; flex-wrap: wrap; } .container { padding: 30px; } h1 { font-size: 24px; } h2 { font-size: 20px; } .referal-top { flex-direction: column; padding: 10px; } .referal-top .rf { flex-basis: 100%; flex-direction: column; } .referal-top .rf label { flex-basis: 100%; padding-right: 0; } .contacts { padding-left: 0; border-left: none; margin-top: 20px; } .patient-info, .pet-owner, .pet-history, .other-records { flex-direction: column; } .row { flex-direction: column; } label input { pointer-events: auto; } } .bottom-btn { display: flex; justify-content: space-around; flex-wrap: wrap; }

PATIENT REFERRAL FORM

REFERRING VETERINARIAN/CLINIC INFORMATION

Patient Information

Pet Owner’s Name and Contact Information

Patient Case History