Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.
.checkbox_grid_wrapper {
display: grid;
grid-auto-columns: 1fr;
gap: 16px;
grid-template-columns: 1fr 1fr 1fr;
grid-template-rows: auto;
}
@media screen and (max-width: 991px) {
.checkbox_grid_wrapper {
grid-template-columns: 1fr 1fr;
}
}
@media screen and (max-width: 767px) {
.checkbox_grid_wrapper {
grid-template-columns: 1fr 1fr;
}
}
@media screen and (max-width: 479px) {
.checkbox_grid_wrapper {
width: 100%;
place-items: center;
gap: 1em;
grid-template-columns: 1fr;
}
}
.form_text_field {
height: 3em;
margin-bottom: 0.5em;
padding: 1em;
border-style: none;
border-width: 0px;
border-color: black;
border-top-left-radius: var(--12px-rounded);
border-top-right-radius: var(--12px-rounded);
border-bottom-left-radius: var(--12px-rounded);
border-bottom-right-radius: var(--12px-rounded);
color: var(--dark-grey);
font-size: 1.1em;
font-weight: 500;
letter-spacing: 0.02em;
}
.form_text_field.is-example {
margin-bottom: 1em;
border-radius: 12px;
}
@media screen and (max-width: 479px) {
.form_text_field {
height: 3.5em;
padding: 0.5em;
border-top-left-radius: var(--8px-rounded);
border-top-right-radius: var(--8px-rounded);
border-bottom-left-radius: var(--8px-rounded);
border-bottom-right-radius: var(--8px-rounded);
font-size: 1rem;
}
}
.form_paragraph_field {
max-width: 100%;
min-height: 6em;
min-width: 100%;
margin-bottom: 0.5em;
padding: 0.5em 0.5em 0.5em 1em;
border-style: none;
border-width: 0px;
border-color: black;
border-top-left-radius: var(--12px-rounded);
border-top-right-radius: var(--12px-rounded);
border-bottom-left-radius: var(--12px-rounded);
border-bottom-right-radius: var(--12px-rounded);
color: var(--dark-grey);
font-size: 1.1em;
font-weight: 500;
letter-spacing: 0.02em;
}
@media screen and (max-width: 479px) {
.form_paragraph_field {
min-height: 7.5em;
padding-top: 0.7em;
padding-left: 0.5em;
border-top-left-radius: var(--8px-rounded);
border-top-right-radius: var(--8px-rounded);
border-bottom-left-radius: var(--8px-rounded);
border-bottom-right-radius: var(--8px-rounded);
font-size: 1rem;
}
}
.form_radio_button {
width: 1.8em;
height: 1.8em;
margin-top: 0px;
margin-right: 0.8em;
border-style: solid;
border-width: 1px;
border-color: rgba(40, 40, 40, 0.25);
background-color: var(--white);
}
.form_checkbox {
width: 1.8em;
height: 1.8em;
margin-right: 0.8em;
border-style: solid;
border-width: 1px;
border-color: rgba(40, 40, 40, 0.25);
border-radius: 6px;
background-color: var(--white);
}
.form_button {
width: 100%;
height: 3em;
margin-top: 2em;
margin-right: auto;
margin-left: auto;
padding: 0.5em 1.5em;
border-top-left-radius: var(--12px-rounded);
border-top-right-radius: var(--12px-rounded);
border-bottom-left-radius: var(--12px-rounded);
border-bottom-right-radius: var(--12px-rounded);
background-color: white;
color: var(--dark-grey);
font-weight: 700;
letter-spacing: 0.05em;
}
.form_button.-wfp-hover,
.form_button:hover {
box-shadow: rgba(0, 0, 0, 0.1) 0px 5px 10px 0px;
}
.form_button.is-back {
max-width: 25em;
margin-top: 2em;
background-color: var(--white);
background-image: none;
}
@media screen and (max-width: 479px) {
.form_button {
height: 4em;
font-size: 1rem;
}
}
.form_button {
width: 100%;
height: 3em;
margin-top: 2em;
margin-right: auto;
margin-left: auto;
padding: 0.5em 1.5em;
border-top-left-radius: var(--12px-rounded);
border-top-right-radius: var(--12px-rounded);
border-bottom-left-radius: var(--12px-rounded);
border-bottom-right-radius: var(--12px-rounded);
background-color: transparent;
background-image: linear-gradient(135deg, rgb(203, 237, 169), rgb(191, 216, 140) 50%, rgb(196, 206, 128));
color: var(--dark-grey);
font-weight: 700;
letter-spacing: 0.05em;
}
.form_button.-wfp-hover,
.form_button:hover {
box-shadow: rgba(0, 0, 0, 0.1) 0px 5px 10px 0px;
}
.form_button.is-example {
max-width: 25em;
margin-top: 1em;
margin-right: auto;
margin-left: auto;
}
@media screen and (max-width: 479px) {
.form_button {
height: 4em;
font-size: 1rem;
}
}
Dark Grey: #282828
White: #FFFFFF
Cream White: #F2EEE6
We appreciate your time in taking the initial screening.
Based on your responses, you medically qualify for the MPL care program.

Monthly subscription cost varies based on insurance coverage and plans.
We will contact you when you get off the waitlist.
We appreciate your time in taking the initial screening.
Based on your responses, unfortunately you do not qualify for our program at this time.

Monthly subscription cost varies based on insurance coverage and plans.
We will contact you when you get off the waitlist.