form.providerForm {
	width:100% !important;
	background-color:transparent !important;
	border:none !important;
	font-size:1em !important;
	padding:0px !important;
}
form.providerForm legend{
	 font-size:150% !important;
	 color:#b52b2b;
	 padding:20px 0px 5px 15px;
 
}
form.providerForm p{
	color:#999999;
	font-size:95%;
	text-transform:uppercase;	
}

form.providerForm  div.fields{
	border:1px solid #C0C0C0;
	padding:10px 5px 5px 5px;
	margin:5px;
	background-color:#f2f2f2;
}

div.fields div {
	width: 100%;
	clear: both;
}

form.providerForm label {
	margin: 4px 8px 10px 0;
	display: block;
	float:left;
	font-size:1.05em;
	font-weight:normal;
	width:35%;
	color:#00428e;
	padding-left:5px;
	line-height: 1.5em;
	text-align:right;
}


form.providerForm input.text, textarea {
	font-size:12px;
	padding:3px;
	display:block;
	width:60%;
	margin-bottom:4px;
	background-color:#f9f9f9;
	border:1px solid #ccc;
}

form.providerForm input#submit, form.providerForm p.required, form.providerForm input#form-captcha, form.providerForm div.submit img{
	 margin-left:28%;
}
form.providerForm span{
	color:#F00 ;
	padding-right:5px;
	margin-left:-10px;
	font-size:100% !important;
}

form.providerForm input#submit{
	background: #c41e3a url(../../images/sendto_btn.png) top no-repeat;
	width:169px;
	height:22px;
	border:0px;
	cursor:pointer;
	margin-top:20px;

}

div.hiddenFields {
	height: 0;
	width: 0;
	overflow: hidden;
	position: absolute;
	left: -9999px;
}

form.providerForm select {
	margin-bottom: 4px;
}