.RefillForm_form____UBa{display:flex;flex-direction:column;gap:22px}.RefillForm_signedInBanner__v3pMw{display:flex;align-items:flex-start;gap:10px;padding:12px 16px;background:rgba(46,164,79,.06);border:1px solid rgba(46,164,79,.2);border-left:3px solid #2ea44f;border-radius:4px;font-size:13px;line-height:1.5;color:var(--ink)}.RefillForm_signedInBanner__v3pMw svg{color:#2ea44f;flex-shrink:0;margin-top:2px}.RefillForm_signedInBanner__v3pMw strong{font-weight:700}.RefillForm_formHead__gijwB{margin-bottom:8px;padding-bottom:24px;border-bottom:1px solid var(--border)}.RefillForm_formTitle__jIc_j{display:flex;align-items:center;gap:10px;font-family:var(--font-display);font-weight:600;font-size:22px;letter-spacing:-.01em;color:var(--ink)}.RefillForm_formTitleIcon__mLMCw{color:var(--fv-red)}.RefillForm_formSubtitle__isMmO{margin-top:8px;font-size:14px;line-height:1.5;color:var(--ink-soft);max-width:56ch}.RefillForm_row__tUyC_{display:grid;grid-template-columns:1fr 1fr;grid-gap:18px;gap:18px}@media (max-width:600px){.RefillForm_row__tUyC_{grid-template-columns:1fr;gap:22px}}.RefillForm_sectionRule__ZYYC1{height:1px;background:var(--border);margin:12px 0 4px}.RefillForm_photoBlock__gNYME,.RefillForm_photoDropzone__QNgIm{display:flex;flex-direction:column}.RefillForm_photoDropzone__QNgIm{align-items:center;justify-content:center;text-align:center;gap:8px;padding:36px 24px;background:var(--paper-cream);border:2px dashed var(--border-strong);border-radius:6px;cursor:pointer;transition:all .2s ease;position:relative}.RefillForm_photoDropzone__QNgIm:hover{border-color:var(--fv-red);background:var(--fv-red-soft)}.RefillForm_photoInput__BJYDk{position:absolute;width:0;height:0;opacity:0;overflow:hidden}.RefillForm_photoDropIcon__ezWpo{width:56px;height:56px;display:flex;align-items:center;justify-content:center;background:var(--paper);color:var(--fv-red);border-radius:50%;margin-bottom:4px;box-shadow:var(--shadow-card)}.RefillForm_photoDropTitle__WDLp1{font-family:var(--font-body);font-weight:700;font-size:15px;color:var(--ink);letter-spacing:-.005em}.RefillForm_photoDropHint__979yZ{font-size:12.5px;color:var(--ink-muted)}.RefillForm_photoPreview__EUquC{position:relative;width:100%;max-width:320px;aspect-ratio:1/1;background:var(--paper-cream);border-radius:6px;overflow:hidden;border:1px solid var(--border-strong)}.RefillForm_photoImg__GSkFf{width:100%;height:100%;object-fit:cover}.RefillForm_photoRemove__PYjuq{position:absolute;top:10px;right:10px;width:32px;height:32px;display:flex;align-items:center;justify-content:center;background:var(--ink);color:var(--paper);border-radius:50%;cursor:pointer;transition:background .18s ease}.RefillForm_photoRemove__PYjuq:hover{background:var(--fv-red)}.RefillForm_photoMeta__L_XWN{position:absolute;left:10px;bottom:10px;right:50px;display:inline-flex;align-items:center;gap:6px;padding:6px 10px;background:hsla(0,0%,4%,.78);color:var(--paper);border-radius:4px;font-size:12px;font-weight:500;overflow:hidden;text-overflow:ellipsis;white-space:nowrap}.RefillForm_photoMetaIcon__05Do_{color:var(--fv-red);flex-shrink:0}.RefillForm_photoMeta__L_XWN span{overflow:hidden;text-overflow:ellipsis}.RefillForm_divider__ANWED{display:flex;align-items:center;gap:16px;margin:4px 0;color:var(--ink-muted);font-size:12px;font-weight:600;letter-spacing:.12em;text-transform:uppercase}.RefillForm_divider__ANWED:after,.RefillForm_divider__ANWED:before{content:"";flex:1 1;height:1px;background:var(--border-strong)}.RefillForm_radioGroup__Vone7{display:flex;flex-wrap:wrap;gap:8px}.RefillForm_radio__rlycT{display:inline-flex;align-items:center;gap:8px;padding:10px 16px;font-size:13.5px;font-weight:500;color:var(--ink-soft);background:var(--paper);border:1.5px solid var(--border-strong);border-radius:4px;cursor:pointer;transition:all .15s ease}.RefillForm_radio__rlycT:hover{border-color:var(--ink);color:var(--ink)}.RefillForm_radio__rlycT input{width:14px;height:14px;accent-color:var(--fv-red)}.RefillForm_radio__rlycT:has(input:checked){background:var(--ink);color:var(--paper);border-color:var(--ink)}.RefillForm_error__5_Xq_{display:flex;align-items:center;gap:10px;padding:12px 16px;background:var(--fv-red-soft);color:var(--fv-red-deep);border-radius:4px;border:1px solid rgba(214,40,40,.2);font-size:13.5px;font-weight:500}.RefillForm_notice__ImxS5{padding:16px 18px;background:var(--paper-cream);border-radius:4px;border-left:3px solid var(--fv-red);font-size:13px;line-height:1.55;color:var(--ink-soft)}.RefillForm_notice__ImxS5 strong{color:var(--ink);font-weight:700}.RefillForm_actions__4TXfL{display:flex;align-items:center;gap:18px;flex-wrap:wrap;padding-top:16px;border-top:1px solid var(--border)}.RefillForm_actionsHint__8d7Wz{font-size:12.5px;color:var(--ink-muted)}.RefillForm_success__fKht1{text-align:center;padding:32px 16px;display:flex;flex-direction:column;align-items:center}.RefillForm_successIcon__eKKyp{width:64px;height:64px;display:flex;align-items:center;justify-content:center;background:var(--fv-red);color:var(--paper);border-radius:50%;margin-bottom:24px}.RefillForm_successTitle__cLH8H{font-family:var(--font-display);font-weight:600;font-size:28px;letter-spacing:-.01em;color:var(--ink);margin-bottom:14px}.RefillForm_successBody__u0KeA{font-size:15px;line-height:1.55;color:var(--ink-soft);max-width:44ch;margin:0 auto 24px}.RefillForm_privacyLine__DkQPR{font-family:var(--font-body);font-size:.8125rem;line-height:1.5;color:var(--ink-muted,hsla(0,0%,4%,.6));text-align:center;margin:1rem 0 0}