.base_form__yzRm9{display:grid;justify-items:center;align-content:center;min-height:calc(100vh - 3rem)}@media screen and (min-width:768px){.base_form__yzRm9{max-width:25rem;min-height:calc(100vh - 4rem);margin-inline:auto}}@media screen and (min-width:1200px){.base_form__yzRm9{min-height:calc(100vh - 5rem)}}.base_link__iPHuD{width:8.625rem;color:#1a0826}.base_link__iPHuD:before{border-radius:var(--focus-border-radius);outline:1px solid transparent;transition-property:box-shadow,outline;transition-timing-function:linear;transition-duration:.25s;position:absolute;inset:calc(.2rem * -1) calc(.4rem*-1);content:""}.base_link__iPHuD:focus-visible:before{outline-color:var(--focus-outline);box-shadow:var(--focus-ring)}.base_link__iPHuD svg{width:100%;height:auto}.base_title__YmK3I{display:grid;row-gap:2rem;justify-items:center;margin-top:1.5rem;text-align:center}.base_title__YmK3I:before{position:relative;content:"";display:block;width:5rem;height:5rem;background-image:url(/us/_assets/_next/static/media/HeartBalloonSimple.7a2e6922.svg);background-repeat:no-repeat;background-position:50%;background-size:cover}.base_text__fC_Fc{margin-top:1rem;text-align:center}.base_label__bYNMa{width:100%;margin-top:2rem}.base_limit__dy0TJ{display:inline-block;margin-left:auto}.base_feedback__FoCoj{margin-top:2rem;text-align:center}.base_submit___sPZT{margin-top:1rem}.base_note__t_QXm{display:grid;justify-items:center}.base_note__t_QXm:before{position:relative;content:"";display:block;width:2.5rem;height:2px;margin-block:2rem;background-color:#c6c3c5}