<style type="text/css">

  #modal_wrapper.overlay::before {
    content: " ";
    width: 100%;
    height: 100%;
    position: fixed;
    z-index: 100;
    top: 0;
    left: 0;
    background: #000;
    background: rgba(0,0,0,0.7);
  }

  #modal_window {
    display: none;
    z-index: 200;
    position: fixed;
    left: 50%;
    top: 50%;
    width: 360px;
    overflow: auto;
    padding: 10px 20px;
    background: #fff;
    border: 5px solid #999;
    border-radius: 10px;
    box-shadow: 0 0 10px rgba(0,0,0,0.5);
  }

  #modal_wrapper.overlay #modal_window {
    display: block;
  }

  form, input, select, textarea, label { 
      padding: 0;
      margin: 0;
      outline: none;
      font-family: Roboto, Arial, sans-serif;
      font-size: 14px;
      color: #666;
      line-height: 22px;
  }
  
  .testbox {
      display: flex;
      justify-content: center;
      align-items: center;
      height: inherit;
      padding: 20px;
  }
  form {
      width: 100%;
      padding: 20px;
      border-radius: 6px;
      background: #fff;
      box-shadow: 0 0 8px  #19B5FE; 
  }

  input, select, textarea {
      margin-bottom: 10px;
      border: 1px solid #ccc;
      border-radius: 3px;
  }
  input {
      width: calc(100% - 10px);
      padding: 5px;
  }
  input[type="date"] {
      padding: 4px 5px;
  }
  textarea {
      width: calc(100% - 12px);
      padding: 5px;
  }
  .item:hover p, .item:hover i, .question:hover p, .question label:hover, input:hover::placeholder {
      color: #19B5FE;
  }
  .item input:hover, .item select:hover, .item textarea:hover {
      border: 1px solid transparent;
      box-shadow: 0 0 3px 0 #19B5FE;
      color: #19B5FE;
  }
  .item {
      position: relative;
      margin: 10px 0;
  }
      .item span {
      color: red;
      }
      input[type="date"]::-webkit-inner-spin-button {
      display: none;
      }
      .item i, input[type="date"]::-webkit-calendar-picker-indicator {
      position: absolute;
      font-size: 20px;
      color: #19B5FE;
      }
      .item i {
      right: 10%;
      top: 30px;
      z-index: 1;
      }
      [type="date"]::-webkit-calendar-picker-indicator {
      right: 10%;
      z-index: 2;
      opacity: 0;
      cursor: pointer;
      }
      input[type=radio], input[type=checkbox]  {
      display: none;
      }
      label.radio {
      position: relative;
      display: inline-block;
      margin: 5px 20px 15px 0;
      cursor: pointer;
      }
      .question span {
      margin-left: 30px;
      }
      .question-answer label {
      display: block;
      }
      label.radio:before {
      content: "";
      position: absolute;
      left: 0;
      width: 17px;
      height: 17px;
      border-radius: 50%;
      border: 2px solid #ccc;
      }
      input[type=radio]:checked + label:before, label.radio:hover:before {
      border: 2px solid #19B5FE;
      }
      label.radio:after {
      content: "";
      position: absolute;
      top: 6px;
      left: 5px;
      width: 8px;
      height: 4px;
      border: 3px solid #19B5FE;
      border-top: none;
      border-right: none;
      transform: rotate(-45deg);
      opacity: 0;
      }
      input[type=radio]:checked + label:after {
      opacity: 1;
      }
      .btn-block {
      margin-top: 10px;
      text-align: center;
      }
      button {
      width: 150px;
      padding: 10px;
      border: none;
      border-radius: 5px; 
      background: #19B5FE;
      font-size: 16px;
      color: #fff;
      cursor: pointer;
      }
      button:hover {
      background: #ff9800;
      }
      @media (min-width: 568px) {
      .name-item, .city-item {
      display: flex;
      flex-wrap: wrap;
      justify-content: space-between;
      }
      .name-item input, .name-item div {
      width: calc(50% - 20px);
      }
      .name-item div input {
      width:97%;}
      .name-item div label {
      display:block;
      padding-bottom:5px;
      }
      }
