Version
Download 1237
File Size 6 MB
File Count 1
Create Date December 30, 2020
Last Updated January 8, 2021

Lucere Medical Referral Request

Leave a Reply Cancel reply

img.wp-smiley,img.emoji{display:inline !important;border:none !important;box-shadow:none !important;height:1em !important;width:1em !important;margin:0 .07em !important;vertical-align:-.1em !important;background:none !important;padding:0 !important;}body{--wp--preset--color--black:#000;--wp--preset--color--cyan-bluish-gray:#abb8c3;--wp--preset--color--white:#fff;--wp--preset--color--pale-pink:#f78da7;--wp--preset--color--vivid-red:#cf2e2e;--wp--preset--color--luminous-vivid-orange:#ff6900;--wp--preset--color--luminous-vivid-amber:#fcb900;--wp--preset--color--light-green-cyan:#7bdcb5;--wp--preset--color--vivid-green-cyan:#00d084;--wp--preset--color--pale-cyan-blue:#8ed1fc;--wp--preset--color--vivid-cyan-blue:#0693e3;--wp--preset--color--vivid-purple:#9b51e0;--wp--preset--color--accent:#e22658;--wp--preset--color--primary:#000;--wp--preset--color--secondary:#6d6d6d;--wp--preset--color--subtle-background:#dbdbdb;--wp--preset--color--background:#fff;--wp--preset--gradient--vivid-cyan-blue-to-vivid-purple:linear-gradient(135deg,rgba(6,147,227,1) 0%,#9b51e0 100%);--wp--preset--gradient--light-green-cyan-to-vivid-green-cyan:linear-gradient(135deg,#7adcb4 0%,#00d082 100%);--wp--preset--gradient--luminous-vivid-amber-to-luminous-vivid-orange:linear-gradient(135deg,rgba(252,185,0,1) 0%,rgba(255,105,0,1) 100%);--wp--preset--gradient--luminous-vivid-orange-to-vivid-red:linear-gradient(135deg,rgba(255,105,0,1) 0%,#cf2e2e 100%);--wp--preset--gradient--very-light-gray-to-cyan-bluish-gray:linear-gradient(135deg,#eee 0%,#a9b8c3 100%);--wp--preset--gradient--cool-to-warm-spectrum:linear-gradient(135deg,#4aeadc 0%,#9778d1 20%,#cf2aba 40%,#ee2c82 60%,#fb6962 80%,#fef84c 100%);--wp--preset--gradient--blush-light-purple:linear-gradient(135deg,#ffceec 0%,#9896f0 100%);--wp--preset--gradient--blush-bordeaux:linear-gradient(135deg,#fecda5 0%,#fe2d2d 50%,#6b003e 100%);--wp--preset--gradient--luminous-dusk:linear-gradient(135deg,#ffcb70 0%,#c751c0 50%,#4158d0 100%);--wp--preset--gradient--pale-ocean:linear-gradient(135deg,#fff5cb 0%,#b6e3d4 50%,#33a7b5 100%);--wp--preset--gradient--electric-grass:linear-gradient(135deg,#caf880 0%,#71ce7e 100%);--wp--preset--gradient--midnight:linear-gradient(135deg,#020381 0%,#2874fc 100%);--wp--preset--duotone--dark-grayscale:url("#wp-duotone-dark-grayscale");--wp--preset--duotone--grayscale:url("#wp-duotone-grayscale");--wp--preset--duotone--purple-yellow:url("#wp-duotone-purple-yellow");--wp--preset--duotone--blue-red:url("#wp-duotone-blue-red");--wp--preset--duotone--midnight:url("#wp-duotone-midnight");--wp--preset--duotone--magenta-yellow:url("#wp-duotone-magenta-yellow");--wp--preset--duotone--purple-green:url("#wp-duotone-purple-green");--wp--preset--duotone--blue-orange:url("#wp-duotone-blue-orange");--wp--preset--font-size--small:18px;--wp--preset--font-size--medium:20px;--wp--preset--font-size--large:26.25px;--wp--preset--font-size--x-large:42px;--wp--preset--font-size--normal:21px;--wp--preset--font-size--larger:32px;}.has-black-color{color:var(--wp--preset--color--black) !important;}.has-cyan-bluish-gray-color{color:var(--wp--preset--color--cyan-bluish-gray) !important;}.has-white-color{color:var(--wp--preset--color--white) !important;}.has-pale-pink-color{color:var(--wp--preset--color--pale-pink) !important;}.has-vivid-red-color{color:var(--wp--preset--color--vivid-red) !important;}.has-luminous-vivid-orange-color{color:var(--wp--preset--color--luminous-vivid-orange) !important;}.has-luminous-vivid-amber-color{color:var(--wp--preset--color--luminous-vivid-amber) !important;}.has-light-green-cyan-color{color:var(--wp--preset--color--light-green-cyan) !important;}.has-vivid-green-cyan-color{color:var(--wp--preset--color--vivid-green-cyan) !important;}.has-pale-cyan-blue-color{color:var(--wp--preset--color--pale-cyan-blue) !important;}.has-vivid-cyan-blue-color{color:var(--wp--preset--color--vivid-cyan-blue) !important;}.has-vivid-purple-color{color:var(--wp--preset--color--vivid-purple) !important;}.has-black-background-color{background-color:var(--wp--preset--color--black) !important;}.has-cyan-bluish-gray-background-color{background-color:var(--wp--preset--color--cyan-bluish-gray) !important;}.has-white-background-color{background-color:var(--wp--preset--color--white) !important;}.has-pale-pink-background-color{background-color:var(--wp--preset--color--pale-pink) !important;}.has-vivid-red-background-color{background-color:var(--wp--preset--color--vivid-red) !important;}.has-luminous-vivid-orange-background-color{background-color:var(--wp--preset--color--luminous-vivid-orange) !important;}.has-luminous-vivid-amber-background-color{background-color:var(--wp--preset--color--luminous-vivid-amber) !important;}.has-light-green-cyan-background-color{background-color:var(--wp--preset--color--light-green-cyan) !important;}.has-vivid-green-cyan-background-color{background-color:var(--wp--preset--color--vivid-green-cyan) !important;}.has-pale-cyan-blue-background-color{background-color:var(--wp--preset--color--pale-cyan-blue) !important;}.has-vivid-cyan-blue-background-color{background-color:var(--wp--preset--color--vivid-cyan-blue) !important;}.has-vivid-purple-background-color{background-color:var(--wp--preset--color--vivid-purple) !important;}.has-black-border-color{border-color:var(--wp--preset--color--black) !important;}.has-cyan-bluish-gray-border-color{border-color:var(--wp--preset--color--cyan-bluish-gray) !important;}.has-white-border-color{border-color:var(--wp--preset--color--white) !important;}.has-pale-pink-border-color{border-color:var(--wp--preset--color--pale-pink) !important;}.has-vivid-red-border-color{border-color:var(--wp--preset--color--vivid-red) !important;}.has-luminous-vivid-orange-border-color{border-color:var(--wp--preset--color--luminous-vivid-orange) !important;}.has-luminous-vivid-amber-border-color{border-color:var(--wp--preset--color--luminous-vivid-amber) !important;}.has-light-green-cyan-border-color{border-color:var(--wp--preset--color--light-green-cyan) !important;}.has-vivid-green-cyan-border-color{border-color:var(--wp--preset--color--vivid-green-cyan) !important;}.has-pale-cyan-blue-border-color{border-color:var(--wp--preset--color--pale-cyan-blue) !important;}.has-vivid-cyan-blue-border-color{border-color:var(--wp--preset--color--vivid-cyan-blue) !important;}.has-vivid-purple-border-color{border-color:var(--wp--preset--color--vivid-purple) !important;}.has-vivid-cyan-blue-to-vivid-purple-gradient-background{background:var(--wp--preset--gradient--vivid-cyan-blue-to-vivid-purple) !important;}.has-light-green-cyan-to-vivid-green-cyan-gradient-background{background:var(--wp--preset--gradient--light-green-cyan-to-vivid-green-cyan) !important;}.has-luminous-vivid-amber-to-luminous-vivid-orange-gradient-background{background:var(--wp--preset--gradient--luminous-vivid-amber-to-luminous-vivid-orange) !important;}.has-luminous-vivid-orange-to-vivid-red-gradient-background{background:var(--wp--preset--gradient--luminous-vivid-orange-to-vivid-red) !important;}.has-very-light-gray-to-cyan-bluish-gray-gradient-background{background:var(--wp--preset--gradient--very-light-gray-to-cyan-bluish-gray) !important;}.has-cool-to-warm-spectrum-gradient-background{background:var(--wp--preset--gradient--cool-to-warm-spectrum) !important;}.has-blush-light-purple-gradient-background{background:var(--wp--preset--gradient--blush-light-purple) !important;}.has-blush-bordeaux-gradient-background{background:var(--wp--preset--gradient--blush-bordeaux) !important;}.has-luminous-dusk-gradient-background{background:var(--wp--preset--gradient--luminous-dusk) !important;}.has-pale-ocean-gradient-background{background:var(--wp--preset--gradient--pale-ocean) !important;}.has-electric-grass-gradient-background{background:var(--wp--preset--gradient--electric-grass) !important;}.has-midnight-gradient-background{background:var(--wp--preset--gradient--midnight) !important;}.has-small-font-size{font-size:var(--wp--preset--font-size--small) !important;}.has-medium-font-size{font-size:var(--wp--preset--font-size--medium) !important;}.has-large-font-size{font-size:var(--wp--preset--font-size--large) !important;}.has-x-large-font-size{font-size:var(--wp--preset--font-size--x-large) !important;}.woocommerce form .form-row .required{visibility:visible;}.color-accent,.color-accent-hover:hover,.color-accent-hover:focus,:root .has-accent-color,.has-drop-cap:not(:focus):first-letter,.wp-block-button.is-style-outline,a{color:#e22658;}blockquote,.border-color-accent,.border-color-accent-hover:hover,.border-color-accent-hover:focus{border-color:#e22658;}button,.button,.faux-button,.wp-block-button__link,.wp-block-file .wp-block-file__button,input[type="button"],input[type="reset"],input[type="submit"],.bg-accent,.bg-accent-hover:hover,.bg-accent-hover:focus,:root .has-accent-background-color,.comment-reply-link{background-color:#e22658;}.fill-children-accent,.fill-children-accent *{fill:#e22658;}:root .has-background-color,button,.button,.faux-button,.wp-block-button__link,.wp-block-file__button,input[type="button"],input[type="reset"],input[type="submit"],.wp-block-button,.comment-reply-link,.has-background.has-primary-background-color:not(.has-text-color),.has-background.has-primary-background-color *:not(.has-text-color),.has-background.has-accent-background-color:not(.has-text-color),.has-background.has-accent-background-color *:not(.has-text-color){color:#fff;}:root .has-background-background-color{background-color:#fff;}body,.entry-title a,:root .has-primary-color{color:#000;}:root .has-primary-background-color{background-color:#000;}cite,figcaption,.wp-caption-text,.post-meta,.entry-content .wp-block-archives li,.entry-content .wp-block-categories li,.entry-content .wp-block-latest-posts li,.wp-block-latest-comments__comment-date,.wp-block-latest-posts__post-date,.wp-block-embed figcaption,.wp-block-image figcaption,.wp-block-pullquote cite,.comment-metadata,.comment-respond .comment-notes,.comment-respond .logged-in-as,.pagination .dots,.entry-content hr:not(.has-background),hr.styled-separator,:root .has-secondary-color{color:#6d6d6d;}:root .has-secondary-background-color{background-color:#6d6d6d;}pre,fieldset,input,textarea,table,table *,hr{border-color:#dbdbdb;}caption,code,code,kbd,samp,.wp-block-table.is-style-stripes tbody tr:nth-child(odd),:root .has-subtle-background-background-color{background-color:#dbdbdb;}.wp-block-table.is-style-stripes{border-bottom-color:#dbdbdb;}.wp-block-latest-posts.is-grid li{border-top-color:#dbdbdb;}:root .has-subtle-background-color{color:#dbdbdb;}body:not(.overlay-header) .primary-menu > li > a,body:not(.overlay-header) .primary-menu > li > .icon,.modal-menu a,.footer-menu a,.footer-widgets a,#site-footer .wp-block-button.is-style-outline,.wp-block-pullquote:before,.singular:not(.overlay-header) .entry-header a,.archive-header a,.header-footer-group .color-accent,.header-footer-group .color-accent-hover:hover{color:#cd2653;}.social-icons a,#site-footer button:not(.toggle),#site-footer .button,#site-footer .faux-button,#site-footer .wp-block-button__link,#site-footer .wp-block-file__button,#site-footer input[type="button"],#site-footer input[type="reset"],#site-footer input[type="submit"]{background-color:#cd2653;}.header-footer-group,body:not(.overlay-header) #site-header .toggle,.menu-modal .toggle{color:#000;}body:not(.overlay-header) .primary-menu ul{background-color:#000;}body:not(.overlay-header) .primary-menu > li > ul:after{border-bottom-color:#000;}body:not(.overlay-header) .primary-menu ul ul:after{border-left-color:#000;}.site-description,body:not(.overlay-header) .toggle-inner .toggle-text,.widget .post-date,.widget .rss-date,.widget_archive li,.widget_categories li,.widget cite,.widget_pages li,.widget_meta li,.widget_nav_menu li,.powered-by-wordpress,.to-the-top,.singular .entry-header .post-meta,.singular:not(.overlay-header) .entry-header .post-meta a{color:#6d6d6d;}.header-footer-group pre,.header-footer-group fieldset,.header-footer-group input,.header-footer-group textarea,.header-footer-group table,.header-footer-group table *,.footer-nav-widgets-wrapper,#site-footer,.menu-modal nav *,.footer-widgets-outer-wrapper,.footer-top{border-color:#dcd7ca;}.header-footer-group table caption,body:not(.overlay-header) .header-inner .toggle-wrapper::before{background-color:#dcd7ca;}.wpdm-download-link.btn.btn-primary.{border-radius:4px;}body #sbi_lightbox{z-index:9999999;}body #sbi_lightboxOverlay{z-index:9999999;}body.custom-background{background-color:#fff;}@import url("https://cdn-cjdni.nitrocdn.com/oZsESZxYrpaVejkWHOmOJCiEaImbNtoc/assets/desktop/source/rev-7d95364/bf7d44bb3e9e521af4e5164bcfb41a08.css");.w3eden .fetfont,.w3eden .btn,.w3eden .btn.wpdm-front h3.title,.w3eden .wpdm-social-lock-box .IN-widget a span:last-child,.w3eden #xfilelist .panel-heading,.w3eden .wpdm-frontend-tabs a,.w3eden .alert:before,.w3eden .panel .panel-heading,.w3eden .discount-msg,.w3eden .panel.dashboard-panel h3,.w3eden #wpdm-dashboard-sidebar .list-group-item,.w3eden #package-description .wp-switch-editor,.w3eden .w3eden.author-dashbboard .nav.nav-tabs li a,.w3eden .wpdm_cart thead th,.w3eden #csp .list-group-item,.w3eden .modal-title{font-family:Rubik,-apple-system,BlinkMacSystemFont,"Segoe UI",Roboto,Helvetica,Arial,sans-serif,"Apple Color Emoji","Segoe UI Emoji","Segoe UI Symbol";text-transform:uppercase;font-weight:500;}.w3eden #csp .list-group-item{text-transform:unset;}:root{--color-primary:#5d3754;--color-primary-rgb:93,55,84;--color-primary-hover:#ac9395;--color-primary-active:#5d3754;--color-secondary:#6c757d;--color-secondary-rgb:108,117,125;--color-secondary-hover:#6c757d;--color-secondary-active:#6c757d;--color-success:#18ce0f;--color-success-rgb:24,206,15;--color-success-hover:#18ce0f;--color-success-active:#18ce0f;--color-info:#2ca8ff;--color-info-rgb:44,168,255;--color-info-hover:#2ca8ff;--color-info-active:#2ca8ff;--color-warning:#ffb236;--color-warning-rgb:255,178,54;--color-warning-hover:#ffb236;--color-warning-active:#ffb236;--color-danger:#ff5062;--color-danger-rgb:255,80,98;--color-danger-hover:#ff5062;--color-danger-active:#ff5062;--color-green:#30b570;--color-blue:#0073ff;--color-purple:#8557d3;--color-red:#ff5062;--color-muted:rgba(69,89,122,.6);--wpdm-font:Rubik,-apple-system,BlinkMacSystemFont,"Segoe UI",Roboto,Helvetica,Arial,sans-serif,"Apple Color Emoji","Segoe UI Emoji","Segoe UI Symbol";}.wpdm-download-link.btn.btn-primary{border-radius:4px;}

Lucere Medical Referral Request

SOUTH SIDE LOCATION

DOWNTOWN LOCATION