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Fill out the information below to request a free consulting visit by a DIS.IN.FX disinfection service professional. html,body{ margin: 0px; } #crmWebToEntityForm.zcwf_lblLeft { width:100%; padding: 0px; margin: 0 auto; box-sizing: border-box; } #crmWebToEntityForm.zcwf_lblLeft * { box-sizing: border-box; } #crmWebToEntityForm{text-align: left;} #crmWebToEntityForm * { direction: ltr; } .zcwf_lblLeft .zcwf_title { word-wrap: break-word; padding: 0px 6px 10px; font-weight: bold; } .zcwf_lblLeft .zcwf_col_fld input[type=text], .zcwf_lblLeft .zcwf_col_fld textarea { width: 100%; border: 1px solid #ccc !important; resize: vertical; border-radius: 2px; float: left; } .zcwf_lblLeft .zcwf_col_lab { width: 100%; word-break: break-word; padding: 0px 6px 0px; margin-right: 10px; margin-top: 5px; float: left; min-height: 1px; } .zcwf_lblLeft .zcwf_col_fld { float: left; width: 68%; padding: 0px 6px 0px; position: relative; margin-top: 5px; } .zcwf_lblLeft .zcwf_privacy{padding: 6px;} .zcwf_lblLeft .wfrm_fld_dpNn{display: none;} .dIB{display: inline-block;} .zcwf_lblLeft .zcwf_col_fld_slt { width: 60%; border: 0px solid #ccc; background: #fff; border-radius: 0px; font-size: 16px; float: left; resize: vertical; } .zcwf_lblLeft .zcwf_row:after, .zcwf_lblLeft .zcwf_col_fld:after { content: ''; display: table; clear: both; } .zcwf_lblLeft .zcwf_col_help { float: left; margin-left: 7px; font-size: 16px; max-width: 35%; word-break: break-word; } .zcwf_lblLeft .zcwf_help_icon { cursor: pointer; width: 16px; height: 16px; display: inline-block; background: #fff; border: 1px solid #ccc; color: #ccc; text-align: center; font-size: 11px; line-height: 16px; font-weight: bold; border-radius: 50%; } .zcwf_lblLeft .zcwf_row {margin: 15px 0px;} .zcwf_lblLeft .formsubmit { margin-right: 5px; cursor: pointer; color: #333; font-size: 16px; } .zcwf_lblLeft .zcwf_privacy_txt { color: rgb(0, 0, 0); font-size: 16px; font-family: Arial; display: inline-block; vertical-align: top; color: #333; padding-top: 2px; margin-left: 6px; } .zcwf_lblLeft .zcwf_button { font-size: 16px; color: #333; border: 1px solid #ccc; padding: 3px 9px; border-radius: 4px; cursor: pointer; max-width: 120px; overflow: hidden; text-overflow: ellipsis; white-space: nowrap; } .zcwf_lblLeft .zcwf_tooltip_over{ position: relative; } .zcwf_lblLeft .zcwf_tooltip_ctn{ position: absolute; background: #dedede; padding: 3px 6px; top: 3px; border-radius: 4px;word-break: break-all; min-width: 50px; max-width: 150px; color: #333; } .zcwf_lblLeft .zcwf_ckbox{ float: left; } .zcwf_lblLeft .zcwf_file{ width: 55%; box-sizing: border-box; float: left; } .clearB:after{ content:''; display: block; clear: both; } @media all and (max-width: 700px) { .zcwf_lblLeft .zcwf_col_lab, .zcwf_lblLeft .zcwf_col_fld { width: auto; float: none !important; } .zcwf_lblLeft .zcwf_col_help {width: 40%;} } First Name* Last Name* Email* Phone Company* Zip Code* Captcha validation failed. If you are not a robot then please try again. /* Do not remove this code. */ function rccallback1618160000019315001() { if(document.getElementById('recap1618160000019315001')!=undefined){ document.getElementById('recap1618160000019315001').setAttribute('captcha-verified',true); } if(document.getElementById('recapErr1618160000019315001')!=undefined && document.getElementById('recapErr1618160000019315001').style.visibility == 'visible' ){ document.getElementById('recapErr1618160000019315001').style.visibility='hidden'; } } function reCaptchaAlert1618160000019315001() { var recap = document.getElementById('recap1618160000019315001'); if( recap !=undefined && recap.getAttribute('captcha-verified') == 'false') { document.getElementById('recapErr1618160000019315001').style.visibility='visible'; return false; } return true; } function validateEmail1618160000019315001() { var form = document.forms['WebToLeads1618160000019315001']; var emailFld = form.querySelectorAll('[ftype=email]'); var i; for (i = 0; i < emailFld.length; i++) { var emailVal = emailFld[i].value; if((emailVal.replace(/^\s+|\s+$/g, '')).length!=0 ) { var atpos=emailVal.indexOf('@'); var dotpos=emailVal.lastIndexOf('.'); if (atpos