[vc_row css=”.vc_custom_1418726910927{margin-top: -70px !important;margin-bottom: 0px !important;padding-top: 70px !important;padding-bottom: 70px !important;}” bg_type=”no_bg” bg_grad=”background: -webkit-gradient(linear, left top, left bottom, color-stop(0%, #FBFBFB), color-stop(50%, #E3E3E3), color-stop(100%, #C2C2C2));background: -moz-linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);background: -webkit-linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);background: -o-linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);background: -ms-linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);background: linear-gradient(top,#FBFBFB 0%,#E3E3E3 50%,#C2C2C2 100%);” bg_color_value=”#f8f8f8″ parallax_style=”vcpb-default” bg_image_repeat=”no-repeat” bg_image_size=”cover” bg_img_attach=”fixed” parallax_sense=”30″ animation_direction=”left-animation” animation_repeat=”repeat” bg_override=”full” parallax_content_sense=”30″ fadeout_start_effect=”30″ overlay_pattern_opacity=”80″ seperator_type=”none_seperator” seperator_position=”top_seperator” seperator_shape_size=”40″ seperator_svg_height=”60″ seperator_shape_background=”#ffffff” seperator_shape_border=”none” seperator_shape_border_width=”1″ icon_type=”no_icon” icon_size=”32″ icon_style=”none” icon_color_border=”#333333″ icon_border_size=”1″ icon_border_radius=”500″ icon_border_spacing=”50″ img_width=”48″ multi_color_overlay_opacity=”0.6″ ult_hide_row_large_screen=”off” ult_hide_row_desktop=”off” ult_hide_row_tablet=”off” ult_hide_row_tablet_small=”off” ult_hide_row_mobile=”off” ult_hide_row_mobile_large=”off”][vc_column width=”1/2″][ult_animation_block animation=”fadeInLeft” animation_duration=”0.5″ animation_delay=”0.8″ animation_iteration_count=”1″ opacity=”set” opacity_start_effect=”90″][ultimate_heading main_heading=”Forms” main_heading_color=”#0015cc” heading_tag=”h2″ sub_heading_color=”#3d3d3d” alignment=”left” spacer=”no_spacer” spacer_position=”top” spacer_img_width=”48″ line_style=”solid” line_height=”1″ line_color=”#333333″ icon_type=”selector” icon_size=”32″ icon_style=”none” icon_color_border=”#333333″ icon_border_size=”1″ icon_border_radius=”500″ icon_border_spacing=”50″ img_width=”48″ line_icon_fixer=”10″ main_heading_font_family=”font_family:Open Sans|font_call:Open+Sans|variant:300″ main_heading_font_size=”desktop:37px;” sub_heading_font_family=”font_family:Open Sans|font_call:Open+Sans” sub_heading_font_size=”desktop:15px;” main_heading_style=”font-weight:300;” sub_heading_line_height=”desktop:25px;” main_heading_margin=”margin-bottom:20px;” sub_heading_margin=”margin-bottom:5px;”]
Co-Payment Application For Seniors Form
[/ultimate_heading][/ult_animation_block][/vc_column][vc_column width=”1/2″][ult_animation_block animation=”fadeInRight” animation_duration=”0.5″ animation_delay=”0.8″ animation_iteration_count=”1″ opacity=”set” opacity_start_effect=”90″][ultimate_spacer height=”40″][imedica_image_gallery images=”7917″][/ult_animation_block][/vc_column][/vc_row]