New styles for edit patient profile

![screen shot 2014-09-23 at 7 10 18 pm](https://cloud.githubusercontent.com/assets/1306536/4381476/d4fa1a80-4376-11e4-86b4-98af7e113946.png)

**NOTE:** There is a "legacy" version (full name not editable from here if patient === current logged in user) of this screen, that we can revisit when we implement the proper "child account" functionality:

![screen shot 2014-09-23 at 6 15 39 pm](https://cloud.githubusercontent.com/assets/1306536/4381470/b596780a-4376-11e4-8b8f-036953d33a62.png)