document.write("<center>")
              document.write("<table width='100%' height='140' border='0' cellspacing='0' cellpadding='1' align='left'>")
              	document.write("<tr align='center' >")
              		document.write("<td align='center' valign='top' class='CBoxHeading'><b>Your Opinion Matters!</b></td>")
              	document.write("</tr>")
              	document.write("<tr align='center'>")
              		document.write("<td valign='top' align='center' class='CBoxContent'>")
					 document.write(" <table align='center' width='100%' border='0' cellspacing='0' cellpadding='1'>")
						document.write("<tr align='center'>")
							document.write("<td align='center' valign='top'>")
											 document.write(" <table align='center' width='100%' border='0' cellspacing='1' cellpadding='1'>")
												
												document.write("<form action='/poll/default.asp' method='post'>")
												
												document.write("<input type='hidden' name='a' value='vote'>")
												document.write("<input type='hidden' name='poll_id' value='SETTF22372'>")
												document.write("<input type='hidden' name='f' value=''>")
													document.write("<tr align='center'>")
														document.write("<td align='center' colspan='2' class='CBoxSubHeading'>How long have you been considering the need for help for detox?<br><img src='../images/spacer.gif' width='1' height='7'><br></td>")
													document.write("</tr>")
														document.write(" <table align='center' width='80%' border='0' cellspacing='1' cellpadding='1'><tr><td>")
													document.write("<tr>")
													
														document.write("<td width='5%' valign='top'><input type=radio name=vote value=choice1></td><td class='CBoxContent'>1 month or less</td>")
													
													document.write("</tr>")
													document.write("<tr>")
													
														document.write("<td width='5%' valign='top'><input type=radio name=vote value=choice2></td><td class='CBoxContent'>6 months -11 months</td>")
													
													document.write("</tr>")
													document.write("<tr>")
													
														document.write("<td width='5%' valign='top'><input type=radio name=vote value=choice3></td><td class='CBoxContent'>1 year-2 years</td>")
													
													document.write("</tr>")
													document.write("<tr>")
													
														document.write("<td width='5%' valign='top'><input type=radio name=vote value=choice4></td><td class='CBoxContent'>2 years - 3 years</td>")
													
													document.write("</tr>")
													document.write("<tr>")
													
														document.write("<td width='5%' valign='top'><input type=radio name=vote value=choice5></td><td class='CBoxContent'>over 3 years</td>")
													
													document.write("</tr>")
													document.write("<tr>")
														document.write("<td colspan='2' align='center'><img src='../images/spacer.gif' width='1' height='9'><br><input type='image' name'vote' value'vote' src='/images/btn_vote.gif' border='0'><img src='../images/spacer.gif' width='12' height='1'><br><img src='../images/spacer.gif' width='1' height='3'></td>")
													document.write("</tr>")
												document.write("</form>")
												document.write("</table>")
							document.write("</td>")
						document.write("</tr>")
					document.write("</table>")
							document.write("</td>")
						document.write("</tr>")
					document.write("</table>")
						document.write("</center>")