document.write("<!-- Web Form Generator 2.0 --><center><form method=\"post\" action=\"http://www.aweber.com/scripts/addlead.pl\"><input type=\"hidden\" name=\"meta_web_form_id\" value=\"631702671\"><input type=\"hidden\" name=\"meta_split_id\" value=\"\"><input type=\"hidden\" name=\"unit\" value=\"free-pain-book\"><input type=\"hidden\" name=\"redirect\" value=\"http://www.aweber.com/thankyou-coi.htm?m=audio\" id=\"redirect_5d1cd943e792659703f28de70dccddbf\"><input type=\"hidden\" name=\"meta_redirect_onlist\" value=\"\"><input type=\"hidden\" name=\"meta_adtracking\" value=\"homepage\"><input type=\"hidden\" name=\"meta_message\" value=\"1\"><input type=\"hidden\" name=\"meta_required\" value=\"from\"><input type=\"hidden\" name=\"meta_forward_vars\" value=\"0\"><table><tr><td colspan=2><center><DIV align=center><FONT face=Arial size=7><STRONG>PAIN?</STRONG></FONT></DIV><DIV><FONT size=4>Amazing FREE Book Reveals How You Can Use This Breakthrough (100% Drug Free) Pain Relief Method... Get Your Free Copy Today (no obligation) </FONT></DIV><DIV align=center><FONT size=4><STRONG>A Story of Terrible Pain Resolved</STRONG></FONT></DIV><DIV align=left>&nbsp;Nurse Debbie Shimadry&nbsp; fractured her spine in 2 places 17 years ago&nbsp; in an&nbsp; accident. She suffered intense pain and wasn't able to bend, twist , lift or sit for long periods. <BR>&nbsp;sleepless nights took their toll...Pain restricted all Debbie’s movements. Plus, she would wake a dozen or more times every night in agony and would have to manoeuvre herself off the bed to release the muscle spasms in her back.&nbsp;</DIV><DIV align=center><BR>&nbsp;<STRONG><FONT size=4>A ‘miraculous’ solution was in sight</FONT></STRONG></DIV><DIV align=left><BR>Crisis point hit December 1999, as.she lifted her&nbsp; eldest son. Her&nbsp; back just popped. Christmas day&nbsp; was spent lying on the sofa. The family enjoyed the christmas festivites while Debbie lay in pain. <STRONG>Then, a chance discovery provided a ‘miracle’ solution...</STRONG><BR>Debbie was introduced to a non traditional, zero drug treatment, magnetic therapy,&nbsp;by her mother. By this stage there&nbsp; was nothing to lose, so she gave it a try.&nbsp; <BR>&nbsp;</DIV><DIV align=left>Although it took about 7 weeks in total Debbie found gradually the pain&nbsp; was being relieved, the mobility&nbsp; was being restored until she was able to&nbsp; get up and live a completely&nbsp; normal life.<BR>Debbie has recently written a&nbsp;breakthrough new book about this&nbsp; zero drug and&nbsp; natural treatment. <STRONG>Get your free copy today, no obligation. It reveals&nbsp; what Debbie calls the remarkable, treatment you can use to resolve pain. <BR></STRONG></DIV></center></td></tr><tr><td>Name:</td><td><input type=\"text\" name=\"name\" value=\"\" size=\"20\"></td></tr><tr><td>Address line 1:</td><td><input type=\"text\" name=\"custom Address line 1\" value=\"\" size=\"20\"></td></tr><tr><td>Address line 2:</td><td><input type=\"text\" name=\"custom Address line 2\" value=\"\" size=\"20\"></td></tr><tr><td>Address line 3:</td><td><input type=\"text\" name=\"custom Address line 3\" value=\"\" size=\"20\"></td></tr><tr><td>Postcode:</td><td><input type=\"text\" name=\"custom Postcode\" value=\"\" size=\"20\"></td></tr><tr><td>Email:</td><td><input type=\"text\" name=\"from\" value=\"\" size=\"20\"></td></tr><tr><td>Please state your area of pain:</td><td><input type=\"text\" name=\"custom Please state your area of pain\" value=\"\" size=\"20\"></td></tr>    <tr><td colspan=2><center><DIV align=center><STRONG><FONT size=5>Get Your Free Paperback Book Now! (no obligation)</FONT></STRONG></DIV><DIV>Simply fill in the details above and your paperback copy of this free book&nbsp;will be&nbsp;posted&nbsp;to you the same day via first class royal mail.&nbsp;If you do not enter your name and address details into the form above we will not be able to send you your free paperback book.</DIV></center></td></tr><tr><td align=\"center\" colspan=\"2\"><input type=\"submit\" name=\"submit\" value=\"Submit\"></td></tr></table></form></center>");

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