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=\"1430376279\">    <input type=\"hidden\" name=\"meta_split_id\" value=\"\">    <input type=\"hidden\" name=\"unit\" value=\"offthecouch\">    <input type=\"hidden\" name=\"redirect\" value=\"http://www.aweber.com/thankyou-coi.htm?m=audio\" id=\"redirect_491b27650c69f341dec95325e7dec84e\">    <input type=\"hidden\" name=\"meta_redirect_onlist\" value=\"\">    <input type=\"hidden\" name=\"meta_adtracking\" value=\"\">    <input type=\"hidden\" name=\"meta_message\" value=\"1\">    <input type=\"hidden\" name=\"meta_required\" value=\"name,from\">    <input type=\"hidden\" name=\"meta_forward_vars\" value=\"0\">    <table>    <tr><td colspan=2><center><div><div class=\"style19\" align=\"center\"><font size=\"2\" face=\"Georgia\"><font color=\"#660099\">Stories, Information, Inspiration, </font></font></div><div class=\"style19\" align=\"center\"><font size=\"2\" face=\"Georgia\"><font color=\"#660099\">Tips, &amp; Support. </font></font></div><div class=\"style19\" align=\"center\"><font size=\"2\" face=\"Georgia\"><font color=\"#660099\">Plus - immediate access to my special report: </font></font></div><div class=\"style19\" align=\"center\"><strong>\"The Top 10 Things You Need to Know Before Weight Loss Surgery\"</strong></div><div class=\"style19\" align=\"center\"><font size=\"2\" face=\"Georgia\"><font color=\"#660099\"><br></font></font></div><div class=\"style19\" align=\"center\"><font size=\"2\" face=\"Georgia\"><font color=\"#660099\">Interested?</font></font></div><div align=\"center\"><div class=\"style25\"><font size=\"2\" face=\"Georgia\"><strong><font color=\"#660099\">Subscribe now! </font></strong></font></div><div class=\"style25\"><strong><font color=\"#660099\" face=\"Georgia\">&nbsp;</font></strong></div><div class=\"style25\"><p class=\"style16\" align=\"center\"><strong><font color=\"#660099\" face=\"Georgia\"></font></strong></p><p class=\"style16\" align=\"center\"><strong><font color=\"#660099\" face=\"Georgia\"></font></strong></p>&nbsp;</div></div></div></center></td></tr><tr><td>First Name:</td><td><input type=\"text\" name=\"name\" value=\"\" size=\"20\"></td></tr><tr><td>Email:</td><td><input type=\"text\" name=\"from\" value=\"\" size=\"20\"></td></tr>        <tr><td colspan=2><center><div align=\"center\"><font size=\"2\" face=\"Times New Roman\"><font color=\"#660099\">Privacy Policy: Trust. I hate spam as much you do.</font></font><br><font size=\"2\" face=\"Times New Roman\"><font color=\"#660099\">I will never rent or sell your information.</font></font></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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