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=\"882611498\"><input type=\"hidden\" name=\"meta_split_id\" value=\"\"><input type=\"hidden\" name=\"unit\" value=\"healthtips2\"><input type=\"hidden\" name=\"redirect\" value=\"http://www.health-doc.com/thanks.html\" id=\"redirect_d04f64a6922db235d43fc7690610a092\"><input type=\"hidden\" name=\"meta_redirect_onlist\" value=\"\"><input type=\"hidden\" name=\"meta_adtracking\" value=\"HDnewsletter page\"><input type=\"hidden\" name=\"meta_message\" value=\"1\"><input type=\"hidden\" name=\"meta_required\" value=\"from\"><input type=\"hidden\" name=\"meta_forward_vars\" value=\"1\"><table><tr><td colspan=2><center><DIV align=left><FONT size=4><DIV align=left><FONT color=#000000><DIV align=left><FONT color=#000033 size=2><FONT color=#336699 size=3><DIV align=left><FONT color=#003333><FONT face=Arial><STRONG><DIV align=left><FONT color=#000033 size=2><FONT color=#336699><FONT color=#003333><STRONG></STRONG><DIV align=left><FONT face=Arial><FONT size=3><FONT style=\"BACKGROUND-COLOR: #ffffcc\"><STRONG>Free Bonus Report:<BR></STRONG>&nbsp;\"Amazing Top 20 <BR>Brain Foods\"</FONT></FONT></FONT></DIV><DIV align=left><FONT face=Arial size=3>&nbsp;</FONT></FONT></FONT></FONT></STRONG><FONT face=Arial color=#000000><STRONG><BR></STRONG>is delivered along <BR>with your </FONT>\"<STRONG>Health Tips <BR>Newsletter</STRONG>\" with tips <BR>for the whole family, <BR>from a health <BR>practitioner.<BR><BR></FONT></FONT></DIV></DIV></DIV><DIV align=left><FONT color=#003333><FONT face=Arial>Your email address <BR>will not be shared.<BR></FONT></FONT><FONT color=#003333><BR><FONT face=Arial>Get Started Now</FONT></FONT></DIV><DIV align=left><FONT face=Arial color=#003333 size=1>&nbsp;</FONT></DIV></FONT></FONT></DIV></FONT></DIV></FONT></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></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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