document.writeln("<div align=\"center\" style=\"position:absolute; top:185px; left:305px;\"><br />");
document.writeln("<!-- BoldChat Live Chat Button HTML v1.20 (Type=Web,ChatButton=My Chat Button,ChatWindow=My Chat Window,Website=- None -,Department=- None -) -->");
document.writeln("<table cellpadding=\"0\" cellspacing=\"0\" border=\"0\">");
document.writeln("<tr><td align=\"center\"><a href=\"http://livechat.boldchat.com/aid/2611627403659895218/bc.chat?cwdid=6017834491416787697\" target=\"_blank\" onClick=\"window.open(\'http://livechat.boldchat.com/aid/2611627403659895218/bc.chat?cwdid=6017834491416787697&amp;url=\' + escape(document.location.href), \'Chat8628327199049472835\', \'toolbar=0,scrollbars=1,location=0,statusbar=0,menubar=0,resizable=1,width=640,height=480\');return false;\"><img alt=\"Live chat by BoldChat\" src=\"http://cbi.boldchat.com/aid/2611627403659895218/bc.cbi?cbdid=7433766030261678149\" border=\"0\" width=\"200\" /></a></td></tr>");
document.writeln("</table>");
document.writeln("<!-- /BoldChat Live Chat Button HTML v1.20 -->");
document.writeln("</div>");
document.writeln("<div style=\"background-image:url(images/smlfrm.jpg); width:171px; height:282px; padding-top:54px; padding-left:10px; padding-right: 20px; padding-bottom: 14px; margin-left:auto; margin-right:auto;\">");
document.writeln("            <form action=\"http://www.kugelhernialawsuit.com/lead_tracker/scripts/add_lead_v.php\" method=\"post\" onsubmit=\"MM_validateForm(\'name_from\',\'\',\'R\',\'email_from\',\'\',\'R\',\'comments\',\'\',\'R\',\'homephone\',\'\',\'R\',\'captcha_input\',\'\',\'R\');return document.MM_returnValue\">");
document.writeln("<input name=\"website_from\" type=\"hidden\" value=\"californiamotorcycleaccidents.com\" />");
document.writeln("<input name=\"company_from\" type=\"hidden\" value=\"Motorcycle Accident Lawyers\" />");
document.writeln("<input name=\"thankyoupage\" type=\"hidden\" value=\"http://www.californiamotorcycleaccidents.com/thankyou.html\"/>	");
document.writeln("<input name=\"product3\" type=\"hidden\" value=\"1\" />");
document.writeln("                                    <table >");
document.writeln("                                      <tbody>");
document.writeln("                                        <tr>");
document.writeln("                                          <td class=\"titulosR\" align=\"left\"> Name:</span><br />");
document.writeln("                                          <input name=\"name_from\" class=\"texto\" id=\"name_from\" size=\"18\" style=\"width: 130px;\" /></td>");
document.writeln("                                        </tr>");
document.writeln("                                        <tr>");
document.writeln("                                          <td class=\"titulosR\" align=\"left\">Phone:</span><br />");
document.writeln("                                          <input class=\"texto\" size=\"18\" name=\"homephone\" style=\"width: 130px;\" /></td>");
document.writeln("                                        </tr>");
document.writeln("                                        <tr>");
document.writeln("                                          <td class=\"titulosR\" align=\"left\">E-mail:<br />");
document.writeln("                                          <input name=\"email_from\" class=\"texto\" id=\"email_from\" size=\"18\" style=\"width: 130px;\" /></td>");
document.writeln("                                        </tr>");
document.writeln("                                        <tr>");
document.writeln("                                          <td class=\"titulosR\" align=\"left\">Comments:<br />");
document.writeln("                                          <textarea name=\"comments\" cols=\"15\" rows=\"3\" class=\"texto\" id=\"comments\" style=\"width: 130px;\"></textarea></td>");
document.writeln("                                        </tr>");
document.writeln("                                        <tr>");
document.writeln("                                          <td height=\"45\" align=\"center\" class=\"titulosR\">Security Code:<br />");
document.writeln("                                          <input type=\"text\" name=\"captcha_input\" size=\"12\" maxlength=\"5\" value=\"\"><br />");
document.writeln("                                          <img src=\"http://www.kugelhernialawsuit.com/scripts/captcha_image.php\" />&nbsp;</td>");
document.writeln("                                        </tr>");
document.writeln("                                        <tr>");
document.writeln("                                          <td class=\"titulosR\" align=\"center\"><input type=\"submit\" name=\"Submit\" value=\"Submit\" class=\"titulosGrandeG\" />");
document.writeln("                                          &nbsp;&nbsp;<input name=\"reset\" type=\"reset\" class=\"titulosGrandeG\" value=\"Reset\" /></td>");
document.writeln("                                        </tr>");
document.writeln("                                      </tbody>");
document.writeln("                                    </table>");
document.writeln("                  </form></div>");
