document.write('<form action="/legacy/pages/quick_polls/quick_polls.jsp">');
document.write('	<h1 style="margin-top : 5px;">Quick Polls</h1>');
document.write('	<p><a id="_idJsp1" name="_idJsp1" href="http://www.ncmedsoc.org/legacy/pages/quick_polls/quick_polls.jsp">View All Polls</a></p>');
document.write('	<p style="margin : 0px; padding : 0px;">Should Medicare eligibility be expanded to permit persons age 55+ to &quot;buy in&quot; to the system to obtain health care coverage?</p>');
document.write('<table cellpadding="3" cellspacing="0" width="100%" style="margin-bottom : 15px;">');
document.write('<tbody id="_idJsp4:tbody_element">');
document.write('<tr class="valign_top"><td><input value=\'178\' name=\'answer\' class=\'input\' type=\'radio\'></td><td>Yes</td></tr>');
document.write('<tr class="valign_top"><td><input value=\'179\' name=\'answer\' class=\'input\' type=\'radio\'></td><td>No</td></tr>');
document.write('<tr class="valign_top"><td><input value=\'180\' name=\'answer\' class=\'input\' type=\'radio\'></td><td>I\'m not sure</td></tr></tbody></table>');
document.write('	<div style="margin-bottom : 15px;"><input type="submit" class="button" value="Submit" /></div>');
document.write('</form>');