document.write("<" + "div id='popupContact'>");  
document.write("<a" + " id='popupContactClose'>Close Window</a>");
document.write("<h2>FREE E-Newsletter</h2>");
document.write("<p>Keep up to date with the latest <br>Hepatitis C news and information.</p>");
document.write("<form action='/list.html'>");
document.write("<input type='text' class='email' name='email' value='Enter email address' onFocus='this.value=\"\"' />");
document.write("<input type='hidden' name='nsrc' value='p' />");
document.write("<input type='image' class='submit' src='/images/testLayout2/signupBtn.png' />");
document.write("</form>");
document.write("<p class='privacy'>We value your <a href='/privacy.html'>privacy.</a> We will not rent your email to anyone.</p>");
document.write("<div id='popupLater'><a href='#' onclick='return false;'>Remind me in a month</a></div>");
document.write("</div>");
document.write("<div id='backgroundPopup'></div>");