function generateCaseQualifier() {
	document.getElementById('cont-case-qualifier').innerHTML = '<form method="post" enctype="application/x-www-form-urlencoded" '+
'action="http://www.sellmylifeinsurancepolicynow.com/CaseQualifier/CaseQualifierResponseLogic.php" class="stansberry_form">'+
'<input type="hidden" name="ID" />'+
'<p>Answer <strong>3</strong> simple questions<br />to find out if you qualify</p>'+
'<p><strong>Age of policy holder</strong><br />'+
'<select name="age" id="age">'+
'<option value="76 and older" selected="selected">76 and older</option>'+
'<option value="75 and younger">75 and younger</option>'+
'</select>'+
'</p>'+
'<p><strong>Health of policy holder</strong><br />'+
'<select name="health" id="health">'+
'<option value="Poor">Poor</option>'+
'<option selected="selected" value="Average">Average</option>'+
'<option value="Excellent">Excellent</option>'+
'</select>'+
'</p>'+
'<p><strong>Approximate policy size</strong><br />(for all eligible policies)<br />'+
'<select name="policy_size" id="policy_size">'+
'<option value="More than $250,000">$250,000 or above</option>'+
'<option value="Less than $249,999">$249,999 or below</option>'+
'</select>'+
'</p>'+
'<p>'+
'<input type="image" value="Submit" src="images/box-cq-clickhere.jpg" name="submit" class="box-case-qualifier-submit" id="saveForm" />'+
'</p>'+
'</form>';
}