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document.write("<a href=\"http://ehrscope.com\"><img src=\"http://www.emrconsultant.com/v4img/remote_header.jpg\"></a>");
document.write("<br />");
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document.write("<label id=\"specialty\">My Primary Specialty: ");
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document.write("<option value=9050>Allergy</option>");
document.write("<option value=9015>Anesthesiology</option>");
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document.write("<option value=9008>Neurosurgery</option>");
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document.write("<option value=9059>Occ Med/Physiatry/Pain Mgmt</option>");
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document.write("<option value=9026>Ophthalmology</option>");
document.write("<option value=9009>Optometry</option>");
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document.write("<option value=9029>Otolaryngology</option>");
document.write("<option value=9032>Pediatrics</option>");
document.write("<option value=9012>Physical Therapy</option>");
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document.write("<option value=9034>Podiatry</option>");
document.write("<option value=9063>Psychiatry</option>");
document.write("<option value=9064>Pulmonology</option>");
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document.write("<option value=9019>Sleep Medicine</option>");
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document.write("<option value=9002>SurgiCenter</option>");
document.write("<option value=9051>Urgent Care</option>");
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document.write("<div id=\"systemAcquire\">I am looking to acquire the following system:<br /><div>");
document.write("<label id=\"emrOnly\"><input type=\"radio\" name=\"r_18801\" value=\"EMR only\"/>EMR Only</label>");
document.write("-<span>or</span>-");
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document.write("<div id=\"trusted\">Trusted by over 10,000 Physicians &amp; Administrators</div>");
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