document.write('<table border=0 cellpadding=0 cellspacing=0><tr><form method=post action="http://www.web-survey.dk/kvik/jsreply.asp?id=2&aq=847"><td>');
			document.write('<font class="reg11px"><b>Kunne du tænke dig en balkon på dit hus?</b></font><br>');
		
				document.write('<input onclick="javascript:submit();" type=radio name="reply" value="2561"> <font class="guidenytcontent">Ja</font><br>');
		
				document.write('<input onclick="javascript:submit();" type=radio name="reply" value="2562"> <font class="guidenytcontent">Nej</font><br>');
		
				document.write('<input onclick="javascript:submit();" type=radio name="reply" value="2563"> <font class="guidenytcontent">Nej, jeg har ingen 1. sal</font><br>');
		
				document.write('<input onclick="javascript:submit();" type=radio name="reply" value="2564"> <font class="guidenytcontent">Jeg har allerede en</font><br>');
		
				document.write('<input onclick="javascript:submit();" type=radio name="reply" value="2565"> <font class="guidenytcontent">Ved ikke</font><br>');
		
			document.write('</td></form></tr></table>');