I need a question box created like in the website below
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If you can't see the site in your country I am attaching a screen shot of the question box. Basically the script will ask a series of questions and once answered it will present a form item asking the user to submit their email.
I am going to use this script on multiple pages so I would like instructions on the page pointing to areas that I can edit such as the buttons and where I can edit the questions or add and remove questions