// JavaScript Document
document.write("<div class=\"layer_box\" id='l2'>");
document.write("<div onclick='layeraus(\"l2\",ve);' class='close'></div><div class='layer_top'></div><div class='layer_center'><span class='text1' class='text2'>CALL BACK SERVICE</span><br/><span class='text3' class='text3'>WIR RUFEN SIE ZURÜCK</span><form action=\"http://www.citylasik.com/layer/form_callback.php\" method=\"post\" name=\"Callbackformular\"><fieldset class=\"csc-mailform\"><input type=\"text\" name=\"Telefon\" id=\"mailformTelefon\" size=\"20\" value=\"Telefonnummer*\" onfocus=\"if (this.value==this.defaultValue) this.value=''\" onblur=\" if (this.value=='') this.value='Telefonnummer*'\" /><br /><label class=\"label_ie6\">Datum:</label><input type=\"text\" name=\"datum\" value=\"\" style=\"width: 65px;margin-right: 5px;\" class=\"floatL\"><label>Uhrzeit:</label><select name=\"time\"><option>08.00 Uhr</option><option>09.00 Uhr</option><option>10.00 Uhr</option><option>11.00 Uhr</option><option>12.00 Uhr</option><option>13.00 Uhr</option><option>14.00 Uhr</option><option>15.00 Uhr</option><option>16.00 Uhr</option><option>17.00 Uhr</option><option>18.00 Uhr</option><option>19.00 Uhr</option><option>20.00 Uhr</option></select><div class=\"clear\"></div>																																																																																					<span class=\"sterntext floatR\"><a target=\"popup\" onclick=\"window.open('http://www.citylasik.com/bilder/Datenschutz-CityLasik.jpg', 'popup', 'width=580,height=450,scrollbars=no,toolbar=no,status=no,resizable=yes,menubar=no,location=no,directories=no,top=10,left=10'); return false;\" href=\"http://citylasik.com/datenschutz.php\">Datenschutz</a> <!--<a href=\"http://www.citylasik.com/datenschutz.php\">Datenschutz</a>--> </span><input type=\"image\" src=\"http://www.citylasik.com/bilder/callback_layer.gif\" name=\"formtype_mail\" class=\"form_submit\" onClick=\"return EingabenUeberpruefen2();\" /></fieldset></form></div><div class='layer_bottom'></div>");
document.write("</div>");