function formHandler(){
var URL = document.form.site.options[document.form.site.selectedIndex].value;
window.location.href = URL;
}

document.write('<form name="form">');
document.write('<select name="site" size=1>');
document.write('<option value="">Choose State');
document.write('<option value="http://www.insurancequest.com/stm_quote.html">Short Term Medical');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Alaska');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Alabama');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Arizona');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Arkansas');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">California');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Colorado');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Delaware');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Florida');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Georgia');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Hawaii');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Idaho');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Illinois');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Indiana');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Iowa');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Kansas');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Kentucky');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Louisiana');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Maine');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Maryland');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Massachusetts');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Michigan');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Minnesota');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Mississippi');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Missouri');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Montana');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Nebraska');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Nevada');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">New Hampshire');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">New Jersey');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">New Mexico');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">New York');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">North Carolina');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">North Dakota');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Ohio');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Oklahoma');
document.write('<option value="http://www.oregon-health-insurance.com">Oregon');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Pennsylvania');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Rhode Island');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">South Carolina');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">South Dakota');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Tennessee');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Texas');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Utah');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Vermont');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Virginia');
document.write('<option value="http://www.healthinsurancewashington.com">Washington');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">West Virginia');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Wisconsin');
document.write('<option value="http://www.insurancequest.com/health_quote1.shtml">Wyoming');
document.write('</select>');
document.write('<input type=button value="Go!" onClick="javascript:formHandler()">');
document.write('</form>');