Question path java script creation

I need a question box created like in the website below [login to view URL] 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