165061 Web page wisitor poll

We want a simple script there can be placed in the page Html code. The script must show new(frist time) visitors an overlay window with a list of questions about how they found the site. The visitor should be able to answer with a single click and the window must then auto close. The poll results must be presented on a seperate webpage the site owner can open. When a visitor have answered the poll it should newer be shown to him again. It should be posible to reset the poll and change the questions. Ind code. No need for userinterface. The window design must be simple and with a white background and maby blue/black border and font color.