Kelly,
You're welcome to steal it from our Subscription Center here:
http://revmarketer.pedowitzgroup.com/SubscriptionManagement.htmlYou'll need to customize it for your needs. Here is the code we used:
$jQ("#Unsubscribed").click(function() {
if ($jQ('#Unsubscribed:checked').val() != null) {
$jQ("input[name=Subscribed__c],input[name=Subscribed_Webinars__c],input[name=Revenue_Marketer_Series__c],input[name=Subscription-Suspendfor90Days]").attr("checked", false);
}