Dr. Heather Body Profile Body Profile Questionnaire Gender* Male Female Primary Sleeping Position*Select OneBackSideStomachSelect a Male Body Style* Profile 1 Profile 2 Profile 3 Profile 4 Choose OneSelect a Female Body Style Profile 1 Profile 2 Profile 3 Profile 4 Choose OneShoulders and Hips Shoulders are Wider than Your Hips Hips are Wider than Your Shoulders Shoulders and Hips are the Same Width Shoulders are Wider By Approximately:* 1 Inch to 3 Inches 4 Inches to 6 Inches Wider than 6 Inches Shoulders and Hips Shoulders are Wider than Your Hips Hips are Wider than Your Shoulders Shoulders and Hips are the Same Width Shoulders are Wider by Approximately:* 1 Inch to 3 Inches 4 Inches to 5 Inches Greater than 5 Inches Do you experience back pain in the morning?Yes or NoYesNoLocation of Back Pain* Neck Area Shoulder Area Middle Of Your Back Lower Back DDF Do you experience back pain in the morning?Yes or NoYesNoLocation of Back Pain* Neck Area Shoulder Area Middle Of Your Back Lower Back Height*Select4' 5"4' 6"4' 7"4' 8"4' 9"4' 10"4' 11"5' 0"5' 1"5' 2"5' 3"5' 4"5' 5"5' 6"5' 7"5' 8"5' 9"5' 10"5' 11"6' 0"6' 1"6' 2"6' 3"6' 4"6' 5"6' 6"Your height is a preliminary piece of data that will help our engineers:Weight*Select95 lbs. to 110 lbs.111 lbs. to 125 lbs.126 lbs. to 140 lbs.141 lbs. to 155 lbs.156 lbs. to 170 lbs.171 lbs. to 185 lbs.186 lbs. to 200 lbs.201 lbs. to 215 lbs.216 lbs. to 230 lbs.231 lbs. to 245 lbs.246 lbs. to 260 lbs.261 lbs. PlusAny additional physical issues we should be aware of? Your First Name Only*So we can address you properly in our email.Email Address* Delivery Zip Code*What Size Mattress are You Considering?*King (80" L x 76" W)Queen (80" L x 60" W)Full (76" L x 54" W)Twin Extra Long (80" L x 39" W)Twin (76" L x 39" W)Will you be sharing this mattress with a partner?*Select Yes or NoYesNo Partners Gender* Male Female Partners Sleeping Position*SelectBackSideStomachPartners Body Style* Profile 1 Profile 2 Profile 3 Profile 4 Choose OnePartners Body Style* Profile 1 Profile 2 Profile 3 Profile 4 Choose OnePartners Shoulders and Hips Shoulders are Wider than Your Hips Hips are Wider than Your Shoulders Shoulders and Hips are the Same Width Shoulders are Wider By Approximately:* 1 Inch to 3 Inches 4 Inches to 6 Inches Wider than 6 Inches Partners Shoulders and Hips Shoulders and Wider than Your Hips Hips are Wider than Your Shoulders Shoulders and Hips are the Same Width Shoulders are Wider by Approximately:* 1 Inch to 3 Inches 4 Inches to 5 Inches Greater than 5 Inches Does your partner experience back pain in the morning? Yes No Location of your partners back pain?* Neck Area Shoulder Area Middle Of Your Back Lower Back Does your partner experience back pain in the morning? Yes No Location of your partners back pain?* Neck Area Shoulder Area Middle Of Your Back Lower Back Partners Height*Select4' 5"4' 6"4' 7"4' 8"4' 9"4' 10"4' 11"5' 0"5' 1"5' 2"5' 3"5' 4"5' 5"5' 6"5' 7"5' 8"5' 9"5' 10"5' 11"6' 0"6' 1"6' 2"6' 3"6' 4"6' 5"Partners Weight*Select95 Lbs. to 110 Lbs.111 lbs. to 125 lbs.126 lbs. to 140 lbs.141 lbs. to 155 lbs.156 lbs. to 170 lbs.171 lbs. to 185 lbs.186 lbs. to 200 lbs.201 lbs. to 215 lbs.216 lbs. to 230 lbs.231 lbs. to 245 lbs.246 lbs. to 260 lbs.261 lbs.Partners First Name*Additional InformationIdentify any physical issues that affect your partner's sleep. Please complete our Body Profile Questionnaire and we will begin designing your Personalized Mattress.
