ENTER HERE

To enter the drawing for a free Ortho-Gel Distinctions Sleep System, fill out the form below entirely and click submit. Your information will not be sold or dis-tributed.

Name:
Email Address:
Phone #:
Address:
Where did you hear about us?
To enter the drawing, please describe here the things you DON'T like about your current bed.
How soon would you like a new bed?
Would you be interested in a demo, scratch and dent, or seconds bed?
Yes
No
Maybe
Would you be interested in attending a Sleep Seminar (about 1 hour) for extra discounts and freebies?
Yes
No
Maybe
Have you been into any MyComfort Store before, or any other store that sells gel beds?
Yes
No
If yes on the previous question, which location?
To help us better understand our customers, what age are you? (optional)
To help us better understand our customers, how much do you make annually? (optional)
Finally, has a doctor, therapist, or Chiropractor ever told you that a new bed could help you?
Yes
No
Not sure