Godby Home Furnishings Checklist For A Better Nights Sleep

Name:   _______________________________

Delivery Town:   _______________________

1.   How long has it been since you shopped for a new mattress?
___ 0-5 years ___ 6-10 years ___ More than 10 years

2. Have you established your comfort level?   ___Yes   ___ No

3. Who is the bed for?   ___ Adult   ___ Child   ___ Guest

4. How old is your current set?   __________

5. What size mattress do you currently own?
___ Twin   ___ Twin XL   ___ Full   ___ Full XL
___ Queen   ___ King   ___ California King

6. What size would you like to purchase?
___ Twin   ___ Twin XL   ___ Full   ___ Full XL
___ Queen   ___ King   ___ California King

7. What type of sleep surface have you slept on?
___ Coil (innerspring)   ___ Foam   ___ Water   ___ Air

8. What type of bed do you have?
___ Headboard and footboard   ___ Headboard only   ___ Frame only

9. If you look under your bed, how many slats do you see?    _______

10. What is the measurement from the floor to the top of your bed frame or rail?   ___________________

11. How thick is your mattress set?   _________________________

12. Is your bed/mattress set currently   ___ Too high?   ___ Too low?

13. Do you currently have any back pain or medical concerns?
___ No   ___ Yes, please describe:   __________________________

14. What position do you sleep in?   ___ Back    ___ Stomach   ___ Side

15. How soon do you need your new sleep surface? _______________

Feel free to print out this survey and bring it to one of our store locations.

Download in .pdf format