MATTRESS PICKUP REQUEST FORM
Need a charity receipt to get your refund for the mattress you bought online that's still in the trial period? Adopt a Bed can help! Simply fill out this form and a representative will contact you to schedule and in-home pickup. If you need to reach us, call or text us here: 385-333-6692

Please note we cannot remove your old bed.

Thank you for Your Donation!
First and Last Name *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Mattress Name *
Brand name of the mattress you're donating such as Purple, Casper, Ghostbed...
Your answer
Mattress Size *
Home Address *
We need your home address so we know where to pick up your mattress. Include city and zip.
Your answer
How to Best Reach You
Would you prefer to get a text, phone call or email?
Your answer
Availability *
Let us know what days/times are generally best and if you need a RUSH pickup.
Your answer
Any additional info you’d like us to know....
Your answer
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