Noble Pillow Questionnaire
First Name (how you would like it to appear) *
Your answer
Last Name *
Your answer
Email *
Your answer
Height (in inches-use decimals to the nearest .25)
Your answer
Weight (in lbs-to the nearest .5)
Your answer
Gender
Date of birth
MM
/
DD
/
YYYY
What is your overall quality of sleep?(Optional)
Your answer
Choose the approximate amount of time you spend sleeping in each position on average: *
Always
Most of the time
Sometimes
Rarely
Never
On your back
On your Side
On your Stomach
Would you like your pillow designed for combined back and side sleeping or side sleeping only? *
What kind of a pillow do you like?
How high (in inches-use decimals to the nearest .25) is your current pillow? (if you sleep with multiple pillows add up the total height)
Your answer
How much support do you like your neck to have while sleeping? *
A little
A lot
How hot or cold do you feel while you are sleeping? *
Do you currently or have you in the past had any head, neck, shoulders, and/or back issues?
If Yes, describe here:
Your answer
Mattress firmness *
Extra soft
Extra firm
If you have a mattress topper how thick is it (in inches-use decimals to the nearest .25) Enter 0 if none
Your answer
Are you sensitive to: *
Required
If you have sensitivities, we can customize your inner pillow-top materials. The extra cost for substituting depends on your pillow specifications. *
Head Circumference: Measured just above the ears (in inches-use decimals to the nearest .25)
Captionless Image
Your answer
Ear/Neck to Wall: Standing with your shoulder touching the wall measure the following distances (in inches-use decimals to the nearest .25):
Left side of ear to wall (use decimals)
Your answer
Left side of neck to wall (use decimals)
Your answer
Right side of ear to wall (use decimals)
Your answer
Right side of neck to wall (use decimals)
Your answer
Head Jut: Stand with your heels against wall and looking straight ahead (no head tilt up or down) measure the following distance from the back of your head to the wall (in inches - use decimals to the nearest .25)
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Your answer
Neck Distance: Stand with your heels against wall, press your head against the wall looking straight ahead and measure greatest space between the curve of neck and wall (use decimals to the nearest .25)
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Your answer
Length of Neck Curve: Measure length of the curve in the neck (in inches - use decimals to the nearest .25)
Captionless Image
Your answer
Please share your comments and requests below
Your answer
Referred by
Other
Your answer
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