Mattress Submission Form

For in-store use only. Complete this at the time of sale to register the customer's old mattress for collection.

Customer full name *

Invoice / Sales Order # *

Participating Retailer *

Mattress size *

Approximate age *

Under 5 years 5–10 years 10 years+

Mattress brand *

The customer has reported no liquid stains or structural damage *

The customer understands that our collection driver has final discretion on whether the mattress is suitable to be rehomed or recycled *