Web to Case Form

Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState

Zip Code
Product Code*
4-5 digit alphanumeric code (e.g., B500-A)
Serial Number*
14-18 digit code (e.g., 20181101-W123456)
How to find your serial number and product code
Date of Purchase*

MonthDayYear
Date
Retailer you purchased from
Retailer state
Upload a photo of your receipt (proof of purchase)

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Upload a photo of your adjustable base law tag (optional)

The law tag can be found on the head section of your adjustable base.
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To help us look you up, please provide your name and contact info below.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Product Code*
4-5 digit alphanumeric code (e.g., B500-A)
Serial Number*
14-18 digit code (e.g., 20181101-W123456)
Have you changed address? Provide your current one!

Street Address

Street Address Line 2

CityState

Zip Code

If available, please provide your case number.
case # should be 6 digits
What question can we answer?
Please provide additional details here.
Please do not provide payment information in this form.
Upload a photo or video to describe the issue you are experiencing (optional)

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9 am - 11 am ET11 am - 1 pm ET1 pm - 4 pm ET4 pm - 6 pm ET
EmailPhone
Preferred Email (this may be different than your registered address)
example@example.com
Preferred Phone Number (this may be different than your registered number)
Please enter a valid phone number.Format: (000) 000-0000.

Remote Pairing Instructions: 1 remote for 2 beds
To pair one remote to two (2) bases, please review the following video instructions.
How to pair 1 remote to 2 bases.
Were you able to resolve your questions by following these steps?

Help for a bed stuck in an upright position
To manually move your adjustable bed to a flat position when it is stuck in an upright position, please watch the video instructions below.
How to get your bed out of a stuck upright position.
Were you able to resolve your questions by following these steps?

The video below shows you how to reconfigure your DreamCell(TM) mattress.

Please note, your DreamCell foam springs may look different than what is pictured.
How to reconfigure a Reverie DreamCell mattress.
Were you able to resolve your question by reviewing these troubleshooting tips?

Please provide a detailed description of your issue, including what troubleshooting steps you completed.
Upload a photo or video to describe the issue you are experiencing (optional)

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9 am - 11 am ET11 am - 1 pm ET1 pm - 4 pm ET4 pm - 6 pm ET
EmailPhone
Preferred Email (this may be different than your registered address)
example@example.com
Preferred Phone Number (this may be different than your registered number)
Please enter a valid phone number.Format: (000) 000-0000.

We're glad we could help today! Please leave a review about your experience. (Please note, we may publish your review using first name, last name initial.) Thank you!
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