Quote Request for Dream Series

This is not an order.  It is the first step to placing an order, but we will not proceed without your explicit approval.  

Please fill out this form completely.  Know that any of the choices you select today can be changed, but we need this information to provide you the best possible price. When this form is completed, we will contact you with your price.  We do not distribute nor sell your contact information to anyone.

Beds By George DREAM SERIES Quote Request. All fields with * are required *Mattress Size * Select Desired Mattress size Std Twin Ext Twin (approx 80" long) Double (n/a for electric) *Safety Sides * Please select Std Side (doors on front and back) Hi-Side (regular) Hi-Side Dual (doors on front and back +$) *Door Style * Please select Clear View Clear View w/Slat Raised Panel Clear View w/Raised panel *Sleep Surface Function * Please select Fixed Height, Flat Bunkie Board Fixed Height, Adjustable Head (manual) Fixed Height, Adjustable Head and Foot (manual) HiLo, Full Articulation (electric) *Transfer Height from floor * Please select 24 in 30 in *Headboard Style * Please Select Colonial Hemisphere Straight (required. for canopy) If canopy is desired, select straight headboard *Corner Post Style * Please select Squared off at top Lathe turned finial at top *Wood * Please select wood Oak Maple Poplar *Stain * Please select finish Natural Fruitwood Michael's Cherry Rosewood (upcharge) Asbury White Paint (upcharge) Accent Carving Head/Foot None Chantilly Serenity Soothing Wave Accent Carving Doors None Soothing Wave Engraving (enter text) text should be spelled and punctuated exactly as you wish it to appear on the headboard. *Feet * Please select Adjustable Feet Casters (wheels), 3 inch Accessory  IV pole   Interior Padding   Drawers (na for electric)   Window in headboard   Window in footboard   Access port in headboard (for tubes)   Access port in footboard (for tubes)  Mesh Canopy Topper None YES; Red 724602 YES: Grape 724613 YES: Royal Blue 724600 YES: Bone 724616 YES: Beige 724603 YES: Charcoal Gray 724623 YES: Other (write selection in comments) *I am a *  Parent   Caregiver   Therapist   Medical Personnel   Advocate   DME   Other  Contact Name * First Last Quote Reference Company Name Shipping Address * Address 2 City, State, Zip Code * Do you have a forklift or dock? * Please select Yes No Phone Number * ### - ### - #### *Contact e-mail * Quotes are emailed to this address Plan to submit to insurance * Please select Yes No Private insurance, Medicaid, Waiver, etc. Comments Powered byEMF Web Form Report Abuse //]]>