Warranty Registration

Personal Data Collection Statement:
All personal data provided below are subject to the willingness of customers. Information collected by Simmons Bedding & Furniture (HK) Limited is exclusively for the puposes of warranty registration, marketing analysis and promotions. All information collected will be kept strictly confidential.

Fields marked with * are required.
A. Customer and Purchase Information
1. Name: *

(Mr./Ms.) (in BLOCK letters)

2. Home Address:*

3. Home Tel. No.:*

4. Mobile/Office No.:*

5. Email Address:*

6. Delivery Date:*

Day Month Year
7. Invoice No.:*

8. Merchant:

9. Product:*
Mattress Box Spring
10. Mattress Model:
BackCare® 3 BackCare® Essential Capital
Custom Royal® Deluxe Artina Manton Extra Firm
Kailey Extra Firm Kailey Plush Firm Zoe Ultra Plush Pillow Top
Others (Please specify):
11. Size:*

 
B. Customer survey
12. Gender:
Male Female
13. Age Group:
<=25 26-35 36-45 =>46
14. Education:
Primary Secondary Post-secondary/College University
15. Occupation:
Owner/Sole Proprietor Professional Manager/Senior Executive
Technician/Engineer Clerk Blue Collar
Housewife Retired  
Others (Please specify):
16. Monthly Household Income:
<=$30,000 $30,001 - $60,000 $60,001 - $100,000
$100,001 - $150,000 =>$150,001  
17. Marital Status:
Single Single w/ child(ren)  
Married, w/o child Married, w/ child(ren)  
18. Reason(s) for the
       purchase
New Home Getting Married  
Upgrade sleep quality Replace old Simmons® product  
Replace non-Simmons® product (Please specify brand name):
19. Why choose Simmons®?

(Can choose more than one option)
Brand reputation Comfort
Product quality & craftsmanship Promise of uninterrupted sleep
Recommendation from by relatives/friends Promotion
Convincing sales consultants Good experience w/ Simmons®
Others (Please specify):
20. Warranty Card No.*

    
 

Customer Service Hotline:  +852  2378 4848