Thank You

Thank you for your order!

We just need a bit more information before we can start processing your order. Please fill out the form below and give us as much detail as possible.

What date would you like your mask to start?

To ensure the mask works for you, please tell us your normal hours of sleep e.g. 10pm – 7am*

Do you work shifts? Please give time details (If yes, we will need to call you to discuss - please expect our call.)*

Are you travelling outside of your normal timezone within the next 4 months? (If yes, we will need to call you to discuss- please expect our call.)*

Yes

Date of birth

If you would prefer we can call you to discuss details; please enter preferred call back time

If a healthcare professional signposted or referred you to us, please note their name and medical / optical practice here

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The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.

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