Mattress Toxicology Report Form

Use the form below to report health problems resulting from exposure to chemicals emitted from new (or old) mattresses. Due to an increase in "unrelated" posts (spam/sales promotions etc), your entry will be emailed to us and then posted to the site after review.  It is extremely important that others be made aware of the potential health problems resulting from exposure to the chemicals used in mattress manufacture.  If you would like others to contact you regarding your situation, you can complete the email box as well.  Thank you and hope our information was helpful. Chem-Tox.com

Choose a Title to draw attention to your circumstance:
 Title:

Describe the problem -  Limit to 2 or 3 paragraphs

City: State: Country:

Email Address:

After reviewing your information we will add it to our site. 
Thank you - Chem-Tox

* Back to Mattress Toxicology Page