The following questionnaire will guide usin creating a  custom blanket designed especially for you.  The answers to the following questions should be referenced toward the person for whom the blanket will be made.

Please note: For the most extreme sensory situations a combination of colors and textures is often chosen.

Please provide us a list of favorite colors this person enjoys:

What about:

Pastels? Yes No

Bright Colors? Yes No

Dark Colors? Yes No

Describe any favorite activities that this person enjoys:

Are there any favorite animals and/or characters that should be included?

Are there any specific prints that should be included?

While we make every effort to use hypo-allergenic materials, please list all sensitive and/or allergic fabrics:

Are there any uncomfortable fabrics (list all)?

Select Favorite Textures:

Soft Furry Velvet Flannel Coarse RoughShinySilky All

Other Textures?

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To assure we make the most appropriate blanket, please answer some of the following personal questions:

Gender?

Male Female

Age:

Weight:

Any additional information that you can provide based on your thoughts, doctors or occupational therapist comments:

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Should we need to get in touch with you for additional questions please provide your contact information below:

Name:   

Email Address:   

Telephone where we may contact you: