Contact Form

1. Contact Data

First Name *

Last Name *

Date of Birth *

Street *

City *

Zip Code *

Email *

2. Anatomical Data

Height

Weight

Please measure with clothes on, standing comfortably upright
Use the image on the right as a reference.

C1 (cm/inches)

C2 (cm/inches)

C3 (cm/inches)

L1 measured on front of thigh (cm/inches)

3. Sports and other activities

Sports, including dance, hiking, etc: What, how intensely? If stopped, why?

Childhood till age 17

17 till late 20s

Late 20s till now

In case of injury:

Sports and movement before

Sports and movement since

4. General Information About How You Move

Yoga
YesNo

Pilates
YesNo

I usually walk around when on the phone at work
YesNo

I fidget
YesNo

I tend to sit quietly for long periods of time
YesNo

I enjoy dancing to music
YesNo

I enjoy sports like skiing, surfing:
YesNo

5. Your Workplace/ Where You‘ll Be Using Your Limbic® Chair

Profession

Typical clothes for work

I have a hight-adjustable table
YesNo

I like a challenge and would like my Limbic® Chair to be active and provocative
YesNo

I‘d rather start with a milder version of the Limbic® Chair and upgrade later
YesNo

6. Personal remarks - Promotion code