This version of the Royal-Pedic Natural Cotton Mattress includes a chemical-free French wool wrap that is layered on top of the hand tufted organic cotton padding and quilted to the 100% organic cotton ticking for a safe, healthy and supportive sleep. This organic cotton mattress does not require a doctor's note. Royal-Pedic Mattress are available in Twin,Twin XL, Full, Queen, Cal King, or Est. King. Box spring is not included.