Prescription

Download The Prescription Form Here

*Click on the button to download the form & please read the detailed instructions below.

Prescription Form Additional Information

To ensure we are able to provide you with the best possible service please provide:

  • Accurate models packaged for safe transport
  • Opposing model with bite registration
  • Models with properly seated bands for fixed appliances
  • Placement date *this should be 1 day prior to patients actual appointment
  • All information and all fields completed on the prescription form *1 form per case
  • Text instructions accompanied by drawings for clarification
  • Please do not hesitate to call or email with any questions, concerns or additional information

Timeline Schedule

Nightguards, Bleaching trays, mouthguards……………………………………………………. 2-3 business days

Fixed & Removable Appliances and Splints……………………………………………………. 4-5 business days

Additional Add-ons: please note that our base prices will be affected by laboratory band fitting, screws, spurs, springs, claps, etc.