Please help us expedite your case by completely filling out the prescription and returning it with your case. 

**All prescriptions must include the following:

Doctor name, address, phone, city, state, zip, patient's name and requested delivery date.  Please be sure you sign the RX and include your license number at the bottom of the form.

Also include your material choice on Splint Rxs and include shade, metal type and porcelain butts # on fixed Rxs.

To print our work orders properly formatted-

1. Right click on the link.

2. Select save target as.

3. Save the file to your desktop.

Launch the file in your graphics manager and select

PRINT PREVIEW to size properly.

DOWNLOAD A CROWN/BRIDGE PRESCRIPTION

DOWNLOAD A SPLINT/NIGHTGUARD PRESCRIPTION

DOWNLOAD PAGE 2 SPLINT/NIGHTGUARD PRESCRIPTION

DOWNLOAD AN IMPLANT/SURGICAL STENT PRESCRIPTION