We are excited to release new Rx forms for 2017, including a brand new Implant Form! The changes aren’t huge, but we think you will like the upgrades. Starting Monday, January 9, these will be available with the drivers.

Click on the headers below and you can download a copy of the new form. You can also download them on our Downloads & Tech Tips page.

Don’t worry, we will still accept the old forms if you still have those in stock.

Here are some of the new features you will see:

Fixed Rx Form –

• Contact name and email for case questions added.
• Check box for intraoral scan sent and system used.
• Nautilus Elite added to All Ceramic Restorations.
• Patient specific temporary added to All Ceramic Restorations.
• Select metal hue to Full Cast Restorations.
• Non-precious to under Full Cast Restorations.
• Diagnostic wax up options added.
• Occlusal staining options added to Esthetics.
• Surface texture and contour options added to Esthetics.
• Diastemas options added to Esthetics.

Removable Rx Form –

• Contact name and email for case questions added.
• Ivoclar Phonares teeth added.
• Material color added.
• Personal ID option added.
• Patient specific tray option added.
• Composite on metal added to Partial Denture.
• Immediate denture indication added.

Orthodontic Rx Form –

• Contact name and email for case questions added.
• Check box for intraoral scan sent and system used.
• Anterior coverage only added to Splints.
• DPS Clear Align Retainer (bridge splint retainer) added to Retainers.

Dental Sleep Medicine Rx Form –

• Contact name and email for case questions added.
• Check box for intraoral scan sent and system used.
• dreamTap appliance added.
• SomnoDent appliance selections changed.

New!!! Implant Rx Form –

• All new Rx for implants!
• Fixed and removable restorations on one form.