Dental lab prescription form
A complete Rx lets us start your case the day it arrives. Fill in the PDF on your computer, or print it and include it with the case.
Download the Rx
The form is a fillable PDF. Type into it, save it, and email it to ron@dentalcreations.net with your case, or print it and send it with physical impressions.
Scans go to dentalcreationscad@gmail.com. Use the patient name or case ID in the subject so we can match the scan to the Rx.
What the form covers
- Doctor, practice and license number
- Patient name or ID and due date
- Tooth chart (universal numbering)
- Restoration type and material
- Shade, stump shade and shade appointment request
- Implant system, platform and retention
- Contacts, occlusion and special instructions
Tips for a complete prescription
Most questions we have to call about come down to the same few details. Including them on the Rx keeps your case moving:
- Stump shade as well as target shade, especially for e.max and other translucent materials
- Material preference, or “lab to advise” if you want our recommendation
- Implant details: system, platform size, connection and screw-retained or cemented
- Photos with a shade tab in frame for anything in the esthetic zone
- The date you need it, and whether it is a rush
New to Dental Creations? See how to send a case, or call us and we will set up your first one together.