Get Removable Rx Form - New Image Dental Laboratory

This guide provides clear instructions for users on how to accurately fill out the Removable Rx Form for New Image Dental Laboratory online. By following these steps, users can ensure that their dental appliance orders are processed smoothly and effectively.

Follow the steps to complete the Removable Rx Form online.

1. Press the ‘Get Form’ button to access and open the Removable Rx Form in your digital editing tool.
2. Begin by entering the doctor's name in the designated 'DR.' field, followed by the date in the 'DATE' section.
3. Provide the patient's address, phone number, and email address in the corresponding fields. Ensure accuracy for effective communication.
4. In the 'PARTIAL DENTURES' section, select the type of denture needed by checking the relevant boxes - options include Custom Tray, Standard Denture, Premium Denture, or Immediate.
5. Fill in the details about the make of teeth in the 'Make of Teeth' field and select the acrylic type from the options provided.
6. Specify the mold and shade preferences from the dropdown menus, ensuring to indicate the shade for Lucitone options correctly.
7. For additional denture services, mark any needed treatments such as reline or rebase in the ‘ADDITIONAL DENTURE SERVICES’ section.
8. If users require a nightguard, specify the type (upper or lower) and select any preferences for acrylic and colors listed.
9. In the section labeled 'ADDITIONAL SERVICES,' check off any additional features or products required for the order.
10. Review all entered information for accuracy before finalizing. Then, save changes, download the completed form, print it, or share it according to your needs.

Complete your Removable Rx Form online today to facilitate your dental needs.