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  • Ks Fti Dental Lab Fixed Laboratory Work Authorization Form 2017

Get Ks Fti Dental Lab Fixed Laboratory Work Authorization Form 2017-2026

Rx Date: Due Date: Patient: Age: Sex: SHADE INSTRUCTIONS SPECIAL INSTRUCTIONS: Stump (Prep) Shade (Required for All-Ceramic) OCCL STAIN q None q Light* q Medium * Standard unless otherwise specified Final Shade q Dark ALL-CERAMICS q Porcelain Veneer q PFZ Porcelain-Fused-to-Zirconia q Full-Contour ZR q Anterior 600 MPa q CubeX2.

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How to fill out the KS FTI Dental Lab Fixed Laboratory Work Authorization Form online

Filling out the KS FTI Dental Lab Fixed Laboratory Work Authorization Form online can be a straightforward process when you know the steps to take. This guide will provide clear, step-by-step instructions to help you complete the form efficiently and accurately.

Follow the steps to successfully complete the form online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering the doctor’s name in the designated field. This should include the name of the dental professional who is issuing the authorization.
  3. Next, fill in the Rx Date and Due Date; ensure that the dates are accurate to avoid any processing delays.
  4. Then, complete the Patient section by inputting the patient's full name, age, and sex. These details are essential for record-keeping.
  5. In the Shade Instructions section, specify the stump (prep) shade required for the procedure, particularly for all-ceramic options.
  6. Indicate any special instructions that need to be communicated to the lab. Clear communication is vital to ensure your expectations are met.
  7. Next, specify the type of all-ceramics required by selecting from the provided options, such as Porcelain Veneer or Full-Contour ZR.
  8. For implant specifications, choose the implant type that applies from the list (e.g., Screw Retained or Cement Retained).
  9. In the Porcelain-Fused-to-Metal section, select the alloy type as applicable for the restoration being requested.
  10. Complete the Facial Margins section by selecting one of the options available to ensure proper alignment and aesthetics.
  11. Confirm that you have included crucial documents listed at the bottom of the form, like bite, photos, and pre-op models.
  12. Designate the Pontic Design and Metal Design options selected; these details are key for the lab to understand your requirements.
  13. If applicable, specify the type of Full Cast Restorations required, and make sure to include any additional models or shade confirmations.
  14. Finally, make sure to provide the signature of the dentist and their license number to authenticate the authorization before submission.
  15. Once all sections are filled out, you can save changes, download, print, or share the form as needed.

Complete your dental lab work authorization form online today for a seamless process.

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