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Get KS FTI Dental Lab Fixed Laboratory Work Authorization Form 2017-2024

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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