Which sheet do I need?
One sheet per appliance family. Fill it in on screen and save it, or print it and send it with the case.
Herbst Rx
PDF · Fillable
MARA Rx
PDF · Fillable
Hawley Retainers & FLR Rx
PDF · Fillable
Indirect Bonding Rx
PDF · Fillable
Clear Image® Aligners Rx
PDF · Fillable
Metals Rx
PDF · Fillable
Digital Services Rx
PDF · Fillable
Guardian Retainer Rx
PDF · Fillable
Functionals Rx
PDF · Fillable
Positioners Rx
PDF · Fillable
Splints Rx
PDF · Fillable
Surgical Wire Rx
PDF · Fillable
Hybrid Complete Rx
PDF · Fillable
TADs Rx
PDF · Fillable
Accutech Rx
PDF · Fillable
Sending from
Canada?
Canadian practices use their own four sheets, with the customs details we need on them.
Getting the sheet
right first time.
A complete sheet goes straight onto the bench. These are the details we most often have to call about.
Patient name and the requested return date
The appliance and the options you want, ticked on the sheet
Any special instructions, written as you’d say them to the technician
Your practice name and account number