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NIGHT GUARD / SPLINT
CUSTOM IMPRESSION TRAY
MODEL
DUAL ARCH
SINGLE ARCH
DUPLICATE DENTURES
RESOURCES
SUPPORT
NIGHT GUARD / SPLINT ORDER FORM
New Project:
Please complete the order form below.
Night Guard / Splint
Patient Initials:
*
Patient Number:
*
Arch:
*
UPPER
LOWER
Desired Anterior Overjet:
*
SMOOTH
ANATOMICAL
Lingual Bite Guide:
YES
NO
Notes:
Please upload a scan of the Upper Arch.
Scan files should be in *.STL format. If uploading more than three files, the files will need to be compressed into a *.zip file.