SINGLE ARCH

Patient Initials:*

Patient Number:*

Patient Gender:*

Scan Source:*

Arch:*

Upper Lip Length:*

Desired Anterior Overjet:*

Teeth Mold:*

Teeth Mold Shape:*

Post Dam:*

Set Up Type:*

Final Output of File (Choose all that apply):*

FULLY PRINTED OPTION (All in one Try-in, and split files for Printed Base and Teeth
PRINTED BASE ONLY (Printed Base and Carded Teeth, includes tooth jig if necesary
CONVENTIONAL OPTION (All in one Try-in and Tooth Jig if neceassary

Notes:

Please upload scans of the Upper Arch and Lower Arch in relation to each other or include a Bite Scan.

Scan files should be in *.STL format. If uploading more than three files, the files will need to be compressed into a *.zip file.