Laboratory Solutions Rx:
Our Rx forms are designed to accurately collect the information we need for the restoration(s) you are requesting.
You can recieve additional Rx's pad by contacting our customer service department and temporary Rx's can be downloaded on this page.
RX Instructions:
- Write in your lab's name and the patient's name.
- Check off the box that corresponds to your restoration of choice in the restoration list.
- Note the boxes to the right that correspond to the restoration you have chosen and complete those boxes below.
- Select your payment method.
- Write in any notes. You may use the reverse side as well.
- Sign the Rx.
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