For dentists
DenTec RX form.
Download the RX form, print it, and fill it out by hand — then enclose it with your case or tape it to the outside of your case bag.
Prescription
Print it, fill it out, send it with your case.
Our RX form captures everything we need to start your case — doctor and patient details, service selection, tooth numbers, shade, and special instructions. Download the PDF, print it, and complete it by hand.
- Compact 5.5" × 8.5" layout — prints two per letter sheet.
- Enclose the completed form with your impressions or scan paperwork.
- No printer? Call us at 704.563.1111 and we’ll mail you a pad.
Print it, fill it out, send it with your case.
PDF preview