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European Dental
595 Taylor Way, Unit #5
San Carlos, CA 94070
Mon-Fri, 8am-6pm
650-557-2063 tel
415-723-7075 fax
info@european-dental.com
LAB SLIP
European Dental Technology Group
595 Taylor Way, Unit #5, San Carlos, CA 94070
ph: 650-557-2063 · fx: 415.723.7075
Email
*
:
Doctor
*
:
Patient
*
:
SHADE:
Date/Time:
Try In:
Due Date:
Construct and deliver to the undersigned only
the herein described dental restoration.
High Noble
Semi-Precious
Non-Precious
CROWN
GOLD #
PBM #
LAVA #
PRESS TO METAL #
INCERAM #
INLAY
GOLD #
EMPRESS #
SINFONY #
VENEER AUTHENTIC #
PORCELAIN MARGIN #
DIAGNOSTIC WAX-UP
LVI ORTHOTIC
(Removable)
LVI ORTHOTIC
(Fixed)
LENGTH OF CENTALS
(mm)
MIDLINE SHIFT
(mm)
(mm)
Left
Right
VERTICAL INDEX (Shimbashi)
Anterior (CEJ to CEJ)
(mm)
Posterior (CEJ to CEJ)
(mm)
(mm)
Left
Right
YOUR SHIPMENT INCLUDES:
Impressions
Bite
Stickbite
Opposing
Shade
Pre Op Model
Photos
Model of Temps
Implant components
Facebow
Please send attachments for your lab slip by
clicking here
.
INSTRUCTIONS
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*
Denotes required fields.
© 2008 European Dental Technology Group | 415-834-1531 |
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