Forms › Client Preferences

We want to deliver accurate cases for your patients. Our Client Preferences Form helps us meet your expectations on every case. Please complete and submit the form below.

Step 1: Client Information
Preferred Method of Contact:
  • Office Contact:

If you have specific preferences that apply to every case, please check the appropriate boxes below. If you would rather submit criteria on a case-by-case basis, feel free to leave that question blank and proceed to the next question.

Step 2: Details
Interproximal Contacts:
Occlusal Stain:
Lack of Occlusal Clearance/Reduction:
PFM Margin Design:

Anterior:


Posterior:


Bridge Pontic Design:

Anterior:

Posterior:

Diagnostic Wax-Ups:

In addition to wax-up, please provide:

Anterior Tooth Form, Embrasures and Arrangement:

Restoration Level Choice:

Implant Restorations:
  • Implant Abutments:
  • Multiple Adjacent Implant Restorations
Material Choice—Anterior Crowns:

Material Choice—Posterior Crowns:


Alloy Choice:

PFM

Full Gold

Technology / Visual Aids

What type of technology / visual aids are you currently implementing in your office to assist in treatment planning and case acceptance?

Step 3: Comments/Notes
Enter your comments here:
Step 4: Submit