Lab Rx Form (PDF) - Excel Dental Lab Co., Ltd. 2025

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The document is a prescription form for Excel Dental Lab, detailing the necessary information and requirements for dental lab services. It includes sections for patient and clinic details, types of dental work requested (such as crowns, bridges, and dentures), material specifications, margin designs, pontic designs, and additional instructions. The form also emphasizes the need for enclosed items like impressions and models.

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Click ‘Get Form’ to open the Lab Rx Form in the editor.
Begin by entering the 'Send date' and 'Due date' at the top of the form. This helps track your submission timeline.
Fill in the clinic name, dentist's name, and patient details in their respective fields to ensure accurate processing.
Select the appropriate options for case type, such as 'Crown', 'Bridge', or 'Implant Service'. Specify any additional details like material types or specific designs.
Indicate if this is a lab remake and whether it requires an old prosthesis work by checking the relevant boxes.
Complete sections for enclosed items, including impressions and models, ensuring all necessary materials are included for processing.
Finally, provide any additional instructions or shade preferences to guide the lab in fulfilling your request accurately.

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2007	3.9 Satisfied (30 Votes)

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