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lab work completed Form

This form is for when your lab work has been fitted. Please note - This form is completed when a final device is fitted and the patient leaves the surgery wearing it, with the exception of implant bar work. For dentures, do not complete this form for wax rims special tray impression wax try ins etc.

LAB
standard
reconciliated
denture item 1
dentures item 2
dentures item 3
dentures item 4
dentures item 5
crown and bridge appliance
IMPLANT screw retained zirconium crown
IMPLANT device company
implant device order
ortho device
remakes link
Notes
  • {name}
lab sheet
Attach file
Drop files here
Attachments
Attach file
Drop files here
was analogue/ impression coping returned?
This relates to a device use to take impressions of implants. You should find it with the returned implant crown. This should be cleaned and sterilised.
your initial

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