These pre-submission forms ensure accurate treatment prescription.

SKU: SA-001-07 Category:


A 8 ½ x 11, 2-part NCR form that prints in 2 colors. Every clinician must submit a pre-submission form prior to prescribing Reveal Aligners to their patient. This form allows for accurate treatment prescription and will provide both the clinician and patient with insight into the length and cost of treatment. This form can be branded with your lab’s logo and is available in 250 and 500 quantities. Simply select quantity and add to cart. During checkout, you will be prompted to upload your logo. Please choose a hi-res version in any of the following, approved formats: .ai, .eps, .pdf, .png, .jpg, or .jpeg.

Additional information


250, 500, 1000