Designer Dental LabDesigner Dental Lab

Digital Prescription

Crown & Bridge Rx

Complete the form below and submit your prescription directly to our team. No paper, no fax — just fast, accurate communication.

Dental Professionals Only

Doctor & Patient Information

//

Type of Restoration

Fixed — Crown & Bridge

Zirconia & Ceramic

Try-In

Translucent

Full Cast Crown

Mark Shading Zone(s)

Tooth shading zones

Cervical

Body

Incisal

* Please mark shading!

Pontic Options

Implant Custom Abutment

Abutment Type

Margin Depth

Emergence Profile

* Standard unless specified

Night Guards / Bite Splints

IO Scan

Items Enclosed

Tooth Chart

Click to select

1234567891011121314151617181920212223242526272829303132

Case Files & Images

Drag & drop files here

or browse files

Images, STL, PDF, and more — no size limit

Special Instructions