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Your general preferences on cases is important to us. Please use the form below to indicate what you prefer on each of your cases on a regular basis, and please let us know if you have additional requirements. Thank you!

Doctor's Name: *
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PORCELAIN-TO-METAL Non Precious (nickel free) Semi Precious Yellow High Noble White High Noble Metal Try-In		MARGIN DESIGN Facial All Porcelain Margin 360° All Porcelain Margin Show No Metal (sm lingual collar) 360° Show No Metal
FULL METAL 52% Au type IV N 77% Au type II HN		IF INSUFFICIENT ROOM Reduce/Mark Opposing Reduction Coping Call Doctor
OCCLUSAL CLEARANCE In Occlusion Out of Occlusion Space relief on opposing		TISSUE RELIEF None Light Heavy
OCCLUSAL STAIN None Light Medium Dark		CONTACTS Normal Light Tight Wide/Broad
METAL DESIGN		PONTIC DESIGN
Full porcelain coverage Partial metal occlusion Full metal occlusion including buccat cusp lips		Sanitary Bullet Ovale Hair Ridge lap Full Ridge lap
Special Notes:

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