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Product Type
Patient Details
Medical & Technical Info
Case Confirmation
Shipping Address
Product Type
Product Type
Clear Aligners (3D Aligners)
Clear Aligners (3D Aligners)
Patient Details
First Name
Last Name
Email
Gender
Male
Female
Prefer not to say
Date of Birth
Medical & Technical Info
Tooth information
Please indicate on each tooth the state if necessary.
Tooth Naming System
ISO
Alpha-numeric
Universal Numbering System
Treatment Request
Treat
Both arches
Upper Arch
Lower Arch
Treatment Type
3-3 Social Smile
5-5 Pre molar to pre molar
7-7 Full Treatment
As Recommended
Overjet
Maintain
Improve
Overbite
Maintain
Improve
Midline
Maintain
Improve
IPR
Yes
No
As Recommended
Attachments
Yes
No
As Recommended
Doctor's Instructions
Patient's Chief Complaints
Case Confirmation
Files
Impression Type
Intraoral Scan
Desktop Scan
Silicone Impression
Others
Upper scan
Choose File
One file only. 100 MB limit. Allowed types: stl obj ply dcm.
Lower scan
Choose File
One file only. 100 MB limit. Allowed types: stl obj ply dcm.
Bite scan
Choose File
The upload of a bite scan is recommended for more accuracy
Clinical Photos
Radiographs
Add a new file
Choose File
Unlimited number of files can be uploaded to this field. 100 MB limit. Allowed types: png jpg jpeg.
Other documents / Photos
Add a new file
Choose File
Unlimited number of files can be uploaded to this field. 100 MB limit. Allowed types: zip tar png jpg jpeg pdf stl rar 7z.
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Shipping Address
Address
Clinic
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New Shipping Address
Full Name
Company
Street Address
City
State/Province
Postal Code/ZIP Code
Country
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Germany
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United Kingdom
United States
Email Address
Phone Number
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