Medium

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Apple Android Windows

Dental Labortatory Rx Form Mobile App

The Dental Laboratory Rx Form mobile app allows dentist and dental technicians to complete a dental lab request form using a smartphone or tablet. The app covers Shade Instructions, Zirconia, All- Ceramic, PFM Alloys, Full Cat Alloys, Ceramage Zirconia Silica, Implants, Buccal Margin Design, Metal Design, Pontic Design, Stage, If No Occlusal Clearance and Specific Instructions. GoCanvas has thousands of pre-built mobile business apps in our Application Store

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Take a peek inside the Dental Labortatory Rx Form Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    DOCTOR:

  • Ico textbox

    PATIENT:

  • Ico textbox

    PHONE:

  • Ico date

    DATE SENT:

  • Ico textbox

    WANTED:

  • Ico checkbox

    PLEASE CALL DOCTOR BEFORE STARTING THIS CARE

  • Ico textbox

    SHADE #

  • Ico statictext

    OCCULUSAL STAINING

  • Ico checkbox

    NONE

  • Ico checkbox

    LIGHT

  • Ico checkbox

    MEDIUM

  • Ico checkbox

    HEAVY

  • Ico statictext

    SURFACE TEXTURE

  • Ico checkbox

    SMOOTH

  • Ico checkbox

    MODERATE

  • Ico checkbox

    HEAVY

  • Ico statictext

    LUSTER

  • Ico checkbox

    SHINY

  • Ico checkbox

    MODERATE

  • Ico checkbox

    DULL

  • Ico drawing

    SHADE INSTRUCTIONS

  • Ico statictext

    Please Provide the Following Information

  • Ico statictext

    PURPOSE OF VENEER

  • Ico checkbox

    CHANGE COLOR

  • Ico checkbox

    CLOSE SPACE

  • Ico checkbox

    CORRECT MALALIGNMENT

  • Ico checkbox

    INCREASE LENGTH (mm)

  • Ico decimal

    INCREASE LENGTH (mm)

  • ...and More!

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