Patient Form

292 S. La Cienega Blvd. Suite 205
Beverly Hills, CA 90211
Phone: 424.302.0455
16661 Ventura Blvd. Suite 508
Encino, CA 91436
Phone: 818.386.8562

Pregnant

2D DIGITAL IMAGING SURVEYS

Beginning    Progress/Final  
Diagnostic Photographs
Panoramic View
Lateral Ceph  PA Ceph

Ceph Tracing

Full mouth series (Periapicals and Bitewings)

PeriapicalsCarpal Index

Bitewings

INTRAORAL SCANNING
& 3D PRINTING

iRECORD (open STL file)
Invisalign ClearCorrect
iCAST-ABO base digital models
Hard models Articulated
Surgical Guide

3D CBCT DIGITAL SURVEYS

Maxilla    
Mandible    
3rd Molar    
TMJ    
Implant    
Orthodontic    
Endodontic    
Other    
Dual scan
Radiographic stent or marked denture provided
Maxillary sinus floor mapping
Mandibular canal mapping
SlicingWith measurments
RADIOLOGY REPORT

DELIVERY

DVD given to PatientUpload to Cloud (box.com)Hard copies mailed to Dental Office
DICOM, Romexis viewerDICOM, TxStudio/Invivo viewerDICOM only