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CHANGE or APPROVAL FOR CASE IN PROGRESS

$0.00

⚠️ THIS IS FOR ONGOING CASE ONLY Use this to approve or make changes to an ongoing restorative case in try-in stage ✅ Critical steps & requirements are clearly outlined in your initial order📌 Missing info may delay or void your case

Please use patient first initial and complete last name

APPROVAL OR EDITS?

Please add any additional notes, comments, or concerns that would be helpful to the processing of this case

If the appointment date is not possible, we will contact you.

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