Laboratory Prescription Form (4 books)
Perforated across the top for easy tear-off. Consecutive tracking number on each set for your added convenience.Approved by the Missouri Dental Board.
Note: Missouri state law requires a copy of the work order indicating shade verification shall be retained by the lab AND dentist for 7 years from the date appearing on the order or the date of prescription.
Measurement: 5.5" wide by 8.5" high. Contains 50 forms per book, each with carbon copy and wrap around cover. Quantity: 4 books.
Click here to view a sample form.
||MDA Office Manager