To recieve additional Rx's script splease contact our Customer Service Department. Temporary Rx's can be downloaded on this page.
RX Instructions:
- Fill in the doctor's name and the patient's name.
- Check off the box that corresponds to your restoration of choice in the restoration list.
- Note the boxes that correspond to the restoration you have chosen and complete those boxes below.
- Provide any special instructions in the designated area.
- Fill in return date.
- Sign the Rx.
- Attach any photographs. For digital photos, please email as a jpeg file to rbanister@newimagedl.com
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