How to Complete an Rx Form for e.max ® Facial Cutback Please complete all of the highlighted areas. 1 Select e.max® Facial Cutback Crown.
2 Due to the high level
Dental Crafters Rx Form Requirements
of translucency (HT) a stump shade is required for e.max® Facial Cutback restorations.
Low
Medium
High
3 Indicate Shade, Gingival, Body and Incisal. 4 Provide patient photos. 5 Fill in the date and
time needed for the case to be returned, along with doctor and patient information.
6 Indicate the tooth number(s). 7 Complete signature.
Shade Taking Video
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