How to Complete an Rx Form for N.Dura™ HT Crown
Please complete all of the highlighted areas. 1 Select N.Dura ™ HT Crown.
2 Due to the high level of
translucency (HT) a stump shade is required for N.Dura™ HT restorations.
Dental Crafters Rx Form Requirements
Low
High
3 Indicate Shade, Gingival, Body and Incisal. 4 For Anterior cases, select the level of translucency. 5 Provide patient photos. 6 For bridge cases, indicate the Pontic Design. 7 Fill in the date and
time needed for the case to be returned, along with doctor and patient information.
8 Indicate the tooth number(s). 9 Complete signature.
Shade Taking Video
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