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  • 812-945-7122
  • 800-999-7122
  • Fax: 812-949-3492

Giving you more reasons to smile.

Preference Sheet

Please complete this form and return it to us as soon as possible; this is an excellent tool for us to better serve you.

Preference Sheet

"*" indicates required fields

Name*
MM slash DD slash YYYY

Days & Hours of Operation

 

Articulator Preference*

Alloy Requirements: Ceramic*
Alloy Requirements: Full Cast*
Articulator Preference: Quadrant or Larger*
Insufficient Clearance*
Opposing Relief*
Contacts*
Occlusal Staining*
Die Spacer*
Metal Design
Please refer to our Metal Design Chart
This field is for validation purposes and should be left unchanged.
Kelley Dental Laboratory
812-945-7122