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Removable Appliance
Fixed Metal Appliance
Diagnostic Study Model
Mailing Labels
Blank Removable Appliance Form


PO Box 4064
Woburn, MA
01888-9944

Doctor

Address

City

State

Zip

Telephone

Patient

Due Date (1-2 days prior to insertion)
(781) 938-5088 (781) 938-0795 (800) 922-6365 www.neolab.com
Removable Appliances
Retainers Upper Lower
Standard Design
Wrap Around
Bow Solder to Clasps
Flat Bow Labial Wire
Invisible Retainer
KD Overlay
Pedo Partials
Clasp Options Acrylic Option Acrylic Design
Adams Clasps Clear Anterior Bite Plane
Ball Clasps Pink Posterior Bite Plane
Arrow Clasps Add Pontic(s) Reverse Incline
"C" Clasps Color/Graphics Horseshoe Palate
Soldered "C"s Sticker Hi Trim Anteriors
Finger Springs Upper Scallop Anteriors
Rests Lower Acrylic Bow
Springs
Z Spring
Helical Spring
Interproximal Spurs
Stabilizing Wire
Elastic Hooks/Soldered
Spring Retainers Upper Lower
Modified Spring Hawley
Ext w/Clasps or Rest
Do Not Reset Teeth
Reset Teeth Ideally
Compromise Reset
Special Instructions
Mouthguards
Clear
Color
Chin Strap
2mm 3mm
Splints
Acrylic Bruxisam
Hard - Soft
Gelb Splint
Hard Vacuum 3mm
Study Models
Finished Soaped
No-Soaped
Rough-Cut
Duplication
Screws
7mm - 12mm
Micro Screw
3-Way
Fan Expansion
Bionator
Corrector
Screw
Open
Close
Maintain Bite
Transverse
Sagittals
One Screw
Two Screw
Three Screw
Occlusal Cover
Doctor's Signature License Number Call Doctor
Supplies Requests
Removable Scripts Fixed Scripts Study Model Scripts
Boxes Mailing

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©2007 by New England Orthodontic Lab
5 Green Street
Woburn, MA 01888
(800) 922-6365