TFO Lab and Imaging Services

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TFO Digital Lab and Imaging Services -- Order Form

Doctor First Name

Doctor's Email

Doctor Last Name

Office Name

Shipping Address

Office Phone

Patient First Name

Patient Last Name

Date Needed

Please choose the service needed:

CBCT + Intraoral Scan with Radiology Review - $650

CBCT + Intraoral Scan without Radiology Review - $525

CBCT with Radiology Review - $450

CBCT without Radiology Review - $325

Intraoral Scan - $100

3D Printed Nightguard / Splint (Upper Arch Appliance) - $90

3D Printed Nightguard / Splint (Lower Arch Appliance) - $90

Clear Shell Retainer with Bite Plate - $35

Clear Shell Retainer (Both Arches) - $50

Clear Shell Retainer (One Arch) - $25

Bleaching Trays (Pair) - $20

3D Printed Study Model (Pair) - $10

Aligner Assistance - $325

Aligner Assistance + 5 Aligners - $400

Aligner Assistance + 10 Aligners - $475

Special Instructions

***PLEASE EMAIL ANY .STL FILES TO admin@tfolab.com AFTER SUBMITTING YOUR ORDER***

Thanks for submitting!

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