Call for appliance fabrication times.

985-871-9893

We know how important it is to have a set date to receive your appliance and we do our best to be timely. All fabrication times given are for amount of days IN LAB and exclude weekends and holidays. The day AFTER we receive the model or impressions with a completed prescription starts day 1.

Please be aware that we will call if we have questions or concerns on any cases and that until we have all questions or concerns resolved this does delay fabrication time resulting in longer completion dates. We ask that if you receive any notification from us regarding a case to please get back with us as quickly as possible in order for us to be timely with your case.

How did you hear about us? If referred, by who?

Doctors Name

E-mail

Message

Doctors License Number & Expiration

Multiple Office Locations ?

Yes

Main address

Main Phone Number

Billing Contact and Phone Number

Appliance Contact & Phone Number

How would you like to receive your billing?

Payment Policy: Invoices are mailed or emailed on the 1st business day of every month. Payments are due before the 15th of the month in which you received the invoice (You receive the invoice on July 1st payment should be received by July 15th). Please see our full billing and payments policy under our "About us> Billing and Payments Policy" section of our website. What type of payments are accepted?: We accept checks via mail or E-Check. Your account can also be setup for automatic withdrawl via ACH on the 1st or the 10th of every month. Thank you for taking the time to fill out this form, please sign below to state you have read and understand our billing and payment policy.

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