Download Printable RX Form

NDX Lumident has a few different RX form options to download for the type of case you need to send us.  Each prescription form is customized for certain product and service offerings and the location you will be sending your case to. Please be sure you completely fill out all the required fields and check the appropriate boxes to ensure your RX specifications are met.
 

‚ÄčIndianapolis:

If you are shipping cases to our Indianapolis location, please download the following forms.
 
Fixed RX Form Removable RX Form
     
Implant RX Form Orthodontic RX Form
 


Fort Wayne:

If you are shipping cases to our Fort Wayne location, please download the following forms.
 
Fixed RX Form Removable RX Form
   
Implant RX Form Orthodontic RX Form



Going Digital?

NDX Lumident can accept digital files from almost every intra-oral scanner on the market. Click here for directions on sending your scans to us.