Treatment SubmissionTreatment Submissions Patient Name * Patient Name Patient Name Patient Name Treatment * Broken Bracket Lab Laser: Gingivectomy | Exposure | Frenectomy TADs for Gummy Smile Permanent Tooth Extraction Invisalign Case Opening Convert: P1 to Full Convert Convert: Braces | InvisalignLaser Procedure? (select all that apply) * Gingivectomy Exposure Frenectomy (Lip) Frenectomy (Tongue)Lab Type * Lifetime Retainer Promo Replacement Retainers Temporary Retainers Relapse AlignersScan complete? * Yes NoTeeth Requiring Gingivectomy * Upper 5-5 Lower 5-5 Upper and Lower 5-5 OtherOther What tooth or teeth need exposure? * Ext * U4’s OtherOtherHas treatment recommendation been discussed with patient or parent? * Yes NoTiming * ASAP Debond Message If you are human, leave this field blank. Submit
