For a downloadable PDF click here

1.  Login to Implant Concierge and click on the patient’s name to open the case.

2.  Click on the red “Authorize Surgical Guide” button.

3.  After you verify that the patient information, charges, and shipping information is correct, please scroll down to fill out and sign the Authorization Form.

4.  First, choose the supporting structure of your guide (Mucosa, Tooth Borne, Bone Borne, or Bone Borne with Reduction Guide). Second, you have the option to leave any additional notes. Third, please virtually sign the form by typing your first and last name. Fourth, click the box to verify that you have read and agree to the terms. Next, choose which date you would like the guide to be delivered by. Lastly, click the green “I Authorize” button. If the button is not highlighted, that means a necessary field has been left blank. Please ensure that all necessary fields are filled out.