Forms

Dental Scan Request Form

If you are a doctor looking to send your patient to a Facial Imaging partner scan site, please click here for the Dental Scan Request Form.

• Dental Scan Request Form

Scan Processing Order Form

If you have a cone beam scanner or have prescribed a scan outside the Facial Imaging network please click here for the Scan Processing Order Form.

• Scan Processing Order Form

Treatment Planning Questionnaire and Order Form

Please fill out the Treatment Planning and Consultation Questionnaire and Order Form and our professional and experienced staff will evaluate your patient's CT scan data and create a treatment plan according to your surgical criteria, prosthesis design, and treatment plan. Please visit the Treatment Planning Services page for more information.

• Treatment Planning and Consultation Questionnaire and Order Form