Technical support form

1

Type of case* This field is required.

Sleep

Prosthetics

Implants or anaplastology

2

Enter email and contact name

Please enter your email

Please enter the contact name

3

Case number* This field is required.This is the 6 digit number associated with your case

5

Describe the issue* This field is required.

6

Please describe the issue* This field is required.

0/5000

7

The issue with the bite is related to:* This field is required.

Starting point

Lateral deviation

Vertical dimension

8

Which arch is problematic ?* This field is required.

Upper

Lower

Both

9

Are you experiencing the same issue on the provided models ?* This field is required.

YESNO

10

Were adjustments made chairside ?* This field is required.

YESNO

11

Please describe the adjustments made* This field is required.

12

Date of the last calibration of your scanner (if applicable, digital case)If you don't know, simply skip this question

Date

13

Additional comments / Useful information