RX Form

Please Allow 5 Days in the Lab (Travel Time Not Included)

Contour and Occlusion Design

* Indicates required field.

Terms and Warranty Information

Terms: Cost of collection of any account will be paid by the customer. All accounts are payable within 30 days of statement date. Accounts not paid within the stated terms will be subject to COD status and a late charge of 2 percent of the unpaid balance. Prices subject to change without notice. Rx must be enclosed with original case submission (we do not accept Visa or MasterCard).

Limited Warranty/Limitation of Liability: Precision Dental Implant Laboratory (“the lab”) warrants that all dental devices (“a device”) are made according to your specification and approval in the belief that the device that the device will be useful and MAKES NO OTHER WARRANTIES INCLUDING, BUT NOT LIMITED TO, ANY IMPLIED WARRANTY OF MERCHANTIBILITY OR FITNESS FOR A PARTICULAR PURPOSE. Subject to the return of a device that is placed and then fails, the lab will repair or replace the device without charge for the cost of materials and workmanship or refund the original price paid, at the lab’s option, as follow: screw-retained crowns and implant abutments up to 20 years. This warranty is exclusively for your benefit, is not transferable and does not extend to any patients. You agree to pay all of the other costs of adjustment, repair and replacement of a device. Except where prohibited by law, the lab WILL NOT BE LIABLE FOR ANY LOSS OR DAMAGES ARISING FROM THE USE OF A DEVICE, WHETHER DIRECT, SPECIAL, INCIDENTAL OR CONSEQUENTIAL, regardless of the theory asserted, including warranty, contract, negligence or strict liability and if such disclaimer is not permitted by law, the duration of any implied warranty is limited to 90 days from the date of delivery. In the event of a dispute and absent and amicable resolution the parties mutually agree to waive class actions in favor of mandatory individual arbitration of claims under the limited warranty in and in accordance to the laws of California. The lab does not guarantee the performance of independent carriers.