DOWNLOAD our Rx Form: (PDF format – Download Adobe Reader if you do not have it)
Complete the above PDF and send it to us via email (contact@rrdental.com) or by Fax to 231-929-7776 AND place copy of completed Rx form with your case.
To provide more depth and context, feel free to complete this optional online form. Be sure to provide your name and the patient’s first name and last initial to help us match this information with the Rx Form, which should come with their case.
