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Lab Form

Lab Form PDF

Click here for the Lab Form PDF or fill out the online form below.

Case File Upload

Click here to upload your case files photos. We accept the following files: iTero, 3M, Carestream, and Trios.

Doctor Contact Info
Patient Info
Patient Name:*
Tooth Number(s):*
Select Shade Guide:
Stump Shade:
Cement Date:*
Items Included With The Case
Select items included:
If "Other," please explain:
Type of Restoration Desired
Select type of restoration:*
If "Other," please explain:
Case Notes and Goals
Please type out any necessary notes and goals:*
Doctor's Electronic Signature:*
Doctor's License Number:*
Implant Restorations
Type of Restoration:
If Screw Retained
If Cement Retained
Select Custom Abutment:
If "Other," please explain:
Please enter the text you see:

Additional Ordering Information
* Implants with zirconia connections will be manufactured by Nobel Biocare, Straumann, or Atlantis.

** Implants with metal connections on zirconia abutments can be milled by Group 4 Dental Lab or Nobel Biocare.

Metal connections are cemented to the zirconia abutment in lab. Pricing varies by manufacturer, most companies can produce platforms on their competitors, call us or consult your rep for more information. Group 4 Dental Lab warranties zirconia custom abutments for breakage or defects in workmanship for 5 years. No warranty is provided for the implant fixture itself. Some implant companies will negate their warranty on the implant if the abutment used is manufactured by a competitor, partner, or third party. Group 4 Dental Lab assumes no responsibility for the implant fixture. Please consult your warranty information provided by the implant manufacturer.
Phone: (503) 297-2431

Learn about our dental lab technology
Learn about our dental lab technology
Group 4 Dental Lab
14791 SW. Millikan Way,
Beaverton, OR 97006-2388

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