Product Order form

MEMOTAIN® Order Form


Practice Details	Patient & Treatment Details	File Upload & Confirmation

Practice Name *
N/A
Doctor Name *
N/A
Email *
N/A
Country *
N/A

-Select-

Patient Name *
N/A
Case ID
N/A

Please reference the original treatment ID, if applicable.
Select Jaws
*
N/A

Please select jawbone(s)
Upper Jaw Tooth Range
*
N/A

Please select tooth range for upper jaw
Lower Jaw Tooth Range
*
N/A

Please select tooth range for lower jaw

Please upload your scan files.

Please check your data for correctness (patient name or assignment) as well as possible scan errors, holes or distortions prior to uploading.
Please do not forget to place the upper and lower jaw scan in occlusion first.

Allowed file formats: STL, PLY (max. 75 MB)
File Upload *
N/A
Upload file

1/3

2/3

3/3