AORTA Lab Form Please enable JavaScript in your browser to complete this form. - Step 1 of 3Practice: *Clinician Name *Patient Name *Scan Date: *Due Date: *NextSelection: *Aligner/LaboratoryDigital Services ProsthodonticsAligner/Laboratory: *White-Label Aligners (DIY)Zendura RetainersZendura Retainers for life (3 pack)Active retainers (corrective retainers) Pontic RetainerWhitening TraysMouthguardsSplintLingual WireRetainer options 1: *Zendura retainerRestorative retainer (cut short)Corrective retainer options: *Active retainers (corrective retainers) Active: Up to 3 sets of aligners (maximum 5° rotation / 0.5mm movement)Upper/Lower retainer option: *Upper and LowerUpper OnlyLower Only Upper/Lower retainer for life options: *Upper and LowerUpper OnlyLower Only Upper/Lower restorative (cut short) retainer options: *Upper and LowerUpper OnlyLower Only Active retainer options: *Upper and LowerUpper OnlyLower Only Retainer with pointic options: *Upper and LowerUpper OnlyLower Only Upper/Lower Lingual wire options: *Upper and LowerUpper OnlyLower Only Upper/Lower whitening tray option: *Upper and LowerUpper OnlyLower Only Mouthguard color:White-label Aligner options: *Simulation only:Platinum:Simulation only: Preliminary simulation - no cost Platinum: Up to 10 sets of aligners + 1 refinement (20 total)White-label Aligner options: *Express:Active retainers (corrective retainers) Express: Up to 10 sets of aligners - no refinement Active: Up to 3 sets of aligners (maximum 5° rotation / 0.5mm movement)White-label options: *Upper and LowerUpper OnlyLower Only Refinement Platinum # *N/A - First order1 (included with Platinum option)Extra - Additional cost Refinement # *N/A - First orderExtra - Additional cost Splint options 1: *Milled (Hard)3D Printed (Soft) Digital Services: *Virtual Interdisciplinary Smile Simulation (VISS)Mentorship (select for options) Mentorship: AORTA Students only - to register see website or call 0400 480 850*VISS options 1: *Restorative OnlyRestorative + OrthoVISS Restorative options: *Simulation only Stent OnlySimulation + Stents VISS Restorative + Ortho options: *Simulation only Stent OnlySimulation + Stents VISS Restorative options: *Upper and LowerUpper OnlyLower Only VISS Restorative + Ortho options: *Upper and LowerUpper OnlyLower Only Mentorship options: *Ortho/Aligners Multidisciplinary (Resto)Practice Growth/BusinessAORTA Students only - to register see website or call 0400 480 850*Prosthodontics *VeneersCrownsBridge Pontic RetainerProsthodontic notes: *PreviousNextAdditional notes:Signature *Clear Signature Title of the document Privacy Policy Terms & Conditions