RX SLIPS

If you'd like to download one of Summit Ortho's prescription blanks, please click on the Rx image below. We can also send you hard copies, which are duplicate forms...you send us a copy and keep one for yourself.

We pay for shipping one way...please call us for a free postage-paid First Class US mailing labels: 1-800-321-9124.

If you'd like either of these forms faxed to you, please call and ask.

SummitOrthodonticServicesRXsheet.jpg

Please click the image to the left to download a pdf file of Summit Ortho's prescription blank.