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.


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