Exquisite Dental Studios Inc. New Client Agreement. Required for new accounts. Doctor Name(Required) Email Address(Required) Address(Required) City(Required) State(Required) Zip(Required) Phone(Required) Occlusal ContactsChoose selectionSlightly out of occlusionLight contactMedium contactHeavy contactAdjacent ContactsChoose selectionVery lightLightMediumHeavyOcclusal Stain SelectionChoose selectionOn all casesOnly if specifiedOcclusal StainChoose selectionNoneSlightMediumDarkAnatomyChoose selectionFollow opposing/adjacent teethIdeal anatomy whenever possibleMetal Margins On All PosteriorsChoose selectionYesNoI will specifyMetal Margin PreferenceChoose SelectionHairline0.5 mm1.0 mmType Of Metal For Porcelain Fused To Metal If Not Specified On Lab SlipChoose SelectionNon-preciousNobleHigh noble (white)High noble (yellow)Type Of Metal For Full Gold Crowns If Not Specified On Lab SlipChoose selectionNoble (white)Noble (yellow)High noble (white)High noble (yellow)Please Indicate Below Your Pontic Design Preference (if not specified on Rx)Choose selectionFull ridgePartial ridgeNo ridgePoint contactNo contactAdditional Notes & CommentsCAPTCHA