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Customer Profile

Account Number

Office Name*

Office Address*

Street Address Address Line 2 City State ZIP Code

Best Contact*

First Last

Best Phone*

Best Email*

Data Acquisition & File Preparation

Do you have an intraoral scanner?*

Yes
No

Make & Model*

Make & Model of Other IOS*

Are you designing in-house?*

Yes
No

Dental Design Software*

Other Dental Design Software*

Are you using a non-dental software?*

Yes
No

What are you using?*

Other Non-dental Software*

Equipment Profile

We use this information to help identify workflow resources that may already be available.

Do you have a 3D printer(s)?

Yes
No

Make & Model*

(Check all that apply)

other printer*

Please include make and model

Nesting Software*

From printer manufacturer
other

Other nesting software*

Do you have a UV Curing Light Box

Yes
No

Make & Model*

Make & Model of Other UV Curing Light Box*

Resin

What kind of resin are you using?*

Other Resin*

Case Profile

What are you planning on printing?*

Select All
Implants
Dentures
Crown & Bridge
Splints
Orthodontics
Surgical Guides
other

other*

How did you hear about us?

Who referred you?*

3DDDS Team Member
Vendor
Search / Social Media / Email
Postcard
other

3DDDS Team Member

Vendor

other

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Customer Profile

Data Acquisition & File Preparation

Equipment Profile

Resin

Case Profile

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