old Smiles Dental Order Request - Innovate Dental Marketing

Smiles Dental Order Request

Please select your office location and add quantities for requested items.

Order Information

Location

Forms

Orders for all forms (excluding Walk-out Forms) will be shipped once bulk quantity has been reached.

HIPPA Acknowledgement Form

Records Release

Medical History Form

Dental History Form

Registration and Treatment

Financial Agreement

Statement Walk-out Form

Patient Notices Form

Preoperative Prep Sheet

Informed Consent Third Molars

Postoperative Instructions

Patient Referral Form

Stationery

Letterhead

Envelopes

Fax Cover Sheet

Blank Cards & Envelopes

Business and Referral Cards

Large Referral Cards

Small Referral Cards

Yelp Referral Cards

Business/Appt. Reminder Cards

Name(s) for Business/Appt. Reminder Cards

LIFT Business Cards*

*LIFT Business Cards may only be ordered by Executive Team Members

Name(s) for LIFT Business Cards

Brochures & Handouts

Savings Plan Brochures - English

Savings Plan Brochures - Spanish

Emergency Handout

Laser Whitening Handout

Whitening for Life Handout

Promotional Items

See below for images of these items.

Stickers

Ordered By

First Name

Last Name

Email

Phone

Order Notes

Sales Tax and Shipping not included in above pricing.

If you have any questions regarding your request, please inquire at: Brandy Jones
503-213-4368 ext. 101
brandy@innovatedentalmarketing.com

Forms

Business and Referral Cards

Brochures & Handouts

Promotional Items

Optima Forms

Optima Brochures & Handouts

Optima Promotional Items

Other Optima Items

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