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Prescription Forms

UPDATED FOR 2012! Once you download the prescription form, you can type in the fields on your computer. Save the file as a copy, and you have an electronic record of your prescriptions. If you forget to “Save As...,” just download a new form or copy the form and erase the information in the fields. Of course you can always email us or call us at 808.941.6308 and we’ll send you as many two-sheet, carbonless, duplicate paper prescription forms as you need.

The benefit of using the PDF for your prescriptions is three-fold. First, it‘s much easier. Second, it‘s more legible. Third, you can retain a digital copy for your files and reduce your paperwork.

Download our new, interactive, prescription form. (PDF, 250 KB)

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Do you have a question? Send us an email. We try to respond quickly, normally within one day. We respect your privacy. We don’t give out your information.

This page was updated on January 25, 2012. Copyright 2004−2012 Clair de Lune Dental Laboratories, LLC.

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