At Home Impression Kit UPPER AND LOWER Retainer

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$520.00

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An At Home Impression Kit will be mailed to your home, you will be required to follow the step by step impression instructions and use the return shipping label to send your impressions back to the Retainers For Life® Lab for an Upper and Lower Retainer production.

After your retainers have been completed, Retainers For Life® will ship your new retainers directly to you.

What is the name of your orthodontist? *

What is the date of birth of the person wearing the retainer? *

Do you require an artificial tooth in your retainer? (Please note retainers with an artificial tooth can exceed our normal turnaround time) Select all that apply 1 (+ $30.00) 2 (+ $60.00) 3 (+ $90.00) 4 (+ $120.00) 5 (+ $150.00) 6 (+ $180.00)

Let's customize your protection plan: PATIENT NAME (please give us the name of the person who will be wearing the retainer) *

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At Home Impression Kit UPPER AND LOWER Retainer

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