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About
Why Choose TAP?
How To Order
Getting Started
Print Lab Slip
Print UPS Shipping Label
Digital Impressions
Resources
Compliance Guarantee and Warranty
Informed Consent
Instructions for Use
Contact
Menu
About
Why Choose TAP?
How To Order
Getting Started
Print Lab Slip
Print UPS Shipping Label
Digital Impressions
Resources
Compliance Guarantee and Warranty
Informed Consent
Instructions for Use
Contact
Digital Impressions
Doctor's Name
(Required)
First
Last
Contact Email
(Required)
Contact Phone
(Required)
Customer ID #
(Required)
Patient Name
(Required)
First
Last
YOU MUST CHOOSE ONE (1) HARDWARE AND ONE (1) LINER
Please call with questions BEFORE ordering or an additional charge may be added for error in selection.
TAP Hardware and Liner - Choose One
(Required)
flexTAP w/ New ThermAcryl
dreamTAP w/ Triple Laminate (TL)
dreamTAP w/ AccuTherm
TAP 3 w/ Triple Laminate (TL)
TAP 3 w/ AccuTherm
Posterior Pads
Please check this box if you want to add posterior pads on your selected TAP appliance. (Note: Every flexTAP appliance comes with a Mouth Shield that includes posterior pads/bite tabs)
Fabricate to meet Medicare requirements?
All TAP appliances are Medicare coded (E0486). TAP 3 appliances can be fabricated to meet Medicare requirements. If you have any questions, please call Airway Labs customer service at (866) 264-7667.
Please check this box if your TAP 3 appliance needs to be fabricated to meet Medicare requirements.
Is this a REWORK or REMAKE?
Leave empty if this does not apply.
Reset Hardware
Remake Trays
Bite Index
(Required)
Include Bite Index
No Bite Index
NOTE: Trios 3 Shape or CS Connect-Carestream
If you are submitting a TRIOS 3 shape, Medit, or CS Connect-Carestream scan, email the scans to
digital@rdldental.com
.
Upload Files
Upper Impression File (.STl file type accepted)
(Required)
Accepted file types: stl, Max. file size: 256 MB.
Lower Impression File (.STl file type accepted)
(Required)
Accepted file types: stl, Max. file size: 256 MB.
Bite Index File - if included (.STl file type accepted)
Accepted file types: stl, Max. file size: 256 MB.
Acknowledgment
(Required)
I acknowledge that each file name must contain a reference number (i.e. initials, patient ID) or case may be delayed.
Shipping
Shipping Options
Airway Management will ship UPS Ground unless otherwise specified below.
Ground
2 Day
Overnight
Patient's appointment date (if scheduled)
Month
Day
Year
Appointment time (if scheduled)
Hours
:
Minutes
AM
PM
AM/PM
Comments/Instructions
Dentist License #
(Required)
