CBCT Scan RX Order Form

Please complete the entire form below. All fields indicated by * are required. Scans per patient cost $215. 

If you are an existing customer, you can skip this.

We will email the completed radiology report to your email address listed above and deliver the disc containing the scans to your office.

Note: nSequence will not scan patients with improperly fitting dentures for the purpose of surgical guide fabrication or implant evaluation.

Order Information

Let us know if you would like us to match a particular shade for the patient.