Your online Cone Beam CT Imaging service provider.

DIMENSIONS IMAGING ORDER FORM


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PATIENT INFORMATION

           
*Dimensions ID#:     *Doctor Name:  
*Patient First Name:     *Patient Last Name:  
*Doctor Email:     *Patient Birth Date:
(Year/Month/Day)		  

CHOOSE YOUR REPORT

 
RADIOLOGY REPORT ($69)
Our expert radiologists will review your CBCT data for incidental pathology and trauma and will include general, specific and incidental radiologic findings in their report. If applicable to the clinical findings their report may also include reformatted images and analytical assessment.
  IMAGE REFORMATTING
Dimension’s reformatted reports are designed to help you optimize the diagnosis, treatment plan, presentation and treatment by providing you with comprehensive imagery and an assessment of each proposed site or area. We will reconstruct your patients unformatted CBCT scan file into a concise, easy to understand report made available to you from any web browser in ’.pdf’ and or ’.ppt’ format via Dimension’s secure and easy-to-use image distribution system.
 
Implant Upper Arch ($49) Implant Lower Arch ($49) Implant Both Arches ($79)
Ortho 2d Survey ($79) Ortho 3D Survey ($99)    
 
DICOM CONVERSION
Your DICOM data set is converted by Dimension’s to a proprietary format for use with implant planning, surgical guide manufacture and / or model fabrication. Both SimPlant™ and NobelGuide™ conversions are currently available.
 
SimPlant™ Upper Arch ($79) SimPlant™ Lower Arch ($79) SimPlant™ Both Arches ($149)
Nobel Upper Arch ($109) Nobel Lower Arch ($109) Nobel Both Arches ($209)
DICOM to STL File format ($39)        
Please add any additional information that would assist us in providing the most comprehensive report based on your needs:
 
 
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  ***Disclaimer***
All services provided by Dimensions Imaging are delivered as is without warranty, express or implied as to any matter whatsoever, including and without limitation to merchantability and fitness for a particular purpose. Dimensions Imaging makes no warranty as to the sufficiency or suitability of said services and does not warrant the accuracy, completeness or correctness of the services. Radiologic findings and impressions are developed and provided in consultation with a board certified Oral and Maxillofacial Radiologist or Pathologist. The information and/or recommendations contained herein are based upon the provided images and volumetric data set and are for consultation purposes only. The results must be verified by a treating physician or dentist to ensure accuracy before being used. In no event shall Dimensions Imaging be liable to anyone for action taken in connection with the use of said services.