Single sheet, dental exam forms for accurate recording of patient history and exam details.

• Single sided form includes Medical Alert box for highlighting important medical information
• Teeth in dental diagrams marked with two numbering systems for convenient record-keeping and reference.
• Light green ledger stock printed in black ink.
• Size: 8 1/2" X 11"
• Shrinkwrapped 50 per pack.

FREIGHT CHARGES
ACS always confirms to our customers total amount to be charged including freight costs before order
is processed.

RETURNS
There is a 15 day return policy. Customers have 15 days to return products after they have received them. Products are not returnable after this time. Returns are subject to a restocking fee of 25%. If the return is a result of our error, we will issue a call tag. We grant returns on products only if the product and the packaging are in re-sellable condition. Custom products are not returnable.

SALES TAX
ACS charges sales tax if you are a Texas resident, Texas State Sales Tax will be added at the time your
order is invoiced. If you are tax exempt you must provide a Texas Sales Tax Exemption Certificate.