University Questionnaire


Indicate preferred month, time frame, and day for the training:*

A 30 minute webinar follow-up session is a required part of scheduling a webinar/workshop. We will review case photos (at least four cases) during this time. Indicate preferred month, time frame, and day for the follow-up webinar (typically 45-90 days after original training):*

Provide Shipping Information (used to send materials for the Webinar / Hands-On Workshop . No P.O. Boxes please):

If Interested In Hands On Training...


The address the Workshop will take place:

Program Information


* Pre-fab Porcelain Ceramic (Zirconia) (D2929) are currently covered in the following states: Alaska, Arizona, California, Maryland, Missouri, Montana, New Mexico, Virginia, Washington, and Wyoming

Pre-fab esthetic coated SSC (Pre-veneered) (D2934) are currently covered in the following states: Alaska, Arizona, California, Colorado, Connecticut, District of Columbia, Georgia, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Pennsylvania, South Carolina, South Dakota, Texas, Virginia, Washington, Wisconsin, Wyoming