CHROME Patient Request Form

ROE Dental Laboratory works only with doctors, dental practices and other dental laboratories. We cannot do any dental work for patients. We do not want to leave you needing help with no recourse though.

If you complete the form below, and provide consent, we will forward your information to a dental practice in your area that does CHROME GuidedSMILE. They will be able to take care of you, help you with your case and start treatment that works for both of you. Please provide your information below.