Lab Script
This Lab Script is for submitting orders only

* indicates required fields 
  *NAME::
  *CONTACT#:
  *ADDRESS::
  *CITY::
  *STATE::
  *ZIP::
  *DO YOU HAVE A GAG REFLEX?:  YES
 NO
  *COLOR OF GUARD:
  *COLOR OF WRITING/LOGO:
  *DESCRIPTION OF WRITING/LOGO:
  *TYPE OF GUARD:
  *Email Address:
  *Sales Representative:
 

By clicking on the SUBMIT button you agree that you have released Custom Guards, LLC. dba. Python Guards, from all liabilities associated with taking your own impression.  You also agree that Custom Guards, LLC, dba. Python Guards. is not responsible for loss of teeth or any injury sustained to the oral region while using our Custom Mouth Guard.

 

Disclaimer:  The dental material used is approved for use by the National Dental Association and has also been cleared by the FDA. 

 
 
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