ODL Orthodontics

Onboarding Form

To ensure a smooth transition to ODL lab services, please provide the necessary details for the following contacts. If one person handles multiple roles, you can use the checkmark to autofill the information.

Step 1 of 2

Onboarding Contact

The person responsible for transitioning the practice to ODL lab services.

First Name

Last Name

Mobile Number

Office Number

Doctors

Please select an option.

Same as Onboarding Contact

Add New Doctor Contact Information

First Name

Last Name

Doctor's Mobile Number for Clinical

Office Number

Add additonal doctors?

Please select an option.

Yes

Additional Doctors

First Name

Last Name

Doctor's Mobile Number for Clinical

Office Number

Clinical Lead

Please select an option.

Same as Onboarding & Doctors Contact

Add New Clinical Lead Contact Information

First Name

Last Name

Doctor's Mobile Number for Clinical

Office Number

Contact name for finance/portal access/billing

First Name

Last Name

Mobile Number

Office Number

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Local Sales Tax Area / Rate

CAPTCHA

Name

This field is for validation purposes and should be left unchanged.

ODL Orthodontics

Onboarding Form

Onboarding Contact

Contact name for finance/portal access/billing

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