Max Rad Path - Registration Form
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Office Name
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First Name
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Last Name
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Office Address
Stress Address
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City
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State / Province
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ZIP / Postal Code
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Country
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Primary Email (All correspondence will be sent here)
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Office Phone Number
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Type of Service Required
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Make a selection
Radiology
Pathology
Both
What is your Office Specialty?
Make a selection
Dental Anesthesiology
Dental Public Health
Endodontics
General Dentistry
Oral and Maxillofacial Pathology
Oral and Maxillofacial Surgery
Oral Medicine
Orofacial Pain
Orthodontics
Pediatric Dentistry
Periodontics
Prosthodontics
Other
None / Don't Know
What is your CBCT Manufacturer?
Make a selection
Acteon
Carestream
Gendex
i-CAT
Instrumentarium
J. Morita – Accuitomo
J. Morita – Veraview X800
KaVo
NewTom
Planmeca
PreXion
Rayscan
Sirona – Galileos
Sirona – Orthophos / Axeos
Vatech
Other
None / Don’t Know
What imaging software do you use?
Make a selection
Acteon
Anatomage – Invivo / Tx Studio
Carestream
DEXIS (2D Imaging)
i-CAT Vision
i-Dixel
NewTom
Planmeca Romexis
PreXion
Rayscan
Sidexis 4
Sidexis XG
Vatech Ez3D-i
Vatech EzDent-i
Other
None / Don’t Know
What is your role?
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Dental Assistant
Oral Surgeon
Practice Manager
Radiology Technician
Referring Dentist
Specialist / Consultant
Other
What is your Office Specialty?
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Cytopathology
General Pathology
Histopathology
Oral and Maxillofacial Pathology
Oral Medicine
Surgical Pathology
Other
None / Don't Know
What is your Laboratory Type?
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Hospital-Based Laboratory
Independent Pathology Practice
In-House Laboratory
Partner Laboratory
What is your Specimen Transport Method?
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Courier Pick-Up
Digital Upload / Electronic Submission
Drop-Off at Collection Center
Other
What is your role?
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Cytotechnologist
Laboratory Technician
Oral Pathologist
Practice Manager
Referring Dentist
Specialist / Consultant
Other
Submit