Tracking form - CREOSTM regenerative solutions

Regulatory agencies require all dental offices using allograft tissue for transplants to maintain records that allows the identification of the tissue recipient. Nobel Biocare provides patient tracking as a service to your practice via an electronic form, which is maintained in a secure database. This service does not replace your responsibility to maintain records per your existing protocol.

If any questions, problems or adverse reactions occur, pleasecontact Nobel Biocare

Patient

Clinician

Tissue ID

REF *SN *
REF *
tissuetooltip
SN *
tissuetooltip
Please type the letters and numbers below