Submit a Study

Please fill out this form to submit a CBCT study.

"*" indicates required fields

Referring Clinician Name*
Patient Name*
Patient Date of Birth*
Please write “NIL” if there is nothing significant.
Do you need the report urgently? (within 24-hours)*

Please upload your CBCT image below:

1. The image must be in DICOM format.
2. Please ZIP the folder before uploading.
3. Do not close or navigate away from this window before uploading finishes.

Once you click the “Next” button, you will be taken to a payment gate way.

If you have a coupon code, please apply it before proceeding with payment.
Drop files here or
Accepted file types: zip, 7z, rar, Max. file size: 2 GB, Max. files: 2.
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