Work Request

Please fill out the form below or download the form here to place your work order and detail your specifications. Send a completed copy along with your case, or call us with any questions.

This form is in compliance with the Illinois Dental Practice Act. Download the pertinent section of the Act if you wish to review it.

The Tooth Factory, Inc.
484 Spring Road
Elmhurst, IL 60126

Phone 630-279-4646

Work Request