Submit a case

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Submit a case

Please only use this form if you wish for the Active Aligners UK team to upload a case on your behalf. If you would like to upload a case yourself, please log into the online portal: https://www.activealigners.co.uk/doctors-login/

Dentists Name *

Patients Name *

Practice Name *

Case Type *

Anterior (5 to 5)

Full arch (7 to 7)

Refinement

Required

Attachment preference - if left blank, attachments will be allowed

Yes, allow attachments

No attachments

Option 3

IPR preference - if left blank, IPR will be allowed

Yes, first expansion and proclination then IPR

Yes, first IPR, then try to avoid expansion and proclination

No IPR

Lower crowding

Lower crowding - IPR primarily

Lower crowding - expansion primarily

Upper crowding

Upper crowding - IPR primarily

Upper crowding - expansion primarily

Lower midline

Lower midline - Maintain

Lower midline - move to patients left

Lower midline - move to patients right

Lower midline - Improve

Upper midline

Upper midline - Maintain

Upper midline - move to patients left

Upper midline - move to patients right

Upper midline - Improve

Posterior crossbite handling

Maintain posterior crossbite

Correct premolars

Correct molars

Anterior posterior relation

Maintain anterior posterior relation

Improve canine relationship

Improve molar relationship

Improve canine and molar relationship

Retainers *

Yes

No retainers needed

Required

Original order ID (if a refinement case)

Design instructions *

I am sending impressions (not scans) for this case

I already have freepost envelopes

Please send me freepost envelopes

Please send any related files or scans to info@activealigners.co.uk

Submit

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