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Support Request Type

Subject

Description

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Priority

Billing Category

Priority

Contact Phone Number

The best number for us to reach you on.

Phone Extension

Office ID

The OID for the office reporting the issue as shown in Denticon (Upper Right or Office selection dropdown)

Patient Name and ID# (or Responsible party name and ID#) in which problem occurs

May a Denticon Secondary Support technician login to your account to confirm this issue

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Affected Imaging Hardware (Required for Imaging Tickets)

What imaging hardware is related to the Ticket's issue? [i.e. Schick 33 Sensor or Planmeca Promax Pan]

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