Dental Sharpening/Retip/Repair Order Form Sharpening Per End Qty Elevators/Root Tip Picks $3.60 Elevators (Reshape) $5.50 Surgical Curettes - Small $2.00 Perio Files - Small $3.50 Bone Files/Rasps $3.60 Bone/Oschenbein Chisels $3.60 Extraction Forceps $8.00 Aspirator Tips (Reshape – Polish) $9.00 Handpiece – High Speed Overhaul $69.99 Handpiece – Slow Speed starting at…. $69.99 Scissors (Plain Edge) $7.00 Scissors (Serrated – Suture) $9.00 Scissors (Micro – Spring) $15.00 *** Please mark (X) one box*** Orders without instructions will be sharpened/retipped/repair as needed. Retip as Needed Do Not Retip (Return) Instructions Included Scalers Sickle/Curette/Explorers $3.50 Chisels/Hatchets/Margin Trimmers $5.00 Elevators/Root Tip Picks $10.00 Large Elevators/Periosteal $12.00 Surgical Curettes - Small $5.00 Perio Files - Small $8.25 Perio Files - Large $10.00 Needle Holders (carbide inserts) $35.00 Probe $7.00 Plugger/Burnisher $3.50 Replacement Rest Pad Band Remover $4.50 Wire Cutters Distal End/Ligature $35.00 *** Please mark (X) one box*** Orders without instructions will be sharpened/retipped/repair as needed. Do not replace damaged/cracked/odd size/plastic handles if unable to retip (return) Replace damaged/cracked/odd size/plastic handles Handle Replacement if Needed – Preferred Size #2 Replacement Handle 6.35mm $5.50 #4 Replacement Handle 7.93mm $5.75 #6 Replacement Handle 9.52mm $6.00 Dr./Practice: Contact: Address: Suite: City: State Zip: Phone: Fax: Email: #4/#6 Mirror Handle 7.93/9.52mm $8.50 Excavators/Cleoid Discoid $2.60 Carvers $2.60 Rongeurs $25.00 Excavators/Cleoid Discoid $5.25 Carvers $7.00 Mirror Heads #4 & #5 $2.50 Scalers Sickle/Curette/Explorers $1.50 Chisels/Hatchets/Margin Trimmers $1.50 Needle Holders (Align – Serrate) $12.00 Mathieus/Hemostats (Align – Serrate) $12.00 Wire Cutters Distal End/Ligature $18.00 Bird Beak/Utility/How/Forming Pliers $12.00 Bracket/Band Removers/Debond Plier $12.00 Gingivectomy/Periodontal Knives $6.50 Gingivectomy/Periodontal Knives $13.00 Plastic Fillings $7.00 Composites $7.00 Cord Packers $7.00 Bird Beak/Utility/How/Forming Pliers $35.00 Bracket/Band Removers/Debond Plier $35.00