Case revision form

Warning: Revisions should be requested online. Only download this form if you've been directed to do so.

If you just want to request a revision, do not use this form. Go to the doctor's portal, find the case you want to revise, and click "REVISE". More details are available here.

This form is being provided for one reason: if you mistakenly send in impressions without requesting a revision first, our staff may create a revision request for you. On the case page, you will then see "Waiting for revision form."


That's the only time you need this form. Download it and fill it out, then return to the case page, click "upload," and upload the scanned form. To avoid this inconvenience, submit your revision online before sending in impressions.

If you're still sure you need this form, you can find it here:

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ClearCorrect is a medical device manufacturer and does not practice dentistry. The treating physician is solely responsible for prescribing and administering orthodontic treatment. Clear aligner therapy is unpredictable. ClearCorrect does not guarantee a successful treatment outcome. Individual results will vary.

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