Reporting a Concern with Your Appliance

If you are currently being treated with a Luco Hybrid OSA Appliance and are having a concern that your dentist, your patient manual and this website cannot answer, please complete this form and send.

You will receive a response promptly!

    Your Name (required)

    Your Email (required)

    Topic of Concern (required)

    Please enter the following information:

    Street Address:

    City:

    Prov/State:

    Postal/Zip Code

    Your telephone number

    The Name of the Dentist who treated you

    Address of the Dentist Who Treated You

    Telephone Number of Dentist who Treated You:

    The Name of the Dental Lab that made the appliance (if known)

    How long have you had the appliance?
    years

    Please Enter Details Here