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