Encoris Order Form

Model Builder

Please choose the sections of the spine

Model Start

Model End

Add Implants to your model

Implants

Implant Location Start

Implant Location End

Add Screws

Plate Level 1 Screws

4 Screws

Plate Level 1 Spacers

1 Spacer

Plate Level 2 Screws

6 Screws

Plate Level 2 Spacers

2 Spacer

Screws

8 Screws

Spacers

3 Spacer

Pedicle Screw Count

Pedicle Set Screws

Rods

2 Rods

Spacer Option

Glue only/no fastners

Add Screws

Do you want the model to articulate

Add Screws

Glue only/no fastners

Add Levels

Number of Rods

Cross Connector

1 Each

Dropdown

Oblique

PLIF

TLIF

Lateral

Add Screws

Add Remove

Base Options

Choose Base Options

Base Color

Custom Logo

Include Logo on Base

Attach Logo

Maximum file size: 268.44MB

Admin Fields

The Fields below will be hidden on the live form

Occipital Plate Extra Labor

Cervical Bone Count

Hemi Pelvis Bone Count

Sacrum Bone Count

Lumbar Bone Count

Thoracic Bone Count

Full Pelvis Bone Count

OCC Pelvis Bone Count

Additional Labor Cost

Base Cost

Total Implant Cost

Total Bone Cost

Total Model Cost

Billing Information

Name

First

Last

Email

Shipping Address

City

State/Province

Zip/Postal

Payment Details

Payment

Sample Page

Model Builder

Add Implants to your model

Base Options

Admin Fields

Billing Information

Payment Details