Custom Grillz Requirement Form First Name Last Name Email Address Phone Number Grillz Budget (USD $) How many Teeth? Top, Bottom or Both Top Bottom Both Precious Metal Select Option Silver 925 10KT Gold 14KT Gold 18KT Gold Platinum Unsure Metal Color Select Color Gold Plated Yellow White Rose Rose Plated Silver Silver Plated Permanent Gold Grillz No Yes Diamond ? Yes No Diamond Clarity I SI VS VVS FL Unsure Specifications: (describe your Ring requirements) Send us your DEMO or SAMPLE Send Requirement If you have any further questions please do not hesitate to contact us at +1 901 292 1354