SOTA Dental Patient Form

Please fill out the form below and upload files related to your case. This is not scheduling an appointment or a commitment of any kind. This is a required step for all local & international patients. Our doctors & patient managers review questions and new cases after 5pm each business day. All of your information is confidential and only shared with our doctors and patient managers.

If you have trouble attaching files, email them to: [email protected]
Choose which file(s) you will be uploading along with your form.*
- Smartphone images of mouth & smile
- X-rays or CT scan images
- Treatment plan from your dentist
- I will upload later
If you do not have a treatment plan or x-rays, we accept smartphone images of your mouth. These are best taken in bright light, and with the help of someone else (or a mirror). Due to the volume of inquiries we receive, we move cases along more quickly if they contain smartphone photos or x-rays.

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Email Address (for private information)*
Please provide your email address for receiving medical information. SOTA Dental uses email to send private information related to your case. Please supply an email address that you feel comfortable receiving dental information with.
Enter Email Confirm Email

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Do you have any allergies?
Do you have active gum disease?
Have you had any recent surgeries?
Do you take blood thinners?
Do you have osteoporosis?
If you answered yes to any of the questions above, please explain in detail.

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Do you drink alcohol?
If yes, how often do you drink?
Have you smoked in the last 5 years?
If yes, explain your smoking habits.

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Are you specifically interested in the All-on-X Treatment?
Do you request Ozone, IV Vitamin C, or metal free dentistry?
Have you traveled abroad for dental before?
Do you require immediate care (RAPID CARE)?
What date (roughly) are you interested in?
MM slash DD slash YYYY
How do you plan to travel to us?
If travel assistance is needed, please explain details here.

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Did you already speak with someone at SOTA Dental?

If you already spoke with someone on our team, and remember their name, please write it here. This will help speed your case along.
Do you have any specific questions?

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Upload : X-rays, panoramics, & ct scans
Drop files here or

Max. file size: 128 MB.
Files can take a while to upload if they are large. Please wait until you see a confirmation page.
Upload : Treatment plan from dentist
Drop files here or

Max. file size: 128 MB.
Files can take a while to upload if they are large. Please wait until you see a confirmation page.
Upload : Smartphone photos of mouth & smile
Drop files here or

Max. file size: 128 MB.
Files can take a while to upload if they are large. Please wait until you see a confirmation page.

Save and Continue Later

2022 Croatia Price List

Receive the monthly updated SOTA Dental price list PDF file. Input your email address below, and it will be sent to you immediately. This includes monthly deals & specials as well.

2022 Rapid Care Price List

Receive the monthly updated SOTA Dental price list PDF file. Input your email address below, and it will be sent to you immediately. This includes monthly deals & specials as well.

Financing Information

Don't know where to start with dental financing? Receive our up-to-date list of lending options which includes US & Canadian lenders we've had success with.

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SOTA Dental Patient Form 2022

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