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.

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

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?

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.