SOTA Dental Patient Form • SOTA Dental Mexico

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
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?
Do you smoke?
If yes, do you intend to quit?
Have you smoked in the last 5 years?
If yes, how long did you smoke?

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Are you specifically interested in the USA Made NanoCeramic™ All-on-X Treatment?
Do you request Ozone, IV Vitamin C, or metal free dentistry?
Have you traveled to Mexico before?
Are you looking to get an appointment this month?
What date (roughly) are you interested in?
MM slash DD slash YYYY
If you have a limited travel window, please explain your situation here.
Will you need transportation assistance from the airport, hotel, or border?
If yes, please explain.

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Do you have any specific questions?

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Upload : X-rays, panoramics, & ct scans
Drop files here or
Max. file size: 2 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: 2 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: 2 MB.
Files can take a while to upload if they are large. Please wait until you see a confirmation page.

Save and Continue Later

SOTA Dental Financing & Payment Plans

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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2021 SOTA Dental full price list.

Receive the monthly updated SOTA Dental price list .PDF file. Just input your email address below, and it will be sent to you immediately. This includes monthly deals & specials as well. Be sure to check your promotions folder within your inbox!

Receive our All-on-4 in Mexico Survival Guide

Our free All-on-4 in Mexico Guide is written from an insider's perspective & holds nothing back. This guide is essential for any patient thinking about traveling to Mexico for dental work. Access link is sent immediately to your email address. Please check your promotions folder in your inbox.

SOTA Dental Patient Form 2021

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