Questionnaire

Rather than do things the typical way, we’ve created a system designed around our client’s individual needs.

Simply fill out the questionnaire below and schedule your complimentary call to begin your journey to a better smile.

We will discuss your dental concerns and develop a complete personalized plan. Our team is here to assist you.

If you are a Portugal Resident looking for Dental Care click here.

If you are interested in Facial Aesthetics click here.

** Clients Outside of Portugal for DENTAL CARE only fill out the form below.**

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth

YYYY

Briefly describe your dental concerns.

When are you looking to have your dental work?

Are you also interested in Facial Aesthetic treatments ?

Is this your first trip to Portugal?

How long are you able to stay in Portugal?

What is your main reason for choosing Portugal?

Any additional information

How did you hear about us?

What to send prior to your call with the Dentist

1. X-Rays and/or CBCT scans less than 12 months old. Please have your dentist send these to you in a digital format vs a cd. Readable formats for X-Rays are: Jpeg, Owandy and Carestream 2. Photos of your smile and teeth - Smart phone photos are acceptable. One of our friendly coordinators will be in touch to let you know where to send these so the dentist can more accurately assess your needs prior to your call.

Questionnaire

Dental Destinations Portugal