top of page
Image by The Humble Co.

Dental Treatment 

To schedule your appointment or learn more about the services available, please complete the form below

Before completing the form below, please review our Disclaimer and Legal Release. This ensures you understand the terms and conditions related to the services provided.

Dental Treatment Inquiry Form

Date of Birth
Month
Day
Year
Image by lafayett zapata montero

Dental Services Disclaimer

By submitting this form and requesting dental services through our partners, you acknowledge and agree to the following terms:
   1.    Dental Treatments:
All dental services, including consultations, cleanings, fillings, and other treatments, are provided by licensed dental professionals. You understand that treatment plans will be based on your individual assessment, and results may vary depending on the complexity of your dental needs.
   2.    Informed Consent:
You agree to provide accurate and complete information regarding your dental history, medical conditions, and any medications you are currently taking. This is crucial to ensure the suitability of the proposed treatment plan. You acknowledge that any complications or issues that arise during treatment will be addressed by the medical team.
   3.    No Guarantees on Outcomes:
While every effort is made to ensure the best possible care, you acknowledge that no guarantees can be made regarding specific outcomes, including the success or longevity of dental treatments. Results may vary based on individual health conditions.
   4.    Legal Release:
By completing this form, you release Costa Rica Travel & Health from any liability related to dental treatments, including injuries, complications, or dissatisfaction with the results. You understand that Costa Rica Travel & Health is not responsible for any follow-up care or dental issues that may arise post-treatment.
   5.    Privacy and Confidentiality:
All personal and dental information provided will be kept confidential and used solely for the purpose of scheduling and providing dental services. Your information will not be shared with third parties without your consent, except as necessary for treatment or legal purposes.
   6.    Acknowledgment:
By submitting this form, you confirm that you have read and understood this dental disclaimer and legal release. You consent to receive communication from Costa Rica Travel & Health and our Partners regarding your dental services.

bottom of page