Medical and Dental History

Goodness Dental

Complete this dental/medical history form so that we may provide you with the best possible dental care. Please fill out all parts completely. All information is completely confidential.

Complete Medical / Dental History Form

Please complete the Procedural Sedation Record

Costa Rica

Habitat Empresarial Escazú, Floor 3
Escazú, San José 10201

Phone: (866) 406-2744

Monday: 8:00 AM - 6:00 PM

Tuesday: 8:00 AM - 6:00 PM

Wednesday: 8:00 AM - 6:00 PM

Thursday: 8:00 AM - 6:00 PM

Friday: 8:00 AM - 6:00 PM

Costa Rica
Habitat Empresarial Escazú, Floor 3
Escazú, San José 10201
(866) 406-2744

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We see patients from United States and Canada, including:
Miami, FL • New York, NY • Chicago, IL • Atlanta, GA • Philadelphia, PA
Jacksonville, FL • and many more