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dental-quoteMary Ford2023-02-11T09:34:19+00:00

Medical Tourism
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Request a Quote

You will receive a customized quote within three business days!

First name *

Last name *

Email *

Phone number *

Date of Birth *

Readiness Status *

Ready to Book

Getting Quotes

Tentative Travel Date *

City & State *

Promo Code

Payment Option *

One Time Payment

Layaway

Financing

How did you hear about us? *

Social Media

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Smiley Aesthetics (Please provide the name of the person)

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Smiley Aesthetics

Name of the person who referred you

Would you be traveling alone? *

Yes

Do you have a valid Passport? *

Yes

What procedure are you interested in?

Veneer in Resin (20 Teeth)

Veneer in Porcelain (20 teeth)

Zirconium Crown (Crown only)

Porcelain Crown (Crown only)

Implant & Zirconium Crown

Implant-Supported Denture

Implant & Porcelain Crown

Implant-Supported Bridge

Traditional Bridge

Root Canal

Inlay/Onlay (Fillings)

Aligners

Whitening

Deep Cleaning

Other (Please specify in the comments section)

Add-Ons

Cosmetic Procedure (Please specify in the comments section)

Bariatric Procedure (Please specify in the comments section)

Compression Girdle (Faja)

Tourism- Bogota City Tour

Tourism- Salt Cathedral of Zipaquirá and Nemocón mine

Tourism- Coffee Farm

Other (Please specify in the comments section)

If you have a recent X-Ray, please upload it. Not required, but preferred (not necessary for Veneers).

Please upload current pictures of your teeth. Please click here to see examples of pictures.

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Questions & Comments

Terms and Condition *

I declare that the info I’ve provided is accurate & complete. I read & agree to the Medical Release Authorization Terms

By submitting this form, you consent to Smiley/ My Body by Design LLC and the clinic's medical team to use of your data contained in this questionnaire for purposes limited to medical use only. Smiley/My Body by Design takes no responsibility if you provide false information or conceal your entire medical history. I understand that my personal information will be treated separately and confidentially. I declare that the info I’ve provided is accurate & complete.

View Terms*

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GENERAL INQUIRIES

P.O. Box 18346
7058 Charlotte Pike

We Specialize In Medical Aesthetics Provided By Licensed Medical Providers. We Have A Passion For Helping People Enhance Their Natural Beauty With Injectables On The Outside And Health and Well-Being Products From The Inside.

OFFICE HOURS

Monday – Friday | 8:30am – 4:30pm
*Later appointments available*

Saturday – Sunday* | Closed
*Available for appointments – Office closed*

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