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Quotation Estimate Dentist in China Beijing –Free Word Template Download with AI

No. 88 Chaoyangmen Outer Street, Chaoyang District, Beijing, China 100020

Tel: +86-10-6555-8899 | Email: [email protected]

License No.: 京医广〔2024〕第00312号 | Medical Institution Practice Permit: PDY100882111010517A

Quotation Estimate

Quotation Reference No.: QTE-BJ-2025-04187

Date of Issue: 15 June 2025

Valid Until: 15 July 2025

Prepared For

Client Name: Mr. / Ms. [Full Name]

Address: [Street, District, Beijing, China]

Contact: [Phone Number]

Email: [Email Address]

Prepared By

Dentist: Dr. Li Wei, DDS, PhD

Specialty: General & Cosmetic Dentistry

Clinic: Beijing Capital Dental Care Center

Location: China Beijing, Chaoyang District

This Quotation Estimate has been prepared by our qualified Dentist team at Beijing Capital Dental Care Center, located in the heart of China Beijing, to provide a comprehensive and transparent breakdown of all anticipated dental treatment costs. This document serves as a formal financial projection for the proposed dental care plan and does not constitute a binding invoice until the client provides written acceptance. All pricing is quoted in Chinese Yuan (CNY / RMB) and reflects the current service rates applicable in the Beijing metropolitan area as of the date of issue.

Following a thorough clinical examination conducted by our lead Dentist on 10 June 2025, the following treatment plan has been recommended. Each procedure listed below has been assessed based on the patient's oral health condition, radiographic findings, and long-term dental wellness objectives within the China Beijing healthcare framework.

Item No. Dental Procedure / Service Description Qty Unit Price (CNY) Subtotal (CNY)
01 Comprehensive Oral Examination Full clinical assessment, intraoral photography, and digital panoramic X-ray (CBCT) performed by the attending Dentist 1 ¥ 380.00 ¥ 380.00
02 Professional Dental Cleaning (Scaling & Polishing) Ultrasonic scaling, hand scaling, and prophylactic polishing of all visible tooth surfaces 1 ¥ 650.00 ¥ 650.00
03 Composite Resin Filling (Tooth #14, #24) Removal of carious tissue and restoration with light-cured composite resin material (3M Z350XT) 2 ¥ 880.00 ¥ 1,760.00
04 Root Canal Treatment (Tooth #36) Complete endodontic therapy including access cavity preparation, canal instrumentation, obturation, and temporary restoration 1 ¥ 2,800.00 ¥ 2,800.00
05 Ceramic Crown (Tooth #36) Fully sintered zirconia crown, custom-fabricated, including temporary crown and final cementation 1 ¥ 4,500.00 ¥ 4,500.00
06 Wisdom Tooth Extraction (Tooth #48) Surgical extraction of impacted mandibular third molar under local anesthesia, including post-operative care 1 ¥ 1,950.00 ¥ 1,950.00
07 Full-Mouth Digital Periapical Radiographs Set of 14 digital periapical X-rays for baseline documentation and treatment monitoring 1 ¥ 520.00 ¥ 520.00
08 Follow-Up Consultation (3 visits) Post-treatment review appointments with the treating Dentist at 1-week, 1-month, and 3-month intervals 3 ¥ 200.00 ¥ 600.00
09 Prescription Medication & Aftercare Kit Antibiotics, analgesics, chlorhexidine mouthwash, and soft-bristle toothbrush 1 ¥ 280.00 ¥ 280.00
Description Amount (CNY)
Subtotal – All Dental Procedures & Services ¥ 14,440.00
Applicable VAT (6% – Medical Services, China Beijing) ¥ 866.40
Grand Total (Quotation Estimate) ¥ 15,306.40

* All prices are inclusive of materials, laboratory fees, and the professional time of the Dentist. This Quotation Estimate does not include emergency re-treatment or procedures arising from patient non-compliance with post-operative instructions.

  • Validity: This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After the expiry date, the Dentist reserves the right to revise pricing due to changes in material costs, regulatory adjustments in China Beijing, or availability of clinical resources.
  • Payment Schedule: A deposit of 30% (¥ 4,591.92) is required to confirm the treatment appointment. The remaining 70% balance (¥ 10,714.48) shall be settled in full upon completion of the final procedure. Payment may be made via bank transfer, WeChat Pay, Alipay, or major credit cards accepted at our China Beijing clinic.
  • Cancellation Policy: Should the client wish to cancel or reschedule, a minimum of 48 hours' written notice is required. Cancellations made within 48 hours of the scheduled appointment will incur a 15% administrative fee on the total Quotation Estimate value.
  • Warranty: All restorative work (crowns, fillings) carries a 12-month warranty from the date of final cementation. Root canal treatment carries an 18-month warranty. Warranty coverage is void if the patient fails to attend scheduled follow-up visits with the Dentist.
  • Regulatory Compliance: All procedures are performed in strict accordance with the National Health Commission of the People's Republic of China regulations and the Beijing Municipal Medical Administration guidelines. The treating Dentist holds a valid practicing license registered with the Beijing Medical Association.
  • Confidentiality: All patient records, radiographic images, and clinical notes are stored in compliance with China's Personal Information Protection Law (PIPL) and the Data Security Law of the People's Republic of China.
  • Dispute Resolution: Any disputes arising from this Quotation Estimate shall be resolved through amicable negotiation. In the event of unresolved disagreement, matters shall be submitted to the Beijing Arbitration Commission for binding arbitration under its rules.

By signing below, the client acknowledges that they have received, read, and understood this Quotation Estimate for the dental services to be provided by the Dentist at Beijing Capital Dental Care Center, China Beijing. The client consents to the proposed treatment plan and agrees to the payment terms and conditions outlined in Section 5.

Client Signature: ___________________________

Name: ___________________________

Date: ___________________________

Dentist / Authorized Representative: ___________________________

Name: Dr. Li Wei, DDS, PhD

Date: ___________________________

(Seal of Beijing Capital Dental Care Center)

Beijing Capital Dental Care Center | No. 88 Chaoyangmen Outer Street, Chaoyang District, Beijing, China 100020

This Quotation Estimate document is generated electronically and is valid without a physical seal. For verification, contact our front desk at +86-10-6555-8899.

© 2025 Beijing Capital Dental Care Center. All rights reserved.

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