Quotation Estimate Dentist in DR Congo Kinshasa –Free Word Template Download with AI
12 Avenue de la Paix, Gombe, Kinshasa, DR Congo
Tel: +243 990 000 000 | Email: [email protected]
Licensed by the Ministry of Health, Democratic Republic of the Congo
Quotation EstimateQuotation Details
Quotation No.: QTE-KIN-2025-0487
Date Issued: 15 June 2025
Valid Until: 15 July 2025 (30 days)
Currency: US Dollars (USD)
Client Information
Name: Mr. Jean-Pierre Mbuyi
Address: Quartier Matonge, Commune de Matete, Kinshasa, DR Congo
Phone: +243 810 123 456
Email: [email protected]
Dear Mr. Mbuyi,
Thank you for contacting Kinshasa Dental Care Centre, a leading Dentist practice serving the community of DR Congo Kinshasa. Following your consultation on 10 June 2025, we are pleased to present this formal Quotation Estimate outlining the comprehensive dental treatment plan recommended for your oral health needs. This Quotation Estimate has been prepared in accordance with the professional standards established by the National Order of Dentists of the Democratic Republic of the Congo and reflects current market rates for dental services in the Kinshasa metropolitan area.
Scope of Dental ServicesAs your designated Dentist in DR Congo Kinshasa, our clinical team has conducted a thorough examination including panoramic radiography, intraoral photography, and periodontal assessment. Based on these findings, the following procedures are recommended to restore and maintain optimal oral health:
| No. | Dental Procedure | Description | Qty | Unit Price (USD) |
|---|---|---|---|---|
| 1 | Comprehensive Dental Examination & Consultation | Full oral assessment, medical history review, and treatment planning by a licensed Dentist in Kinshasa | 1 | $85.00 |
| 2 | Panoramic Radiograph (OPG) & Periapical X-rays | Digital imaging for diagnostic purposes; 4 periapical views included | 1 | $60.00 |
| 3 | Ultrasonic Scaling & Root Planing (Full Mouth) | Deep cleaning of all four quadrants to remove calculus and treat periodontal inflammation | 4 | $95.00 |
| 4 | Composite Resin Restorations (Class II) | Placement of aesthetic composite fillings on molars (teeth #16, #26, #36, #46) | 4 | $120.00 |
| 5 | Root Canal Treatment (Single-Root Molar) | Endodontic therapy on tooth #36 including obturation and temporary restoration | 1 | $350.00 |
| 6 | Porcelain-Fused-to-Metal Crown (PFM) | Custom-fabricated crown for tooth #36, including abutment preparation and cementation | 1 | $480.00 |
| 7 | Extraction of Impacted Third Molar (Tooth #48) | Surgical removal under local anaesthesia with suturing and post-operative instructions | 1 | $200.00 |
| 8 | Professional Prophylaxis & Fluoride Application | Polishing, fluoride varnish application, and oral hygiene instruction | 1 | $55.00 |
| 9 | Follow-Up Visits (Post-Operative Review) | Two scheduled follow-up appointments at 2 weeks and 6 weeks for healing assessment | 2 | $40.00 |
| 10 | Prescription Medications & Post-Operative Kit | Antibiotics, analgesics, antiseptic mouthwash, and soft diet recommendations | 1 | $45.00 |
| Cost Summary | Amount (USD) | ||
|---|---|---|---|
| Subtotal | $2,615.00 | ||
| VAT (16% – DR Congo Standard Rate) | $418.40 | ||
| Emergency After-Hours Availability Fee | $50.00 | ||
| TOTAL ESTIMATED COST | $3,083.40 | ||
- Validity: This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. Prices are subject to revision based on fluctuations in the exchange rate between the US Dollar and the Congolese Franc (CDF) as well as changes in the cost of imported dental materials in DR Congo Kinshasa.
- Payment Schedule: A deposit of 40% ($1,233.36) is required to confirm the treatment plan and schedule appointments. The remaining 60% ($1,850.04) is due upon completion of all procedures. Payments may be made in US Dollars, Congolese Francs at the prevailing bank rate, or via mobile money (M-Pesa, Airtel Money) at our Kinshasa office.
- Scheduling: The full treatment plan is estimated to be completed within four (4) to six (6) weeks, subject to the availability of the patient and the laboratory turnaround time for the PFM crown. Our Dentist team in DR Congo Kinshasa will coordinate all appointments to minimize disruption to the patient's schedule.
- Warranty: All restorations and crowns carry a warranty of twelve (12) months against manufacturing defects. This warranty does not cover damage resulting from trauma, bruxism, or failure to attend scheduled follow-up appointments.
- Regulatory Compliance: All procedures will be performed in strict compliance with the regulations of the Ministry of Health of the Democratic Republic of the Congo and the ethical code of the National Order of Dentists. Our practice holds a valid operating licence for dental services in the city of Kinshasa.
- Confidentiality: All patient records, radiographic images, and treatment details are protected under the data privacy provisions applicable in DR Congo. No information will be disclosed to third parties without written consent.
- Revisions: Should additional procedures become necessary during treatment (e.g., discovery of hidden caries or periodontal pockets), a supplementary Quotation Estimate will be issued and must be approved in writing by the patient before any additional work commences.
- Refunds: The initial deposit is non-refundable once the treatment plan has been confirmed and materials have been ordered. Unused follow-up visits may be rescheduled once at no additional charge.
By signing below, the patient acknowledges receipt of this Quotation Estimate, confirms understanding of the recommended dental treatment plan, and authorizes Kinshasa Dental Care Centre to proceed with the services described herein. The patient agrees to the terms and conditions outlined above.
Patient / Authorized Representative
Name: ______________________________
Signature: ______________________________
Date: ______________________________
Kinshasa Dental Care Centre
Dentist in Charge: Dr. Amina Kalala, DDS
Signature: ______________________________
Date: ______________________________
Official Stamp:
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