Quotation Estimate Dentist in Ethiopia Addis Ababa –Free Word Template Download with AI
Quotation Reference No: QTE-ADD-2025-04782 | Date of Issue: 15 June 2025 | Valid Until: 15 July 2025
Prepared By:Addis Ababa Comprehensive Dental Clinic
Bole Road, Near Friendship Hotel
Addis Ababa, Ethiopia
Tel: +251-11-551-2345
Email: [email protected]
License No: ETH-DENT-2019-00342 Prepared For:
Mr. Tadesse Bekele
Residential Area: Kazanchis
Addis Ababa, Ethiopia
Tel: +251-911-456-789
Email: [email protected]
Dear Mr. Bekele,
Thank you for visiting our Dentist practice at Addis Ababa Comprehensive Dental Clinic. Following your comprehensive oral examination conducted on 10 June 2025, our lead Dentist, Dr. Selamawit Alemu (Licensure No. ETH-DR-2014-1187), has prepared this detailed Quotation Estimate outlining the recommended treatment plan, associated costs, and projected timelines. This Quotation Estimate is issued in accordance with the Ethiopian Ministry of Health guidelines for private dental practice in Ethiopia Addis Ababa and reflects current market rates for professional dental care in the capital region.
Itemized Treatment Plan & Cost Breakdown
The following Quotation Estimate covers all recommended procedures identified during your consultation. All prices are quoted in Ethiopian Birr (ETB) and include the use of certified dental materials, sterilization protocols, and post-operative follow-up consultations within the Ethiopia Addis Ababa metropolitan area.
| No. | Dental Procedure / Service | Quantity | Unit Price (ETB) | Subtotal (ETB) | Est. Duration |
|---|---|---|---|---|---|
| 1 | Full Oral Examination & Digital X-Ray (Panoramic + Periapical) | 1 session | 2,500 | 2,500 | 45 min |
| 2 | Ultrasonic Scaling & Polishing (Upper & Lower Arch) | 1 session | 3,800 | 3,800 | 60 min |
| 3 | Composite Resin Filling — Tooth #14 (Molar, Class II Cavity) | 1 tooth | 4,200 | 4,200 | 50 min |
| 4 | Composite Resin Filling — Tooth #36 (Molar, Class I Cavity) | 1 tooth | 4,200 | 4,200 | 50 min |
| 5 | Root Canal Treatment — Tooth #21 (Incisor, Single Canal) | 1 tooth | 8,500 | 8,500 | 90 min |
| 6 | Porcelain-Fused-to-Metal (PFM) Crown — Tooth #21 | 1 unit | 12,000 | 12,000 | 2 visits |
| 7 | Extraction of Impacted Wisdom Tooth — Tooth #38 (Lower Right) | 1 tooth | 6,500 | 6,500 | 75 min |
| 8 | Post-Operative Follow-Up Consultation (Week 2 & Week 6) | 2 visits | 1,200 | 2,400 | 30 min each |
| 9 | Prescription Medication (Antibiotics + Analgesics, 7-day course) | 1 course | 1,800 | 1,800 | N/A |
| 10 | Dental Hygiene Kit (Toothbrush, Fluoride Paste, Interdental Brush) | 1 set | 950 | 950 | N/A |
| Subtotal (All Procedures) | 46,850 ETB |
| VAT (15% — Ethiopian Tax Authority) | 7,027.50 ETB |
| TOTAL QUOTATION ESTIMATE | 53,877.50 ETB |
Terms & Conditions of This Quotation Estimate
- Validity: This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After 15 July 2025, prices may be subject to revision based on material cost fluctuations in the Ethiopia Addis Ababa dental supply market.
- Payment Schedule: A 40% deposit (21,551 ETB) is required at the time of scheduling the first procedure. The remaining 60% (32,326.50 ETB) is due upon completion of the final procedure. Payment may be made via bank transfer (CBE, Awash Bank, or Dashen Bank), mobile money (Telebirr, M-Pesa Ethiopia), or cash at our Addis Ababa clinic reception.
- Appointment Scheduling: The Dentist team will coordinate a treatment calendar within five (5) business days of your confirmed acceptance. All appointments are conducted at our Bole Road facility in Ethiopia Addis Ababa, Monday through Saturday, 8:00 AM to 6:00 PM.
- Warranty: All restorative work (fillings, crowns, root canal treatments) carries a twelve-month warranty against material defects. This warranty is valid only when follow-up appointments are completed as scheduled at our Dentist clinic in Addis Ababa.
- Emergency Care: In the event of post-operative complications (severe pain, swelling, or infection) within 72 hours of any procedure, our Dentist on-call team in Ethiopia Addis Ababa will provide emergency consultation at no additional charge.
- Insurance Note: This Quotation Estimate is prepared for private-pay patients. If you hold coverage through a recognized Ethiopian health insurance provider (e.g., Nyala, Jubilee, or Ethiopian Insurance Corporation), please present your policy documents at the time of your first visit for potential partial reimbursement.
- Regulatory Compliance: All procedures outlined in this Quotation Estimate are performed in strict compliance with the Ethiopian Health Professions Authority (EHPA) regulations and the standards set by the Addis Ababa City Health Bureau for licensed dental practices in Ethiopia Addis Ababa.
Acceptance & Authorization
By signing below, the patient acknowledges receipt of this Quotation Estimate for Dentist services at Addis Ababa Comprehensive Dental Clinic, Ethiopia Addis Ababa, and authorizes the clinic to proceed with the outlined treatment plan upon payment of the required deposit.
Dr. Selamawit AlemuLead Dentist & Clinic Director
Addis Ababa Comprehensive Dental Clinic
Date: _______________ Mr. Tadesse Bekele
Patient / Authorized Signatory
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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