Quotation Estimate Dentist in Kazakhstan Almaty –Free Word Template Download with AI
Professional Dental Services — Almaty, Kazakhstan
Valid for 30 Days
Provider:Almaty Premier Dental Clinic LLP
45 Abai Avenue, Office 12
Almaty, 050040, Kazakhstan
Tel: +7 (727) 312-45-67
Email: [email protected]
BIN: 201450001234 Quotation No.: QTE-2025-0784
Date Issued: 15 June 2025
Valid Until: 15 July 2025
Prepared By: Dr. Aigerim Nurlanova, DDS
License No.: KZ-2019-004521 Client Information
| Client Name: Mr. Sergey Ivanov | Client ID: CL-2025-0312 |
| Address: 12 Dostyk Avenue, Apt. 45, Almaty, Kazakhstan | Phone: +7 (701) 555-88-99 |
| Email: [email protected] | Insurance Provider: N/A (Self-Pay) |
This Quotation Estimate has been prepared by our qualified Dentist team at Almaty Premier Dental Clinic to provide a comprehensive and transparent breakdown of all recommended dental treatment procedures for the client listed above. The following services have been identified following a full clinical examination, digital X-ray imaging, and periodontal assessment conducted on 10 June 2025 in Almaty, Kazakhstan.
Itemized Cost Breakdown| # | Procedure / Service | Description | Qty | Unit Price (KZT) | Subtotal (KZT) |
|---|---|---|---|---|---|
| 1 | Comprehensive Dental Examination & Consultation | Full oral assessment, digital panoramic X-ray, and treatment planning by a senior Dentist | 1 | 12,000 | 12,000 |
| 2 | Professional Dental Cleaning (Ultrasonic Scaling & Polishing) | Removal of calculus, plaque, and surface stains; includes air-polishing | 1 | 18,500 | 18,500 |
| 3 | Composite Resin Filling (Tooth #14, #24) | Minimally invasive restoration using 3M Filtek Z350 composite material | 2 | 28,000 | 56,000 |
| 4 | Root Canal Treatment (Tooth #36) | Single-visit endodontic therapy with rotary instrumentation and gutta-percha obturation | 1 | 85,000 | 85,000 |
| 5 | Full-Ceramic Crown (Tooth #36, E.max Lithium Disilicate) | CAD/CAM milled crown, try-in, and cementation with resin luting agent | 1 | 145,000 | 145,000 |
| 6 | Periodontal Deep Cleaning (Scaling & Root Planing, Quadrant 4) | Subgingival debridement for moderate periodontitis, local anesthesia included | 1 | 42,000 | 42,000 |
| 7 | Preventive Fluoride Varnish Application | Topical fluoride treatment for enamel strengthening | 1 | 5,500 | 5,500 |
| 8 | Follow-Up Appointment (2 weeks post-treatment) | Review of healing, crown fit verification, and periodontal re-evaluation | 1 | 8,000 | 8,000 |
| Subtotal (KZT): | 372,000 | ||||
| VAT 12% (Kazakhstan Standard Rate): | 44,640 | ||||
| TOTAL ESTIMATED COST (KZT): | 416,640 | ||||
| TOTAL ESTIMATED COST (USD, approx. at 450 KZT/USD): | $925.87 | ||||
- This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After the expiration date, pricing may be subject to revision based on material cost fluctuations in Kazakhstan.
- All dental procedures will be performed by a licensed Dentist or dental specialist at our clinic located in Almaty, Kazakhstan, in full compliance with the regulations of the Ministry of Health of the Republic of Kazakhstan.
- Payment is due in two installments: 50% upon acceptance of this Quotation Estimate and scheduling of the first appointment, and the remaining 50% upon completion of the final procedure. Payment may be made in KZT or USD via bank transfer, cash, or major credit/debit card.
- A warranty period of twelve (12) months applies to all restorative work (fillings, crowns) and twenty-four (24) months to endodontic treatment, provided the client adheres to the recommended recall schedule of every six months.
- The client agrees to attend all scheduled follow-up appointments. Missed appointments must be rescheduled at least 48 hours in advance to avoid a no-show fee of 10,000 KZT.
- All medical records, radiographs, and treatment documentation remain the property of Almaty Premier Dental Clinic. The client may request a copy of their records in accordance with Kazakhstan's personal data protection legislation (Law No. 94-V of 21 May 2014).
- In the event of a medical emergency arising directly from a procedure performed under this Quotation Estimate, emergency care will be provided at no additional charge within the first 72 hours.
- This Quotation Estimate does not constitute a binding contract until signed and countersigned by both parties. Acceptance of this document authorizes the Dentist team to proceed with the outlined treatment plan.
- Any disputes arising from this Quotation Estimate shall be resolved through negotiation, and if unresolved, through the competent courts of Almaty City, Kazakhstan, in accordance with the Civil Code of the Republic of Kazakhstan.
By signing below, the client acknowledges receipt of this Quotation Estimate, confirms understanding of the proposed dental treatment plan, and authorizes the Dentist team at Almaty Premier Dental Clinic to perform the procedures described herein in Almaty, Kazakhstan.
For Almaty Premier Dental Clinic LLP
Dr. Aigerim Nurlanova, DDSLead Dentist & Clinic Director
Signature & Date: _________________________
Client Acknowledgment
Mr. Sergey IvanovSignature & Date: _________________________ ⬇️ Download as DOCX Edit online as DOCX
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