Quotation Estimate Dentist in Kuwait Kuwait City –Free Word Template Download with AI
Al-Nahda Dental Clinic — 12th Floor, Al-Salem Tower, Al-Salem Street, Kuwait City, State of Kuwait
License No. KDHA-2019-4471 | P.O. Box 3821, Safat 13001, Kuwait | Tel: +965 2244 7890 | Email: [email protected]
1. Purpose of This Quotation Estimate
This Quotation Estimate has been prepared by our licensed Dentist team at Al-Nahda Dental Clinic, located in the heart of Kuwait, Kuwait City, following a comprehensive clinical examination and diagnostic imaging session conducted on 10 June 2025. The purpose of this document is to provide Mr. Khalid Al-Mubarak with a transparent, itemized breakdown of all recommended dental treatments, associated costs, and applicable terms. This Quotation Estimate serves as a formal proposal and does not constitute a binding contract until accepted in writing by the patient.
2. Clinical Summary & Recommended Treatment Plan
Following a full intraoral examination, panoramic radiograph (OPG), and periapical X-rays performed by our senior Dentist, Dr. Layla Al-Rashid (Board-Certified Prosthodontist, Kuwait Medical Specialization Board), the following treatment plan has been formulated. All procedures will be carried out at our clinic in Kuwait, Kuwait City, in strict compliance with the regulations set forth by the Kuwait Health Affairs (KHA) and the Ministry of Health.
3. Itemized Quotation Estimate Breakdown
| # | Dental Procedure / Service | Dentist in Charge | Qty | Unit Price (KWD) | Subtotal (KWD) |
|---|---|---|---|---|---|
| 1 | Full Oral Hygiene & Ultrasonic Scaling (Upper & Lower Arch) | Dr. Layla Al-Rashid | 1 | 45.000 | 45.000 |
| 2 | Composite Resin Restorations (Tooth #14, #24, #36) | Dr. Layla Al-Rashid | 3 | 35.000 | 105.000 |
| 3 | Root Canal Treatment — Single-Root Molar (Tooth #36) | Dr. Omar Al-Sabah (Endodontist) | 1 | 180.000 | 180.000 |
| 4 | Full-Ceramic Crown (Zirconia) — Tooth #36 | Dr. Layla Al-Rashid | 1 | 220.000 | 220.000 |
| 5 | Extraction of Impacted Wisdom Tooth (Tooth #48) under Local Anesthesia | Dr. Faisal Al-Harbi (Oral Surgeon) | 1 | 150.000 | 150.000 |
| 6 | Professional Teeth Whitening (In-Office, LED System) — 1 Session | Dr. Layla Al-Rashid | 1 | 120.000 | 120.000 |
| 7 | Diagnostic Imaging: OPG + 4 Periapical Radiographs | Clinic Radiology Dept. | 1 | 25.000 | 25.000 |
| 8 | Follow-Up Consultation & Post-Operative Review (2 Visits) | Dr. Layla Al-Rashid | 2 | 15.000 | 30.000 |
| 9 | Prescription Medications (Antibiotics, Analgesics, Post-Extraction Care Kit) | Clinic Pharmacy | 1 | 18.000 | 18.000 |
| TOTAL ESTIMATED COST (KWD) | 913.000 | ||||
4. Payment Terms & Conditions
- Payment Schedule: A 50% deposit (KWD 456.500) is required at the time of acceptance of this Quotation Estimate to reserve the treatment slot. The remaining 50% balance (KWD 456.500) shall be settled upon completion of all procedures.
- Accepted Payment Methods: Cash, bank transfer (Kuwait National Bank, NBB, or Boubyan), and all major credit/debit cards (Visa, Mastercard, Amex). Installment plans of up to 6 months are available for treatments exceeding KWD 500, subject to credit approval.
- Validity: This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. Prices are quoted in Kuwaiti Dinar (KWD) and are inclusive of all applicable taxes as per Kuwaiti tax law. No additional VAT is currently levied on medical and dental services in Kuwait.
- Warranty: All restorative work (crowns, composite fillings) carries a 12-month warranty against material defects. Root canal treatment carries an 18-month warranty. Warranty claims must be presented to the treating Dentist at our Kuwait, Kuwait City clinic within the warranty period.
- Rescheduling: Appointments may be rescheduled up to 48 hours in advance without penalty. Cancellations within 48 hours will incur a 20% fee of the scheduled procedure cost.
- Medical Consent: The patient must sign a separate informed consent form prior to any invasive procedure. Our Dentist will explain all risks, alternatives, and expected outcomes in detail before treatment begins.
- Confidentiality: All patient records, radiographs, and clinical notes are maintained in strict accordance with Kuwaiti data protection regulations and the ethical code of the Kuwait Medical Association.
- Dispute Resolution: Any disputes arising from this Quotation Estimate or the subsequent treatment shall be resolved amicably. In the event of unresolved disagreement, the matter shall be referred to the Kuwait Health Affairs dispute resolution panel.
5. Acceptance & Authorization
By signing below, the patient acknowledges that this Quotation Estimate has been reviewed, all recommended procedures by the Dentist have been explained, and the patient consents to proceed with the treatment plan at Al-Nahda Dental Clinic, Kuwait, Kuwait City.
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Patient Signature: ______________________________ Name: Khalid Al-Mubarak Date: _______________ |
Authorized Dentist / Clinic Representative: ______________________________ Dr. Layla Al-Rashid, DMD Al-Nahda Dental Clinic, Kuwait City Date: _______________ |
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