Quotation Estimate Dentist in Malaysia Kuala Lumpur –Free Word Template Download with AI
Professional Dental Services — Malaysia Kuala Lumpur
Document Reference: QE-KL-2025-0847
Dental Practice Information| Practice Name: | KL Smile Dental Clinic Sdn. Bhd. |
| Address: | Suite 402, Level 4, Menara KLCC, 12, Jalan P. Ramlee, 50250 Kuala Lumpur, Malaysia |
| Registration No.: | 201901034567 (K) — Ministry of Health Malaysia |
| Lead Dentist: | Dr. Aisyah Rahman (Registration No. MD-2015-8842) |
| Phone / Email: | +60 3-2181 4567 / [email protected] |
This Quotation Estimate has been prepared by our experienced Dentist team at KL Smile Dental Clinic, located in the heart of Malaysia Kuala Lumpur, following a comprehensive clinical examination conducted on 10 June 2025. The following line items detail the proposed dental treatment plan, associated materials, and professional fees. All pricing is quoted in Malaysian Ringgit (MYR) and is inclusive of applicable Goods and Services Tax (GST) at 6% as mandated by the Royal Malaysian Customs Department.
| No. | Dental Procedure / Service | Description & Materials | Qty | Unit Price (MYR) | Amount (MYR) |
|---|---|---|---|---|---|
| 1 | Comprehensive Dental Examination & Digital X-Ray (Panoramic + Periapical) | Full oral assessment, periodontal charting, and 2D digital radiography by the attending Dentist | 1 | 350.00 | 350.00 |
| 2 | Ultrasonic Scaling & Polishing (Full Mouth) | Removal of supragingival and subgingival calculus, professional prophylaxis, and fluoride varnish application | 1 | 480.00 | 480.00 |
| 3 | Composite Resin Restorations (Anterior & Posterior) | 3M Z350 XT nanohybrid composite, shade-matched; includes local anaesthesia and occlusal adjustment | 4 | 550.00 | 2,200.00 |
| 4 | Root Canal Treatment (Single-Root Molar, Tooth #36) | Endodontic therapy with rotary NiTi instruments, gutta-percha obturation, and temporary restoration; performed by specialist Dentist | 1 | 2,800.00 | 2,800.00 |
| 5 | Full-Coverage Porcelain Crown (Tooth #36) | E.max lithium disilicate crown, CAD/CAM milled, cemented with resin-modified glass ionomer | 1 | 3,200.00 | 3,200.00 |
| 6 | Extraction of Impacted Wisdom Tooth (Tooth #48) | Surgical extraction under local anaesthesia with sedation; includes post-operative care and sutures | 1 | 1,500.00 | 1,500.00 |
| 7 | Professional Teeth Whitening (In-Office, Zoom! System) | Single-session LED-activated whitening by our Dentist; includes take-home maintenance kit | 1 | 1,800.00 | 1,800.00 |
| 8 | Follow-Up Consultations & Post-Operative Reviews | Three (3) scheduled review appointments within 6 months; includes re-evaluation X-rays if required | 3 | 150.00 | 450.00 |
| 9 | Prescription Medications & Post-Extraction Care Kit | Antibiotics (Amoxicillin 500mg x10), analgesics, chlorhexidine mouthwash, and ice pack | 1 | 120.00 | 120.00 |
| Subtotal (MYR) | 12,900.00 | ||||
| GST @ 6% | 774.00 | ||||
| TOTAL QUOTATION ESTIMATE (MYR) | 13,674.00 | ||||
- This Quotation Estimate is issued by KL Smile Dental Clinic Sdn. Bhd., a registered dental practice operating in Malaysia Kuala Lumpur, and is non-transferable to any third party without prior written consent from the treating Dentist.
- Payment terms: A deposit of 50% (MYR 6,837.00) is required to confirm the treatment schedule. The remaining balance shall be settled upon completion of the final procedure. Payment may be made via bank transfer, credit/debit card, or FPX online banking.
- All dental treatments outlined in this Quotation Estimate will be performed by a qualified and registered Dentist or dental specialist under the supervision of Dr. Aisyah Rahman, in accordance with the Malaysian Dental Council (MDC) Code of Ethics and the Private Healthcare Facilities and Services Act 1998 (Act 586).
- The client acknowledges that dental procedures, while performed to the highest standard of care, may carry inherent risks. A detailed informed consent form will be signed prior to each procedure. The Dentist will explain all potential complications, alternative treatments, and expected outcomes in clear language.
- Warranty: Porcelain crowns carry a 2-year warranty against manufacturing defects. Composite restorations carry a 1-year warranty. Root canal treatment is warranted for 12 months against re-infection under normal oral hygiene conditions. Warranty does not cover damage caused by trauma, bruxism, or neglect of post-operative instructions.
- Any additional procedures identified during the course of treatment that are not included in this Quotation Estimate will be communicated to the client in writing before commencement, and a supplementary Quotation Estimate will be issued for approval.
- This Quotation Estimate does not constitute a guarantee of specific aesthetic or functional outcomes. The treating Dentist will use reasonable professional judgement to achieve the best possible result within the scope of modern dental science.
- Disputes arising from this Quotation Estimate shall be resolved in accordance with the laws of Malaysia and shall be subject to the exclusive jurisdiction of the courts in Kuala Lumpur, Malaysia.
- Client data and medical records are protected under the Personal Data Protection Act 2010 (PDPA) of Malaysia. No information will be disclosed to third parties without explicit written consent.
By signing below, the client confirms that they have read, understood, and accepted all terms and conditions set forth in this Quotation Estimate. The client authorises the treating Dentist at KL Smile Dental Clinic, Malaysia Kuala Lumpur, to proceed with the dental services as described above.
Client SignatureName: Mr. Tan Wei Ming
Date: ____________________ Dentist / Authorised Representative
Name: Dr. Aisyah Rahman, DDS
Date: ____________________ ⬇️ Download as DOCX Edit online as DOCX
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