Quotation Estimate Dentist in United Kingdom London –Free Word Template Download with AI
Professional Dental Services — United Kingdom London
Quotation Reference: QTE-LDN-2025-04872 | VALID 30 DAYS
Date of Issue: 14 June 2025
Thames Dental Practice Ltd42 Marylebone High Street
London, W1U 4NP
United Kingdom
Tel: +44 (0)20 7946 0821
Email: [email protected]
GDC Registration No: 10482937 Prepared For:
Mr. James A. Whitfield
18 Kensington Gardens
London, W8 5PT
United Kingdom
Tel: +44 (0)7700 900342
NHS Number: 485 776 2201 Scope of Dental Treatment — Quotation Estimate Details
This Quotation Estimate has been prepared by our senior Dentist, Dr. Eleanor Hartley (GDC Reg. No. 10482937), following a comprehensive clinical examination and diagnostic imaging session conducted on 10 June 2025 at our practice in central London, United Kingdom. The following Quotation Estimate outlines the recommended course of dental treatment, associated professional fees, and material costs. All pricing reflects current rates for dental services provided in the United Kingdom London metropolitan area as of June 2025.
| Ref | Treatment / Procedure | Clinical Description | Qty | Unit Price | Total |
|---|---|---|---|---|---|
| 01 | Comprehensive Dental Examination & Digital X-Rays | Full intraoral examination, periapical and panoramic radiographs, periodontal charting, and oral cancer screening performed by the treating Dentist. | 1 | £120.00 | £120.00 |
| 02 | Ultrasonic Scale and Polish (Upper & Lower) | Removal of supragingival and subgingival calculus using ultrasonic scaler, followed by professional air-flow polishing and fluoride varnish application. | 1 | £95.00 | £95.00 |
| 03 | Composite Resin Filling — Tooth 26 (Upper Left First Molar) | Removal of carious dentine and restoration with aesthetic nanohybrid composite resin, including shade matching and occlusal adjustment by the Dentist. | 1 | £285.00 | £285.00 |
| 04 | Root Canal Treatment — Tooth 36 (Lower Left First Molar) | Endodontic treatment including access cavity preparation, canal instrumentation, obturation with gutta-percha, and temporary restoration. Performed by the specialist Dentist under local anaesthesia. | 1 | £650.00 | £650.00 |
| 05 | Full-Ceramic Crown — Tooth 36 | Custom-fabricated lithium disilicate (e.max) crown, including digital impression, temporary crown, and final cementation with resin luting agent. | 1 | £890.00 | £890.00 |
| 06 | Extraction of Tooth 38 (Lower Left Third Molar) | Surgical removal of partially erupted wisdom tooth under local anaesthesia, including suturing and post-operative instructions from the Dentist. | 1 | £320.00 | £320.00 |
| 07 | Post-Operative Review & Suture Removal | Follow-up appointment at 7 days for wound assessment, suture removal, and verification of healing by the treating Dentist. | 1 | £45.00 | £45.00 |
| 08 | Emergency Dental Appointment (if required) | Provisional allocation for one emergency visit within 12 months should post-operative complications arise. Charged only if utilised. | 1 | £85.00 | £85.00 |
| Subtotal (Excluding VAT) | £2,490.00 | ||||
| VAT @ 20% (where applicable) | £498.00 | ||||
| TOTAL QUOTATION ESTIMATE | £2,988.00 | ||||
Note: Certain NHS-registered dental treatments may be exempt from VAT under UK legislation. The final VAT treatment will be confirmed at the point of invoicing. This Quotation Estimate is based on private dental fees in London, United Kingdom.
Payment Terms & Conditions1. Validity of Quotation Estimate
This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. Should the patient wish to proceed after this period, the Dentist reserves the right to re-assess clinical requirements and issue a revised Quotation Estimate reflecting any changes in material costs or clinical findings.
2. Payment Schedule
A deposit of 30% of the total Quotation Estimate amount (£896.40) is required to secure the treatment appointment. The remaining balance is payable upon completion of each individual procedure. Payment may be made by bank transfer, debit/credit card, or direct debit. No payment plans exceeding six (6) monthly instalments will be offered without prior written agreement from the practice.
3. Cancellation Policy
Appointments must be cancelled with a minimum of forty-eight (48) hours' notice. Failure to do so will result in a cancellation fee of 50% of the scheduled procedure fee. The deposit is non-refundable once treatment has commenced.
4. Clinical Disclaimer
This Quotation Estimate is based on the clinical findings at the time of examination. The treating Dentist may, in the course of treatment, identify additional pathology requiring further intervention. In such cases, a supplementary Quotation Estimate will be provided and the patient's written consent will be obtained before any additional work is undertaken.
5. Regulatory Compliance
All dental services described in this Quotation Estimate are provided in full compliance with the General Dental Council (GDC) standards, the Care Quality Commission (CQC) regulations, and applicable United Kingdom healthcare legislation. The practice is registered with the CQC and operates from a premises in London, United Kingdom, that meets all statutory requirements for dental premises.
6. Data Protection
Patient data processed in connection with this Quotation Estimate and subsequent treatment will be handled in accordance with the UK General Data Protection Regulation (UK GDPR) and the Data Protection Act 2018. Clinical records will be retained for a minimum of eight (8) years in line with GDC guidance.
AcceptanceBy signing below, the patient acknowledges having received and reviewed this Quotation Estimate for dental services in London, United Kingdom. The patient confirms that the Dentist has explained the proposed treatment plan, alternative options, associated risks, and costs in full. The patient consents to proceed with the treatment as outlined in this Quotation Estimate.
Patient SignatureName: James A. Whitfield
Date: _______________
Dr. Eleanor Hartley, BDS, MSc
GDC Reg. No. 10482937
Date: _______________
Thames Dental Practice Ltd — Registered in England & Wales No. 09876543 — 42 Marylebone High Street, London W1U 4NP, United Kingdom
This Quotation Estimate document is issued in accordance with the practice's terms of service. For queries regarding this Quotation Estimate, please contact the practice reception during opening hours (Monday to Friday, 08:00–18:00).
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