Quotation Estimate Dentist in United Kingdom Manchester –Free Word Template Download with AI
142 Deansgate, Manchester, M3 2ER, United Kingdom
Telephone: 0161 496 0000 | Email: [email protected]
Registered in England & Wales No. 08765432 | GDC Registration: 1234567
Quotation EstimateQuotation Details
Quotation No: QTE-2025-04871
Date of Issue: 12 June 2025
Valid Until: 12 July 2025 (30 days)
Prepared By: Dr. Sarah Whitfield, BDS, MSc, FDSRCS
Practice Location: Manchester, United Kingdom
Client Information
Name: Mr. James A. Richardson
Address: 27 Chorlton Road, Manchester, M21 9PL
Telephone: 07700 900123
Email: [email protected]
NHS Number: 485 777 3456
Dear Mr. Richardson,
Thank you for visiting our practice at Manchester Dental Care Centre. Following your comprehensive consultation and clinical examination conducted on 10 June 2025, this Quotation Estimate sets out the full scope of recommended dental treatment, associated costs, and the terms under which our practice will deliver the services outlined below. As your treating Dentist in Manchester, United Kingdom, I have prepared this document to ensure complete transparency regarding the procedures required, the estimated timeline, and the financial commitment involved.
| Ref | Description of Dental Procedure | Unit | Quantity | Unit Price (GBP) | Subtotal (GBP) |
|---|---|---|---|---|---|
| 01 | Full intra-oral digital radiography (8 views) and panoramic X-ray for diagnostic assessment | Session | 1 | £85.00 | £85.00 |
| 02 | Ultrasonic scale and polish (upper and lower arches) with fluoride varnish application | Session | 1 | £120.00 | £120.00 |
| 03 | Composite resin restoration – tooth 26 (upper left first molar), two-surface restoration with bonding agent | Tooth | 1 | £245.00 | £245.00 |
| 04 | Root canal treatment (endodontic therapy) – tooth 36 (lower left first molar), including gutta-percha obturation and temporary restoration | Tooth | 1 | £680.00 | £680.00 |
| 05 | Full ceramic crown (zirconia) – tooth 36, including impression, temporary crown, and final cementation | Tooth | 1 | £890.00 | £890.00 |
| 06 | Extraction of tooth 48 (lower right third molar / wisdom tooth) under local anaesthesia, including post-operative instructions and follow-up review | Tooth | 1 | £320.00 | £320.00 |
| 07 | Professional whitening treatment (in-say, 2-hour session) using hydrogen peroxide gel with LED activation | Session | 1 | £350.00 | £350.00 |
| 08 | Follow-up review and post-treatment check (includes 6-week and 3-month appointments) | Session | 2 | £45.00 | £90.00 |
| 09 | Prescription of post-operative analgesics and antibiotics (where clinically indicated) | Item | 1 | £18.00 | £18.00 |
| 10 | Emergency call-out fee (included in this Quotation Estimate for the duration of treatment) | Item | 1 | £0.00 | £0.00 |
| TOTAL ESTIMATED COST (Excluding VAT where applicable) | £2,798.00 | ||||
Note: NHS-eligible procedures are charged at the standard NHS tariff. Private procedures are charged at the rates listed above. VAT is not applicable to most dental services in the United Kingdom as they are exempt under HMRC regulations. Any additional costs arising from unforeseen clinical complications will be communicated to the patient in writing prior to commencement of further treatment.
The complete treatment plan outlined in this Quotation Estimate is anticipated to be completed over a period of approximately eight to ten weeks, subject to the healing requirements of the root canal treatment and the extraction site. The Dentist will schedule all appointments in advance and will provide a minimum of 48 hours' notice for any rescheduling. The patient is advised to attend all scheduled appointments to ensure the treatment progresses within the estimated timeframe.
- A deposit of 25% (£699.50) is required at the time of acceptance of this Quotation Estimate to secure the first appointment slot.
- The remaining balance of 75% (£2,098.50) is payable in two equal instalments: 50% at the commencement of the root canal treatment and 50% upon final crown cementation.
- Payment may be made by bank transfer, debit card, credit card (Visa, Mastercard, Amex), or direct debit. A 1.5% surcharge applies to credit card payments in accordance with UK payment regulations.
- 0% interest finance options are available for treatment plans exceeding £500 over a period of 12 months, subject to credit approval. Please contact our practice administrator for details.
- All payments are due within 14 calendar days of the invoice date. Late payments may incur a 4% monthly interest charge in line with the Late Payment of Commercial Debts (Interest) Act 1998.
- This Quotation Estimate is valid for 30 days from the date of issue. Should the patient wish to proceed after the validity period, the Dentist reserves the right to re-assess the clinical situation and issue a revised estimate.
- All treatment will be carried out in accordance with the General Dental Council (GDC) Standards for the Dental Team and the Care Quality Commission (CQC) regulations applicable in Manchester, United Kingdom.
- The patient acknowledges that dental treatment carries inherent risks. A detailed informed consent form, including all material risks, will be provided prior to each procedure. The patient must sign this form before treatment commences.
- Should the patient cancel an appointment with less than 48 hours' notice, a cancellation fee of £50.00 will be charged to cover the reserved clinical time.
- Missed appointments will be charged at the full fee for the session. The patient is responsible for attending all scheduled follow-up appointments included in this Quotation Estimate.
- Our practice maintains comprehensive professional indemnity insurance and public liability insurance. The patient's personal data will be processed in accordance with the UK General Data Protection Regulation (UK GDPR) and the Data Protection Act 2018.
- Any disputes arising from this Quotation Estimate or the treatment provided will be resolved in accordance with the practice's complaints procedure, which is available on request and on our website. The patient may also contact the Dental Complaints Service or the CQC if unresolved.
- This Quotation Estimate does not constitute a guarantee of outcome. The Dentist will use reasonable skill and care in the delivery of all procedures, but individual healing responses may vary.
By signing below, the patient confirms that they have read and understood this Quotation Estimate, that they have had the opportunity to ask questions regarding the proposed treatment, and that they consent to the procedures and costs outlined above. The patient further confirms that they have been advised of alternative treatment options, including the option of no treatment, and the potential consequences of declining the recommended care.
Patient Signature:
Name: Mr. James A. Richardson
Date: ______________________
Dentist / Practice Representative:
Name: Dr. Sarah Whitfield, BDS, MSc, FDSRCS
Date: ______________________
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