Quotation Estimate Dentist in Uzbekistan Tashkent –Free Word Template Download with AI
This Quotation Estimate has been prepared by Tashkent Smile Dental Clinic, a licensed and fully accredited Dentist practice operating in the heart of Uzbekistan Tashkent, to provide Ms. Elena Petrova with a comprehensive, itemized breakdown of the proposed dental treatment plan. This document serves as a formal financial estimate for all recommended procedures, materials, and professional services. The Dentist team at our clinic in Uzbekistan Tashkent has conducted a full clinical examination, digital radiography, and intraoral scanning to determine the most appropriate course of treatment. All pricing in this Quotation Estimate reflects the current market rates for dental care in Uzbekistan Tashkent as of June 2025.
The following table details each procedure recommended by our Dentist specialists. All services are performed in compliance with the Ministry of Health of the Republic of Uzbekistan regulations governing dental practice in Uzbekistan Tashkent.
| # | Procedure / Service | Qty | Unit Price (USD) | Subtotal (USD) | Notes |
|---|---|---|---|---|---|
| 1 | Comprehensive Dental Examination & Digital X-Ray (Panoramic + Periapical) | 1 | $45.00 | $45.00 | Initial diagnostic session |
| 2 | Professional Ultrasonic Scaling & Polishing (Full Mouth) | 1 | $65.00 | $65.00 | Includes fluoride application |
| 3 | Composite Resin Filling (Posterior Tooth, 2-surface) | 3 | $85.00 | $255.00 | 3M Z350 XT material |
| 4 | Root Canal Treatment (Single-Root Molar) | 1 | $320.00 | $320.00 | Includes rubber dam isolation |
| 5 | Full-Ceramic Crown (E.max Lithium Disilicate) | 1 | $450.00 | $450.00 | Milled in-house, 2 visits |
| 6 | Extraction of Impacted Third Molar (Wisdom Tooth) | 1 | $180.00 | $180.00 | Local anesthesia included |
| 7 | Intraoral Digital Impression & Shade Matching | 1 | $30.00 | $30.00 | 3Shape TRIOS scanner |
| 8 | Post-Operative Follow-Up Visits (2 sessions) | 2 | $25.00 | $50.00 | Week 1 and Week 4 |
| 9 | Prescription Medication & Aftercare Kit | 1 | $35.00 | $35.00 | Analgesics, antiseptic rinse |
| GRAND TOTAL (Before Tax) | $1,430.00 | ||||
| VAT (12% — Republic of Uzbekistan) | $171.60 | ||||
| TOTAL AMOUNT DUE | $1,601.60 | ||||
This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. Payment for the full treatment plan outlined above is due as follows: a 50% deposit ($800.80) is required at the time of scheduling the first procedure, and the remaining 50% ($800.80) is due upon completion of the final procedure. Our Dentist clinic in Uzbekistan Tashkent accepts payments via bank transfer to the clinic's registered account with the Central Bank of the Republic of Uzbekistan, as well as major international credit cards (Visa, Mastercard). All transactions are processed in US Dollars, and receipts are issued in accordance with Uzbek tax law.
- This Quotation Estimate is a good-faith estimate based on the clinical findings at the time of examination. Should the Dentist discover additional pathology during treatment (e.g., hidden caries, periodontal pockets, or fracture lines not visible on initial imaging), a supplementary estimate will be provided and must be approved in writing by the patient before any additional work commences.
- All dental procedures are performed by licensed Dentist professionals registered with the Ministry of Health of the Republic of Uzbekistan. The clinic holds a valid medical practice license (License No. UZ-MH-2019-0342) issued for operation in Uzbekistan Tashkent.
- Materials and equipment used in this treatment plan meet the quality standards established by the State Sanitary-Epidemiological Service of Uzbekistan. All implants, ceramics, and restorative materials carry manufacturer warranties as specified in the product documentation.
- The patient agrees to attend all scheduled follow-up appointments. Missed appointments may result in rescheduling fees of $20.00 per occurrence, as per the standard policy of dental practices in Uzbekistan Tashkent.
- This Quotation Estimate does not constitute a guarantee of specific aesthetic or functional outcomes. The Dentist will use reasonable professional judgment to achieve the best possible result within the scope of the agreed treatment plan.
- In the event of a dispute, both parties agree to first attempt resolution through good-faith negotiation. If unresolved, the matter shall be submitted to the competent court of Tashkent City, Republic of Uzbekistan, in accordance with the Civil Code of Uzbekistan.
- Personal health data collected during the preparation of this Quotation Estimate and subsequent treatment is protected under the Law of the Republic of Uzbekistan "On Personal Data Protection" (2019). Data will not be shared with third parties without explicit written consent.
By signing below, the patient acknowledges receipt of this Quotation Estimate, confirms understanding of the proposed Dentist treatment plan, and authorizes Tashkent Smile Dental Clinic to proceed with the services described herein. The patient further confirms that all relevant medical history, allergies, and current medications have been disclosed to the treating Dentist.
For Tashkent Smile Dental ClinicDr. Aziz Karimov, DDS
Lead Dentist & Clinic Director
Date: _______________ Patient / Authorized Representative
Ms. Elena Petrova
Signature: _______________
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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