Quotation Estimate Doctor General Practitioner in Colombia Bogotá –Free Word Template Download with AI

This Quotation Estimate is issued by Dr. Carolina Restrepo Márquez, a licensed Doctor General Practitioner operating in Bogotá, Colombia, to provide a comprehensive set of primary care services as detailed below. All services are rendered in compliance with the Colombian General Health System (Ley 100 de 1993) and the regulations established by the Ministerio de Salud y Protección Social of Colombia.

• This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. After this period, prices may be subject to revision due to changes in the Colombian healthcare market or adjustments by the EPS providers in Bogotá.
• All services described in this document are to be performed by the Doctor General Practitioner, Dr. Carolina Restrepo Márquez, or by a duly authorized substitute of equivalent qualification at the clinic located in Chapinero, Bogotá, Colombia.
• Payment is due within fifteen (15) calendar days from the date of service delivery. Accepted payment methods include: bank transfer (Bancolombia, Davivienda, Banco de Bogotá), credit/debit card, and cash at the clinic reception.
• If the client is covered by an EPS (Entidad Promotora de Salud) in Bogotá, the Doctor General Practitioner will submit the corresponding billing directly to the insurer. The client is responsible only for any co-payment (copago) or deductible (deducible) as established by their specific health plan.
• This Quotation Estimate does not constitute a binding contract. Final service delivery is subject to clinical availability, scheduling, and the client's informed consent.
• All medical records generated during the course of treatment will be stored in accordance with Colombian data protection law (Ley 1581 de 2012) and the regulations of the Superintendencia Nacional de Salud.
• Any additional services not listed in this Quotation Estimate will be communicated to the client in writing prior to their execution, with a separate cost estimate provided.
• The Doctor General Practitioner reserves the right to modify the scope of services if the clinical findings during the initial consultation warrant a different treatment pathway. In such cases, a revised Quotation Estimate will be issued.

By signing below, the client acknowledges receipt of this Quotation Estimate for Doctor General Practitioner services in Bogotá, Colombia, and authorizes the provider to proceed with the described services under the terms stated herein.