Quotation Estimate Ophthalmologist in Argentina Buenos Aires –Free Word Template Download with AI
Specialized Ophthalmologist Practice — Argentina Buenos Aires
Av. Corrientes 2450, Piso 7, C1043AAB, Buenos Aires, Argentina
Tel: +54 11 4321-5678 | Email: [email protected]
CUIT: 30-12345678-9 | Mat. Médica: 12345678
Quotation EstimateQuotation Details
Quotation No.: QE-2025-00847
Date Issued: 15 June 2025
Valid Until: 15 July 2025 (30 days)
Currency: Argentine Peso (ARS)
Prepared By: Dr. Martín E. Sosa, Ophthalmologist
Client Information
Name: ___________________________
CUIL/CUIT: ___________________________
Address: ___________________________
City: Buenos Aires, Argentina
Phone: ___________________________
Email: ___________________________
Important Notice: This Quotation Estimate is issued by a licensed Ophthalmologist operating in Argentina Buenos Aires and is intended solely for the client identified above. All prices are expressed in Argentine Pesos (ARS) and are subject to the current tax regulations established by the Administración Federal de Ingresos Públicos (AFIP). This document does not constitute a binding contract until formally accepted in writing by both parties.The following Quotation Estimate outlines the comprehensive ophthalmological services to be provided by our Ophthalmologist team at Clínica Ocular Buenos Aires, located in the heart of Argentina Buenos Aires. The services described below encompass a full diagnostic and therapeutic protocol tailored to the specific ocular condition identified during the initial consultation. All procedures will be performed in accordance with the standards established by the Colegio de Médicos de la Ciudad Autónoma de Buenos Aires and the Argentine Society of Ophthalmology (Sociedad Argentina de Oftalmología).
| Item | Service Description | Quantity | Unit Price (ARS) | Subtotal (ARS) |
|---|---|---|---|---|
| 01 | Comprehensive Ophthalmologist Consultation & Initial Assessment (includes visual acuity testing, refraction, slit-lamp examination, and intraocular pressure measurement) | 1 | $18,500.00 | $18,500.00 |
| 02 | Dilated Fundus Examination with Optical Coherence Tomography (OCT) — performed by the Ophthalmologist to evaluate retinal health and detect early signs of macular degeneration or diabetic retinopathy | 1 | $24,000.00 | $24,000.00 |
| 03 | Corneal Topography & Pachymetry — advanced diagnostic imaging of the corneal surface conducted in our Argentina Buenos Aires facility using state-of-the-art Pentacam equipment | 1 | $16,800.00 | $16,800.00 |
| 04 | Phacoemulsification Cataract Surgery (monofocal intraocular lens) — surgical procedure performed by the Ophthalmologist with pre-operative and post-operative follow-up visits included (3 follow-up sessions) | 1 | $185,000.00 | $185,000.00 |
| 05 | Post-Operative Ophthalmologist Follow-Up Visits (weeks 1, 4, and 8) — includes suture removal if applicable, lens positioning check, and prescription of post-operative eye drops | 3 | $8,500.00 | $25,500.00 |
| 06 | Prescription of Post-Operative Medication (antibiotic drops, anti-inflammatory drops, and lubricating eye drops) — dispensed from our in-clinic pharmacy in Argentina Buenos Aires | 1 | $12,300.00 | $12,300.00 |
| 07 | Emergency Ophthalmologist Consultation (if required within 30 days post-surgery) — priority access to the Ophthalmologist for any post-operative complications | 1 | $0.00 (Included) | $0.00 |
| Subtotal | $282,100.00 |
| IVA (21% — Argentine Value Added Tax) | $59,241.00 |
| Grand Total (ARS) | $341,341.00 |
Terms and Conditions of This Quotation Estimate
- This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issuance. After this period, prices may be adjusted to reflect changes in the Argentine Peso exchange rate or updates in medical supply costs in Argentina Buenos Aires.
- All services described in this Quotation Estimate will be performed by a board-certified Ophthalmologist registered with the Colegio de Médicos de la Ciudad Autónoma de Buenos Aires. The Ophthalmologist responsible for the surgical procedure is Dr. Martín E. Sosa, Mat. Médica 12345678.
- Payment may be made in full prior to the surgical procedure or in two (2) equal installments: 50% upon acceptance of this Quotation Estimate and 50% on the day of the procedure. Payment methods accepted include bank transfer (CBU/CVU), credit card (Visa, Mastercard, American Express), and cash at our Argentina Buenos Aires clinic.
- The client acknowledges that all ophthalmological procedures carry inherent risks. A detailed informed consent form, specific to the Ophthalmologist's surgical plan, will be provided and must be signed prior to any intervention.
- This Quotation Estimate does not include hospitalization fees, anesthesia costs beyond local anesthesia, or any additional procedures that may become necessary during surgery at the discretion of the Ophthalmologist. Such additional costs will be communicated to the client or their authorized representative before any further intervention.
- Post-operative care is limited to the follow-up visits specified in this Quotation Estimate. Any additional consultations with the Ophthalmologist beyond the included visits will be billed separately at the standard consultation rate of ARS $18,500.00 per session.
- In the event of cancellation by the client after the surgical date has been scheduled, a cancellation fee of 30% of the total Quotation Estimate amount will be applied. Cancellations made more than fourteen (14) days prior to the scheduled procedure will be exempt from this fee.
- All medical records generated during the course of treatment will be maintained in accordance with Argentine data protection law (Ley 25.326) and the ethical guidelines of the Argentine Society of Ophthalmology.
- This Quotation Estimate is governed by the laws of the City of Buenos Aires, Argentina. Any disputes arising from this document shall be resolved in the competent courts of Argentina Buenos Aires.
- The Ophthalmologist reserves the right to modify the surgical plan based on intra-operative findings. In such cases, the client will be notified of any changes to the scope of services and associated costs before the modification is implemented.
Dr. Martín E. Sosa — Ophthalmologist
Mat. Médica: 12345678
Date: _______________ Client Acceptance
Name: ___________________________
CUIL: ___________________________
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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