Quotation Estimate Ophthalmologist in Argentina Córdoba –Free Word Template Download with AI
Clinica Ocular del Centro — Córdoba, Argentina
Av. Vélez Sarsfield 1245, Piso 3, Ciudad de Córdoba, CP 5000, Provincia de Córdoba, Argentina
Tel: +54 (351) 422-8890 | Email: [email protected]
CABA & Córdoba Medical Registry No. 4521-OFTQuotation Details
Quotation No.: QE-CBA-2025-0487
Date of Issue: 15 June 2025
Valid Until: 15 July 2025 (30 calendar days)
Currency: Argentine Peso (ARS)
Prepared By: Dr. Mariana López Herrera, Ophthalmologist
Client Information
Client Name: [To be completed]
CUIT / CUIL: [To be completed]
Address: [To be completed], Córdoba, Argentina
Phone: [To be completed]
Email: [To be completed]
Dear Valued Client,
Thank you for considering the professional ophthalmological services offered by our clinic in Córdoba, Argentina. This Quotation Estimate has been prepared in accordance with your request for a comprehensive ophthalmological evaluation and treatment plan. As a licensed Ophthalmologist registered with the Colegio de Médicos de la Provincia de Córdoba, I am pleased to present the following detailed cost breakdown for the services to be rendered at our facility located in the heart of the Ciudad de Córdoba.
| Item | Service Description | Quantity | Unit Price (ARS) | Subtotal (ARS) |
|---|---|---|---|---|
| 01 | Comprehensive Ophthalmological Consultation & Initial Assessment (including medical history review, visual acuity testing, and slit-lamp examination) | 1 session | $ 48.500,00 | $ 48.500,00 |
| 02 | Complete Dilated Fundus Examination with Optical Coherence Tomography (OCT) of the macula and optic nerve | 1 session | $ 62.000,00 | $ 62.000,00 |
| 03 | Automated Refraction & Keratometry (topographical mapping of the cornea) | 1 session | $ 35.800,00 | $ 35.800,00 |
| 04 | Intraocular Pressure Measurement (Tonometry) & Gonioscopy | 1 session | $ 22.400,00 | $ 22.400,00 |
| 05 | Visual Field Testing (Humphrey Perimetry) — bilateral assessment | 1 session | $ 41.200,00 | $ 41.200,00 |
| 06 | Anterior Segment Photography & Digital Fundus Photography (4-field) | 1 session | $ 28.600,00 | $ 28.600,00 |
| 07 | Prescription of Corrective Lenses (single-vision or progressive) — consultation and fitting | 1 pair | $ 85.000,00 | $ 85.000,00 |
| 08 | Follow-up Ophthalmologist Consultation (30-day post-evaluation review) | 1 session | $ 32.000,00 | $ 32.000,00 |
| 09 | Written Medical Report & Diagnostic Summary (bilingual: Spanish / English) for insurance or occupational purposes | 1 report | $ 15.500,00 | $ 15.500,00 |
| 10 | Pharmacological Dilating Drops (Tropicamide 1% + Phenylephrine 2.5%) — included in examination | 1 set | $ 0,00 | $ 0,00 |
Subtotal: ARS $ 371.000,00
IVA (21% — Argentine Value Added Tax): ARS $ 77.910,00
GRAND TOTAL: ARS $ 448.910,00
* All prices are expressed in Argentine Pesos (ARS) and are subject to adjustment in accordance with the official exchange rate and inflation index published by the Banco Central de la República Argentina (BCRA).
Terms and Conditions of this Quotation Estimate
- This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. After this period, prices may be revised to reflect changes in the Argentine economic context, including inflation adjustments and currency fluctuations.
- All ophthalmological services will be performed by Dr. Mariana López Herrera, a certified Ophthalmologist with over fifteen (15) years of clinical experience, registered with the Colegio de Médicos de la Provincia de Córdoba under license number 4521-OFT.
- Payment may be made in full upon completion of services, or in two (2) equal installments: 50% upon scheduling and 50% upon completion of the final follow-up session. Accepted payment methods include: bank transfer (CBU/CVU), credit/debit card (Visa, Mastercard, American Express), and cash at our Córdoba office.
- For clients covered by Argentine health insurance (Obra Social / Prepagada), this Quotation Estimate may be submitted for prior authorization. Our clinic maintains active agreements with OSDE, Galeno, Swiss Medical, and IOMA in the province of Córdoba.
- All diagnostic imaging, OCT scans, and photographic records will be provided to the client in digital format (USB or secure cloud link) at no additional cost.
- This Quotation Estimate does not constitute a binding medical commitment. The final treatment plan may be adjusted by the attending Ophthalmologist following the initial clinical evaluation, in which case a supplementary Quotation Estimate will be issued.
- Confidentiality of all medical information is guaranteed in compliance with Argentine Law 25.326 (Personal Data Protection) and the ethical code of the Colegio de Médicos de Córdoba.
- Cancellation or rescheduling of appointments must be communicated at least forty-eight (48) hours in advance to avoid a 20% administrative fee on the scheduled session value.
Ophthalmologist — Lead Clinician
Clinica Ocular del Centro, Córdoba, Argentina
Mat. N° 4521-OFT | C.M. Córdoba Client Acceptance
Name & Signature
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
Create your own Word template with our GoGPT AI prompt:
GoGPT