Quotation Estimate Ophthalmologist in China Beijing –Free Word Template Download with AI
Quotation Reference No.: QTE-BJ-2025-04782 | Date of Issue: 15 June 2025 | Valid Until: 15 July 2025
Service Provider
Beijing Vision Care Ophthalmology Center
No. 88, Xueyuan Road, Haidian District
Beijing, 100083, People's Republic of China
Tel: +86-10-6258-XXXX
Email: [email protected]
Medical License No.: BJ-MED-2019-004521
Client / Recipient
Mr. / Ms. [Client Full Name]
[Client Address]
Beijing, [Postal Code], China
Tel: +86-13X-XXXX-XXXX
Email: [[email protected]]
Patient ID: PT-2025-09834
This Quotation Estimate is issued by Beijing Vision Care Ophthalmology Center to provide a comprehensive, itemized breakdown of all anticipated costs associated with the full spectrum of Ophthalmologist services to be delivered to the named client within the metropolitan area of China Beijing. This document serves as a formal, non-binding financial projection and does not constitute a final invoice. All pricing is presented in Chinese Yuan (CNY / RMB) and is subject to the terms and conditions outlined in Section 6 of this Quotation Estimate.
The following Ophthalmologist services have been recommended following the initial diagnostic consultation conducted on 10 June 2025 at our China Beijing clinic facility. The treating Ophthalmologist, Dr. Wei Zhang (Board-Certified Ophthalmologist, 18 years of clinical experience), has outlined the treatment plan below:
| No. | Service Description | Frequency / Qty | Unit Price (CNY) | Subtotal (CNY) | Notes |
|---|---|---|---|---|---|
| 1 | Comprehensive Ophthalmologist Diagnostic Examination (visual acuity, intraocular pressure, retinal imaging, corneal topography) | 1 session | 1,200.00 | 1,200.00 | Initial assessment |
| 2 | Advanced OCT (Optical Coherence Tomography) & Fundus Fluorescein Angiography | 2 sessions | 850.00 | 1,700.00 | Retinal evaluation |
| 3 | Phacoemulsification Cataract Surgery (monofocal IOL implantation) — performed by senior Ophthalmologist | 1 procedure (per eye) | 12,500.00 | 25,000.00 | Bilateral; includes IOL |
| 4 | Post-operative Ophthalmologist Follow-up Consultations (Day 1, Week 1, Month 1, Month 3) | 4 visits | 400.00 | 1,600.00 | Standard recovery |
| 5 | Prescription Medications (antibiotic & anti-inflammatory eye drops, 30-day supply) | 1 course | 680.00 | 680.00 | Pharmacy dispensed |
| 6 | Corneal Topography & Wavefront Analysis (pre-surgical planning) | 1 session | 950.00 | 950.00 | Pre-op requirement |
| 7 | Emergency Ophthalmologist On-Call Coverage (24/7 hotline access during 90-day recovery period) | 90 days | 300.00 | 300.00 | Tele-consultation |
| 8 | Administrative & Medical Record Filing (Beijing Municipal Health Commission compliance) | 1 package | 200.00 | 200.00 | Regulatory fee |
| TOTAL ESTIMATED COST (CNY) | 32,630.00 | ||||
| VAT (6% Medical Service Tax, China Beijing) | 1,957.80 | ||||
| GRAND TOTAL (CNY) | 34,587.80 | ||||
All procedures outlined in this Quotation Estimate will be supervised and, where indicated, personally performed by our senior Ophthalmologist team at the China Beijing facility. The lead surgeon, Dr. Wei Zhang, holds a Doctor of Medicine degree from Peking University Health Science Center and is a certified member of the Chinese Ophthalmological Society. The supporting team includes two resident ophthalmologists, a certified ophthalmic technician, and a dedicated patient-care coordinator fluent in Mandarin and English. All staff operate under the regulatory oversight of the Beijing Municipal Health Commission.
Payment for the services described in this Quotation Estimate shall be structured as follows:
- Deposit (30%): CNY 10,376.34 — due upon acceptance of this quotation, prior to scheduling the surgical date.
- Balance (70%): CNY 24,211.46 — due within 7 calendar days following the completion of the final post-operative follow-up visit.
Accepted payment methods include bank transfer (ICBC, CMB, or BOC accounts registered in China Beijing), Alipay, WeChat Pay, and major international credit cards (Visa, Mastercard). A 1.5% surcharge applies to international card transactions.
This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. Should the client require the Ophthalmologist services beyond this validity window, a revised quotation will be issued to reflect any changes in material costs, regulatory fees applicable in China Beijing, or updated clinical recommendations. This estimate assumes standard, uncomplicated surgical outcomes. In the event of intra-operative complications necessitating additional interventions, a supplementary Quotation Estimate will be presented to the client for written approval before any additional procedures are performed.
- This Quotation Estimate is a good-faith projection and does not guarantee a fixed final cost. Actual charges may vary by up to 10% based on clinical findings during the procedure.
- All Ophthalmologist services are subject to the patient's informed consent, signed in accordance with the Civil Code of the People's Republic of China and the Regulations on the Administration of Medical Institutions.
- The clinic reserves the right to reassign the treating Ophthalmologist in cases of medical emergency or unavailability, provided the substitute holds equivalent or superior qualifications.
- Confidentiality of all patient medical records is maintained in compliance with the Personal Information Protection Law (PIPL) of the People's Republic of China and Beijing municipal data-protection ordinances.
- Disputes arising from this Quotation Estimate or the services rendered shall be resolved through mediation by the Beijing Medical Dispute Mediation Committee, or, failing mediation, through the competent people's court in Haidian District, China Beijing.
- Refunds for the deposit are available within 14 days of payment if the client cancels prior to the scheduled surgical date, subject to a 5% administrative processing fee.
- This document is issued in duplicate. One copy is retained by the client and one by the clinic's medical records department in China Beijing.
By signing below, the client acknowledges receipt of this Quotation Estimate, confirms understanding of the proposed Ophthalmologist treatment plan, and authorizes Beijing Vision Care Ophthalmology Center to proceed with scheduling services in China Beijing upon receipt of the initial deposit.
For Beijing Vision Care Ophthalmology Center
Dr. Wei Zhang, Lead OphthalmologistDate: _______________
Client / Authorized Representative
Name (Printed): _______________Signature & Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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