Quotation Estimate Ophthalmologist in Egypt Cairo –Free Word Template Download with AI

Quotation No.: QTE-CAI-2025-03847
Date of Issue: 15 June 2025
Valid Until: 15 July 2025 Prepared For:
Mr. Ahmed Hassan El-Sayed
45 Maadi Road, Maadi District
Egypt Cairo, 11728
Phone: +20 100 555 7823 1. Purpose of This Quotation Estimate

This Quotation Estimate is issued by Nile Vision & Ophthalmology Center, a fully licensed and accredited ophthalmic practice located in the heart of Egypt Cairo, to provide Mr. Ahmed Hassan El-Sayed with a detailed and transparent breakdown of all anticipated costs associated with the recommended Ophthalmologist consultation, diagnostic examinations, and corrective treatment plan. This document serves as a formal financial projection and does not constitute a binding contract until both parties have signed and accepted the terms outlined herein. All pricing is quoted in Egyptian Pounds (EGP) and reflects the current market rates for premium Ophthalmologist services available in the Egypt Cairo metropolitan area as of the date of issue.

2. Scope of Ophthalmologist Services Included

The following Ophthalmologist services have been recommended following the initial screening conducted at our Egypt Cairo clinic on 10 June 2025. Each service is performed by a board-certified Ophthalmologist with over fifteen years of clinical experience in anterior and posterior segment eye care, refractive surgery, and ocular pathology management.

Item No.	Description of Ophthalmologist Service	Quantity	Unit Price (EGP)	Total (EGP)
01	Comprehensive Ophthalmologist Consultation & Medical History Review (45 minutes)	1	1,500	1,500
02	Dilated Fundus Examination & Optical Coherence Tomography (OCT) Scan	2	1,200	2,400
03	Automated Refraction & Keratometry Assessment by Senior Ophthalmologist	1	800	800
04	Intraocular Pressure Measurement (Gonioscopy & Tonometry)	2	600	1,200
05	Phacoemulsification Cataract Surgery (Monofocal IOL) – Bilateral	2	28,000	56,000
06	Post-Operative Ophthalmologist Follow-Up Visits (4 sessions over 6 weeks)	4	750	3,000
07	Prescription Medications & Post-Surgical Eye Drops (30-day supply)	1	2,200	2,200
08	Custom Prescription Spectacles (Anti-Reflective Coating, Blue-Light Filter)	1	4,500	4,500
09	Annual Ophthalmologist Preventive Eye Screening Package (Next 12 months)	1	3,500	3,500
SUBTOTAL				75,100
VAT (14% – Egyptian Tax Authority)				10,514
GRAND TOTAL (EGP)				85,614

3. Payment Terms & Conditions

Payment Schedule: A 40% deposit (EGP 34,245.60) is due upon acceptance of this Quotation Estimate to secure the Ophthalmologist surgical slot. The remaining 60% balance (EGP 51,368.40) shall be settled no later than 72 hours prior to the scheduled surgical procedure at our Egypt Cairo facility.
Accepted Payment Methods: Cash, bank transfer (CIB, NBE, or QNB Egypt), and major credit/debit cards (Visa, Mastercard). Installment plans of up to 6 months are available for surgical packages exceeding EGP 50,000, subject to credit approval.
Validity: This Quotation Estimate remains valid for thirty (30) calendar days from the date of issue. Prices are subject to revision based on fluctuations in medical supply costs, currency exchange rates, or changes in Egyptian healthcare regulations.
Insurance & Reimbursement: Nile Vision & Ophthalmology Center is empaneled with major Egyptian insurance providers including MetLife Egypt, AXA Egypt, and the Social Insurance Fund. The patient is advised to verify coverage eligibility with their insurer prior to accepting this estimate. Our Ophthalmologist team will assist in preparing all necessary documentation for claims submission.
Cancellation Policy: Should the patient wish to cancel the scheduled Ophthalmologist procedure, a 48-hour advance notice is required. Cancellations within 48 hours of the procedure will incur a 25% non-refundable fee on the deposit amount.
Warranty: All surgical interventions performed by our Ophthalmologist team carry a 12-month clinical warranty covering re-intervention for complications directly attributable to the surgical procedure, in accordance with Egyptian Medical Syndicate guidelines.

4. Facility & Regulatory Compliance

Nile Vision & Ophthalmology Center operates in full compliance with the Egyptian Ministry of Health and Population regulations governing ophthalmic surgical facilities. Our Ophthalmologist team is registered with the Egyptian Medical Syndicate, and all surgical procedures are conducted in a fully accredited operating theatre equipped with state-of-the-art phacoemulsification machines, femtosecond laser systems, and intraoperative OCT. The center is located in the Zamalek district of Egypt Cairo, offering convenient access for patients residing across Greater Cairo, including the districts of Maadi, Heliopolis, Nasr City, and Giza. Parking, wheelchair accessibility, and multilingual (Arabic/English) patient support are available on all floors of the facility.

5. Acceptance & Authorization

By signing below, the patient acknowledges receipt of this Quotation Estimate, confirms understanding of the recommended Ophthalmologist treatment plan, and authorizes Nile Vision & Ophthalmology Center to proceed with the outlined services at the Egypt Cairo location. The patient further confirms that all medical information has been disclosed and that the Ophthalmologist has explained all potential risks, alternatives, and expected outcomes in a language the patient fully comprehends.

Patient / Authorized Representative

Name: ______________________________ Signature: ______________________________ Date: ______________________________

Nile Vision & Ophthalmology Center

Dr. Mona Fathy – Lead Ophthalmologist Signature: ______________________________ Date: ______________________________ ⬇️ Download as DOCX Edit online as DOCX

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