Quotation Estimate Ophthalmologist in Japan Osaka –Free Word Template Download with AI
Osaka Vision Care Center
2-14-8 Umeda, Kita-ku, Osaka 530-0001, Japan Osaka
Tel: +81-6-6371-8800 | Email: [email protected]
License No. JP-OPH-2024-00482 | Medical Institution Registration: Osaka Prefecture #7721
Quotation Details
Quotation Estimate No.: QTE-2025-OSK-0317
Date of Issue: June 12, 2025
Valid Until: July 12, 2025 (30 days)
Prepared By: Dr. Kenji Tanaka, MD, PhD (Ophthalmologist)
Service Location: Japan Osaka, Umeda Medical District
Client Information
Client Name: Mr. David R. Mitchell
Company: Pacific Rim Trading Co., Ltd.
Address: 15-3-9 Nakanoshima, Kita-ku, Osaka, Japan
Contact: +81-90-5521-3344
Email: [email protected]
1. SCOPE OF OPTHALMOLOGIST SERVICES – JAPAN OSAKAThis Quotation Estimate is issued by Osaka Vision Care Center, a licensed ophthalmology practice located in the heart of Japan Osaka, to provide comprehensive ophthalmological examination, diagnostic, and treatment services for the client identified above. All services described herein will be performed by a board-certified Ophthalmologist and supporting clinical staff at our facility in Umeda, Osaka. This Quotation Estimate covers a full-cycle ophthalmic care package including initial consultation, advanced diagnostic imaging, corrective treatment planning, and follow-up monitoring over a twelve-month period.
2. ITEMIZED COST BREAKDOWN| No. | Service / Item Description | Quantity | Unit Price (JPY) | Subtotal (JPY) | Notes |
|---|---|---|---|---|---|
| 1 | Initial Ophthalmologist Consultation & Comprehensive Eye Examination (visual acuity, refraction, intraocular pressure, slit-lamp biomicroscopy) | 1 session | 18,000 | 18,000 | Conducted by Dr. Tanaka, Ophthalmologist |
| 2 | Advanced Diagnostic Imaging – OCT (Optical Coherence Tomography) & Fundus Photography | 1 session | 25,000 | 25,000 | Retinal and macular assessment |
| 3 | Corneal Topography & Pachymetry (for contact lens fitting or pre-surgical evaluation) | 1 session | 15,000 | 15,000 | Includes digital report |
| 4 | Visual Field Testing (Humphrey Perimetry) – Bilateral | 2 sessions | 12,000 | 24,000 | Glaucoma screening protocol |
| 5 | Prescription of Corrective Lenses (bifocal / progressive) – Pair | 1 pair | 45,000 | 45,000 | Includes anti-reflective coating |
| 6 | Quarterly Follow-up Ophthalmologist Review (4 visits over 12 months) | 4 visits | 10,000 | 40,000 | Monitoring & prescription updates |
| 7 | Emergency Ophthalmologist On-Call Access (Japan Osaka coverage, 24/7) | 12 months | 8,000 | 96,000 | Priority triage line & same-day slot |
| 8 | Pharmacological Treatment – Topical Medications (12-month supply) | 12 months | 6,500 | 78,000 | Prescription drops & ointments |
| 9 | Administrative & Medical Record Management Fee | 1 year | 5,000 | 5,000 | Digital records, insurance filing |
| SUBTOTAL (before tax) | 346,000 | ||||
| Consumption Tax (10% – Japan Osaka rate) | 34,600 | ||||
| TOTAL ESTIMATED COST (JPY) | 380,600 | ≈ USD 2,537 | |||
- This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After the expiration date, pricing may be subject to revision based on changes in medical supply costs, pharmaceutical pricing, or regulatory adjustments within Japan Osaka.
- All ophthalmologist services listed in this Quotation Estimate will be performed at the Osaka Vision Care Center facility located in Kita-ku, Japan Osaka, or at such other approved clinical site as mutually agreed upon in writing.
- The Ophthalmologist responsible for the primary care of the client is Dr. Kenji Tanaka, MD, PhD, a specialist in refractive surgery, glaucoma management, and retinal disorders, registered with the Japan Medical Association and the Osaka Prefectural Medical Board.
- Payment terms: 50% deposit due upon acceptance of this Quotation Estimate; remaining 50% due within fourteen (14) days of the final service delivery. Payment may be made via bank transfer (yen-denominated account), credit card, or corporate invoice billing.
- This Quotation Estimate does not constitute a binding contract until countersigned by both parties. Acceptance is indicated by signature and date in the section below.
- Any additional ophthalmological procedures not explicitly listed herein (e.g., cataract surgery, LASIK, vitreoretinal intervention) will be subject to a separate, supplemental Quotation Estimate issued by the treating Ophthalmologist prior to the procedure.
- All medical data and records generated under this engagement will be handled in strict accordance with Japan's Personal Information Protection Act (PIPA) and the medical confidentiality standards enforced in Japan Osaka.
- Cancellation or rescheduling of scheduled Ophthalmologist appointments must be communicated at least 48 hours in advance. Cancellations within 48 hours may incur a 20% administrative fee on the scheduled session value.
- This Quotation Estimate is prepared exclusively for the named client and may not be transferred, assigned, or applied to any other individual or entity without prior written consent from Osaka Vision Care Center.
- In the event of a medical emergency outside scheduled hours, the client may access the 24/7 Ophthalmologist on-call service in Japan Osaka as described in Item 7. Emergency consultations are billed at the rate specified in this Quotation Estimate.
By signing below, the client acknowledges receipt of this Quotation Estimate for Ophthalmologist services in Japan Osaka and agrees to the terms and conditions outlined above. The undersigned Ophthalmologist confirms that the services, pricing, and clinical protocols described are accurate and available for delivery at the stated facility.
For Osaka Vision Care Center
Dr. Kenji Tanaka, MD, PhD
Ophthalmologist – Principal Physician
Signature: ___________________________
Date: ___________________________
For the Client
Mr. David R. Mitchell
Pacific Rim Trading Co., Ltd.
Signature: ___________________________
Date: ___________________________
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