Quotation Estimate Ophthalmologist in Spain Valencia –Free Word Template Download with AI
Professional Ophthalmologist Services — Spain Valencia
Ref: QTE-VAL-2025-0847
Service Provider
Clinica Ocular del Turia
Av. del Cid, 142, 46003
Valencia, Spain
Tel: +34 963 555 210
Email: [email protected]
NIF: B-46882317
Client / Patient
Mr. / Ms. [Full Name]
[Street Address]
[Postal Code], Valencia, Spain
Tel: +34 [Phone Number]
Email: [Email Address]
NIE / DNI: [Identification Number]
Quotation Estimate Date: 15 June 2025
Valid Until: 15 July 2025 (30 calendar days)
Currency: EUR (€)
Payment Terms: 50% upon booking, 50% upon completion of treatment
Service Location: Clinica Ocular del Turia, Valencia, Spain
This Quotation Estimate has been prepared by our licensed Ophthalmologist team at Clinica Ocular del Turia, located in the heart of Spain Valencia, to provide a comprehensive and transparent breakdown of all ophthalmological services requested. As a specialist Ophthalmologist practice registered with the Colegio Oficial de Médicos de Valencia, we are committed to delivering the highest standard of eye care in the Valencia region of Spain. The following Quotation Estimate covers a full diagnostic and therapeutic package tailored to the patient's specific ophthalmological needs.
| # | Service Description | Ophthalmologist Specialist | Qty | Unit Price (€) | Subtotal (€) |
|---|---|---|---|---|---|
| 1 | Comprehensive Ophthalmologist Consultation & Initial Eye Examination (visual acuity, refraction, intraocular pressure, slit-lamp biomicroscopy) | Dr. Elena Marchetti, Ophthalmologist | 1 | 120.00 | 120.00 |
| 2 | Dilated Fundus Examination with Optical Coherence Tomography (OCT) — performed by senior Ophthalmologist | Dr. Carlos Ferrer, Ophthalmologist | 1 | 95.00 | 95.00 |
| 3 | Corneal Topography & Pachymetry Assessment (Ophthalmologist-supervised diagnostic imaging) | Dr. Elena Marchetti, Ophthalmologist | 1 | 75.00 | 75.00 |
| 4 | Anterior Segment Ultrasound (B-Scan) — Ophthalmologist referral diagnostic | Dr. Miguel Sánchez, Ophthalmologist | 1 | 60.00 | 60.00 |
| 5 | Cataract Surgical Procedure (Phacoemulsification with Premium IOL implant) — performed by Lead Ophthalmologist | Dr. Elena Marchetti, Ophthalmologist | 2 (both eyes) | 1,850.00 | 3,700.00 |
| 6 | Post-Operative Ophthalmologist Follow-Up Visits (3 scheduled reviews at 1 week, 1 month, and 3 months) | Dr. Carlos Ferrer, Ophthalmologist | 3 | 55.00 | 165.00 |
| 7 | Prescription of Post-Operative Medication (antibiotic drops, anti-inflammatory drops, lubricant drops) — dispensed at Spain Valencia clinic pharmacy | Clinic Pharmacy, Valencia | 1 | 48.00 | 48.00 |
| 8 | Custom Prescription Spectacles (post-surgical) — optician service in Spain Valencia | Optical Partner, Valencia | 1 | 210.00 | 210.00 |
| 9 | Administrative & Medical Record Filing (Spain Valencia regional health registry compliance) | Clinic Administration | 1 | 25.00 | 25.00 |
| TOTAL QUOTATION ESTIMATE (before IVA) | 4,498.00 | ||||
| IVA (21% — Spain Valencia tax rate) | 944.58 | ||||
| GRAND TOTAL (Quotation Estimate Final Amount) | 5,442.58 | ||||
- This Quotation Estimate is issued by Clinica Ocular del Turia, a registered Ophthalmologist practice in Spain Valencia, and is valid for a period of thirty (30) calendar days from the date of issue. After this period, prices may be subject to revision due to changes in medical supply costs or regulatory adjustments in the Valencia region of Spain.
- All Ophthalmologist services listed in this Quotation Estimate are to be performed at our facility located in Valencia, Spain, or at the designated surgical centre in the Turia district of Valencia. The patient must present valid identification (DNI, NIE, or passport) at the time of the Ophthalmologist consultation.
- The Ophthalmologist team reserves the right to modify the surgical plan during the pre-operative assessment if additional ophthalmological interventions are deemed medically necessary. Any such modifications will be communicated to the patient in writing, and a supplementary Quotation Estimate will be issued prior to any additional procedure.
- Payment of the 50% booking deposit is required to confirm the Ophthalmologist appointment and secure the surgical date. The remaining 50% balance is due within seven (7) business days following the completion of the final post-operative Ophthalmologist follow-up visit in Spain Valencia.
- This Quotation Estimate does not include emergency Ophthalmologist consultations, hospitalisation beyond the standard day-surgery protocol, or any services arising from pre-existing conditions not disclosed at the initial Ophthalmologist examination.
- All medical data processed under this Quotation Estimate is handled in strict compliance with the Spanish Organic Law 3/2018 on Personal Data Protection (LOPDGDD) and the European General Data Protection Regulation (GDPR). The Ophthalmologist and clinic staff in Spain Valencia are bound by professional confidentiality under the Spanish Medical Code of Ethics.
- In the event of cancellation by the patient, a 20% administrative fee of the total Quotation Estimate amount will be retained if cancellation occurs less than 14 days before the scheduled Ophthalmologist procedure date.
- This Quotation Estimate is governed by the laws of Spain, and any disputes arising from the services described herein shall be subject to the exclusive jurisdiction of the courts of Valencia, Spain.
By signing below, the patient acknowledges receipt of this Quotation Estimate for Ophthalmologist services in Spain Valencia, confirms understanding of all terms and conditions, and authorises the Ophthalmologist team at Clinica Ocular del Turia to proceed with the outlined ophthalmological care plan.
Patient SignatureName: ___________________________
Date: ___________________________ Ophthalmologist / Clinic Representative
Dr. Elena Marchetti, Ophthalmologist
Clinica Ocular del Turia, Valencia, Spain
Date: ___________________________ ⬇️ Download as DOCX Edit online as DOCX
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