Quotation Estimate Ophthalmologist in Turkey Ankara –Free Word Template Download with AI
Ankara Vision Care & Ophthalmology Center
Kızılay Mahallesi, Atakule Caddesi No: 42, Çankaya, 06520 Ankara, Turkey
Tel: +90 (312) 445 6789 | Email: [email protected]
Tax ID (VKN): 1234567890 | MERSIS: 0123004567890123
This Quotation Estimate is issued by Ankara Vision Care & Ophthalmology Center to provide a comprehensive and transparent breakdown of all anticipated costs associated with the full-spectrum Ophthalmologist consultation, diagnostic, and treatment services to be delivered at our facility located in the heart of Turkey Ankara. This document serves as a formal financial proposal and does not constitute a binding contract until both parties have reviewed, agreed upon, and executed the final service agreement. All pricing presented herein reflects the current market rates for specialized ophthalmic care in the Turkey Ankara metropolitan region as of the date of issuance.
| Field | Details |
|---|---|
| Patient Name | Mr. James R. Whitfield |
| Passport / ID No. | GB-448291057 |
| Country of Residence | United Kingdom |
| Referring Physician | Dr. Sarah Mitchell, NHS London |
| Primary Concern | Progressive bilateral cataracts with early-stage glaucoma; comprehensive retinal evaluation |
The following Ophthalmologist services have been recommended by our senior medical team following the initial pre-assessment conducted on 10 June 2025. Each service is performed by a board-certified Ophthalmologist with a minimum of fifteen years of clinical experience in the Turkey Ankara healthcare system. All procedures comply with the standards set forth by the Turkish Ministry of Health and the European Society of Ophthalmology (EURETINA) guidelines.
| Item No. | Service Description | Unit | Qty | Unit Price (EUR) | Total (EUR) |
|---|---|---|---|---|---|
| 01 | Comprehensive Ophthalmologist Consultation & Medical History Review | Session | 1 | 120.00 | 120.00 |
| 02 | Full Diagnostic Workup (OCT, Fundus Photography, Visual Field Test, Pachymetry, Biometry) | Package | 1 | 380.00 | 380.00 |
| 03 | Phacoemulsification Cataract Surgery with Premium Toric IOL (per eye) | Eye | 2 | 1,450.00 | 2,900.00 |
| 04 | Glaucoma Management Plan (Medication + 3 Follow-up Visits over 6 months) | Package | 1 | 420.00 | 420.00 |
| 05 | Retinal Evaluation with Fluorescein Angiography | Session | 1 | 250.00 | 250.00 |
| 06 | Post-Operative Ophthalmologist Follow-up Visits (Week 1, Week 4, Month 3) | Visit | 3 | 85.00 | 255.00 |
| 07 | Prescription Medications & Post-Surgical Eye Drops (3-month supply) | Package | 1 | 185.00 | 185.00 |
| 08 | Airport Transfer & 3-Night Accommodation Coordination in Turkey Ankara | Package | 1 | 650.00 | 650.00 |
| 09 | Medical Interpreter (English–Turkish) for All Consultations | Day | 2 | 150.00 | 300.00 |
| 10 | Comprehensive Medical Report & International Referral Documentation | Document | 1 | 95.00 | 95.00 |
| SUBTOTAL | 5,655.00 | ||||
| VAT (20% – Turkey) | 1,131.00 | ||||
| GRAND TOTAL (EUR) | 6,786.00 | ||||
- This Quotation Estimate is valid for thirty (30) calendar days from the date of issuance. After the expiry date, all prices are subject to revision based on current Turkey Ankara healthcare market conditions and supplier pricing.
- A non-refundable deposit of 40% of the grand total (EUR 2,714.40) is required to secure the Ophthalmologist appointment schedule and reserve the surgical suite. The remaining 60% balance is due within seven (7) business days following the completion of all procedures.
- Payment may be made via international bank transfer (IBAN: TR33 0006 4000 0011 2345 6789 01), credit card (Visa, Mastercard, American Express), or secure online payment gateway. All transactions are processed in compliance with Turkish financial regulations.
- The Ophthalmologist team reserves the right to modify the treatment plan if intra-operative findings necessitate additional or alternative procedures. Any such modifications will be communicated to the patient or their authorized representative prior to implementation, and a supplementary Quotation Estimate will be issued for approval.
- All medical records, diagnostic imaging, and surgical reports generated during the course of treatment at our Turkey Ankara facility are the property of the patient. Digital copies will be provided in DICOM and PDF formats within five (5) business days of the final follow-up visit.
- This Quotation Estimate does not include costs for emergency interventions, complications requiring extended hospitalization beyond the standard three-day post-operative stay, or any services not explicitly listed in Section 4 above.
- The patient acknowledges that all Ophthalmologist procedures carry inherent medical risks. A detailed informed consent form, translated into English, will be presented and signed prior to any surgical intervention.
- Any disputes arising from this Quotation Estimate or the subsequent service agreement shall be governed by the laws of the Republic of Turkey and subject to the exclusive jurisdiction of the competent courts in Turkey Ankara.
- Our facility maintains full medical malpractice insurance coverage through a licensed Turkish insurer, with a minimum coverage of EUR 1,000,000 per incident, in accordance with the requirements of the Turkish Ministry of Health.
By signing below, the client acknowledges receipt of this Quotation Estimate and agrees to the terms and conditions outlined herein. The Ophthalmologist services described will be scheduled upon receipt of the required deposit and a signed service agreement. The undersigned representative of Ankara Vision Care & Ophthalmology Center confirms that all information contained in this document is accurate and that the Ophthalmologist team is fully qualified to deliver the services described in this Turkey Ankara facility.
Client SignatureMr. James R. Whitfield
Date: ____________________ Authorized Representative
Dr. Ayşe Kaya, MD, PhD
Lead Ophthalmologist & Medical Director
Ankara Vision Care & Ophthalmology Center
Date: ____________________ ⬇️ Download as DOCX Edit online as DOCX
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