Quotation Estimate Ophthalmologist in Uzbekistan Tashkent –Free Word Template Download with AI
Ophthalmologist Diagnostic & Treatment Services
Tashkent, Uzbekistan
Document No. QTE-2025-0487Provided By
Tashkent Vision Care Center
142 Amir Temur Avenue, Mirzo Ulug'bek District
Tashkent, 100171, Uzbekistan
Tel: +998 (71) 200-45-67
Email: [email protected]
License No. UZ-MED-2019-0342
Prepared For
Client Name: [Patient / Referring Physician]
Address: Tashkent, Uzbekistan
Phone: +998 (__) ___-__-__
Date of Issue: 15 June 2025
Valid Until: 15 July 2025 (30 days)
Dear Valued Client,
Thank you for considering Tashkent Vision Care Center for your ophthalmological needs. This Quotation Estimate outlines the comprehensive range of Ophthalmologist services available at our facility in Tashkent, Uzbekistan. Our team of board-certified Ophthalmologist specialists is dedicated to providing world-class eye care tailored to the needs of patients in the Uzbekistan Tashkent region and beyond. All pricing below is presented in Uzbek Som (UZS) with approximate USD equivalents for international clients.
| # | Service Description | Quantity | Unit Price (UZS) | Total (UZS) |
|---|---|---|---|---|
| 1 | Comprehensive Ophthalmologist Consultation & Eye Examination (including visual acuity, refraction, and intraocular pressure measurement) | 1 session | 350,000 | 350,000 |
| 2 | Dilated Fundus Examination by Senior Ophthalmologist (retinal assessment with mydriatic drops) | 1 session | 280,000 | 280,000 |
| 3 | OCT (Optical Coherence Tomography) – Macular & Retinal Imaging | 2 scans | 450,000 | 900,000 |
| 4 | Ultrasound B-Scan of the Eye (for media opacity assessment) | 1 session | 220,000 | 220,000 |
| 5 | Corneal Topography & Pachymetry (for contact lens fitting or pre-surgical evaluation) | 1 session | 380,000 | 380,000 |
| 6 | Phacoemulsification Cataract Surgery with Premium IOL (per eye, including Ophthalmologist surgeon fee, anesthesiology, and hospital stay of 1 night) | 1 eye | 4,500,000 | 4,500,000 |
| 7 | Post-Operative Ophthalmologist Follow-Up Visits (3 visits over 6 weeks) | 3 visits | 200,000 | 600,000 |
| 8 | Prescription Medications & Post-Operative Eye Drops (steroidal, antibiotic, and lubricating drops) | 1 set | 420,000 | 420,000 |
| 9 | Visual Field Testing (Humphrey Perimetry) – for glaucoma monitoring | 1 session | 300,000 | 300,000 |
| 10 | Fluorescein Fundus Angiography (FFA) – vascular retinal assessment | 1 session | 650,000 | 650,000 |
| Subtotal (UZS): | 8,600,000 | |||
| VAT (12% – Uzbekistan standard rate): | 1,032,000 | |||
| Grand Total (UZS): | 9,632,000 | |||
| Approximate USD Equivalent (at 12,800 UZS/USD): | ≈ 752.50 USD | |||
- This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. After this period, pricing may be subject to revision based on current market conditions in Tashkent, Uzbekistan.
- All Ophthalmologist services listed above are to be performed at the Tashkent Vision Care Center facility located in the Mirzo Ulug'bek District of Tashkent, Uzbekistan. The facility operates in compliance with the Ministry of Health of the Republic of Uzbekistan regulations.
- Surgical procedures (Item 6) require a minimum of 48 hours' advance scheduling. The Ophthalmologist surgeon will conduct a pre-operative assessment to confirm patient eligibility before proceeding.
- Payment terms: 50% deposit is due upon acceptance of this Quotation Estimate. The remaining 50% balance is payable prior to the commencement of any surgical procedure. Non-surgical diagnostic services are payable in full at the time of service.
- Accepted payment methods include: bank transfer to the clinic's account at National Bank of Uzbekistan, cash payment in Uzbek Som (UZS), and major international credit cards (Visa, Mastercard) for clients residing outside Uzbekistan Tashkent.
- All medical records, diagnostic imaging, and Ophthalmologist consultation notes will be maintained in accordance with Uzbekistan's data protection and medical confidentiality laws. Patients may request a complete copy of their records in writing.
- This Quotation Estimate does not constitute a binding medical treatment plan. The final scope of Ophthalmologist services may be adjusted following the initial comprehensive examination, and any additional procedures will be communicated to the patient with a supplementary estimate prior to authorization.
- In the event of medical emergencies or complications requiring unscheduled intervention, the Ophthalmologist on duty will provide necessary care, and additional charges will be documented in a separate addendum to this Quotation Estimate.
- Insurance: This estimate is prepared for private-pay clients. For patients with international health insurance or Uzbekistan state medical insurance (OMS), a separate authorization letter must be obtained prior to service delivery.
By signing below, the client acknowledges receipt of this Quotation Estimate for Ophthalmologist services at Tashkent Vision Care Center, Tashkent, Uzbekistan, and agrees to the terms and conditions outlined above.
Prepared By:Dr. Aziz Karimov, MD, PhD
Lead Ophthalmologist & Director
Tashkent Vision Care Center
Date: _______________ Accepted By (Client):
Name: _________________________
Signature: _________________________
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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