Quotation Estimate Optometrist in Australia Sydney –Free Word Template Download with AI
ABN: 48 123 456 789 | AHPRA Registration: OPT-2024-001234
Level 3, 128 George Street, Sydney NSW 2000, Australia
Phone: +61 2 9300 4567 | Email: [email protected]
Quotation EstimateQuotation Details
Quotation No.: QTE-2025-00487
Date Issued: 15 June 2025
Valid Until: 15 July 2025
Prepared By: Dr. Sarah Mitchell, Optometrist
Client Information
Name: Mr. James Anderson
Address: 45 Parramatta Road, Leichhardt NSW 2040
Phone: +61 412 345 678
Email: [email protected]
Dear Mr. Anderson,
Thank you for contacting Sydney Vision Care Optometry Centre regarding your comprehensive eye care requirements. This Quotation Estimate has been prepared by our registered Optometrist team to provide you with a detailed breakdown of the professional services, diagnostic procedures, and optical products recommended following your initial consultation on 10 June 2025. As a licensed practice operating in Australia Sydney, we are committed to delivering the highest standard of optometric care in accordance with the Australian Optometry Board of Health Practitioner Regulation Agency (AHPRA) guidelines.
| Ref | Description of Service / Product | Category | Qty | Unit Price (AUD) | Total (AUD) |
|---|---|---|---|---|---|
| 01 | Comprehensive Optometric Examination (including visual acuity, refraction, binocular vision assessment, and ocular health screening) | Professional Service | 1 | $185.00 | $185.00 |
| 02 | Dilated Fundus Examination with Digital Retinal Photography (both eyes) | Diagnostic Procedure | 1 | $95.00 | $95.00 |
| 03 | Optical Coherence Tomography (OCT) Scan – Macular and Peripapillary | Diagnostic Procedure | 1 | $120.00 | $120.00 |
| 04 | Intraocular Pressure Measurement (Non-Contact Tonometry) | Diagnostic Procedure | 1 | $45.00 | $45.00 |
| 05 | Corneal Topography and Pachymetry Assessment | Diagnostic Procedure | 1 | $85.00 | $85.00 |
| 06 | Prescription Spectacles – Frame (Designer, Titanium Alloy, Anti-Reflective Coating) | Optical Product | 1 | $420.00 | $420.00 |
| 07 | Progressive Lenses (Premium Digital Free-Form, 1.67 Index, Blue-Light Filter) | Optical Product | 2 | $385.00 | $770.00 |
| 08 | UV400 Protection and Anti-Scratch Hard Coating (applied to both lenses) | Optical Product | 1 | $65.00 | $65.00 |
| 09 | Follow-Up Adaptation Appointment (within 14 days of lens fitting) | Professional Service | 1 | $75.00 | $75.00 |
| 10 | Annual Eye Health Check (next 12 months, includes re-examination and OCT) | Professional Service | 1 | $150.00 | $150.00 |
| Subtotal | $2,210.00 | ||||
| GST (10%) | $221.00 | ||||
| Grand Total (AUD) | $2,431.00 | ||||
Based on the findings of your initial consultation, our Optometrist, Dr. Sarah Mitchell, has identified early signs of presbyopia progression and mild dry eye symptoms. The comprehensive diagnostic package outlined in this Quotation Estimate is designed to establish a complete baseline of your ocular health. The recommended progressive lenses with a 1.67 refractive index will provide optimal visual correction for both distance and near tasks while maintaining a slim, aesthetically pleasing lens profile. The inclusion of a blue-light filter is particularly relevant given your reported screen time of approximately eight hours per day.
We would like to note that as a registered practice in Australia Sydney, all services provided are covered under the Australian Consumer Law. Your prescription spectacles carry a 12-month manufacturer's warranty against defects in materials and workmanship. The optical products listed are sourced from accredited Australian and international suppliers and meet all Australian Standards (AS/NZS) for optical safety.
- Payment Due: Full payment is due within 14 days of the date of this Quotation Estimate. A 50% deposit is required to secure your appointment and commence lens manufacturing.
- Accepted Payment Methods: Credit card (Visa, Mastercard, American Express), EFTPOS, bank transfer, and HICAPS (for eligible Medicare and private health insurance claims).
- Insurance: This Quotation Estimate may be partially covered by your private health insurance optical benefit. Please provide your health fund details to our front desk to process a direct claim where applicable.
- Quotation Validity: This Quotation Estimate remains valid for 30 days from the date of issue. Prices are subject to change after the validity period due to supplier cost adjustments.
- Delivery / Fitting: Prescription spectacles will be ready for collection within 10 to 14 business days from the date of confirmed order. A fitting and adjustment session will be scheduled at your convenience.
- Cancellation: Should you wish to cancel after the deposit has been paid, the deposit is non-refundable as lens manufacturing will have commenced.
- Warranty: All optical products are covered by a 12-month warranty. The follow-up adaptation appointment is included at no additional cost within the first 14 days.
- Privacy: All patient information is handled in strict accordance with the Australian Privacy Act 1988 and the Privacy Act 1988 (Cth). Your optometric records will be stored securely in compliance with AHPRA regulations.
By signing below, you acknowledge that you have received and reviewed this Quotation Estimate for the optometric services and products described herein. You agree to the terms and conditions outlined above and authorise Sydney Vision Care Optometry Centre to proceed with the recommended care plan.
Client Signature: ___________________________
Name: James Anderson
Date: _______________
Optometrist Signature: ___________________________
Name: Dr. Sarah Mitchell, AOPB Reg. No. 12345
Date: 15 June 2025
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