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Quotation Estimate Optometrist in Brazil São Paulo –Free Word Template Download with AI

VALID QUOTATION

Provider:
Visão Clara Optometria Ltda.
Av. Paulista, 1578 — Bela Vista
São Paulo — SP — CEP 01310-300
CNPJ: 12.345.678/0001-90
Phone: +55 (11) 3456-7890
Email: [email protected]
Quotation No.: QE-2025-04872
Date Issued: 15 June 2025
Valid Until: 15 July 2025
Prepared By: Dra. Camila Ferreira, Optometrist
Registration: CRFO-SP 4521
CLIENT INFORMATION
Client Name: Empresa de Saúde Integral S.A. CNPJ: 98.765.432/0001-10
Address: Rua Oscar Freire, 2200 — Jardins, São Paulo — SP Contact: Sr. Roberto Almeida — (11) 98765-4321
Service Location: Corporate Health Center, São Paulo — SP Estimated Employees: 350
SCOPE OF SERVICES — OPTOMETRIST CONSULTATION PACKAGE

This Quotation Estimate is issued by Visão Clara Optometria Ltda., a licensed Optometrist practice operating in Brazil, São Paulo, to provide comprehensive optometric services for the corporate health program of the client. The Optometrist team will deliver on-site and clinic-based eye examinations, diagnostic assessments, and corrective lens prescriptions tailored to the workforce of the client organization. All services comply with the regulations established by the Conselho Brasileiro de Oftalmologia and the Brazilian Ministry of Health (Ministério da Saúde).

ITEMIZED SERVICES AND PRICING
# Service Description Quantity Unit Price (BRL) Subtotal (BRL) Duration
01 Comprehensive Optometrist Eye Examination (visual acuity, refraction, intraocular pressure, color vision, and binocular function assessment) 350 R$ 280,00 R$ 98.000,00 45 min per patient
02 Advanced Diagnostic Imaging (optical coherence tomography — OCT, fundus photography, and corneal topography) 350 R$ 195,00 R$ 68.250,00 20 min per patient
03 Prescription of Corrective Lenses (single vision, progressive, or occupational lenses) with detailed Optometrist report 350 R$ 120,00 R$ 42.000,00 15 min per patient
04 Occupational Vision Screening — specialized assessment for screen-based workers (blue light exposure, digital eye strain, and ergonomic visual recommendations) 200 R$ 150,00 R$ 30.000,00 30 min per patient
05 Follow-up Consultation with the Optometrist (three-month post-examination review for patients with identified visual conditions) 80 R$ 200,00 R$ 16.000,00 30 min per patient
06 On-site Equipment Setup and Calibration (portable phoropter, autorefractor, OCT unit, and lighting rig) at the client facility in São Paulo 1 R$ 8.500,00 R$ 8.500,00 2 days
07 Written Optometrist Clinical Report per employee (in Portuguese, with English summary) and consolidated corporate report for HR and occupational health departments 351 R$ 45,00 R$ 15.795,00 5 business days
08 Health & Safety Training Session for HR staff on visual health awareness, screen ergonomics, and early detection of ocular pathologies (delivered by the lead Optometrist) 1 R$ 3.200,00 R$ 3.200,00 3 hours
TOTAL ESTIMATED COST (BRL) R$ 281.745,00
Note: All prices are quoted in Brazilian Reais (BRL) and include applicable ICMS (18%) and ISS (5%) taxes for the municipality of São Paulo. Prices are exclusive of any corrective lens manufacturing, which will be quoted separately upon prescription issuance. This Quotation Estimate assumes standard business hours (08:00–18:00, Monday to Friday) for on-site service delivery in São Paulo. TERMS AND CONDITIONS
  • This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After the expiration date, prices may be subject to revision based on market conditions in Brazil, São Paulo.
  • Payment terms: 50% advance payment upon contract signing and 50% upon completion of all services and delivery of the final consolidated Optometrist report. Payment via bank transfer (TED/PIX) to the account of Visão Clara Optometria Ltda.
  • The Optometrist services will be performed by licensed professionals registered with the Conselho Brasileiro de Oftalmologia (CBO) and the Conselho Regional de Medicina (CRM-SP), ensuring full compliance with Brazilian healthcare regulations.
  • Scheduling of individual patient examinations will be coordinated between the client's HR department and our São Paulo operations team, with a minimum of ten (10) business days' notice for on-site visits.
  • All patient data will be handled in strict accordance with the Brazilian General Data Protection Law (LGPD — Lei Geral de Proteção de Dados, Law No. 13.709/2018). Clinical records will be stored securely and accessible only to authorized personnel.
  • Any additional services beyond the scope defined in this Quotation Estimate will be subject to a separate written agreement and additional cost.
  • In the event of force majeure (including but not limited to public health emergencies, natural disasters, or government-mandated closures in São Paulo), both parties agree to reschedule affected services without penalty.
  • This Quotation Estimate does not constitute a binding contract. A formal service agreement must be executed by both parties prior to the commencement of any Optometrist services.
ACCEPTANCE

By signing below, the client acknowledges receipt of this Quotation Estimate for Optometrist services in Brazil, São Paulo, and agrees to the terms and conditions outlined herein. The service provider confirms availability of the Optometrist team and equipment as described.

For the Client
Empresa de Saúde Integral S.A.
Name / CNPJ / Date
For the Provider
Visão Clara Optometria Ltda.
Dra. Camila Ferreira, Optometrist
CRFO-SP 4521 / Date

Visão Clara Optometria Ltda. — CNPJ 12.345.678/0001-90 — Av. Paulista, 1578, São Paulo — SP — Brazil

This Quotation Estimate was generated on 15 June 2025. Document reference: QE-2025-04872. For inquiries, contact our São Paulo office at +55 (11) 3456-7890.

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