Quotation Estimate Optometrist in India Bangalore –Free Word Template Download with AI
2nd Floor, Prestige Tech Park, Outer Ring Road, Koramangala, Bangalore, Karnataka 560034, India
Phone: +91-80-4123-5678 | Email: [email protected]
GSTIN: 29ABCDE1234F1Z5 | CIN: U74999KA2019PTC123456
Quotation EstimateQuotation Details
Quotation No.: CV-EST-2025-00472
Date of Issue: 15 June 2025
Valid Until: 15 July 2025 (30 days)
Prepared By: Dr. Ananya Sharma, B.Optom, M.Optom
Location: Bangalore, Karnataka, India
Client / Recipient
Name: Mr. Rajesh Kumar Nair
Address: 45, 12th Main, HSR Layout, Sector 2, Bangalore, Karnataka 560102, India
Phone: +91-98765-43210
Email: [email protected]
GSTIN (if applicable): 29XXXXX1234X1Z2
Dear Mr. Nair,
Thank you for considering ClearVision Optometry Centre for your comprehensive eye care needs. This Quotation Estimate outlines the full scope of Optometrist services, diagnostic procedures, and corrective lens solutions we propose for your complete visual assessment and management. All services will be delivered at our state-of-the-art facility in Koramangala, Bangalore, India, equipped with the latest diagnostic technology and staffed by certified Optometrists and ophthalmic technicians.
| S.No. | Description of Optometrist Service | Qty | Unit Price (INR) | Amount (INR) | Remarks |
|---|---|---|---|---|---|
| 1 | Comprehensive Optometrist Consultation & Visual Acuity Assessment | 1 | ₹1,500.00 | ₹1,500.00 | Includes manifest and cycloplegic refraction |
| 2 | Autorefraction & Subjective Refinement (Digital Phoropter) | 1 | ₹800.00 | ₹800.00 | Topcon AR-11000A Auto Refractor |
| 3 | Slit Lamp Biomicroscopy Examination | 1 | ₹1,200.00 | ₹1,200.00 | Anterior segment evaluation by Optometrist |
| 4 | Dilated Fundus Examination & Retinal Imaging | 1 | ₹2,500.00 | ₹2,500.00 | Includes 45° fundus photography |
| 5 | Corneal Topography & Pachymetry | 1 | ₹2,000.00 | ₹2,000.00 | Zeiss Pentacam AXL analysis |
| 6 | Binocular Vision & Ocular Motility Assessment | 1 | ₹1,000.00 | ₹1,000.00 | Cover test, MADD, fusion range |
| 7 | Intraocular Pressure Measurement (Non-Contact Tonometry) | 1 | ₹500.00 | ₹500.00 | Screening for glaucoma risk |
| 8 | Prescription of Corrective Lenses (Single Vision, Progressive) | 1 | ₹8,500.00 | ₹8,500.00 | Zeiss Progressive Lenses, 1.60 index, anti-reflective coating |
| 9 | Frame Fitting, Dispensing & Post-Dispensing Review | 1 | ₹1,200.00 | ₹1,200.00 | Includes 30-day adjustment warranty |
| 10 | Follow-up Optometrist Consultation (at 2 weeks) | 1 | ₹500.00 | ₹500.00 | Adaptation check & fine-tuning |
| Subtotal | ₹19,700.00 | ||||
| GST @ 18% (as applicable in India) | ₹3,546.00 | ||||
| Grand Total (INR) | ₹23,246.00 | INCL. GST | |||
* All prices are quoted in Indian Rupees (INR). GST is levied as per the Central Goods and Services Tax Act, 2017, applicable in Karnataka, India. Healthcare services provided by a registered Optometrist are partially exempt; the above GST applies to dispensing of spectacles and lenses as per HSN code 9004.
Terms & Conditions of this Quotation Estimate
- This Quotation Estimate is valid for a period of thirty (30) days from the date of issue. Prices are subject to revision after the validity period due to market fluctuations in lens materials and frame costs in Bangalore, India.
- Payment is due within seven (7) working days of acceptance. Accepted modes include NEFT, RTGS, UPI, Credit/Debit Card, and Cash at our Bangalore clinic. A 50% advance is required to initiate lens ordering.
- All Optometrist consultations and diagnostic procedures will be conducted by a registered Optometrist holding a valid license from the Karnataka State Council of Optometry, India.
- The corrective lenses and frames are covered under a 12-month manufacturing defect warranty. This does not cover damage due to accidental breakage, improper handling, or unauthorized repair.
- Post-dispensing review and minor frame adjustments are included free of charge for thirty (30) days from the date of dispensing at our Koramangala, Bangalore facility.
- This Quotation Estimate does not constitute a medical diagnosis. In case of any abnormal findings during the Optometrist examination, the patient will be referred to a qualified ophthalmologist in Bangalore for further management.
- Any additional services or modifications requested by the client beyond the scope of this estimate will be quoted separately and require written approval before execution.
- This document is issued electronically and is valid without a physical signature. A signed copy may be requested for corporate reimbursement purposes.
- By accepting this Quotation Estimate, the client agrees to the privacy policy of ClearVision Optometry Centre, Bangalore, and consents to the storage and processing of their ophthalmic records in compliance with Indian data protection guidelines.
- For any queries regarding this estimate, please contact our Bangalore office at +91-80-4123-5678 or email [email protected] during business hours (Monday to Saturday, 9:00 AM to 8:00 PM IST).
This Quotation Estimate was generated by ClearVision Optometry Centre, Bangalore, India. Document Ref: CV-EST-2025-00472 | Page 1 of 1
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