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Quotation Estimate Optometrist in Philippines Manila –Free Word Template Download with AI

Professional Optometrist Services — Philippines Manila

Official Estimate Document

Provider / Optometrist Practice

Manila Vision Care Optometry Center
128 Ayala Avenue, Makati City
Philippines Manila, 1226
Tel: +63 (2) 8887-4521
Email: [email protected]
PR No. 2024-0015872 | DOH License No. OPT-2019-4471

Client / Recipient

Mr. / Ms. [Client Full Name]
[Client Address]
Philippines Manila
Tel: +63 (917) 000-0000
Email: [email protected]
TIN: 000-000-000-000

Quotation Estimate No.: QTE-2025-07-00342 Date of Issue: July 14, 2025 Valid Until: August 13, 2025 (30 days) Prepared By: Dr. Maria L. Santos, O.D.

This Quotation Estimate is issued by Manila Vision Care Optometry Center, a licensed and accredited Optometrist practice operating in the Philippines Manila metropolitan area. The following itemized services represent the complete scope of professional Optometrist care, diagnostic evaluations, and corrective lens dispensing that will be rendered to the client. All pricing is quoted in Philippine Pesos (PHP) and reflects current market rates for Optometrist services in the Philippines Manila region as of the date of issue.

No. Description of Optometrist Service Unit Qty Unit Price (PHP) Amount (PHP)
1 Comprehensive Optometrist Eye Examination (including visual acuity, refraction, intraocular pressure, and retinal assessment) Session 1 2,500.00 2,500.00
2 Advanced Corneal Topography & Wavefront Analysis (Optometrist diagnostic procedure) Session 1 3,200.00 3,200.00
3 Binocular Vision Assessment & Ocular Motility Testing by Licensed Optometrist Session 1 1,800.00 1,800.00
4 Prescription Spectacle Lenses (1.67 Index, Anti-Reflective Coating, Blue Light Filter) — per pair Pair 1 8,500.00 8,500.00
5 Optical Frame (Designer Titanium, Philippines Manila exclusive collection) Unit 1 6,800.00 6,800.00
6 Contact Lens Fitting & Trial (Soft Toric Lenses) — Optometrist supervised Session 1 2,200.00 2,200.00
7 Follow-up Optometrist Consultation (30-day post-dispensing review) Session 1 1,500.00 1,500.00
8 Annual Eye Health Screening Package (for dependents, up to 3 persons) — Optometrist administered Package 1 5,400.00 5,400.00
Subtotal 31,900.00
VAT (12%) 3,828.00
Professional Optometrist Service Fee 1,500.00
Grand Total (PHP) 37,228.00
  • This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After the expiration date, pricing for Optometrist services in the Philippines Manila may be subject to revision based on updated material costs and professional fee schedules.
  • All Optometrist services listed herein shall be performed by a duly licensed Optometrist registered with the Philippine Optometric Association (POA) and the Department of Health (DOH) of the Philippines Manila region.
  • Payment terms: Fifty percent (50%) down payment upon acceptance of this Quotation Estimate; the remaining fifty percent (50%) shall be settled upon completion of all Optometrist services and dispensing of corrective lenses.
  • Accepted payment methods include bank transfer (BDO, BPI, Metrobank), cash, credit/debit card, and GCash. All transactions are processed in Philippine Pesos (PHP) at the Manila Vision Care Optometry Center office in the Philippines Manila area.
  • Any additional Optometrist diagnostic procedures or corrective lens modifications not explicitly stated in this Quotation Estimate shall be subject to a separate written estimate prior to execution.
  • The client acknowledges that all Optometrist findings, prescriptions, and diagnostic records generated during the engagement are the property of the practice and shall be maintained in accordance with the Philippine Data Privacy Act of 2012 (RA 10173).
  • This Quotation Estimate does not constitute a guarantee of specific visual outcomes. The Optometrist shall exercise professional judgment in determining the most appropriate corrective measures for the client's ocular condition.
  • Warranty on dispensed spectacle lenses and frames is valid for ninety (90) days from the date of delivery, subject to normal wear and tear conditions as defined by the Optometrist.
  • All services are subject to the availability of the assigned Optometrist. Rescheduling of appointments must be made at least forty-eight (48) hours in advance.

By signing below, the client acknowledges receipt and acceptance of this Quotation Estimate for Optometrist services to be rendered in the Philippines Manila. The undersigned agrees to all terms, conditions, and pricing as stated in this document.

Prepared by (Optometrist)

Dr. Maria L. Santos, O.D.
Licensed Optometrist, Philippines Manila
POA License No. 2019-4471

Signature & Date

Accepted by (Client)

[Client Full Name]
[Client Address]
Philippines Manila

Signature & Date

Manila Vision Care Optometry Center | 128 Ayala Avenue, Makati City, Philippines Manila 1226
This Quotation Estimate document is generated electronically and is valid without a physical seal. For inquiries regarding this Optometrist service estimate, please contact our office at +63 (2) 8887-4521 or visit our facility in the Philippines Manila area during business hours (Monday to Saturday, 8:00 AM to 6:00 PM).

Document Reference: QTE-2025-07-00342 | Page 1 of 1 | Generated: July 14, 2025

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