Quotation Estimate Optometrist in South Africa Cape Town –Free Word Template Download with AI
Cape Town Vision & Optometry Centre (Pty) Ltd
142 Sea Point Promenade, Sea Point, Cape Town, 8005, Western Cape, South Africa
Registration No: 2019/456789/07 | HPCSA No: 00456789
Tel: +27 21 430 5678 | Email: [email protected]
Quotation No: QTE-2025-0847Dear Mr. van der Merwe,
Thank you for considering Cape Town Vision & Optometry Centre for your comprehensive eye care needs. This Quotation Estimate has been prepared specifically for you following your initial consultation at our Sea Point clinic in Cape Town, South Africa. As a registered Optometrist with the Health Professions Council of South Africa (HPCSA), I am pleased to provide you with a detailed breakdown of the recommended optometric services, diagnostic procedures, and corrective solutions tailored to your visual requirements.
Itemised Quotation Estimate – Optometrist Services| Ref | Description of Service | Qty | Unit Price (ZAR) | Amount (ZAR) |
|---|---|---|---|---|
| 01 | Comprehensive Optometrist Eye Examination (including visual acuity, refraction, binocular vision assessment, and ocular health screening) | 1 | R 850.00 | R 850.00 |
| 02 | Dilated Fundus Examination with Digital Retinal Photography (both eyes) | 1 | R 620.00 | R 620.00 |
| 03 | Corneal Topography and Pachymetry (advanced corneal mapping for contact lens fitting) | 1 | R 480.00 | R 480.00 |
| 04 | Non-Contact Intraocular Pressure Measurement (Tonometry) – screening for glaucoma | 1 | R 250.00 | R 250.00 |
| 05 | Binocular Vision and Oculomotor Assessment (convergence, divergence, and eye teaming evaluation) | 1 | R 380.00 | R 380.00 |
| 06 | Prescription of Progressive Multifocal Spectacles – Premium German-made lenses (Zeiss SmartLife) with anti-reflective and blue-light filtering coatings | 1 pair | R 4 250.00 | R 4 250.00 |
| 07 | Acetate Frame – Designer Italian-made (Gucci GG0584O) in tortoiseshell finish | 1 | R 3 800.00 | R 3 800.00 |
| 08 | UV400 Polarised Sunglasses – Prescription lenses matched to your corrected vision (Ray-Ban Aviator) | 1 pair | R 2 950.00 | R 2 950.00 |
| 09 | Follow-up Optometrist Review (6 weeks post-dispensing) – lens adaptation check and frame adjustment | 1 | R 350.00 | R 350.00 |
| 10 | Annual Comprehensive Optometry Package (renewal – includes full re-examination, retinal imaging, and IOP check) | 1 | R 1 200.00 | R 1 200.00 |
| Subtotal (VAT Exclusive) | R 15 130.00 | |||
| VAT @ 15% (South Africa) | R 2 269.50 | |||
| Total Quotation Estimate (VAT Inclusive) | R 17 399.50 | |||
- This Quotation Estimate is valid for a period of thirty (30) days from the date of issue. Prices are subject to change after the validity period due to currency fluctuations affecting imported optical products in South Africa.
- All prices are quoted in South African Rand (ZAR) and are inclusive of 15% Value Added Tax (VAT) as per the South African Revenue Service (SARS) regulations.
- Payment is due within fourteen (14) days of acceptance of this Quotation Estimate. We accept EFT, credit card (Visa, Mastercard), and cash. A 10% deposit is required to secure your order for custom-made lenses and designer frames.
- Medicare / Medical Aid claims: Our Optometrist practice is a registered provider with Discovery Health, Bonitas, Momentum, and Medical Aid SA. We will submit claims on your behalf. Please note that co-payment may apply depending on your specific medical aid scheme and benefits in Cape Town, South Africa.
- Custom-made progressive lenses and designer frames require a manufacturing and delivery period of approximately ten (10) to fourteen (14) business days from the date of confirmed order.
- All corrective lenses carry a twelve (12) month manufacturer's warranty against defects in material and workmanship. Frame adjustments are complimentary for six (6) months.
- This Quotation Estimate does not constitute a medical diagnosis. Should the Optometrist identify a condition requiring referral to an ophthalmologist or other specialist in Cape Town, additional costs will be quoted separately.
- Our practice operates in compliance with the Health Professions Council of South Africa (HPCSA) regulations and the National Health Act (Act No. 61 of 2003). All patient records are maintained in accordance with the Protection of Personal Information Act (POPIA).
- By signing below, you confirm your acceptance of this Quotation Estimate and authorise Cape Town Vision & Optometry Centre to proceed with the services and products listed herein.
Dr. Thandiwe Nkosi
Registered Optometrist, HPCSA
Cape Town Vision & Optometry Centre
Date: _______________ Accepted by (Client):
Mr. James van der Merwe
Signature: _______________
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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