Quotation Estimate Optometrist in South Korea Seoul –Free Word Template Download with AI
123 Gangnam-daero, Gangnam-gu, Seoul, South Korea | Tel: +82-2-555-0198 | Email: [email protected]
License No. KR-OPM-2024-00847 | Registered Optometrist Practice
Quotation EstimateDocument No. QE-2025-0347 Date: 15 June 2025 Valid Until: 15 July 2025
Prepared For (Client)
Name: Mr. James Park
Address: 45 Apgujeong-ro, Gangnam-gu, Seoul, South Korea
Contact: +82-10-3456-7890
Email: [email protected]
Residency: South Korea Seoul (Permanent Resident)
Prepared By (Optometrist)
Optometrist: Dr. Hana Kim, O.D.
Certification: Korean Optometric Association (KOA)
Practice Location: Seoul, South Korea
Specialization: Comprehensive Eye Care & Refractive Surgery Consultation
License: Seoul Metropolitan Optometry Board #4471
This Quotation Estimate is issued by Seoul Vision Care Optometry Center, a licensed Optometrist practice operating in South Korea Seoul, to provide a comprehensive breakdown of all professional optometric services, diagnostic procedures, and associated costs for the client. This document serves as a formal estimate and does not constitute a binding contract until both parties have signed and acknowledged the terms outlined herein. All services will be performed in accordance with the standards set by the Korean Ministry of Health and Welfare and the Korean Optometric Association.
| No. | Service / Item Description | Optometrist Procedure | Qty | Unit Price (KRW) | Subtotal (KRW) |
|---|---|---|---|---|---|
| 1 | Comprehensive Eye Examination (CEX) | Full Optometrist assessment including visual acuity, refraction, and ocular health screening | 1 | 180,000 | 180,000 |
| 2 | Corneal Topography & Pachymetry | Optometrist-guided corneal mapping for contact lens fitting and surgical evaluation | 1 | 95,000 | 95,000 |
| 3 | Dilated Fundus Examination | Optometrist retinal assessment with mydriatic drops and digital retinal imaging | 1 | 75,000 | 75,000 |
| 4 | Optical Coherence Tomography (OCT) | High-resolution cross-sectional imaging performed by the Optometrist team | 1 | 120,000 | 120,000 |
| 5 | Binocular Vision & Oculomotor Assessment | Optometrist evaluation of eye alignment, convergence, and accommodative function | 1 | 65,000 | 65,000 |
| 6 | Custom Prescription Eyeglasses (Frame + Lenses) | Optometrist-selected frame with premium aspheric anti-reflective lenses | 1 pair | 450,000 | 450,000 |
| 7 | Soft Contact Lens Fitting & Trial | Optometrist-fitted daily disposable contact lenses with 30-day supply | 1 | 150,000 | 150,000 |
| 8 | Follow-up Consultation (30 days post-exam) | Optometrist review of adaptation, lens fit, and visual performance | 1 | 50,000 | 50,000 |
| 9 | Annual Eye Health Monitoring Plan | Two scheduled Optometrist check-ups per year in Seoul, South Korea | 2 | 100,000 | 200,000 |
| 10 | Administrative & Record-Keeping Fee | Digital medical record management compliant with South Korea Seoul health data regulations | 1 | 20,000 | 20,000 |
| TOTAL ESTIMATED COST (KRW) | 1,405,000 | ||||
| VAT (10% - South Korea Standard Rate) | 140,500 | ||||
| GRAND TOTAL (KRW) | 1,545,500 | ||||
- This Quotation Estimate is valid for a period of thirty (30) days from the date of issue. After the expiration date, all prices listed herein are subject to revision based on current market conditions in South Korea Seoul.
- All optometric services described in this document will be personally supervised and performed by a licensed Optometrist registered with the Seoul Metropolitan Optometry Board. No service will be delegated to unlicensed personnel.
- The client acknowledges that this Quotation Estimate is a good-faith estimate and that final billing may vary by up to 10% depending on additional clinical findings discovered during the examination by the Optometrist.
- Payment is due within fourteen (14) calendar days of the date of service delivery. Accepted payment methods include bank transfer (KRW), credit card, and cash at the Seoul, South Korea clinic location.
- All medical records and diagnostic imaging generated during the Optometrist consultation will be stored in compliance with the Personal Information Protection Act (PIPA) of the Republic of Korea and retained for a minimum of seven (7) years.
- The Optometrist practice in South Korea Seoul is fully insured under the Korean Medical Malpractice Insurance Program. The client is entitled to a copy of the insurance certificate upon request.
- Any cancellation of scheduled appointments must be made at least 48 hours in advance to avoid a 50% service fee. Emergency cancellations due to medical necessity are exempt from this charge.
- This Quotation Estimate does not include costs for ophthalmological surgical procedures, pharmaceutical prescriptions, or emergency care, which will be quoted separately by the attending Optometrist or referred ophthalmologist.
- All services are subject to the availability of the specific Optometrist and equipment at the Seoul, South Korea clinic. Rescheduling will be arranged at no additional cost if necessary.
- Disputes arising from this Quotation Estimate shall be resolved under the jurisdiction of the Seoul Central District Court, Republic of Korea.
As your designated Optometrist in South Korea Seoul, I am committed to providing the highest standard of vision care. This Quotation Estimate reflects a thorough and transparent breakdown of all anticipated services. I encourage the client to review each line item carefully and to contact our office at +82-2-555-0198 with any questions or requests for clarification before the validity period expires. Your visual health is our priority, and we are dedicated to ensuring that every aspect of your optometric care in Seoul is delivered with precision, compassion, and professionalism.
Optometrist (Service Provider)Dr. Hana Kim, O.D.
Seoul Vision Care Optometry Center
Date: _______________ Client (Recipient)
Mr. James Park
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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