Quotation Estimate Optometrist in Spain Madrid –Free Word Template Download with AI
Optometrist Services
Comprehensive Eye Care & Vision Assessment
Madrid, Spain
Optometrist Practice
Clínica Óptica Madrid Central
Calle de Serrano, 142, 3rd Floor
28006 Madrid, Spain
Tel: +34 91 555 2347
Email: [email protected]
NIF: B-87654321
Collegiate Registration: COO-2019-0456
Client Information
Mr. / Ms. [Client Full Name]
[Client Address]
[Postal Code], Madrid, Spain
Tel: [Client Phone Number]
Email: [Client Email Address]
NIE / DNI: [Client Identification Number]
Quotation Estimate Reference: QE-2025-00487
Date of Issue: 15 June 2025
Valid Until: 15 July 2025 (30 calendar days)
Prepared By: Dr. Elena Martínez-Solís, Optometrist (Registered with the Colegio Oficial de Ópticos-Optometristas de Madrid)
Service Location: Clínica Óptica Madrid Central, Calle de Serrano 142, 28006 Madrid, Spain
| Ref | Description of Optometrist Service | Duration | Unit Price (EUR) | Quantity | Subtotal (EUR) |
|---|---|---|---|---|---|
| 01 | Comprehensive Optometrist Eye Examination including visual acuity testing, refraction (subjective and objective), binocular vision assessment, and ocular motility evaluation | 45 min | €85.00 | 1 | €85.00 |
| 02 | Slit-Lamp Biomicroscopy Examination of the anterior segment of the eye, including cornea, iris, lens, and anterior chamber assessment performed by the Optometrist | 20 min | €45.00 | 1 | €45.00 |
| 03 | Dilated Fundus Examination with mydriatic drops (Tropicamide 1%) to evaluate the retina, optic disc, macula, and retinal vasculature | 30 min | €55.00 | 1 | €55.00 |
| 04 | Non-Contact Tonometry (Goldmann Applanation) for intraocular pressure measurement to screen for glaucoma risk | 10 min | €25.00 | 1 | €25.00 |
| 05 | Optical Coherence Tomography (OCT) of the macula and optic nerve head for detailed cross-sectional imaging | 15 min | €60.00 | 1 | €60.00 |
| 06 | Corneal Topography and Pachymetry for corneal curvature mapping and thickness measurement, essential for contact lens fitting and pre-surgical evaluation | 15 min | €50.00 | 1 | €50.00 |
| 07 | Visual Field Testing (Humphrey 30-2 or 24-2) for peripheral vision assessment and glaucoma monitoring | 20 min | €40.00 | 1 | €40.00 |
| 08 | Optometrist Consultation and Report: Detailed written report in Spanish and English summarising all findings, diagnostic impressions, and recommended follow-up schedule | 20 min | €35.00 | 1 | €35.00 |
| 09 | Prescription of corrective lenses (spectacles or contact lenses) including lens selection, frame fitting guidance, and aftercare instructions | 25 min | €30.00 | 1 | €30.00 |
| 10 | Follow-up Optometrist Appointment (within 6 weeks) to review adaptation, confirm prescription accuracy, and address any residual visual concerns | 20 min | €35.00 | 1 | €35.00 |
| Subtotal (before VAT): | €560.00 | ||||
| VAT (IVA) at 21% (Spain): | €117.60 | ||||
| TOTAL AMOUNT DUE (EUR): | €677.60 | ||||
Terms and Conditions of this Quotation Estimate
- This Quotation Estimate is issued by Clínica Óptica Madrid Central, a registered Optometrist practice operating in Madrid, Spain, and is valid for a period of thirty (30) calendar days from the date of issue. Beyond this period, prices and availability of services may be subject to revision.
- All services described in this Quotation Estimate will be performed by a qualified Optometrist registered with the Colegio Oficial de Ópticos-Optometristas de Madrid and fully compliant with the Spanish Royal Decree 1789/2010 governing the practice of optometry in Spain.
- The total amount of €677.60 (six hundred and seventy-seven euros and sixty cents) includes the applicable Spanish Value Added Tax (IVA) at the standard rate of 21%. No additional fees will be charged unless expressly agreed in writing prior to the commencement of services.
- Payment is due within fifteen (15) calendar days of the date of this Quotation Estimate. Accepted payment methods include bank transfer (IBAN: ES21 0049 0001 5320 1234 5678), credit/debit card (Visa, Mastercard, American Express), and cash at the clinic reception in Madrid. A 1.5% late payment surcharge will apply to overdue balances in accordance with Spanish commercial law.
- The client is required to provide a minimum of forty-eight (48) hours' notice for any cancellation or rescheduling of appointments. Cancellations made within this window will be subject to a 50% fee on the scheduled services.
- All clinical data, examination results, and reports generated during the Optometrist consultation will be stored in accordance with the Spanish Organic Law 3/2018 on Personal Data Protection (LOPDGDD) and the European General Data Protection Regulation (GDPR). The client retains the right to access, rectify, or request deletion of their personal data at any time.
- This Quotation Estimate does not constitute a medical diagnosis. Should the Optometrist identify any condition requiring referral to an ophthalmologist or other medical specialist in Madrid, the client will be informed promptly and a referral letter will be provided at no additional cost.
- All services are subject to the general terms and conditions of Clínica Óptica Madrid Central, which are available for inspection at the clinic premises located in Madrid, Spain, and upon request via email.
- This Quotation Estimate is governed by the laws of the Kingdom of Spain. Any disputes arising from this document shall be subject to the exclusive jurisdiction of the courts of Madrid, Spain.
- The client acknowledges that by accepting this Quotation Estimate, they consent to the performance of the listed Optometrist services and agree to the payment terms outlined herein.
For and on behalf of Clínica Óptica Madrid Central
Dr. Elena Martínez-SolísOptometrist – COO-2019-0456
Date: _______________
Client Acceptance
[Client Full Name]Signature: _______________
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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