Quotation Estimate Optometrist in Vietnam Ho Chi Minh City –Free Word Template Download with AI
Professional Optometrist Services — Vietnam Ho Chi Minh City
Document Reference: QTE-HCM-2025-04782 | Date Issued: 15 June 2025
Prepared By (Optometrist Provider) Saigon Vision Optometry Centre128 Nguyen Hue Boulevard, District 1
Ho Chi Minh City, Vietnam 700000
Tel: +84 28 3822 4567
Email: [email protected]
Tax Code: 0312345678 Prepared For (Client) Mr. Tran Van Minh
45 Le Duan Street, District 3
Ho Chi Minh City, Vietnam 700000
Tel: +84 90 123 4567
Email: [email protected]
This Quotation Estimate is issued by Saigon Vision Optometry Centre, a licensed and accredited Optometrist practice operating in Vietnam Ho Chi Minh City, to provide a comprehensive and transparent breakdown of all professional optometric services, diagnostic examinations, and corrective lens solutions requested by the client. This document serves as a formal Quotation Estimate outlining the estimated costs, scope of work, and applicable terms for the delivery of Optometrist services within the metropolitan area of Vietnam Ho Chi Minh City. All pricing in this Quotation Estimate is quoted in Vietnamese Dong (VND) and reflects the current market rates for Optometrist services as of the date of issue.
The following Quotation Estimate encompasses a full range of Optometrist services to be performed at our clinic located in the central district of Vietnam Ho Chi Minh City. Our team of board-certified Optometrist professionals will conduct all examinations using state-of-the-art diagnostic equipment in compliance with the Ministry of Health of Vietnam regulations governing optometric practice.
| No. | Optometrist Service Description | Unit | Qty | Unit Price (VND) | Subtotal (VND) |
|---|---|---|---|---|---|
| 01 | Comprehensive Optometrist Eye Examination (including visual acuity, refraction, and binocular vision assessment) | Session | 1 | 1,200,000 | 1,200,000 |
| 02 | Optometrist Digital Retinal Imaging & Fundus Photography (both eyes) | Pair | 1 | 850,000 | 850,000 |
| 03 | Optometrist Corneal Topography & Pachymetry Measurement | Pair | 1 | 650,000 | 650,000 |
| 04 | Optometrist Intraocular Pressure (IOP) Measurement & Glaucoma Screening | Session | 1 | 450,000 | 450,000 |
| 05 | Optometrist Visual Field Analysis (Humphrey Perimetry) | Pair | 1 | 780,000 | 780,000 |
| 06 | Prescription Bifocal Lenses (1.60 Index, Anti-Reflective Coating, Blue Light Filter) | Pair | 1 | 4,500,000 | 4,500,000 |
| 07 | Optometrist Frame Fitting, Adjustment & Dispensing (Premium Titanium Frame) | Set | 1 | 3,200,000 | 3,200,000 |
| 08 | Follow-up Optometrist Review Appointment (within 30 days of initial fitting) | Session | 1 | 500,000 | 500,000 |
| 09 | Optometrist Written Report & Medical Documentation (bilingual Vietnamese/English) | Report | 1 | 300,000 | 300,000 |
| 10 | Urgent Optometrist Consultation Fee (if required outside standard hours in Ho Chi Minh City) | Session | 1 | 800,000 | 800,000 |
| TOTAL ESTIMATED AMOUNT (VND) | 13,230,000 | ||||
* All prices are inclusive of 10% Value Added Tax (VAT) as mandated by the General Department of Taxation, Vietnam. No additional service charges apply within the Ho Chi Minh City metropolitan area.
Important Conditions Governing This Quotation Estimate for Optometrist Services in Vietnam Ho Chi Minh City
- Validity: This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. After this period, pricing for Optometrist services may be subject to revision based on supplier costs and market conditions in Vietnam Ho Chi Minh City.
- Payment Terms: A deposit of 50% of the total Quotation Estimate amount is required at the time of booking. The remaining balance is due upon completion of all Optometrist services and lens dispensing.
- Appointment Scheduling: All Optometrist appointments must be scheduled a minimum of 48 hours in advance. Walk-in consultations are subject to availability at our Vietnam Ho Chi Minh City clinic.
- Cancellations: Cancellations made less than 24 hours before a scheduled Optometrist session will incur a 20% cancellation fee of the session value as stated in this Quotation Estimate.
- Warranty: All corrective lenses and frames dispensed under this Quotation Estimate carry a 12-month warranty against manufacturing defects. The Optometrist fitting warranty covers frame adjustments for 6 months.
- Regulatory Compliance: All Optometrist services are performed in strict accordance with the Vietnamese Optometry Practice Standards (Decree No. 109/2016/ND-CP) and the regulations of the Ho Chi Minh City People's Committee Department of Health.
- Confidentiality: All patient data collected during Optometrist examinations in Vietnam Ho Chi Minh City shall be handled in compliance with Vietnam's Personal Data Protection Law (Law No. 13/2018/QH14).
- Revisions: Should the Optometrist examination reveal additional conditions requiring further diagnostic procedures not included in this Quotation Estimate, a supplementary Quotation Estimate will be issued for the client's written approval before any additional services are performed.
By signing below, the client acknowledges receipt of this Quotation Estimate and agrees to the terms and conditions outlined herein for the provision of Optometrist services at Saigon Vision Optometry Centre, Vietnam Ho Chi Minh City. This Quotation Estimate does not constitute a binding contract until both parties have executed their respective signatures and the deposit has been received.
For and on behalf of the Optometrist Provider
Dr. Nguyen Thi LanLead Optometrist, O.D.
Saigon Vision Optometry Centre
Ho Chi Minh City, Vietnam
Date: _______________
Client Acknowledgement
Mr. Tran Van MinhClient / Patient
Ho Chi Minh City, Vietnam
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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