Quotation Estimate Orthodontist in Egypt Alexandria –Free Word Template Download with AI

This Quotation Estimate has been prepared by our licensed Orthodontist team at the Alexandria Dental & Orthodontic Center to provide Mr. Ahmed Hassan El-Sayed with a comprehensive, itemized breakdown of the anticipated costs for a full orthodontic treatment plan. As a recognized Orthodontist practice operating in Egypt Alexandria, we are committed to transparent pricing, high-quality clinical care, and full compliance with the regulations set forth by the Egyptian Ministry of Health and the Alexandria Governorate Health Directorate. This document serves as a formal Quotation Estimate and does not constitute a binding contract until both parties have signed and accepted the terms outlined herein.

Following a comprehensive initial consultation conducted on 10 June 2025 by Dr. Mona Fathy, Lead Orthodontist (MD, MSc in Orthodontics, Faculty of Dentistry, Alexandria University), the patient was diagnosed with Class II malocclusion with moderate crowding in the upper and lower arches, a 4 mm overjet, and a mild crossbite on the left posterior segment. The recommended treatment protocol involves a combination of fixed orthodontic appliances and adjunctive procedures. All diagnostics, including panoramic radiographs (OPG), cephalometric analysis, intraoral impressions, and digital 3D scans, have been completed and are on file at our Egypt Alexandria clinic.

This Quotation Estimate from our Orthodontist practice in Egypt Alexandria offers the following payment structure to accommodate the patient's financial planning:

• Down Payment (upon acceptance): 30% of the Grand Total = EGP 18,690, due within 5 business days of signing.
• Monthly Installments: The remaining 70% (EGP 43,610) shall be paid in 18 equal monthly installments of approximately EGP 2,423, aligned with each orthodontic adjustment visit.
• Accepted Payment Methods: Cash, bank transfer (CIB, NBE, or Alexandria National Bank), or credit/debit card (Visa, Mastercard). A 2% surcharge applies to card payments.
• Late Payment: A 5% monthly interest will be applied to any outstanding balance exceeding 15 days past due.

• This Quotation Estimate is valid for 30 calendar days from the date of issue. After this period, prices may be subject to revision based on material cost fluctuations in the Egyptian market.
• All orthodontic procedures will be performed or directly supervised by a licensed Orthodontist registered with the Alexandria Medical Syndicate and the Egyptian Ministry of Health.
• The estimated treatment duration is 18 to 24 months. Actual duration may vary depending on the patient's biological response and compliance with the Orthodontist's instructions.
• The patient is responsible for maintaining excellent oral hygiene throughout treatment. Failure to do so may result in additional costs for caries treatment or periodontal intervention, which are not included in this Quotation Estimate.
• In the event of treatment interruption exceeding 60 days without medical justification, a re-entry fee of EGP 2,000 will apply.
• All clinical records, radiographs, and digital scans remain the property of the Alexandria Dental & Orthodontic Center. The patient may request a copy at a nominal reproduction cost.
• This Quotation Estimate is governed by the laws of the Arab Republic of Egypt. Any disputes shall be resolved through the Alexandria Medical Disputes Committee or the competent courts in Egypt Alexandria.
• The clinic operates Monday through Saturday, 9:00 AM to 8:00 PM, and Sunday 10:00 AM to 2:00 PM, in accordance with standard working hours in Egypt Alexandria.

By signing below, both parties acknowledge that this Quotation Estimate for Orthodontist services in Egypt Alexandria has been reviewed, understood, and accepted in full. The patient confirms that the Orthodontist has explained the proposed treatment plan, expected outcomes, potential risks, and alternative options in clear and comprehensible terms.