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

Cairo Smile Orthodontic Center

12 Tahrir Square, Downtown District, Egypt Cairo

Tel: +20 2 2578 4433 | Email: [email protected]

Licence No. EGY-ORTHO-2019-0847 | Ministry of Health, Egypt

Quotation Estimate No. QE-2025-04187

Client Information

Name: Ahmed Mohamed El-Sayed

Address: 45 Abbas El-Akkad St., Nasr City, Egypt Cairo

Phone: +20 100 555 7821

National ID: 29805150102345

Quotation Details

Date Issued: 15 June 2025

Valid Until: 15 July 2025 (30 days)

Prepared By: Dr. Nour El-Din Hassan, Orthodontist

Payment Currency: Egyptian Pound (EGP)

Scope of Orthodontist Services – Detailed Breakdown

This Quotation Estimate has been prepared by our senior Orthodontist, Dr. Nour El-Din Hassan, following a comprehensive clinical examination conducted at our Egypt Cairo clinic on 10 June 2025. The treatment plan below outlines the full scope of orthodontic care recommended for the patient, including all diagnostic procedures, active treatment phases, and retention protocols. All pricing reflects current 2025 rates applicable in Egypt Cairo and includes all materials, consultations, and follow-up appointments specified herein.

# Service / Procedure Description Qty Unit Price (EGP) Total (EGP)
1 Initial Orthodontic Consultation & Diagnosis Full clinical exam, intraoral photography, panoramic X-ray (OPG), cephalometric analysis, and digital study models 1 1,500 1,500
2 CBCT Scan (Cone Beam Computed Tomography) 3D imaging for detailed assessment of tooth roots, jaw alignment, and bone structure 1 2,800 2,800
3 Orthodontic Treatment Plan & Digital Simulation Customised treatment roadmap with 3D digital preview of expected outcome 1 1,200 1,200
4 Fixed Metal Braces – Full Arch (Upper & Lower) Application of 0.022" slot metal brackets, archwires, ligatures, and bonding agents on all 28 teeth 1 28,000 28,000
5 Monthly Adjustment & Monitoring Visits Wire changes, elastic adjustments, progress tracking, and professional hygiene check (18-month treatment duration) 18 800 14,400
6 Interproximal Reduction (IPR) / Stripping Minimal enamel reduction to create space for proper tooth alignment (as needed during treatment) 1 3,500 3,500
7 Removable Retainer – Upper & Lower (Hawley Type) Acrylic and wire retainers to maintain corrected alignment post-treatment 2 2,200 4,400
8 Post-Treatment Follow-Up & Retainer Adjustments Three follow-up visits over 12 months to monitor stability and adjust retainers 3 600 1,800
9 Emergency Orthodontic Visit (Included) One complimentary emergency visit for bracket debonding, wire irritation, or appliance repair 1 0 0
GRAND TOTAL (EGP) 57,600

Payment Terms & Conditions

  • Deposit: A non-refundable deposit of 30% (EGP 17,280) is required at the time of accepting this Quotation Estimate to reserve the treatment slot with our Orthodontist in Egypt Cairo.
  • Installment Plan: The remaining balance may be paid in 18 equal monthly installments of EGP 2,480, aligned with each adjustment visit. No additional interest is charged for on-time payments.
  • Accepted Payment Methods: Cash, bank transfer (CIB, NBE, QNB), credit/debit cards (Visa, Mastercard), and mobile wallet (Fawry, Veepay).
  • Validity: This Quotation Estimate is valid for 30 calendar days from the date of issue. Prices are subject to revision after the expiry date due to material cost fluctuations in the Egypt Cairo dental market.
  • Treatment Duration: The estimated treatment period is 18 to 24 months, depending on individual response. The Orthodontist reserves the right to extend or modify the plan based on clinical progress.
  • Cancellations: In the event of early discontinuation, the deposit and all completed service fees are non-refundable. A written notice of 14 days is required before any cancellation.
  • Warranty: All orthodontic appliances carry a 6-month warranty against manufacturing defects. Normal wear, patient-caused damage, or neglect of oral hygiene is excluded from warranty coverage.
  • Confidentiality: All patient records, radiographs, and treatment data are handled in strict accordance with Egyptian Health Ministry regulations and the clinic's data protection policy.

Important Notes

This Quotation Estimate is a professional document issued by Cairo Smile Orthodontic Center, a licensed orthodontic practice operating in Egypt Cairo. It is not a binding contract until formally accepted and signed by both parties. The treating Orthodontist, Dr. Nour El-Din Hassan, holds a Doctorate in Orthodontics from Cairo University and is a certified member of the Egyptian Orthodontic Society. All procedures will be performed in a fully sterilised, state-of-the-art clinic environment compliant with international dental standards. The patient is advised to attend all scheduled appointments and maintain rigorous oral hygiene to ensure optimal treatment outcomes. Any additional procedures not listed in this Quotation Estimate (such as extractions, periodontal therapy, or restorative work) will be quoted separately at the prevailing Egypt Cairo market rates.

Prepared & Signed By
Dr. Nour El-Din Hassan
Lead Orthodontist
Cairo Smile Orthodontic Center, Egypt Cairo
Date: 15/06/2025
Accepted & Signed By (Patient / Guardian)
Name: _________________________
Signature: _________________________
Date: _________________________

Cairo Smile Orthodontic Center | 12 Tahrir Square, Downtown, Egypt Cairo | Tel: +20 2 2578 4433

This Quotation Estimate is generated electronically and is valid without a physical stamp. For any queries regarding this Orthodontist treatment plan, please contact our front desk during business hours (Sat–Thu, 9:00 AM – 8:00 PM).

© 2025 Cairo Smile Orthodontic Center. All rights reserved. Licence No. EGY-ORTHO-2019-0847.

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