Quotation Estimate Orthodontist in India New Delhi –Free Word Template Download with AI

This Quotation Estimate is issued by SmileCraft Orthodontic Centre, a registered and certified orthodontic practice located in the heart of New Delhi, India. Following a thorough clinical examination, radiographic analysis (OPG and panoramic X-ray), and digital intraoral scanning conducted on 10 June 2025, the undersigned Orthodontist has recommended a comprehensive treatment plan to correct the identified Class II malocclusion with anterior crowding. The services outlined below represent the complete scope of orthodontic care to be delivered at our New Delhi clinic over an estimated treatment duration of 24 to 30 months.

The total Quotation Estimate of ₹2,08,270 may be paid in the following instalments to facilitate the client's financial planning:

• Instalment 1 (At Treatment Initiation): ₹80,000 – covers diagnostic workup, pre-orthodontic preparation, and appliance placement.
• Instalment 2 (Month 6): ₹60,000 – covers ongoing orthodontic adjustments and mid-treatment progress.
• Instalment 3 (Month 12): ₹40,000 – covers continued adjustments and active treatment phase.
• Instalment 4 (At Debonding): ₹28,270 – covers debonding, finishing, retainer fabrication, and post-treatment follow-up.

• This Quotation Estimate is valid for 30 days from the date of issue. Beyond this period, the Orthodontist reserves the right to revise pricing based on material cost fluctuations in the Indian market.
• The estimated treatment duration of 24–30 months is an approximation. Actual duration may vary depending on the patient's biological response, compliance with elastics and oral hygiene, and any unforeseen clinical developments.
• All orthodontic procedures will be performed by Dr. Ananya Sharma or her designated associate Orthodontist at the SmileCraft Orthodontic Centre, New Delhi, India. The clinic operates Monday through Saturday, 10:00 AM to 8:00 PM.
• The client agrees to attend all scheduled monthly adjustment appointments. Missed appointments exceeding two consecutive visits may result in a rescheduling fee of ₹1,000 per occurrence.
• This Quotation Estimate does not include the cost of any additional surgical interventions (e.g., orthognathic surgery) that may be recommended during the course of treatment. Such procedures will be quoted separately.
• In the event of appliance breakage due to patient negligence (e.g., biting hard objects, sports-related trauma), a repair charge of ₹500–₹1,500 per incident may apply, in addition to the 3 included emergency visits.
• All payments are subject to the prevailing Goods and Services Tax (GST) regulations of India. A GST-compliant tax invoice will be issued for each payment received.
• The Orthodontist and the clinic maintain comprehensive professional indemnity insurance. In the unlikely event of a clinical complication, the patient will be referred to a specialist at a leading hospital in New Delhi at no additional consultation cost.
• This Quotation Estimate is non-transferable and is issued exclusively for the named client. Any change in patient or treatment scope will require a revised Quotation Estimate.
• Disputes, if any, arising from this Quotation Estimate shall be subject to the jurisdiction of the competent courts in New Delhi, India.

By signing below, the client acknowledges that they have read, understood, and accepted the terms of this Quotation Estimate for orthodontic treatment. The client confirms that the Orthodontist has explained the proposed treatment plan, expected outcomes, potential risks, and alternative options in detail during the initial consultation in New Delhi.