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Quotation Estimate Orthodontist in Japan Osaka –Free Word Template Download with AI

Orthodontist Services — Japan Osaka

Document No. QTE-OSK-2025-0487

Provider (Orthodontist)

Osaka Central Orthodontic Clinic

2-14-8 Umeda, Kita-ku

Osaka 530-0001, Japan

Tel: +81-6-6371-8820

Email: [email protected]

License No. ORTH-JP-2019-4471

Client / Patient

Mr. / Ms. [Patient Name]

Address: [Street, City, Prefecture]

Osaka, Japan

Tel: +81-90-XXXX-XXXX

Email: [[email protected]]

Insurance ID: [If Applicable]

Quotation Date: June 15, 2025   |   Valid Until: July 15, 2025   |   Currency: Japanese Yen (JPY)   |   Prepared By: Dr. Kenji Tanaka, DDS, Orthodontist

This Quotation Estimate has been prepared by our licensed Orthodontist team at Osaka Central Orthodontic Clinic, located in the heart of Japan Osaka. The following itemized breakdown reflects the comprehensive orthodontic treatment plan recommended after a full clinical examination, digital imaging, and diagnostic consultation conducted on June 10, 2025. All pricing is inclusive of applicable consumption tax (10%) as mandated by the National Tax Agency of Japan.

No. Service / Procedure Frequency Duration Unit Price (JPY) Total (JPY)
1 Initial Consultation & Diagnostic Records (X-rays, CBCT, Intraoral Scans) One-time 90 min ¥25,000 ¥25,000
2 Custom Orthodontic Treatment Plan Design (3D Digital Simulation) One-time 60 min ¥18,000 ¥18,000
3 Fixed Orthodontic Braces Placement (Ceramic / Metal) One-time 120 min ¥150,000 ¥150,000
4 Monthly Orthodontist Adjustment & Wire Changes 24 months 45 min ¥12,000 ¥288,000
5 Interproximal Reduction (IPR) & Bonding Repairs As needed 30 min ¥8,000 ¥24,000
6 Removable Retainer Fabrication (Upper & Lower) One-time 60 min ¥35,000 ¥35,000
7 Post-Treatment Follow-Up & Retainer Adjustments 12 months 30 min ¥5,000 ¥60,000
8 Emergency Orthodontist Visit (Broken Bracket / Wire) Up to 2 visits 30 min ¥10,000 ¥20,000
GRAND TOTAL (Incl. 10% Consumption Tax) ¥620,000
  • Deposit: A non-refundable deposit of 20% (¥124,000) is required at the time of accepting this Quotation Estimate to secure your treatment slot with our Orthodontist in Japan Osaka.
  • Installment Plan: The remaining balance may be paid in 24 equal monthly installments of ¥16,667, aligned with your monthly adjustment appointments. No additional interest is charged for on-time payments.
  • Accepted Payment Methods: Cash, bank transfer (Japanese domestic), credit card (Visa, Mastercard, JCB), and Konbini convenience store payment.
  • Insurance Note: Orthodontic treatment for cosmetic purposes is generally not covered by Japan's National Health Insurance. However, if the Orthodontist determines that the treatment is medically necessary (e.g., severe malocclusion affecting mastication), partial coverage may apply. Our front desk will assist with insurance verification.
  • Quotation Validity: This Quotation Estimate is valid for 30 days from the date of issue. Prices are subject to revision based on material cost fluctuations or changes in Japanese tax regulations.
Important Note for International Patients in Japan Osaka: If you are a non-resident or foreign national residing in Japan Osaka, please present your residence card (Zairyu Card) or passport at your first visit. Our clinic provides multilingual support (English, Chinese, Korean) and can arrange interpreter services at no additional cost for the initial consultation. All medical records will be maintained in compliance with Japan's Personal Information Protection Act (PIPA).

Dr. Kenji Tanaka, DDS, is a board-certified Orthodontist registered with the Japanese Orthodontic Society (JOS) and the Japanese Society of Orthodontists (JSO). He holds a Doctor of Dental Surgery degree from Osaka University Graduate School of Dentistry and completed a 3-year orthodontic residency program. Osaka Central Orthodontic Clinic is a licensed medical facility (Medical Institution License No. 29-B-01234) operating in compliance with all regulations set by the Osaka Prefectural Government. The clinic is equipped with state-of-the-art digital orthodontic technology, including iTero 5D scanners, CBCT imaging, and 3D-printed aligner fabrication, ensuring the highest standard of care for every patient in Japan Osaka.

By signing below, the patient (or legal guardian) acknowledges receipt of this Quotation Estimate, agrees to the scope of Orthodontist services outlined above, and authorizes the commencement of treatment at Osaka Central Orthodontic Clinic, Japan Osaka.

Patient / Guardian Signature
Date: _______________
Dr. Kenji Tanaka, DDS
Orthodontist — Osaka Central Orthodontic Clinic
Date: _______________

This Quotation Estimate document is generated by Osaka Central Orthodontic Clinic, Japan Osaka. © 2025 All Rights Reserved.
For inquiries regarding this estimate, please contact our office at +81-6-6371-8820 or visit us at 2-14-8 Umeda, Kita-ku, Osaka, Japan.
Document Reference: QTE-OSK-2025-0487 | Page 1 of 1

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