Quotation Estimate Orthodontist in Morocco Casablanca –Free Word Template Download with AI

Quotation Estimate Quotation No.: QE-2025-0487 Date Issued: 15 June 2025 Valid Until: 15 July 2025 Prepared For: Mr. Youssef El Amrani
Address: 45, Rue Ibn Sina, Maârif, Casablanca, Morocco
Phone: +212 6 61 23 45 67 Prepared By: Dr. Salma Benkirane, DMD, MSc Orthodontics
Chief Orthodontist, Clinique Al Amal
Licence No. ORTH-2019-00342

Patient & Clinical Summary

This Quotation Estimate has been prepared following a comprehensive orthodontic consultation conducted at our Casablanca clinic on 10 June 2025. The patient, Mr. Youssef El Amrani, presented with a Class II malocclusion, moderate crowding in the lower anterior segment, and a 4 mm overjet. After reviewing panoramic radiographs, cephalometric analysis, intraoral photographs, and digital impressions, our Orthodontist in Morocco Casablanca has recommended a full fixed orthodontic treatment plan combined with periodic maintenance sessions. The following Quotation Estimate details all anticipated services, materials, and associated costs for the complete orthodontic journey.

Itemized Quotation Estimate – Orthodontic Treatment Plan

Ref	Description of Service / Material	Qty	Unit Price (MAD)	Total (MAD)	Duration / Frequency
01	Initial Orthodontic Consultation & Diagnostic Workup (panoramic X-ray, cephalometric X-ray, intraoral scan, clinical photographs)	1	1,200.00	1,200.00	One-time
02	Full-Mouth Fixed Orthodontic Braces – Metal (upper and lower arches), including brackets, archwires, ligatures, and bonding materials	1	18,500.00	18,500.00	Installation (one-time)
03	Monthly Orthodontic Adjustment & Wire Changes (archwire upgrades, elastic changes, bracket re-bonding if needed)	14	800.00	11,200.00	Monthly over 14 months
04	Interproximal Reduction (IPR) – selective enamel stripping for crowding resolution	1	2,500.00	2,500.00	One-time (2–3 sessions)
05	Orthodontic Elastics & Auxiliary Appliances (headgear or Class II elastics as prescribed)	14	350.00	4,900.00	Monthly supply
06	Debonding, Finishing, and Polishing (removal of all brackets, adhesive cleanup, occlusal adjustment)	1	3,000.00	3,000.00	One-time
07	Fixed Retainers (upper and lower, 0.016" stainless steel wire bonded to lingual surfaces)	1	4,500.00	4,500.00	One-time
08	Removable Night Retainers (Hawley type, upper and lower, acrylic with wire)	2	1,800.00	3,600.00	One-time (first year)
09	Post-Treatment Orthodontic Review & Retainer Adjustments (included follow-up visits)	4	500.00	2,000.00	At 1, 3, 6, and 12 months post-treatment
10	Emergency Orthodontic Appointment (wire poking, bracket detachment, elastic replacement – up to 3 visits)	3	400.00	1,200.00	As needed
TOTAL ESTIMATED COST (MAD)				52,600.00

Note: All prices are quoted in Moroccan Dirhams (MAD) and include applicable VAT (20%) as per Moroccan tax regulations. This Quotation Estimate is based on the current treatment plan and may be subject to minor adjustments should the Orthodontist in Morocco Casablanca identify additional clinical needs during the course of treatment. No hidden fees are included; all ancillary materials are accounted for above.

Payment Terms & Conditions

Deposit: A non-refundable deposit of 30% (15,780.00 MAD) is due upon acceptance of this Quotation Estimate to secure the patient's treatment slot and initiate the orthodontic process.
Installment Plan: The remaining balance (36,820.00 MAD) may be paid in 14 equal monthly installments of 2,630.00 MAD, aligned with each monthly adjustment visit. Alternatively, the patient may opt for a lump-sum payment of the full balance at the time of bracket installation, in which case a 5% discount (2,630.00 MAD) will be applied.
Payment Methods: Cash, bank transfer (RIB: 011 680 0000123456789 92 – Bank of Africa, Casablanca), or credit/debit card (Visa, Mastercard) are accepted at our clinic located in the Gauthier district of Casablanca.
Validity: This Quotation Estimate is valid for 30 calendar days from the date of issue. After 15 July 2025, prices may be revised to reflect changes in material costs or exchange rates.
Treatment Duration: The estimated total treatment duration is 14 to 18 months, depending on biological response and patient compliance with elastics and oral hygiene instructions provided by our Orthodontist in Morocco Casablanca.
Cancellations: In the event the patient withdraws from treatment after the deposit has been paid, the deposit is non-refundable. If cancellation occurs after bracket installation, a pro-rata charge for materials already used will apply.
Warranty: All orthodontic appliances and retainers carry a 6-month warranty against manufacturing defects. Normal wear, breakage due to patient misuse, or damage from dietary habits (e.g., biting hard objects) is not covered under warranty.
Confidentiality: All patient records, radiographs, and clinical data are handled in strict accordance with Moroccan Law 09-08 on the protection of personal data. This Quotation Estimate and all associated documents are confidential and intended solely for the named patient.
Regulatory Compliance: Clinique Dentaire & Orthodontique Al Amal operates under the supervision of the Moroccan Ministry of Health and the Ordre des Médecins Dentistes du Maroc. Dr. Benkirane holds a valid orthodontic practice licence issued by the Regional Health Directorate of Casablanca-Settat.

Acceptance & Authorization

By signing below, the patient acknowledges that this Quotation Estimate has been reviewed, all terms and conditions have been explained, and the recommended orthodontic treatment plan has been understood. The patient consents to proceed with the treatment as outlined by the Orthodontist in Morocco Casablanca and agrees to the payment schedule specified herein.

Patient Signature & Date

Mr. Youssef El Amrani

Orthodontist Signature & Stamp

Dr. Salma Benkirane, DMD, MSc

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