Quotation Estimate Orthodontist in Pakistan Islamabad –Free Word Template Download with AI

Capital Smile Orthodontic Centre
F-7/2, Jinnah Avenue, Blue Area
Islamabad, Pakistan 44000
Phone: +92-51-227-XXXX
Email: [email protected] Prepared For:
Mr. Ahmed Raza Khan
G-13/4, Sector G-13
Islamabad, Pakistan 44000
Phone: +92-300-XXXXXXX

Quotation Estimate No.	QTE-2025-0487
Date of Issue	15 June 2025
Valid Until	15 July 2025 (30 days from date of issue)
Specialist Orthodontist	Dr. Sana Malik, MDS (Orthodontics), FCPS
Location of Treatment	Capital Smile Orthodontic Centre, Blue Area, Pakistan Islamabad
Currency	Pakistani Rupees (PKR)

The following Quotation Estimate has been prepared by our senior Orthodontist in Pakistan Islamabad after a comprehensive clinical examination, digital X-ray analysis (OPG and panoramic radiograph), intraoral photography, and study model assessment of the patient. This document outlines the complete scope of orthodontic treatment, associated materials, professional fees, and ancillary services required to achieve optimal dental alignment and occlusal correction.

#	Service / Procedure	Description	Frequency	Amount (PKR)
1	Initial Consultation & Diagnostic Workup	Clinical examination, OPG X-ray, cephalometric analysis, intraoral scans, and treatment planning by the Orthodontist	One-time	15,000
2	Pre-Orthodontic Dental Hygiene & Scaling	Full-mouth ultrasonic scaling, polishing, and periodontal assessment prior to appliance placement	One-time	8,500
3	Extraction of Premolars (2 teeth)	Surgical extraction of two first premolars under local anesthesia as part of the Orthodontist's treatment protocol	One-time	12,000
4	Fixed Metal Braces (Full Arch — Upper & Lower)	Placement of 0.022" stainless steel brackets, archwires, ligatures, and bands on all 28 teeth. Includes all adjustment visits.	18 months	185,000
5	Monthly Adjustment & Wire Changes	Regular Orthodontist review appointments, archwire changes, elastic replacements, and progress monitoring	18 visits	45,000
6	Elastics & Auxiliary Appliances	Intermaxillary elastics, power chains, and any auxiliary orthodontic devices required during treatment	18 months	18,000
7	Debonding & Finishing	Removal of all brackets, bonding residue polishing, and final occlusal adjustment by the Orthodontist	One-time	12,000
8	Retainers (Upper & Lower)	Two sets of clear acrylic retainers (Hawley type) with 6-month follow-up checks for the first year post-treatment	One-time + follow-up	14,000
9	Post-Treatment Review & Records	Final OPG, intraoral photographs, and written aftercare instructions from the Orthodontist	One-time	5,500
TOTAL ESTIMATED COST				PKR 315,000

This Quotation Estimate for Orthodontist services in Pakistan Islamabad may be settled through the following installment plan to ease the financial burden on the patient:

Advance Payment (at appliance placement): PKR 120,000
Second Installment (Month 6): PKR 100,000
Final Installment (Month 12, at debonding): PKR 95,000

Payment may be made via bank transfer, cash, or major credit/debit cards. A 5% discount will be applied if the full amount is paid in a single lump sum at the time of initial consultation.

Important Notes Regarding This Quotation Estimate

This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After the validity period, the Orthodontist in Pakistan Islamabad reserves the right to revise pricing due to changes in material costs or exchange rates.
The total treatment duration is estimated at eighteen (18) months. However, the actual duration may vary by two to four months depending on the patient's biological response, compliance with elastics, and attendance at scheduled Orthodontist appointments.
Any emergency visits, broken bracket repairs, or additional procedures not listed in this Quotation Estimate will be quoted separately at the prevailing clinic rates.
The patient is expected to attend all scheduled adjustment appointments at the clinic located in Blue Area, Pakistan Islamabad. Missed appointments beyond two consecutive visits may result in a rescheduling fee of PKR 2,000 per occurrence.
Proper oral hygiene maintenance is the patient's responsibility. Neglect of hygiene leading to decalcification, gingivitis, or caries during treatment will incur additional treatment costs not covered by this estimate.
This Quotation Estimate does not include the cost of any pre-existing dental restorations, root canal treatments, or periodontal surgery that may be identified during the course of orthodontic therapy.
All materials used are of international standard (Dentsply, 3M Unitek, or equivalent) and are sterilized according to Pakistan Medical & Dental Council (PMDC) guidelines.
The Orthodontist providing this treatment is a registered specialist with the Pakistan Medical & Dental Council and holds a valid practice license for Islamabad, Pakistan.

By signing below, the patient acknowledges that they have received and reviewed this Quotation Estimate for Orthodontist services in Pakistan Islamabad, understand the scope of treatment, associated costs, and the terms and conditions outlined above. The patient consents to proceed with the treatment plan as described.

Patient / Guardian Signature
Name: Ahmed Raza Khan
Date: _______________ Orthodontist / Clinic Representative
Dr. Sana Malik, MDS (Ortho)
Capital Smile Orthodontic Centre, Islamabad
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX

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