Quotation Estimate Orthodontist in Peru Lima –Free Word Template Download with AI

Dear Ms. Quispe Torres,

Thank you for scheduling your comprehensive orthodontic consultation at our clinic in Lima, Peru. Following your recent evaluation by our senior Orthodontist, Dr. Ricardo Mendoza Salazar (CEM 004521), we are pleased to present this formal Quotation Estimate detailing the complete orthodontic treatment plan recommended for you. This Quotation Estimate has been prepared in accordance with the standards established by the Colegio Odontológico del Perú and reflects the current market rates for orthodontic services in the Lima metropolitan area.

This Quotation Estimate for orthodontic services may be settled through the following payment options available to residents of Lima, Peru:

• Full Payment: 5% discount applied upon full settlement prior to the first treatment session. Total becomes S/ 11,916.23 (IGV included).
• Installment Plan (18 months): Monthly payment of S/ 696.86 (IGV included), payable on the 5th of each month via bank transfer to BCP, Interbank, or BBVA accounts registered in Lima.
• Down Payment + Installments: 30% down payment (S/ 3,763.02) at the time of brace placement, followed by 17 monthly installments of S/ 563.50.
• Insurance / Prepaid Plans: We accept coverage from major Peruvian health insurance providers including EsSalud (for covered orthodontic procedures), Rimac Seguros, Pacífico Seguros, and Mapfre. Please present your policy card at the time of your first visit.

• This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After this period, prices may be adjusted to reflect current orthodontic material costs in the Lima market.
• All orthodontic procedures will be performed exclusively by Dr. Ricardo Mendoza Salazar, a certified Orthodontist with over fifteen years of clinical experience in Lima, Peru, and a member of the American Association of Orthodontists (AAO) and the Sociedad Peruana de Ortodoncia.
• The estimated treatment duration of eighteen (18) months is based on the initial diagnostic records. The Orthodontist reserves the right to adjust the timeline based on individual patient response and clinical progress observed during monthly adjustments.
• Any additional procedures not included in this Quotation Estimate (such as orthognathic surgery referrals, additional extractions, or extended retention) will be communicated in writing and require the client's prior authorization before being performed.
• The client is responsible for maintaining proper oral hygiene throughout the orthodontic treatment. Failure to attend scheduled appointments in Lima may result in a rescheduling fee of S/ 80.00 per missed visit.
• This Quotation Estimate does not constitute a binding contract. A formal treatment agreement will be executed upon the client's acceptance of this estimate and the scheduling of the first procedure.
• All prices are quoted in Peruvian Soles (S/) and include the applicable IGV of 18% as mandated by the Superintendencia Nacional de Aduanas y de Administración Tributaria (SUNAT) of Peru.
• Our clinic operates Monday through Friday from 8:00 AM to 6:00 PM and Saturday from 9:00 AM to 1:00 PM, located in the San Isidro district of Lima, Peru.

By signing below, the client acknowledges receipt of this Quotation Estimate and agrees to the terms and conditions outlined above. The client confirms that the Orthodontist has explained the recommended treatment plan, expected outcomes, potential risks, and alternative options in a manner that is fully understood.