Quotation Estimate Orthodontist in Switzerland Zurich –Free Word Template Download with AI
Bahnhofstrasse 42, 8001 Zürich, Switzerland
Phone: +41 44 555 1234 | Email: [email protected]
Swiss Medical Association Member No. CH-8001-4472 | VAT No. CHE-112.345.678
Quotation EstimatePrepared For (Patient)
Name: Dr. Anna Müller
Address: Seefeldstrasse 18, 8008 Zürich, Switzerland
Phone: +41 79 123 4567
Email: [email protected]
Insurance: Swiss Health Insurance (Krankenkasse) – Policy No. KAS-2024-8891
Quotation Details
Quotation No.: QTE-2025-00347
Date of Issue: 15 June 2025
Valid Until: 15 September 2025
Prepared By: Dr. Lukas Berger, Orthodontist
Referral: Dr. Sophie Keller, General Dentist, Zürich
This Quotation Estimate has been prepared by the Zürich Orthodontic Centre AG, a licensed and fully accredited Orthodontist practice located in the heart of Switzerland Zurich. The purpose of this document is to provide Dr. Anna Müller with a comprehensive, transparent, and itemised breakdown of all anticipated costs associated with the proposed orthodontic treatment plan. As a registered Orthodontist operating under Swiss medical regulations, our practice in Switzerland Zurich is committed to ensuring that every patient receives a detailed Quotation Estimate prior to the commencement of any treatment, in full compliance with the Swiss Federal Act on Human Data Protection and the Swiss Medical Association guidelines.
The following Quotation Estimate covers the complete orthodontic intervention, including initial diagnostic assessments, active treatment phases, retention, and all follow-up consultations. All pricing is quoted in Swiss Francs (CHF) and reflects the current fee schedule of our Orthodontist practice as of the date of issue. Please note that this Quotation Estimate is a good-faith estimate and may be subject to minor adjustments should the clinical presentation change during the course of treatment.
| Item No. | Description of Service | Frequency | Unit Price (CHF) | Estimated Total (CHF) |
|---|---|---|---|---|
| 01 | Initial Orthodontic Consultation & Diagnostic Assessment (including panoramic X-ray, cephalometric analysis, intraoral photography, and digital 3D scan) | One-time | 450.00 | 450.00 |
| 02 | Comprehensive Treatment Planning & Digital Mock-up Presentation | One-time | 320.00 | 320.00 |
| 03 | Placement of Fixed Ceramic Braces (upper and lower arches, 28 brackets, archwires, ligatures) | One-time | 3,800.00 | 3,800.00 |
| 04 | Monthly Adjustment & Active Treatment Visits (archwire changes, elastic adjustments, progress monitoring) | 18 months | 280.00 | 5,040.00 |
| 05 | Interproximal Reduction (IPR) – enamel stripping for space creation (estimated 12 surfaces) | As required | 45.00 | 540.00 |
| 06 | Removal of Fixed Appliances & Final Bite Registration | One-time | 400.00 | 400.00 |
| 07 | Custom Fabrication & Placement of Fixed Retainers (upper and lower arches) | One-time | 650.00 | 650.00 |
| 08 | Removable Night Retainers (upper and lower, including 2 replacement sets over 2 years) | One-time | 520.00 | 520.00 |
| 09 | Post-Treatment Review Appointments (at 3, 6, 12, and 24 months post-debonding) | 4 visits | 150.00 | 600.00 |
| 10 | Emergency / Unscheduled Adjustments (estimated 2 visits for bracket re-cementation or wire adjustments) | As needed | 180.00 | 360.00 |
| Subtotal (All Services) | CHF 12,680.00 | |||
| Swiss VAT (7.7%) | CHF 976.24 | |||
| Grand Total (Quotation Estimate) | CHF 13,656.24 | |||
As a licensed Orthodontist in Switzerland Zurich, our practice accepts all major Swiss basic health insurance (Krankentagg) providers. The patient's supplementary orthodontic insurance (Zusatzversicherung) will typically cover a portion of the costs outlined in this Quotation Estimate. We recommend that Dr. Müller submit this Quotation Estimate directly to her insurance provider for pre-approval and to confirm the exact reimbursement percentage before treatment begins. Our billing team in Switzerland Zurich will handle all insurance claim submissions on the patient's behalf.
Payment may be arranged in the following manner: a 20% deposit (CHF 2,731.25) is due upon acceptance of this Quotation Estimate, with the remaining balance payable in equal monthly instalments over the 18-month active treatment period. All payments are accepted in Swiss Francs via bank transfer, credit card, or direct debit. A detailed invoice will be issued after each treatment visit.
- This Quotation Estimate is valid for a period of 90 days from the date of issue (15 June 2025 to 15 September 2025). After this period, a revised Quotation Estimate may be required to reflect any changes in material costs or clinical findings.
- The total treatment duration is estimated at 18 to 24 months. The Orthodontist reserves the right to extend or shorten the treatment period based on clinical progress, which may affect the final cost.
- Should the patient discontinue treatment before completion, a cancellation fee of 15% of the remaining estimated balance will apply, in accordance with Swiss consumer protection regulations.
- All diagnostic records, digital scans, and treatment files remain the property of the Zürich Orthodontic Centre AG. The patient is entitled to a full copy of all records upon request, as mandated by Swiss medical law.
- This Quotation Estimate does not include costs for general dental treatment (e.g., fillings, extractions, periodontal therapy) that may be required prior to or during orthodontic treatment. Such services will be quoted separately by the referring general dentist.
- The Orthodontist practice in Switzerland Zurich operates under the Swiss Federal Act on Human Data Protection (DSG). All patient data is stored securely and will not be shared with third parties without explicit written consent.
- Any disputes arising from this Quotation Estimate shall be resolved under the jurisdiction of the courts of the Canton of Zürich, Switzerland.
By signing below, the patient acknowledges receipt of this Quotation Estimate and confirms that all terms, conditions, and estimated costs have been explained by the Orthodontist. The patient agrees to the proposed treatment plan and payment schedule as outlined in this document.
Patient Signature:
Name: Dr. Anna Müller
Date: ____________________
Signature: ____________________
Orthodontist / Practice Representative:
Name: Dr. Lukas Berger, Orthodontist
Zürich Orthodontic Centre AG, Switzerland Zurich
Date: ____________________
Signature: ____________________
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