Quotation Estimate Orthodontist in United Kingdom London –Free Word Template Download with AI
Prepared by a Registered Orthodontist Practising in United Kingdom London
Thames Orthodontic Centre142 Marylebone High Street
London, W1U 4NP
United Kingdom
Tel: +44 (0)20 7946 0821
Email: [email protected]
GDC Registration No: 10482937 Quotation Reference: QTE-2025-04872
Date of Issue: 12 June 2025
Valid Until: 12 September 2025
Prepared By: Dr. Eleanor Whitfield, BDS, MOrthRCSEng
Consultation Date: 28 May 2025
| Prepared For: | Mr. James A. Richardson |
| Address: | 7 Pembroke Road, Kensington, London, W8 6QT, United Kingdom |
| NHS / Private: | Private Patient (NHS Orthodontic Referral: Not Applicable) |
| Diagnosis: | Class II Division 1 Malocclusion with Upper Arch Crowding (6mm) and Protrusive Incisors |
| Treatment Option: | Fixed Orthodontic Appliances (Ceramic Braces) – Upper and Lower Arch |
Itemised Quotation Estimate – Orthodontic Services
| Ref | Description of Orthodontic Service | Duration / Frequency | Unit Price (GBP) | Total (GBP) |
|---|---|---|---|---|
| 01 | Initial Orthodontic Consultation & Diagnostic Records (Panoramic X-ray, OPG, Cephalometric Analysis, Intraoral Photography, Digital Impressions) | One-off | £350.00 | £350.00 |
| 02 | Comprehensive Treatment Planning & Digital Smile Design (includes 3D simulation of projected outcome) | One-off | £120.00 | £120.00 |
| 03 | Extraction of Upper Premolars (2 teeth) under local anaesthesia – performed by associated oral surgeon | One-off | £280.00 | £560.00 |
| 04 | Placement of Ceramic Fixed Orthodontic Braces – Upper Arch (14 brackets, archwire, elastic ligatures, bonding agent) | One-off | £1,850.00 | £1,850.00 |
| 05 | Placement of Ceramic Fixed Orthodontic Braces – Lower Arch (14 brackets, archwire, elastic ligatures, bonding agent) | One-off | £1,850.00 | £1,850.00 |
| 06 | Monthly Orthodontic Review & Adjustment Appointments (archwire changes, elastic adjustments, progress monitoring) | 18 months | £95.00 | £1,710.00 |
| 07 | Interproximal Reduction (IPR) – selective enamel stripping for space creation (estimated 8 surfaces) | As required | £45.00 | £360.00 |
| 08 | Removal of Fixed Orthodontic Appliances & Polishing (upper and lower arches) | One-off | £250.00 | £250.00 |
| 09 | Retention – Fixed Retainers (upper and lower) with composite bonding, plus two sets of removable Essix retainers | One-off | £480.00 | £480.00 |
| 10 | Post-Treatment Orthodontic Review (6-month and 12-month follow-up appointments to monitor retention stability) | 2 visits | £85.00 | £170.00 |
| 11 | Emergency Orthodontic Appointments (broken bracket, wire irritation, debonding) – included allowance | Up to 3 visits | £60.00 | £180.00 |
| Subtotal (All Orthodontic Services) | £7,980.00 |
| VAT (20% – applicable to private orthodontic treatment in the United Kingdom) | £1,596.00 |
| Grand Total (Quotation Estimate) | £9,576.00 |
* All prices are quoted in British Pounds Sterling (GBP). VAT at the standard rate of 20% is included as orthodontic treatment provided on a private basis in London, United Kingdom, is subject to Value Added Tax. This Quotation Estimate is valid for a period of three months from the date of issue.
Payment Schedule – Orthodontic Treatment in London
| Payment Stage | Due Date | Amount (GBP) | Notes |
|---|---|---|---|
| Deposit (upon acceptance of this Quotation Estimate) | Within 7 days of acceptance | £2,394.00 | 25% of grand total – secures treatment slot |
| Second Instalment (at appliance placement) | August 2025 | £2,394.00 | 25% of grand total |
| Third Instalment (mid-treatment review) | February 2026 | £2,394.00 | 25% of grand total |
| Final Instalment (at appliance removal) | February 2027 | £2,394.00 | 25% of grand total |
Terms & Conditions of this Quotation Estimate
- This Quotation Estimate is issued by Thames Orthodontic Centre, a registered dental practice operating in London, United Kingdom, and is valid for a period of ninety (90) days from the date of issue. After this period, prices may be subject to revision in line with prevailing orthodontic service costs in the London area.
- The total treatment duration is estimated at eighteen (18) months from the date of appliance placement. Actual duration may vary depending on individual biological response, patient compliance with oral hygiene and dietary instructions, and the clinical judgement of the treating Orthodontist.
- All orthodontic procedures described in this estimate will be carried out by or under the direct supervision of Dr. Eleanor Whitfield, a specialist Orthodontist registered with the General Dental Council (GDC) of the United Kingdom and a member of the Royal College of Surgeons of England (Orthodontics).
- The patient is required to attend all scheduled review appointments. Missed appointments without prior cancellation (minimum 48 hours' notice) will incur a fee of £75.00 per missed visit, in addition to any rescheduling costs.
- This Quotation Estimate does not include the cost of any additional orthodontic or dental treatment that may become necessary during the course of therapy (e.g., additional extractions, periodontal treatment, or restorative work) unless explicitly stated herein. Any such additional treatment will be discussed and separately quoted before commencement.
- Payment may be made by bank transfer, debit card, or credit card. A 3% surcharge applies to credit card payments in accordance with current United Kingdom financial regulations. Instalment plans are available subject to credit assessment.
- This Quotation Estimate is subject to the practice's standard Terms and Conditions of Treatment, which are available for review at the practice premises in Marylebone, London, and on the practice website. The patient will be asked to sign a separate Consent and Treatment Agreement prior to the commencement of orthodontic treatment.
- Complaints regarding the orthodontic treatment or the administration of this Quotation Estimate should be directed in the first instance to the Practice Manager. Should the matter remain unresolved, the patient may escalate the complaint in accordance with the practice's Complaints Procedure, which complies with the General Dental Council's Standards for the Dental Team (2024) applicable in the United Kingdom.
- This document constitutes a financial estimate only and does not constitute a guarantee of a specific orthodontic outcome. Individual results may vary. A detailed risk and benefit discussion will be provided at the pre-treatment consultation in accordance with the General Medical Council's guidance on consent, adapted for dental practice in London.
For and on behalf of Thames Orthodontic Centre
Dr. Eleanor Whitfield, BDS, MOrthRCSEngSpecialist Orthodontist
GDC Reg. No: 10482937
Date: _______________
Patient Acceptance
Mr. James A. RichardsonSignature: _______________
Date: _______________
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