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Quotation Estimate Orthodontist in United Kingdom Manchester –Free Word Template Download with AI

142 Deansgate, Manchester, M3 2ER, United Kingdom

Telephone: 0161 496 0000 | Email: [email protected]

Registered in England & Wales No. 08765432 | GDC Registered Practice

Quotation Estimate

Quotation Details

Quotation No.: QTE-2025-04871

Date Issued: 12 June 2025

Valid Until: 12 September 2025 (90 days)

Prepared By: Dr. Sarah Whitfield, BDS, MOrthRC

Practice Location: Manchester, United Kingdom

Client Details

Name: Mr. James A. Thornton

Address: 27 Chorlton Road, Manchester, M21 9QW

Telephone: 07700 900123

Email: [email protected]

NHS Number: 485 777 3456

Dear Mr. Thornton,

Thank you for your consultation at our Manchester orthodontic practice on 5 June 2025. Following a comprehensive clinical examination, digital intraoral scanning, and full cephalometric radiographic assessment, we are pleased to present this Quotation Estimate for your orthodontic treatment. This document outlines the full scope of services, associated costs, and payment terms for the orthodontic care to be provided by our team of registered Orthodontists at Manchester Orthodontic Centre, located in the heart of Manchester, United Kingdom.

1. Scope of Orthodontic Treatment

Based on the clinical findings, the recommended orthodontic treatment plan involves the correction of a Class II malocclusion with upper incisor crowding and a mild anterior open bite. The treatment will be carried out using a fixed appliance system (self-ligating brackets) on both the upper and lower dental arches, supplemented by intermaxillary elastics and periodic adjustments. The estimated total treatment duration is between 24 and 30 months, subject to individual biological response and compliance with the prescribed orthodontic protocol.

2. Itemised Quotation Estimate
Ref Description of Service Unit Rate (GBP) Amount (GBP)
1.1 Initial orthodontic consultation, clinical examination, and treatment planning (Manchester, United Kingdom) 1 £120.00 £120.00
1.2 Digital intraoral scanning (upper and lower arches) and 3D treatment simulation 1 £95.00 £95.00
1.3 Full orthodontic radiographic set (OPG, lateral cephalogram, and periapical films) 1 £110.00 £110.00
2.1 Placement of self-ligating fixed orthodontic brackets – upper arch (14 brackets) 1 £1,450.00 £1,450.00
2.2 Placement of self-ligating fixed orthodontic brackets – lower arch (14 brackets) 1 £1,450.00 £1,450.00
2.3 Archwire changes, elastic ligature replacements, and routine orthodontic adjustments (estimated 18 visits over 24–30 months) 18 £85.00 £1,530.00
2.4 Intermaxillary elastics (supplied in packs of 10, estimated 12 packs over treatment) 12 £12.00 £144.00
2.5 Removal of fixed orthodontic appliances and debonding (upper and lower arches) 1 £350.00 £350.00
3.1 Post-orthodontic retention – upper and lower fixed lingual retainers (bonded) 1 £420.00 £420.00
3.2 Removable Essix retainer (upper and lower) – first set 1 £280.00 £280.00
3.3 Annual orthodontic review and retainer check (Year 1 post-treatment) 2 £60.00 £120.00
4.1 Emergency orthodontic appointment (broken bracket, wire irritation) – included up to 3 visits 3 £0.00 £0.00
4.2 Additional emergency orthodontic visits beyond the included allowance per visit £75.00 —
Subtotal (Excluding VAT) £6,369.00
VAT (20% – where applicable under UK HMRC regulations) £1,273.80
Total Quotation Estimate (Including VAT) £7,642.80

Please note: In accordance with UK tax legislation, certain orthodontic services provided to patients under the age of 18 are exempt from VAT. For adult patients, VAT at the standard rate of 20% applies to all items listed above. This Quotation Estimate reflects the standard rate applicable to adult orthodontic treatment in Manchester, United Kingdom.

3. Payment Terms and Conditions
  • Deposit: A non-refundable deposit of £500.00 is required to secure your treatment appointment and commence the orthodontic programme. This deposit is deducted from the total Quotation Estimate.
  • Payment Plan: The remaining balance of £7,142.80 may be settled in equal monthly instalments of £330.63 over a period of 22 months, or in a single lump sum at the commencement of active orthodontic treatment. No interest is charged on the interest-free payment plan.
  • Alternative Financing: Manchester Orthodontic Centre partners with several UK-based healthcare finance providers offering 0% APR plans over 12, 24, or 36 months. Further details are available upon request.
  • NHS Orthodontic Services: Please be advised that this Quotation Estimate is for private orthodontic treatment. NHS orthodontic treatment in Manchester is available only for patients under 18 with a severity rating of 7 or above on the IOTN scale, and is subject to referral by your GP and a waiting list. This private estimate is independent of any NHS pathway.
  • Quotation Validity: This Quotation Estimate is valid for 90 days from the date of issue. Prices are subject to review in line with the practice's annual fee schedule and any changes in UK regulatory or tax requirements.
  • Scope Variations: Should the orthodontist determine during treatment that additional procedures are required (e.g., extraction of premolars, orthognathic referral, or extended retention), a supplementary Quotation Estimate will be issued and agreed upon in writing before any additional work commences.
  • Compliance: The patient is expected to attend all scheduled orthodontic appointments at the Manchester practice and to adhere to the prescribed dietary and oral hygiene instructions. Failure to attend appointments without 48 hours' notice may incur a £50.00 cancellation fee.
  • Complaints and Regulation: Manchester Orthodontic Centre is registered with the General Dental Council (GDC) and is a member of the British Orthodontic Society (BOS). Any concerns regarding the orthodontic treatment may be raised with the practice manager or, alternatively, with the GDC at 36 Red Lion Square, London, WC1R 4PF.
4. Acceptance and Authorisation

By signing below, the patient confirms that they have read and understood this Quotation Estimate for orthodontic treatment at Manchester Orthodontic Centre, Manchester, United Kingdom. The patient acknowledges that the figures provided are estimates based on the current clinical assessment and that the final cost may vary slightly depending on the actual duration and complexity of the orthodontic treatment delivered.

Patient Signature:

Name: Mr. James A. Thornton

Date: ______________________

Orthodontist / Practice Representative:

Name: Dr. Sarah Whitfield, BDS, MOrthRC

Date: ______________________

Manchester Orthodontic Centre | 142 Deansgate, Manchester, M3 2ER, United Kingdom

Registered in England & Wales No. 08765432 | GDC Practice No. 5543210 | VAT No. GB 123 4567 89

This Quotation Estimate is issued in accordance with the practice's terms of service and applicable UK dental regulatory standards.

© 2025 Manchester Orthodontic Centre. All rights reserved.

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