Quotation Estimate Surgeon in Colombia Bogotá –Free Word Template Download with AI

This Quotation Estimate is issued by our institution in Colombia Bogotá to formally outline the scope, schedule, and associated costs for the surgical procedure to be performed by our designated Surgeon, Dr. Alejandro Restrepo M. The Surgeon holds over eighteen (18) years of clinical experience in general surgery, laparoscopic procedures, and post-operative care, and is fully registered with the Colombian Ministry of Health and the Bogotá Medical Association. All services described herein are to be rendered at our accredited surgical center located in the Usaquén district of Bogotá, Colombia, in strict compliance with the regulations established by the Superintendencia Nacional de Salud and the Colombian Health Regulatory Authority (RESOLUCIÓN 3100 DE 2019).

• This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. After this period, prices may be subject to revision due to changes in medical supply costs, currency fluctuations, or institutional fee adjustments in Colombia Bogotá.
• The final cost may vary by up to fifteen percent (15%) depending on intra-operative findings, the complexity of the surgical intervention, or the necessity of additional procedures determined by the Surgeon during the operation. Any such additional costs will be communicated to the patient or legal representative prior to or immediately after the procedure, with written informed consent obtained in accordance with Colombian medical law (Ley 1564 de 2012).
• Payment terms: A deposit of fifty percent (50%) of the total estimated amount is required at the time of scheduling the surgery. The remaining fifty percent (50%) is due within five (5) business days following discharge from the facility. Accepted payment methods include bank transfer to our Bogotá account, credit/debit card, or direct billing to the patient's EPS (Sanitas) where coverage applies.
• The Surgeon reserves the right to reschedule the procedure in the event of medical contraindications identified during pre-operative evaluation, force majeure, or operating room unavailability. In such cases, the patient will be notified at least forty-eight (48) hours in advance, and no cancellation fee will apply.
• All medical records, surgical reports, and post-operative documentation will be maintained in compliance with the data protection regulations of Colombia (Ley 1581 de 2012) and stored at our facility in Bogotá D.C. for a minimum of ten (10) years.
• This Quotation Estimate does not constitute a guarantee of surgical outcome. The Surgeon will perform the procedure with the standard of care expected of a reasonably competent surgeon in Colombia Bogotá, and all risks associated with anesthesia and surgery will be detailed in a separate informed consent document signed by the patient prior to the procedure.
• Any disputes arising from this Quotation Estimate or the services rendered shall be subject to the jurisdiction of the civil and commercial courts of Bogotá, Colombia.

By signing below, the patient (or legal representative) acknowledges receipt of this Quotation Estimate, understands the scope of services to be provided by the Surgeon in Colombia Bogotá, and agrees to the terms and conditions outlined herein. This signature does not constitute a binding commitment to proceed with the surgery until the pre-operative evaluation is completed and the surgical date is confirmed.