Quotation Estimate Surgeon in Italy Milan –Free Word Template Download with AI
Professional Surgeon Services — Italy Milan
Medical Consulting & Surgical Services Division
1. Client / Recipient Information| Client Name: | MediCorp International Health Services S.r.l. |
| Address: | Via Montenapoleone, 22 — 20121 Milan, Italy |
| VAT / P.IVA: | IT09876543210 |
| Contact Person: | Ing. Francesca Colombo — Procurement Director |
| Reference / RFP No.: | MC-2025-SURG-0412 |
This Quotation Estimate is issued in response to the formal request for professional surgical services to be rendered by a qualified Surgeon within the metropolitan area of Italy Milan. The scope encompasses the full spectrum of surgical consultation, operative procedures, post-operative care, and related medical support as detailed below. All services shall be performed in compliance with the regulations set forth by the Italian Ministry of Health (Ministero della Salute) and the professional standards of the Ordine dei Medici Chirurghi e degli Odontoiatri della Provincia di Milano.
The Surgeon designated for this engagement holds board certification in General and Visceral Surgery, with over twenty-two years of clinical experience at leading hospitals in the Milan region. The operative and consultation facilities are located at the Ospedale San Raffaele campus in Milan, Italy, which is fully accredited under the Italian national hospital quality framework (Accreditamento Istituzionale).
3. Itemized Cost Breakdown| No. | Description of Service | Quantity | Unit Price (EUR) | Total (EUR) | Notes |
|---|---|---|---|---|---|
| 1 | Initial surgical consultation and diagnostic assessment by the Surgeon in Milan, Italy (includes review of imaging, blood work, and physical examination) | 1 session | 1,200.00 | 1,200.00 | Half-day |
| 2 | Pre-operative planning meeting with the Surgeon and anaesthesiology team at the Milan facility | 1 session | 850.00 | 850.00 | Includes risk assessment |
| 3 | Primary surgical procedure (laparoscopic cholecystectomy) performed by the Surgeon, including operating theatre time, surgical instruments, and disposable materials | 1 procedure | 12,500.00 | 12,500.00 | 4-hour theatre block |
| 4 | Post-operative inpatient care (3 nights) including daily rounds by the Surgeon, nursing care, and monitoring | 3 nights | 1,800.00 | 5,400.00 | Private room |
| 5 | Follow-up consultations with the Surgeon (2 post-operative visits within 30 days in Milan, Italy) | 2 visits | 600.00 | 1,200.00 | Week 2 and Week 6 |
| 6 | Pathology and histological analysis of excised tissue samples | 1 set | 950.00 | 950.00 | Lab Milan |
| 7 | Translation and certification of all medical reports, operative notes, and discharge documentation into English | 1 package | 450.00 | 450.00 | Sworn translator |
| 8 | Emergency on-call coverage by the Surgeon for 14 days post-discharge (telephone and in-person availability in the Milan area) | 14 days | 350.00 | 4,900.00 | 24/7 standby |
| Subtotal (excl. VAT) | 27,450.00 | ||||
| VAT (22% — Italian standard rate) | 6,039.00 | ||||
| TOTAL AMOUNT DUE (EUR) | 33,489.00 | ||||
- This Quotation Estimate constitutes a formal offer for the professional services of the named Surgeon and associated medical staff at the specified facility in Italy Milan. Acceptance of this Quotation Estimate shall be confirmed in writing by the client within the validity period stated above.
- Payment terms: 40% of the total amount shall be due upon signing of the service agreement; 40% shall be due prior to the scheduled surgical date; and the remaining 20% shall be due within 15 business days following discharge from the hospital in Milan.
- All payments shall be made via bank transfer to the account of Ospedale San Raffaele S.p.A., IBAN: IT60 X030 0000 0000 0000 0000 000, BIC: BLOPIT22. Reference: Quotation Estimate No. QM-2025-07483.
- The Surgeon reserves the right to modify the surgical approach intra-operatively if clinical findings necessitate a change in technique. Any additional costs arising from such modifications will be communicated to the client or their designated representative prior to or immediately after the procedure, and will be itemized in a supplementary invoice.
- This Quotation Estimate does not include costs for pre-operative imaging (CT, MRI, ultrasound) performed at external facilities, pharmaceuticals administered during inpatient stay, or any ancillary services not explicitly listed in Section 3 above.
- All medical records, operative reports, and pathology findings generated in connection with this engagement shall be the property of the treating facility in Milan, Italy, and shall be made available to the client or their referring physician upon written request, in accordance with Italian data protection regulations (GDPR and D.Lgs. 196/2003).
- Liability: The Surgeon and the facility shall bear professional liability in accordance with Italian civil law (Codice Civile, Articles 2043–2059) and the applicable professional indemnity insurance policy. The client acknowledges that all surgical procedures carry inherent risks, which shall be fully disclosed during the pre-operative consultation.
- Dispute resolution: Any disputes arising from this Quotation Estimate or the subsequent service agreement shall be resolved through the competent courts of Milan, Italy, or by arbitration under the rules of the Camera di Commercio di Milano, at the election of the aggrieved party.
- This Quotation Estimate is non-transferable and is issued exclusively for the client named in Section 2. Any assignment or sub-contracting of the services described herein requires prior written consent from the Surgeon and the facility.
By signing below, the client acknowledges receipt of this Quotation Estimate for Surgeon services in Italy Milan, accepts the terms, conditions, and pricing outlined herein, and authorizes the commencement of the described medical services upon fulfillment of the payment schedule.
For the Surgeon / FacilityDr. Alessandro Marchetti, M.D., Ph.D.
Chief of Surgery, Ospedale San Raffaele
Milan, Italy
Date: _______________ For the Client
MediCorp International Health Services S.r.l.
Ing. Francesca Colombo
Milan, Italy
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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