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Quotation Estimate Surgeon in Malaysia Kuala Lumpur –Free Word Template Download with AI

Level 12, Menara Medical, Jalan Sultan Ismail, 50250 Kuala Lumpur, Malaysia

Tel: +603-2181 4567 | Email: [email protected]

Registration No: 201901012345 (K) | Medical Board Malaysia License: MBM-2024-08871

Quotation Estimate

Quotation Details

Quotation No: QTE-2025-0712-KL

Date of Issue: 15 June 2025

Valid Until: 15 July 2025

Prepared By: Dr. Ahmad Farid bin Hassan, Consultant Surgeon

Specialty: General & Laparoscopic Surgery

Client / Recipient

Company: [Client Name / Corporate Entity]

Address: [Client Address], Kuala Lumpur, Malaysia

Contact Person: [Name]

Email: [[email protected]]

Phone: +60 [number]

Dear Sir/Madam,

Thank you for your inquiry regarding the professional services of a qualified Surgeon based in Malaysia Kuala Lumpur. This Quotation Estimate has been prepared in accordance with your requirements for surgical consultation, operative procedures, and post-operative care. MediSurge Specialist Surgical Centre is a fully accredited facility registered with the Ministry of Health Malaysia and the Malaysian Medical Council, ensuring that all surgical services delivered in Malaysia Kuala Lumpur meet the highest standards of clinical excellence and patient safety.

The following Quotation Estimate outlines the comprehensive fee structure for the engagement of our Surgeon team. All rates are quoted in Malaysian Ringgit (MYR) and are inclusive of applicable Goods and Services Tax (GST) at the prevailing rate of 8% as mandated by the Inland Revenue Board of Malaysia.

Itemised Quotation Estimate – Surgeon Services
No. Description of Service Quantity Unit Rate (MYR) Amount (MYR) Remarks
1 Initial Surgical Consultation & Assessment by Consultant Surgeon 1 session 850.00 850.00 60-minute consultation at KL clinic
2 Pre-operative Diagnostic Workup (Blood panels, Imaging, ECG, Anaesthesia Review) 1 package 2,400.00 2,400.00 Includes CT/MRI as required
3 Operative Procedure – Laparoscopic Cholecystectomy (Surgeon Fee) 1 procedure 8,500.00 8,500.00 Surgeon & Assistant Surgeon
4 Operating Theatre Charges & Surgical Consumables 1 session 4,200.00 4,200.00 Includes laparoscopic equipment
5 Anaesthesiologist Fee (General Anaesthesia) 1 session 3,800.00 3,800.00 Includes pre & post-anaesthesia care
6 Inpatient Hospitalisation – Private Ward (2 nights) 2 nights 1,850.00 3,700.00 Single room with attendant bed
7 Post-operative Follow-up Consultations (Surgeon) 3 sessions 450.00 1,350.00 Day 3, Day 14, Day 30 reviews
8 Pharmaceuticals & Post-operative Medications 1 package 680.00 680.00 Analgesics, antibiotics, DVT prophylaxis
9 Pathology & Histology (Tissue Biopsy Analysis) 1 sample 950.00 950.00 Report within 5 working days
10 Emergency Call-out / On-call Surgeon Availability (24-hour standby) 1 day 1,200.00 1,200.00 Post-operative emergency coverage
SUBTOTAL (Before Tax) 27,630.00
GST @ 8% 2,210.40
TOTAL QUOTATION ESTIMATE (MYR) 29,840.40
Terms & Conditions of This Quotation Estimate
  1. This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. Beyond this period, the Surgeon fees and associated charges in Malaysia Kuala Lumpur are subject to revision based on prevailing medical fee schedules and hospital tariff adjustments.
  2. All surgical procedures will be performed by a registered Surgeon who is a member in good standing of the Malaysian Medical Council (MMC) and the Malaysian Society of Surgeons. The specific Surgeon assigned will be confirmed in writing prior to the scheduled operation date.
  3. Payment terms: A deposit of fifty percent (50%) of the total Quotation Estimate amount is required upon acceptance to secure the operating theatre slot and the Surgeon's schedule. The remaining balance shall be settled within fourteen (14) days following discharge from the hospital.
  4. Any additional procedures, complications, or extended hospitalisation beyond the scope outlined in this Quotation Estimate will be communicated to the patient or authorised representative in writing, and a supplementary estimate will be issued prior to any additional intervention.
  5. This Quotation Estimate does not constitute a guarantee of surgical outcome. The Surgeon will provide a detailed informed consent discussion prior to any operative procedure, in compliance with the Malaysian Medical Council's Guidelines on Informed Consent (2023 revision).
  6. All medical records, operative reports, and histopathology findings generated during the engagement of the Surgeon in Malaysia Kuala Lumpur shall be retained in accordance with the Personal Data Protection Act 2010 (PDPA) and the Malaysian Medical Council's record-keeping regulations.
  7. Disputes arising from this Quotation Estimate shall be resolved through the Malaysian Medical Council's Medical Tribunal or, alternatively, through the Small Claims Court in Kuala Lumpur, in accordance with Malaysian law.
  8. This Quotation Estimate is prepared exclusively for the named recipient and may not be transferred or assigned to a third party without the prior written consent of MediSurge Specialist Surgical Centre.
Acceptance & Authorisation

By signing below, the client acknowledges receipt of this Quotation Estimate for Surgeon services in Malaysia Kuala Lumpur and agrees to the terms and conditions stated herein. The Surgeon and the surgical team will be scheduled upon receipt of the required deposit and signed acceptance.

For and on behalf of MediSurge Specialist Surgical Centre
Dr. Ahmad Farid bin Hassan
Consultant Surgeon / Authorising Officer
Date: ____________________
Client / Authorised Representative
Name: ____________________
Designation: ____________________
Date: ____________________

MediSurge Specialist Surgical Centre | Level 12, Menara Medical, Jalan Sultan Ismail, 50250 Kuala Lumpur, Malaysia

This Quotation Estimate document is generated electronically and is valid without a physical stamp. For verification, please contact our billing department at +603-2181 4567.

Document Reference: QTE-2025-0712-KL | Page 1 of 1

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