Quotation Estimate Surgeon in Mexico Mexico City –Free Word Template Download with AI
Professional Surgeon Services — Mexico, Mexico City
| Quotation Estimate No.: | QTE-MX-2025-04871 |
| Date of Issue: | June 12, 2025 |
| Valid Until: | July 12, 2025 (30 calendar days) |
| Prepared By: | Dr. Alejandro Ramírez Cortés, M.D., FACS |
| Practice Location: | Av. Paseo de la Reforma 250, Piso 14, Col. Juárez, 06600 Mexico City, Mexico |
| Client Name: | [Client / Patient Name] |
| Client Address: | [Client Address, Mexico City, Mexico] |
| Contact Email: | [[email protected]] |
| Phone: | +52 (55) 0000-0000 |
This Quotation Estimate is formally issued by Dr. Alejandro Ramírez Cortés, a board-certified Surgeon specializing in general and minimally invasive surgical procedures, to provide a comprehensive and transparent breakdown of all professional fees, facility charges, and ancillary costs associated with the planned surgical intervention. This document is prepared specifically for services to be rendered at the accredited surgical facility located in Mexico, Mexico City, in full compliance with the regulations established by the Secretaría de Salud (Mexican Ministry of Health) and the Colegio de Cirujanos de México.
The Surgeon named herein holds active registration with the Consejo de Salud and maintains malpractice insurance coverage through a nationally recognized carrier. All procedures outlined in this Quotation Estimate will be performed in a state-of-the-art operating facility in Mexico, Mexico City that meets international JCI (Joint Commission International) accreditation standards.
| # | Description of Service | Unit | Qty | Amount (MXN) |
|---|---|---|---|---|
| 1 | Pre-operative consultation and physical examination by the Surgeon | Session | 1 | $4,500.00 |
| 2 | Diagnostic imaging (CT scan, MRI, and laboratory panel) at Mexico City facility | Package | 1 | $12,800.00 |
| 3 | Anesthesiology evaluation and intra-operative anesthesia management | Procedure | 1 | $18,500.00 |
| 4 | Primary surgical procedure performed by the Surgeon (estimated 3–5 hours operative time) | Procedure | 1 | $85,000.00 |
| 5 | Operating room facility fee (Mexico City surgical center, including nursing staff and equipment) | Room | 1 | $22,000.00 |
| 6 | Surgical consumables, implants, and specialized instruments | Lot | 1 | $15,750.00 |
| 7 | Post-operative hospitalization (2 nights, private room, Mexico City hospital) | Nights | 2 | $14,000.00 |
| 8 | Post-operative follow-up visits by the Surgeon (3 visits over 6 weeks) | Visits | 3 | $9,000.00 |
| 9 | Prescribed post-operative medications and wound care supplies | Package | 1 | $3,200.00 |
| 10 | Pathology and histological analysis of excised tissue | Sample | 1 | $6,500.00 |
| TOTAL ESTIMATED COST (MXN) | $191,250.00 | |||
| TOTAL ESTIMATED COST (USD, approx. at 18.50 MXN/USD) | $10,337.84 | |||
- Validity: This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After this period, the Surgeon reserves the right to revise fees to reflect current market rates in Mexico, Mexico City.
- Payment Schedule: A non-refundable deposit of 30% (MXN $57,375.00) is due upon acceptance of this Quotation Estimate. The remaining 70% is payable within five (5) business days following the completion of the surgical procedure and discharge from the hospital.
- Accepted Payment Methods: Bank transfer (SPEI), credit card (Visa, Mastercard, American Express), or cash at the Mexico City facility. International wire transfers are accepted with a 3% processing surcharge.
- Cancellation Policy: Cancellation more than 14 days before the scheduled procedure incurs a 15% fee of the total Quotation Estimate amount. Cancellation within 14 days incurs a 50% fee. Cancellation within 48 hours is non-refundable.
- Regulatory Compliance: All services are performed in accordance with Mexican federal health regulations (Ley General de Salud) and the ethical code of the Colegio de Cirujanos de México. The Surgeon maintains a valid cédula profesional and active CONAMED registration.
- Confidentiality: All patient records, imaging, and surgical reports are protected under Mexico's Ley Federal de Protección de Datos Personales en Posesión de los Particulares. No information will be disclosed without written consent.
- Warranty and Follow-up: The Surgeon provides a 90-day post-operative warranty covering the surgical site. Any complications directly attributable to the surgical technique will be addressed at no additional cost within this period.
- Dispute Resolution: Any disputes arising from this Quotation Estimate shall be resolved through mediation in Mexico, Mexico City, in accordance with the applicable provisions of the Mexican Civil Code.
The Surgeon designated for this procedure, Dr. Alejandro Ramírez Cortés, completed his medical degree at the Universidad Nacional Autónoma de México (UNAM) and his surgical residency at the Hospital General de México "Dr. Eduardo Liceaga." He holds a Fellowship in Advanced Minimally Invasive Surgery and has performed over 4,200 surgical procedures in his career. His practice is based in Mexico, Mexico City, where he operates from a JCI-accredited surgical center equipped with the latest laparoscopic and robotic surgical technology.
The facility in Mexico, Mexico City where this procedure will take place maintains a 24/7 intensive care unit, a dedicated post-anesthesia care unit (PACU), and a full in-house pathology laboratory to ensure continuity of care throughout the patient's surgical journey.
By signing below, the client acknowledges receipt and review of this Quotation Estimate for Surgeon services in Mexico, Mexico City, and authorizes the Surgeon to proceed with the described surgical intervention under the terms outlined herein.
Client / Patient SignatureName: ______________________________
Date: ______________________________ Surgeon / Authorized Representative
Dr. Alejandro Ramírez Cortés, M.D.
Date: ______________________________ ⬇️ Download as DOCX Edit online as DOCX
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