Quotation Estimate Surgeon in Philippines Manila –Free Word Template Download with AI
128 Ayala Avenue, Makati City, Philippines Manila 1226
Tel: +63 (2) 8888-4521 | Email: [email protected]
DTI Registration No. 201912345678 | PRC License No. 458721
Quotation EstimateQuotation Details
Quotation No.: QTE-2025-0714-SRG
Date Issued: July 14, 2025
Valid Until: August 13, 2025 (30 days)
Prepared By: Dr. Ricardo M. Santos, MD, FACS
Service Location: Philippines Manila
Client Information
Client Name: [Client / Hospital / Institution Name]
Address: [Street, City, Philippines Manila]
Contact Person: [Name and Title]
Email: [[email protected]]
Phone: +63 (2) XXXX-XXXX
Dear Valued Client,
Thank you for your inquiry regarding surgical services. This Quotation Estimate has been carefully prepared by our team at Manila Surgical Excellence Center to provide you with a comprehensive and transparent breakdown of costs associated with the engagement of a Surgeon for the procedures and services outlined below. All rates quoted herein are specific to operations conducted within the Philippines Manila metropolitan area and reflect current market standards, facility fees, and professional honoraria as of the date of this document.
Itemized Services and Costs| No. | Description of Service | Quantity | Unit Rate (PHP) | Amount (PHP) | Remarks |
|---|---|---|---|---|---|
| 1 | Consultation and Pre-Operative Assessment by Board-Certified Surgeon | 1 session | 5,500.00 | 5,500.00 | Includes physical examination, imaging review, and surgical planning |
| 2 | Surgeon Professional Fee – General Surgical Procedure (e.g., Appendectomy, Cholecystectomy, Hernia Repair) | 1 procedure | 85,000.00 | 85,000.00 | Covers Surgeon's time, expertise, and intra-operative decision-making |
| 3 | Surgeon Professional Fee – Complex / Specialized Surgical Procedure (e.g., Laparoscopic Bariatric, Colorectal Resection) | 1 procedure | 150,000.00 | 150,000.00 | Applies to advanced techniques requiring specialized training |
| 4 | Assistant Surgeon Fee | 1 procedure | 35,000.00 | 35,000.00 | Second surgical team member for complex cases |
| 5 | Anesthesiologist Fee (General Anesthesia, up to 4 hours) | 1 procedure | 28,000.00 | 28,000.00 | Includes pre-anesthetic evaluation and post-anesthesia monitoring |
| 6 | Operating Room Facility Fee (Philippines Manila Standard OR) | 1 procedure | 45,000.00 | 45,000.00 | Covers OR setup, nursing staff, sterilization, and equipment |
| 7 | Post-Operative Surgeon Follow-Up Visits (Days 1, 3, 7, and 14) | 4 visits | 2,500.00 | 10,000.00 | Wound check, suture removal, and recovery assessment |
| 8 | Emergency / After-Hours Surgeon Call-Out (if applicable) | 1 call | 20,000.00 | 20,000.00 | Available 24/7 within Philippines Manila service area |
| 9 | Medical Supplies, Implants, and Consumables (estimated) | 1 set | 30,000.00 | 30,000.00 | Actual cost may vary; final billing based on items used |
| 10 | Pathology and Laboratory Tests (pre- and post-operative) | 1 package | 8,500.00 | 8,500.00 | Complete blood count, metabolic panel, tissue biopsy if required |
| Subtotal (PHP): | 417,000.00 | ||||
| VAT (12%): | 50,040.00 | ||||
| TOTAL ESTIMATED AMOUNT (PHP): | 467,040.00 | ||||
The Surgeon referenced in this Quotation Estimate is a board-certified general and laparoscopic surgeon with over 18 years of clinical experience, registered with the Philippine Medical Board and the Philippine College of Surgeons. All surgical procedures will be performed in compliance with the standards set by the Department of Health (DOH) of the Republic of the Philippines and the Philippine Nursing and Medical Accreditation bodies. The Surgeon will conduct all consultations, pre-operative assessments, and post-operative follow-ups at our facility located in the heart of Philippines Manila, ensuring accessibility for patients and referring physicians across the National Capital Region (NCR).
Should the surgical procedure require additional time beyond the standard operating window, or if intra-operative findings necessitate a change in surgical approach, the Surgeon will communicate this to the patient or authorized representative prior to proceeding. Any additional fees incurred beyond this Quotation Estimate will be documented in a supplementary addendum and require written client approval before implementation.
Terms and Conditions- This Quotation Estimate is valid for thirty (30) calendar days from the date of issuance. Rates are subject to revision upon expiration without prior notice.
- Payment Terms: Fifty percent (50%) of the total estimated amount is due upon acceptance of this Quotation Estimate. The remaining fifty percent (50%) is due within seven (7) days following the completion of the surgical procedure and discharge.
- All payments shall be made in Philippine Pesos (PHP) via bank transfer to the account designated by Manila Surgical Excellence Center. Checks payable to "Manila Surgical Excellence Center, Inc."
- This Quotation Estimate does not constitute a guarantee of surgical outcome. The Surgeon will exercise the highest standard of medical care in accordance with accepted surgical practice in the Philippines Manila region.
- Any cancellation by the client within 48 hours of the scheduled procedure will incur a non-refundable fee of 30% of the Surgeon's professional fee to cover reserved OR time and staff scheduling.
- Medical records and post-operative reports will be provided to the client within five (5) business days following discharge.
- This Quotation Estimate is confidential and intended solely for the named client. It may not be reproduced or distributed without written consent from Manila Surgical Excellence Center.
- All services are subject to the Surgeon's availability and the operational capacity of the facility in Philippines Manila. Rescheduling will be accommodated on a first-come, first-served basis.
By signing below, the client acknowledges receipt of this Quotation Estimate and agrees to the terms, conditions, and estimated costs outlined herein for the engagement of the Surgeon and associated surgical services in Philippines Manila.
Prepared by:Dr. Ricardo M. Santos, MD, FACS
Lead Surgeon, Manila Surgical Excellence Center
Date: _______________ Accepted by (Client):
Name: ___________________________
Title: ___________________________
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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