Quotation Estimate Veterinarian in United States Chicago –Free Word Template Download with AI
Professional Veterinary Services — Chicago, United States
Veterinarian / Service Provider
Dr. Margaret A. Sullivan, DVM
Lakeview Animal Medical Center
2847 N. Lakeview Avenue, Suite 300
Chicago, Illinois 60657, United States
Phone: (312) 555-0184
Email: [email protected]
IL Veterinary License No. 48291
Client / Pet Owner
Mr. Jonathan R. Whitfield
1420 W. Fullerton Avenue, Apt 5B
Chicago, Illinois 60614, United States
Phone: (773) 555-0267
Email: [email protected]
Pet: Biscuit (Golden Retriever, 4 yrs)
Dear Mr. Whitfield,
Thank you for contacting Lakeview Animal Medical Center for a comprehensive veterinary care plan for your beloved Golden Retriever, Biscuit. This Quotation Estimate has been prepared by our Veterinarian team following the initial consultation conducted on June 10, 2025, at our Chicago, United States clinic. The following itemized services, diagnostic procedures, and estimated costs reflect our professional assessment of Biscuit's current health needs and recommended ongoing care. Please review this Quotation Estimate carefully and contact our office with any questions or requests for clarification before the validity period expires.
| # | Service / Procedure | Description & Notes | Qty | Estimated Cost (USD) |
|---|---|---|---|---|
| 1 | Comprehensive Physical Examination | Full-body veterinary examination including auscultation, palpation, ophthalmic check, dental assessment, and weight measurement. Performed by Dr. Sullivan. | 1 | $185.00 |
| 2 | Complete Blood Count (CBC) & Chemistry Panel | In-house laboratory analysis to evaluate organ function, blood cell counts, glucose levels, and electrolyte balance. Results available within 4 hours. | 1 | $240.00 |
| 3 | Digital Radiography (Thoracic & Abdominal) | Four-view digital X-ray series to assess cardiac silhouette, pulmonary fields, and abdominal organ structures. Images provided on USB drive. | 1 | $320.00 |
| 4 | Abdominal Ultrasound | Real-time sonographic evaluation of liver, spleen, kidneys, bladder, and intestinal walls. Performed by our board-certified veterinary radiology team. | 1 | $410.00 |
| 5 | Annual Core Vaccinations (DHPP, Rabies, Bordetella) | Administration of age-appropriate core and non-core vaccines per AVMA guidelines. Includes post-vaccination observation period of 20 minutes. | 1 | $125.00 |
| 6 | Parasite Prevention (Yearly Supply) | Twelve-month supply of broad-spectrum flea, tick, and intestinal parasite prevention (Bravecto Plus). Includes monthly application instructions. | 1 | $312.00 |
| 7 | Dental Prophylaxis & Scaling | Ultrasonic scaling, polishing, and periodontal assessment under general anesthesia. Includes pre-anesthetic bloodwork and post-operative monitoring. | 1 | $580.00 |
| 8 | Microchip Registration & Verification | Scanning and verification of existing microchip (No. 985-112-447-8821). Update of owner contact information in the national registry database. | 1 | $25.00 |
| 9 | Follow-Up Consultation (30-Day) | Post-procedure check-up to review laboratory results, assess dental healing, and adjust any preventive care protocols. Includes a 15-minute telephone follow-up. | 1 | $95.00 |
| 10 | Prescription Medications (Est.) | Estimated cost for anti-inflammatory medication (carprofen 75 mg, 30 tablets) and a 14-day course of gastroprotective agent (famotidine 20 mg) as recommended by the Veterinarian. | 1 | $88.00 |
Terms & Conditions of This Quotation Estimate
- This Quotation Estimate is valid for thirty (30) calendar days from the date of issuance. After July 12, 2025, pricing may be subject to revision based on current supply costs and veterinary service rates in the Chicago metropolitan area.
- Payment is due within fourteen (14) days of the date of service completion. Accepted payment methods include Visa, Mastercard, American Express, Discover, personal checks, and HSA/FSA cards. A 2% convenience fee applies to credit card transactions exceeding $500.
- A 50% deposit is required to schedule the dental prophylaxis and anesthesia-related procedures. The remaining balance is due at the time of service.
- All veterinary services are performed in compliance with the Illinois Veterinary Practice Act (225 ILCS 110) and the standards set forth by the American Veterinary Medical Association (AVMA).
- Lakeview Animal Medical Center maintains full malpractice liability insurance and operates under the regulatory oversight of the Illinois Department of Financial and Professional Regulation.
- Client records, radiographic images, and laboratory results are retained for a minimum of seven (7) years in accordance with Illinois state veterinary record-keeping statutes.
- This Quotation Estimate does not constitute a guarantee of specific medical outcomes. The treating Veterinarian reserves the right to modify the treatment plan based on intra-procedural findings, and the client will be contacted prior to any additional procedures exceeding the estimated scope.
- By signing below, the client acknowledges receipt of this Quotation Estimate and authorizes the described veterinary services for the pet identified above.
Client Signature
Name: Jonathan R. Whitfield
Date: ____________________
Veterinarian / Authorized Representative
Name: Dr. Margaret A. Sullivan, DVM
Date: ____________________
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