Financial estimation

Lausanne, November 26th 2009

Financial estimation concerning the future stay of your daughter Ioana-Sabina ORBULESCU, born 31.10.2008, in our establishment

Dear Mrs Orbulescu,

The overall estimate for the hospitalisation of your child with general insurance is
CHF. 75'000.--. This estimate is yet to be confirmed as we do not currently have all the relevant details, this depends on the evolution of the treatment.
The additional fees for the surgical team, which are approximately of CHF. 5'000.--, are included and are also to be paid by you.
For the members of the European Union, you must take the E112 form with you,- delivered by your insurance company -, and hand it in on your arrival at the CHUV.
With this form you will be eligible for GENERAL INSURANCE only.
If you're unable to supply us with this form, a deposit of CHF. 90'000.-- (ninety thousand swiss francs) will be required at your arrival as a guarantee. The balance will be returned to you at the end of the stay.

The transfer can be done on the following bank account :
- in favour of : Hospices Cantonaux / CHUV :

 Banque Cantonale Vaudoise : account number E 0328.70.70
Bank Clearing 767
Swift Code BCVLCH2LXXX
IBAN CH65 0076 7000 E032 8707 0
 CCP 17-441803-8
In order to easily identify the motive of the payment, please mention "deposit for + name and first name of the future concerned patient".
Overnight accommodation can be arranged for the parents at the Foundation Interval (2 min. by foot from CHUV). This costs CHF. 90, -- a day (room accommodates one to four people) and is not included in this overall estimate.
If I can be of any further assistance, do no hesitate to contact me.

Kind regards
Carole Pilloud
In charge ENT surgery program