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Purchase Order Physiotherapist in United States Houston –Free Word Template Download with AI

Physiotherapist Professional Services — United States Houston Purchase Order No.: PO-HOU-2025-04782
Date of Issue: June 12, 2025
Valid Until: September 12, 2025
Payment Terms: Net 30 Days
Currency: USD (United States Dollar)
Incoterms: N/A (Local Services)
1. Purchasing Party (Buyer)
Company Name: Bayou City Rehabilitation & Wellness Center, LLC
Address: 4820 Westheimer Road, Suite 310, Houston, Texas 77056, United States
Contact Person: Ms. Angela Torres, Director of Clinical Operations
Phone: (713) 555-0147
Email: [email protected]
Tax ID (EIN): 75-4829103
2. Supplying Party (Seller / Service Provider)
Company Name: Gulf Coast Physiotherapy Associates, PLLC
Address: 2210 Post Oak Boulevard, Floor 5, Houston, Texas 77056, United States
Contact Person: Dr. Marcus J. Whitfield, DPT, Lead Physiotherapist
Phone: (713) 555-0293
Email: [email protected]
Tax ID (EIN): 75-9134578
Licensure: Texas Board of Physical Therapy, License No. TXPT-2019-44821
3. Description of Goods and Services

This Purchase Order is issued by Bayou City Rehabilitation & Wellness Center, LLC for the engagement of qualified Physiotherapist professional services to be delivered at the facility located in United States Houston, Texas. The services encompass a comprehensive physiotherapy program designed to address post-surgical rehabilitation, chronic pain management, sports injury recovery, and mobility restoration for the center's patient population. All clinical services shall be performed by a licensed Physiotherapist or a team of credentialed Physiotherapist professionals under the supervision of Dr. Marcus J. Whitfield, DPT.

Line # Service Description Quantity Unit Unit Price (USD) Extended Price (USD)
1 Individual Physiotherapist Assessment & Treatment Session (60 min) — Post-Surgical Rehabilitation Program 240 Sessions $185.00 $44,400.00
2 Group Physiotherapist Exercise Class (45 min, up to 8 patients) — Chronic Pain Management 96 Sessions $320.00 $30,720.00
3 Sports Injury Recovery Program — Dedicated Physiotherapist (12-week intensive) 12 Patient Programs $2,850.00 $34,200.00
4 Manual Therapy & Soft Tissue Mobilization (45 min) — Mobility Restoration 180 Sessions $150.00 $27,000.00
5 Physiotherapist Home Visit Program (Houston Metro Area) — Geriatric & Post-Acute Care 60 Visits $220.00 $13,200.00
6 Custom Orthotic & Assistive Device Fitting by Physiotherapist 35 Fittings $95.00 $3,325.00
7 Physiotherapist Clinical Supervision & Staff Training (Quarterly, 8-hour workshop) 4 Workshops $1,200.00 $4,800.00
8 Progress Documentation & Insurance Billing Coordination (per patient per month) 480 Reports $12.00 $5,760.00
SUBTOTAL $163,405.00
Texas Sales & Service Tax (8.25%) $13,480.91
TOTAL AMOUNT DUE (USD) $176,885.91
4. Terms and Conditions
  1. Scope of Services: All Physiotherapist services described in this Purchase Order shall be rendered at the Bayou City Rehabilitation & Wellness Center facility in United States Houston, or at patient residences within the Houston metropolitan area as specified in Line Item 5. The Physiotherapist shall comply with all standards set forth by the Texas Board of Physical Therapy and the American Physical Therapy Association (APTA).
  2. Service Period: The engagement period for this Purchase Order shall commence on July 1, 2025, and conclude on December 31, 2025, unless extended by mutual written agreement of both parties.
  3. Payment Schedule: Invoices shall be submitted monthly on the last business day of each calendar month. Payment is due within thirty (30) days of invoice receipt. Late payments shall accrue interest at a rate of 1.5% per month, in accordance with Texas Business & Commerce Code §271.101.
  4. Licensure and Insurance: The Physiotherapist and all associated clinical staff must maintain active Texas state licensure throughout the duration of this Purchase Order. The service provider shall carry professional liability insurance with a minimum coverage of $2,000,000 per occurrence and $5,000,000 aggregate, naming the purchasing party as an additional insured.
  5. Confidentiality and HIPAA: All patient information handled by the Physiotherapist in the course of services in United States Houston shall be protected in strict accordance with the Health Insurance Portability and Accountability Act (HIPAA) and applicable Texas state privacy statutes. A Business Associate Agreement (BAA) is attached as Exhibit A.
  6. Performance Standards: The Physiotherapist shall maintain a patient satisfaction rating of no less than 90% as measured by quarterly surveys. Failure to meet this standard for two consecutive quarters shall constitute a material breach of this Purchase Order.
  7. Termination: Either party may terminate this Purchase Order with thirty (30) days written notice. In the event of termination for cause, the terminating party must provide a detailed written explanation of the breach. All services rendered prior to the effective date of termination shall be invoiced and paid in full.
  8. Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the State of Texas, United States. Any disputes arising hereunder shall be resolved through binding arbitration in United States Houston, Harris County, in accordance with the rules of the American Arbitration Association.
  9. Force Majeure: Neither party shall be liable for delays or failures in performance resulting from acts of God, natural disasters (including but not limited to hurricanes affecting the United States Houston region), pandemics, government orders, or other events beyond reasonable control.
  10. Entire Agreement: This Purchase Order, together with its attached exhibits, constitutes the entire agreement between the parties regarding the Physiotherapist services described herein and supersedes all prior negotiations, representations, and agreements.
5. Authorization and Acceptance

By signing below, both parties acknowledge and agree to all terms, conditions, and service specifications outlined in this Purchase Order for Physiotherapist services to be delivered in United States Houston, Texas.

For the Purchasing Party:
Bayou City Rehabilitation & Wellness Center, LLC

Signature: ______________________________
Name: Angela Torres
Title: Director of Clinical Operations
Date: ______________________________

For the Service Provider:
Gulf Coast Physiotherapy Associates, PLLC

Signature: ______________________________
Name: Marcus J. Whitfield, DPT
Title: Lead Physiotherapist / Managing Partner
Date: ______________________________

This Purchase Order (PO-HOU-2025-04782) is a legally binding document for Physiotherapist professional services in United States Houston, Texas. Please retain a copy for your records. For questions or amendments, contact the purchasing department at [email protected]. © 2025 Bayou City Rehabilitation & Wellness Center, LLC. All rights reserved.

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