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Purchase Order Psychiatrist in Brazil São Paulo –Free Word Template Download with AI

Professional Medical Services Procurement Document

PO-2025-SP-04782

Date of Issue: June 12, 2025  |  Valid Until: September 12, 2025

Issuing Organization (Buyer)

HealthBridge Corporate Wellness S.A.

Av. Paulista, 1578 – Bela Vista

São Paulo, SP – CEP 01310-300

CNPJ: 12.345.678/0001-90

Contact: [email protected]

Phone: +55 (11) 3456-7890

Service Provider (Vendor)

Dr. Helena M. Vasconcelos – Psychiatrist

CRM-SP: 184.562

RQE (Psychiatry): 45.218

Clinica Mente & Equilíbrio

Rua Oscar Freire, 892 – Jardins

São Paulo, SP – CEP 01426-001

Contact: [email protected]

Phone: +55 (11) 98765-4321

This Purchase Order is issued by HealthBridge Corporate Wellness S.A. to formally authorize and procure the professional services of a licensed Psychiatrist operating in Brazil São Paulo. The purpose of this Purchase Order is to establish the contractual terms, scope of services, compensation structure, and operational parameters governing the engagement of Dr. Helena M. Vasconcelos as a contracted Psychiatrist to provide mental health evaluation, diagnosis, and ongoing therapeutic support to employees of the issuing organization. All services rendered under this Purchase Order shall be conducted in compliance with the regulations set forth by the Conselho Federal de Medicina (CFM) and the Conselho Regional de Medicina do Estado de São Paulo (CREMESP), ensuring full adherence to Brazilian medical practice standards within the São Paulo metropolitan area.

The Psychiatrist engaged under this Purchase Order shall provide the following professional services to the workforce of HealthBridge Corporate Wellness S.A. at the designated facility located in Brazil São Paulo:

  • Initial psychiatric evaluation and comprehensive mental health assessment for up to 200 employees per quarter.
  • Diagnosis and treatment planning for mood disorders, anxiety disorders, obsessive-compulsive spectrum conditions, and workplace-related psychological stress.
  • Ongoing follow-up consultations (minimum of 12 sessions per enrolled employee per year) conducted at the Clinica Mente & Equilíbrio office in the Jardins district of São Paulo, SP.
  • Prescription management and pharmacological monitoring in accordance with Brazilian ANVISA guidelines.
  • Issuance of medical reports, fitness-for-work certificates, and disability assessments as required by the employer.
  • Participation in quarterly corporate wellness seminars and mental health awareness workshops held at the HealthBridge headquarters on Av. Paulista, São Paulo.
  • Emergency psychiatric consultation availability (on-call) for critical workplace incidents, with a response time not exceeding 4 hours within the São Paulo metropolitan region.
Item # Description of Service Unit Qty Unit Price (BRL) Total (BRL)
01 Initial Psychiatric Evaluation (per employee) Session 200 R$ 450,00 R$ 90.000,00
02 Follow-up Consultation (per session) Session 2.400 R$ 320,00 R$ 768.000,00
03 Pharmacological Monitoring & Prescription Review Month 12 R$ 8.500,00 R$ 102.000,00
04 Corporate Wellness Seminar (per event) Event 4 R$ 3.200,00 R$ 12.800,00
05 Emergency On-Call Availability (monthly retainer) Month 12 R$ 2.500,00 R$ 30.000,00
06 Medical Reports & Fitness Certificates (per document) Document 150 R$ 180,00 R$ 27.000,00
GRAND TOTAL (BRL) R$ 1.029.800,00
  • Payment shall be made via bank transfer (TED/PIX) to the account designated by the Psychiatrist vendor, in Brazilian Reais (BRL), within 30 (thirty) calendar days from the date of invoice submission.
  • Invoices shall be submitted on a monthly basis by the 5th business day of the following month, itemized by service category as outlined in Section 3 of this Purchase Order.
  • A 2% discount shall apply to payments settled within 10 (ten) business days of the invoice date.
  • All applicable taxes, including ISS (Imposto Sobre Serviços) levied by the municipality of São Paulo, shall be the responsibility of the issuing organization as the service recipient, in accordance with Brazilian tax legislation (LC 116/2003).
  • Any dispute regarding invoiced amounts must be raised in writing within 15 (fifteen) business days of invoice receipt.
  • Regulatory Compliance: The Psychiatrist shall maintain an active and unrestricted registration with CREMESP and the CFM throughout the duration of this Purchase Order. Any lapse in professional registration shall constitute grounds for immediate termination without penalty to the issuing organization.
  • Confidentiality: All patient records, diagnostic information, and treatment details shall be handled in strict accordance with the Brazilian General Data Protection Law (LGPD – Lei nº 13.709/2018) and the CFM Code of Medical Ethics. The Psychiatrist shall not disclose any employee health information to third parties without written consent, except where mandated by law.
  • Service Location: All in-person consultations and clinical services shall be conducted at the registered practice address in São Paulo, SP, or at the HealthBridge corporate facility on Av. Paulista, as mutually agreed upon in advance. Telepsychiatry sessions via secure video platform are permitted for follow-up appointments, provided the Psychiatrist is physically located within the state of São Paulo, Brazil, at the time of the session.
  • Duration and Renewal: This Purchase Order is valid for a period of twelve (12) months from the date of issue. Renewal shall require a written amendment signed by both parties no later than 30 days prior to expiration.
  • Termination: Either party may terminate this Purchase Order with 60 (sixty) days' written notice. In the event of termination, all services rendered up to the effective date of termination shall be invoiced and paid in full.
  • Liability and Insurance: The Psychiatrist shall maintain professional liability insurance (Seguro de Responsabilidade Civil Profissional) with a minimum coverage of R$ 500.000,00, valid throughout the term of this Purchase Order. A certificate of insurance shall be provided upon request.
  • Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the Federative Republic of Brazil, with jurisdiction vested in the courts of the city of São Paulo, SP.

By signing below, both parties acknowledge that they have read, understood, and agree to all terms, conditions, and service specifications outlined in this Purchase Order for the engagement of the Psychiatrist in Brazil São Paulo.

For HealthBridge Corporate Wellness S.A. (Buyer)

Carlos Eduardo Ferreira

Director of Procurement & HR

Date: _______________

For Dr. Helena M. Vasconcelos – Psychiatrist (Vendor)

Dr. Helena M. Vasconcelos

CRM-SP 184.562 / RQE 45.218

Date: _______________

Purchase Order PO-2025-SP-04782 | HealthBridge Corporate Wellness S.A. | Av. Paulista, 1578 – São Paulo, SP – Brazil

This document is valid only when signed by both parties. Unauthorized reproduction or distribution is prohibited.

Document generated in compliance with Brazilian commercial and medical regulatory standards. | Page 1 of 1

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