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Purchase Order Psychiatrist in Italy Rome –Free Word Template Download with AI

Psychiatrist Professional Services — Italy Rome PO No.: IT-ROM-2025-04782 Date of Issue: 14 June 2025
Company Name: Sanità Mentale Roma S.r.l.
Address: Via del Corso 142, 00186 Rome, Italy
VAT Number (Partita IVA): IT01234567890
Contact Person: Dott.ssa Maria Concetta Ferraro, Procurement Director
Email: [email protected]
Telephone: +39 06 4567 8901
Professional Name: Dott. Alessandro Marchetti, M.D., Psychiatrist
Registration: Ordine dei Medici Chirurghi e degli Odontoiatri di Roma — License No. RM-2003-11847
Clinic Address: Clinica Psichiatrica del Tevere, Via Appia Nuova 210, 00183 Rome, Italy
VAT Number (Partita IVA): IT09876543210
Contact Person: Dott. Alessandro Marchetti, Psychiatrist
Email: [email protected]
Telephone: +39 06 7788 4455

This Purchase Order is issued by Sanità Mentale Roma S.r.l. to formally request and authorize the procurement of specialized psychiatric services rendered by the above-named Psychiatrist, Dott. Alessandro Marchetti, operating within the jurisdiction of Italy Rome. The services described herein are intended to support the ongoing mental health care program for the employees and contracted personnel of the purchasing entity, in full compliance with the Italian National Health Service (Servizio Sanitario Nazionale) regulations and the professional standards established by the Ordine dei Medici Chirurghi e degli Odontoiatri di Roma.

The Psychiatrist shall provide diagnostic evaluations, therapeutic consultations, pharmacological management, and follow-up care sessions at the designated clinic located in Italy Rome. All services shall be delivered in accordance with the applicable Italian medical-legal framework, including but not limited to Legislative Decree No. 219/2017 on patient rights and informed consent, and the professional code of ethics governing psychiatric practice in the Lazio region.

Item No. Description of Psychiatrist Service Quantity / Sessions Unit Price (EUR) Total (EUR)
01 Initial psychiatric diagnostic assessment and clinical interview (90 minutes) — Italy Rome clinic 12 sessions € 180.00 € 2,160.00
02 Follow-up psychiatric consultation and treatment plan review (45 minutes) 48 sessions € 120.00 € 5,760.00
03 Psychopharmacological prescription management and medication monitoring (30 minutes) 24 sessions € 95.00 € 2,280.00
04 Psychological testing and neuropsychiatric evaluation (120 minutes) 6 sessions € 250.00 € 1,500.00
05 Urgent psychiatric consultation — after-hours availability in Italy Rome (per occurrence) 4 occurrences € 200.00 € 800.00
06 Written clinical report and medical certificate for employer records (per report) 12 reports € 60.00 € 720.00
TOTAL AMOUNT DUE (EUR) € 13,220.00
IVA (VAT) 22% — Italy Rome € 2,908.40
GRAND TOTAL (EUR) € 16,128.40

The Psychiatrist shall commence the provision of services no later than 1 July 2025 and shall continue to render the contracted services through 31 December 2025. All sessions shall take place at the Clinica Psichiatrica del Tevere, located in Italy Rome, unless otherwise agreed in writing by both parties. The Purchase Order may be extended by mutual written consent for an additional twelve-month period, subject to the same terms and conditions set forth herein.

Payment for the services described in this Purchase Order shall be made in quarterly installments, due within thirty (30) calendar days from the date of invoice issuance. The supplier, Dott. Marchetti, shall issue a compliant Italian fiscal invoice (fattura elettronica) in accordance with the regulations of the Agenzia delle Entrate. Payment shall be executed via bank transfer (bonifico bancario) to the following account:

Bank: Banca Intesa Sanpaolo S.p.A.
IBAN: IT60 X030 1224 0000 1234 5678 901
BIC/SWIFT: BKASITRRXXX

Failure to remit payment within the stipulated period shall incur a late-payment interest charge of 1.5% per month, in accordance with Italian civil law (Codice Civile, Art. 1284). The purchasing entity reserves the right to withhold payment for any services not rendered in full compliance with the scope defined in this Purchase Order.

  1. Professional Qualification: The Psychiatrist warrants that he holds a valid, unrestricted license to practice psychiatry in the Lazio region of Italy Rome and maintains current registration with the relevant medical order. Any lapse in licensure shall constitute immediate grounds for termination of this Purchase Order.
  2. Confidentiality and Data Protection: All patient records, clinical notes, and diagnostic data shall be handled in strict accordance with the EU General Data Protection Regulation (GDPR, Regulation 2016/679) and the Italian Data Protection Code (D.Lgs. 196/2003, as amended by D.Lgs. 101/2018). The Psychiatrist shall not disclose any patient information to third parties without explicit written consent, except where mandated by Italian law.
  3. Scope of Practice: The services are limited to outpatient psychiatric care as described in Section 4. Inpatient hospitalization, surgical procedures, or services outside the scope of psychiatric practice are not covered by this Purchase Order and shall require a separate contractual agreement.
  4. Termination: Either party may terminate this Purchase Order with a written notice of sixty (60) days. In the event of termination, all sessions already scheduled and paid for shall be completed, and any prepaid amounts for unrendered services shall be refunded within fifteen (15) business days.
  5. Governing Law and Jurisdiction: This Purchase Order shall be governed by and construed in accordance with the laws of the Italian Republic. Any disputes arising from or in connection with this agreement shall be subject to the exclusive jurisdiction of the competent courts of Italy Rome (Tribunale di Roma).
  6. Force Majeure: Neither party shall be liable for failure to perform obligations under this Purchase Order due to events beyond reasonable control, including but not limited to natural disasters, pandemics, government-mandated closures, or civil unrest affecting the Italy Rome metropolitan area.
  7. Amendments: No modification, amendment, or supplement to this Purchase Order shall be valid unless executed in writing and signed by authorized representatives of both parties.

By signing below, both parties acknowledge that they have read, understood, and agree to all terms and conditions set forth in this Purchase Order for the procurement of Psychiatrist services in Italy Rome. This document constitutes a binding agreement between the parties as of the date of the last signature.

For the Purchasing Entity:

Sanità Mentale Roma S.r.l.

Name: Dott.ssa Maria Concetta Ferraro

Title: Procurement Director

Signature: ___________________________

Date: ___________________________

For the Service Provider:

Clinica Psichiatrica del Tevere

Name: Dott. Alessandro Marchetti, M.D.

Title: Psychiatrist / Authorized Representative

Signature: ___________________________

Date: ___________________________

Purchase Order No. IT-ROM-2025-04782 — Psychiatrist Services — Italy Rome

Document generated by Sanità Mentale Roma S.r.l. — Procurement Department — Via del Corso 142, 00186 Rome, Italy

This Purchase Order is valid for a period of ninety (90) days from the date of issue. After this period, a new Purchase Order must be issued to authorize the continuation of services.

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