Purchase Order Psychiatrist in Netherlands Amsterdam –Free Word Template Download with AI
Herengracht 450, 1017 CA Amsterdam, Netherlands
Phone: +31 (0)20 555 0142 | Email: [email protected]
KvK: 87654321 | BTW: NL861234567B01
PURCHASE ORDER PO-2025-AM-00847Vendor / Service Provider
Dr. Hendrik van der Berg, M.D.
Psychiatrist – Board-Certified (Nederlands Genootschap voor Psychiatrie)
Amsterdam Psychiatric Care Centre
Keizersgracht 212, 1016 DZ Amsterdam, Netherlands
Phone: +31 (0)20 778 9931
Email: [email protected]
IBAN: NL91 ABNA 0417 1643 00
Bill To / Purchasing Entity
MediCare Group B.V.
Attn: Procurement Department
Herengracht 450, 1017 CA Amsterdam, Netherlands
Phone: +31 (0)20 555 0142
Email: [email protected]
IBAN: NL21 RABO 0300 0652 34
| PO Number | Date Issued | Delivery / Service Start | Delivery / Service End | Payment Terms | Currency |
|---|---|---|---|---|---|
| PO-2025-AM-00847 | 14 June 2025 | 1 July 2025 | 31 December 2025 | Net 30 days | EUR (€) |
| # | Description of Service | Quantity | Unit | Unit Price (EUR) | Total (EUR) | ICD-10 Ref. |
|---|---|---|---|---|---|---|
| 1 | Initial psychiatric assessment and diagnostic consultation by a licensed Psychiatrist at the Amsterdam Psychiatric Care Centre, including comprehensive mental health evaluation, medical history review, and formulation of a treatment plan. | 120 | Sessions | € 185.00 | € 22,200.00 | F32.0 |
| 2 | Follow-up psychiatric therapy sessions (individual) conducted by the assigned Psychiatrist, including cognitive-behavioural therapy (CBT), medication management, and progress monitoring for patients referred by MediCare Group B.V. in the Netherlands Amsterdam region. | 480 | Sessions | € 145.00 | € 69,600.00 | F41.1 |
| 3 | Group psychiatric therapy facilitated by the Psychiatrist for small groups (6–10 participants) focusing on anxiety disorders, depression management, and stress resilience, held at the Amsterdam Psychiatric Care Centre facility. | 96 | Sessions | € 320.00 | € 30,720.00 | F43.2 |
| 4 | Psychiatric medication review and prescription management by the Psychiatrist, including quarterly medication audits, dosage adjustments, and written reports submitted to MediCare Group B.V. for insurance and compliance purposes. | 24 | Reviews | € 210.00 | € 5,040.00 | F32.9 |
| 5 | Urgent psychiatric consultation and crisis intervention services available on a 24/7 basis, provided by the Psychiatrist or designated on-call Psychiatrist at the Netherlands Amsterdam facility, including same-day emergency assessments. | 12 | Consultations | € 350.00 | € 4,200.00 | F51.9 |
| 6 | Written psychiatric reports and clinical documentation for each patient, including discharge summaries, treatment progress reports, and letters of medical necessity, prepared by the Psychiatrist in accordance with Dutch healthcare data protection regulations (AVG/GDPR). | 720 | Reports | € 45.00 | € 32,400.00 | — |
Subtotal: € 164,160.00
VAT (21% – Netherlands): € 34,473.60
Grand Total: € 198,633.60
Terms and Conditions of This Purchase Order
- This Purchase Order is issued by MediCare Group B.V. for the procurement of psychiatric services rendered by a licensed Psychiatrist operating in the Netherlands Amsterdam area. All services shall be delivered in full compliance with the Dutch Medical Treatment Contracts Act (Wgbo) and the regulations of the Dutch Healthcare Inspectorate (IGJ).
- The Psychiatrist named in this Purchase Order, Dr. Hendrik van der Berg, M.D., shall maintain valid professional registration with the Dutch Medical Association (Nederlandse Orde van Artsen) and the Dutch Psychiatric Society throughout the entire service period. Any lapse in registration must be reported to MediCare Group B.V. within 48 hours.
- All patient data processed under this Purchase Order shall be handled in strict accordance with the General Data Protection Regulation (GDPR) as implemented in the Netherlands (AVG). The Psychiatrist and the Amsterdam Psychiatric Care Centre shall act as data processors and shall not transfer patient records outside the European Economic Area without prior written consent from MediCare Group B.V.
- Payment for services rendered under this Purchase Order shall be made via bank transfer to the IBAN specified above within thirty (30) calendar days of receipt of a valid invoice. Late payments shall accrue interest at the statutory Dutch rate (wettelijke rente) as defined under Article 6:119a of the Dutch Civil Code.
- The Psychiatrist shall provide a monthly summary report to the Procurement Department of MediCare Group B.V. detailing the number of sessions conducted, patient outcomes, medication changes, and any adverse events. Failure to submit monthly reports for two consecutive months constitutes a material breach of this Purchase Order.
- MediCare Group B.V. reserves the right to audit the records and service delivery of the Psychiatrist at the Netherlands Amsterdam facility with a minimum of five (5) business days' written notice. The Psychiatrist shall cooperate fully with any such audit.
- This Purchase Order is valid for the period of 1 July 2025 through 31 December 2025. Either party may terminate this Purchase Order with sixty (60) days' written notice. Upon termination, all outstanding invoices for services already rendered shall be settled within the standard payment terms.
- All disputes arising from this Purchase Order shall be governed by the laws of the Netherlands and shall be subject to the exclusive jurisdiction of the competent court in Amsterdam, Netherlands.
- The Psychiatrist shall carry professional liability insurance (beroepsaansprakelijkheidsverzekering) with a minimum coverage of € 2,500,000 per claim and shall provide a certificate of insurance upon request.
- This Purchase Order does not create an employment relationship between MediCare Group B.V. and the Psychiatrist. The Psychiatrist operates as an independent contractor providing specialist medical services in the Netherlands Amsterdam region.
Authorized by – MediCare Group B.V.
Name: Sarah de Vries, Procurement DirectorSignature: _________________________
Date: 14 June 2025
Accepted by – Psychiatrist / Vendor
Name: Dr. Hendrik van der Berg, M.D.Signature: _________________________
Date: _________________________ ⬇️ Download as DOCX Edit online as DOCX
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