Purchase Order Psychiatrist in Philippines Manila –Free Word Template Download with AI
128 Ayala Avenue, Makati City, Philippines Manila, 1226
Tel: +63 (2) 8888-4521 | Email: [email protected]
DTI Registration No. 201912345678 | BIR TIN: 000-123-456-789
Purchase OrderPurchase Order Details
Purchase Order No.: PO-2025-07-0342
Date of Issue: July 15, 2025
Required Service Date: August 1, 2025
Payment Terms: Net 30 Days
Currency: Philippine Peso (PHP)
Valid Until: August 15, 2025
Vendor / Service Provider
Name: Dr. Maria Clara Santos, M.D., Board-Certified Psychiatrist
Practice: Santos Psychiatric Clinic, Philippines Manila
Address: 45th Floor, The Enterprise Center, Ortigas Avenue, Quezon City, Philippines Manila, 1103
License No.: PRC-PSY-2018-004521
Contact: +63 (2) 8765-1234 | [email protected]
BIR TIN: 234-567-890-123
Bill To / Receiving Department
Department: Employee Wellness & Mental Health Program, Manila Wellness & Medical Services, Inc.
Attn: Mr. Juan Dela Cruz, Procurement Manager
Address: 128 Ayala Avenue, Makati City, Philippines Manila, 1226
Phone: +63 (2) 8888-4521 ext. 204
Line Items – Psychiatrist Professional Services
| Item # | Description of Psychiatrist Service | Quantity | Unit | Unit Price (PHP) | Amount (PHP) | Location |
|---|---|---|---|---|---|---|
| 01 | Individual psychiatric consultation and evaluation session (60 minutes) for corporate employees | 40 | Sessions | 3,500.00 | 140,000.00 | Philippines Manila |
| 02 | Group mental health workshop facilitated by the Psychiatrist (3 hours per session) | 6 | Workshops | 15,000.00 | 90,000.00 | Philippines Manila |
| 03 | Psychiatric follow-up and treatment plan review (45 minutes) | 25 | Sessions | 2,800.00 | 70,000.00 | Philippines Manila |
| 04 | Emergency psychiatric consultation and crisis intervention (on-call, Philippines Manila area) | 12 | Hours | 5,000.00 | 60,000.00 | Philippines Manila |
| 05 | Written psychiatric assessment reports and medical clearance documentation | 40 | Reports | 1,200.00 | 48,000.00 | Philippines Manila |
| 06 | Quarterly mental health program review and strategic consultation with company HR | 4 | Quarters | 10,000.00 | 40,000.00 | Philippines Manila |
| Subtotal: | PHP 448,000.00 |
| VAT (12%): | PHP 53,760.00 |
| Withholding Tax (10%): | (PHP 44,800.00) |
| Net Payable Amount: | PHP 456,960.00 |
Terms and Conditions of This Purchase Order
- This Purchase Order is issued by Manila Wellness & Medical Services, Inc. for the engagement of a licensed Psychiatrist to provide mental health services to corporate employees within the Philippines Manila metropolitan area. All services must be rendered by Dr. Maria Clara Santos or a duly authorized associate Psychiatrist holding a valid PRC license.
- The Psychiatrist shall comply with all applicable Philippine laws, including the Mental Health Act of the Philippines (Republic Act No. 10175) and the Data Privacy Act (Republic Act No. 10173), ensuring full confidentiality of all patient records and psychiatric evaluations conducted in Philippines Manila.
- All services described in this Purchase Order shall be performed at the designated locations within Philippines Manila as specified in the line items above. The Psychiatrist is responsible for providing all necessary medical equipment, diagnostic tools, and clinical materials required for the delivery of psychiatric services.
- Payment shall be made within thirty (30) calendar days from the date of receipt of a valid Official Receipt (OR) issued by the Psychiatrist's practice. Payment shall be processed via bank transfer to the account designated by the vendor. All amounts are stated in Philippine Pesos (PHP) and are subject to applicable Philippine tax regulations.
- The Psychiatrist shall submit a detailed service report to the Procurement Department of Manila Wellness & Medical Services, Inc. within five (5) business days following the completion of each service period. Failure to submit reports may result in the suspension of this Purchase Order.
- This Purchase Order is valid for a period of one (1) year from the date of issue, unless terminated earlier by mutual written agreement of both parties. Either party may terminate this Purchase Order with thirty (30) days written notice.
- All disputes arising from this Purchase Order shall be resolved through mediation in accordance with the rules of the Philippine Dispute Resolution Center, with the venue set in Philippines Manila. The governing law shall be the laws of the Republic of the Philippines.
- The Psychiatrist shall maintain professional medical malpractice insurance with a minimum coverage of PHP 5,000,000.00 throughout the duration of this Purchase Order. Proof of insurance shall be provided upon request.
- Any modifications or amendments to this Purchase Order must be made in writing and signed by both parties. Verbal agreements shall not be binding. This Purchase Order constitutes the entire agreement between the parties regarding the procurement of Psychiatrist services in Philippines Manila.
Prepared by:
Juan Dela CruzProcurement Manager
Manila Wellness & Medical Services, Inc.
Date: July 15, 2025
Approved by:
Dr. Maria Clara Santos, M.D.Board-Certified Psychiatrist
Santos Psychiatric Clinic, Philippines Manila
Date: July 15, 2025 ⬇️ Download as DOCX Edit online as DOCX
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