Purchase Order Psychiatrist in Tanzania Dar es Salaam –Free Word Template Download with AI
East African Mental Health Services Ltd.
Plot 14, Sam Nujoma Street, Mikocheni, Tanzania Dar es Salaam
Tel: +255 22 211 4567 | Email: [email protected]
Company Registration No.: 123456-2019 | TIN: 123-456-789
Purchase Order No.: PO-EAMHS-2025-00847Date of Issue: 15 June 2025
Valid Until: 15 September 2025
Provider Name: Dr. Amina Hassan Mwangi, MBChB, MMed (Psychiatry)
Practice: Dar es Salaam Psychiatric & Counselling Centre
Address: 22 Samora Avenue, Masaki, Tanzania Dar es Salaam
License No.: TMC/Psych/2018/0042
TIN: 987-654-321
Bank: CRDB Bank, Masaki Branch
Account Name: Dar es Salaam Psychiatric & Counselling Centre
Account No.: 0102-3456-7890
SWIFT Code: CRDBTZDZ
Contact: +255 754 123 456
| Ref | Service Description | Quantity | Unit Rate (TZS) | Total Amount (TZS) |
|---|---|---|---|---|
| 01 | Initial psychiatric assessment and diagnostic evaluation for corporate wellness programme (per patient session, 60 minutes) | 120 sessions | 150,000 | 18,000,000 |
| 02 | Follow-up psychiatric consultations and treatment plan reviews (per patient session, 45 minutes) | 240 sessions | 120,000 | 28,800,000 |
| 03 | Group psychotherapy and mental health awareness workshops conducted by the Psychiatrist at client premises in Tanzania Dar es Salaam | 12 workshops | 850,000 | 10,200,000 |
| 04 | Prescription management, medication review, and referral coordination with the National Institute of Mental Health, Tanzania Dar es Salaam | 60 reviews | 95,000 | 5,700,000 |
| 05 | Emergency psychiatric consultation and crisis intervention (on-call service, 24/7 availability within Tanzania Dar es Salaam metropolitan area) | 12 months | 2,500,000 | 30,000,000 |
| 06 | Quarterly written progress reports and confidential patient outcome summaries submitted to East African Mental Health Services Ltd. | 4 reports | 350,000 | 1,400,000 |
| SUBTOTAL: | 94,100,000 | |||
| VAT (18%): | 16,938,000 | |||
| GRAND TOTAL (TZS): | 111,038,000 | |||
- This Purchase Order constitutes a binding agreement between East African Mental Health Services Ltd. (hereinafter "the Purchaser") and Dr. Amina Hassan Mwangi operating as Dar es Salaam Psychiatric & Counselling Centre (hereinafter "the Psychiatrist Provider") for the provision of psychiatric and mental health services within the Tanzania Dar es Salaam region.
- The Psychiatrist Provider shall deliver all services in accordance with the standards set by the Tanzania Medical Council and the National Mental Health Policy of the United Republic of Tanzania. All clinical records shall be maintained in compliance with the Data Protection Act, 2022, of Tanzania.
- Payment shall be made in Tanzanian Shillings (TZS) via bank transfer within thirty (30) calendar days of receipt of a valid invoice from the Psychiatrist Provider. Late payments shall attract interest at the rate of 2% per month as stipulated under Tanzanian commercial law.
- The Psychiatrist Provider guarantees a minimum response time of four (4) hours for emergency psychiatric consultations within the Tanzania Dar es Salaam metropolitan area and twenty-four (24) hours for all other service requests.
- All patient data, clinical notes, and treatment records generated under this Purchase Order shall remain the confidential property of the Purchaser. The Psychiatrist Provider shall not disclose any patient information to third parties without written consent, in strict adherence to the Tanzania Medical Council's code of professional conduct.
- The Psychiatrist Provider shall maintain valid professional indemnity insurance with a minimum cover of TZS 500,000,000 throughout the duration of this Purchase Order and shall provide a certificate of insurance upon request.
- Either party may terminate this Purchase Order with thirty (30) days' written notice. In the event of termination, the Psychiatrist Provider shall be compensated for all services rendered up to the date of termination, and all ongoing patient care plans shall be transitioned to a successor psychiatrist approved by the Purchaser.
- This Purchase Order shall be governed by and construed in accordance with the laws of the United Republic of Tanzania. Any disputes arising from this Purchase Order shall be resolved through arbitration in Tanzania Dar es Salaam in accordance with the Arbitration Act, Cap. 20, Laws of Tanzania.
- The Psychiatrist Provider shall submit a monthly summary of sessions conducted, medications prescribed, and any referrals made to the National Institute of Mental Health or other facilities in Tanzania Dar es Salaam.
- This Purchase Order is valid for a period of twelve (12) months from the date of issue and may be renewed by mutual written agreement of both parties.
For and on behalf of the Purchaser:
East African Mental Health Services Ltd.
Name: Mr. Joseph K. MushiTitle: Chief Procurement Officer
Signature: _________________________
Date: 15 June 2025
For and on behalf of the Psychiatrist Provider:
Dar es Salaam Psychiatric & Counselling Centre
Name: Dr. Amina Hassan MwangiTitle: Lead Psychiatrist / Director
Signature: _________________________
Date: _________________________ ⬇️ Download as DOCX Edit online as DOCX
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