Purchase Order Psychologist in Australia Sydney –Free Word Template Download with AI
PO No: PO-2025-SYD-04872
Date: 14 June 2025
Valid Until: 14 July 2025
Level 12, 200 George Street, Sydney NSW 2000, Australia
ABN: 54 123 456 789 | Phone: +61 2 9300 4500 | Email: [email protected]
1. Supplier / Vendor Information
| Field | Details |
|---|---|
| Supplier Name | Dr. Eleanor Whitfield, Registered Psychologist |
| Practice Name | Whitfield Psychological Services, Australia Sydney |
| Address | Suite 5, 88 Pitt Street, Sydney NSW 2000, Australia |
| ABN | 28 987 654 321 |
| APS Registration No. | PSY-482917 (Australian Psychology Board) |
| Contact Person | Dr. Eleanor Whitfield |
| [email protected] | |
| Phone | +61 2 9200 7800 |
2. Buyer / Receiving Department
| Field | Details |
|---|---|
| Department | Employee Assistance & Corporate Wellness Division |
| Requesting Manager | Ms. Catherine Liu, Head of People & Culture |
| Approval Authority | Mr. David Thornton, Chief Financial Officer |
| Delivery / Service Location | Harbourview Corporate Wellness Group, Level 12, 200 George Street, Sydney NSW 2000, Australia |
3. Line Items – Psychologist Services
| Item # | Description of Service | Qty | Unit | Unit Price (AUD) | Amount (AUD) |
|---|---|---|---|---|---|
| 01 | Individual psychological assessment and diagnostic consultation (90-minute session) – Psychologist-led, conducted at Australia Sydney office | 24 | Sessions | $320.00 | $7,680.00 |
| 02 | Group mental health workshop for corporate staff (3-hour session, up to 25 participants) – delivered by Registered Psychologist | 6 | Workshops | $1,850.00 | $11,100.00 |
| 03 | Post-traumatic stress debriefing and crisis intervention service – on-call Psychologist availability (monthly retainer) | 12 | Months | $950.00 | $11,400.00 |
| 04 | Written psychological evaluation reports for occupational health compliance (per report, Australia Sydney jurisdiction) | 18 | Reports | $450.00 | $8,100.00 |
| 05 | Telehealth psychological counselling sessions (60-minute, NDIS-eligible) – Psychologist conducted via secure video platform | 48 | Sessions | $260.00 | $12,480.00 |
| 06 | Annual organisational mental health risk assessment and strategic wellness plan – Psychologist-led audit | 1 | Assessment | $4,200.00 | $4,200.00 |
| Subtotal (AUD) | $54,960.00 | ||||
| GST (10%) | $5,496.00 | ||||
| TOTAL AMOUNT DUE (AUD) | $60,456.00 | ||||
4. Terms and Conditions
- This Purchase Order is issued by Harbourview Corporate Wellness Group Pty Ltd for the engagement of a Registered Psychologist to deliver clinical and corporate mental health services within Australia Sydney. All services shall be performed in accordance with the Australian Psychology Board (APB) Code of Ethics and the Health Services Act 1987 (NSW).
- The Psychologist named on this Purchase Order must maintain current registration with the Australian Health Practitioner Regulation Agency (AHPRA) and hold valid professional indemnity insurance of no less than AUD $10,000,000 for the entire duration of the contract period.
- Payment terms: Net 30 days from the date of a valid tax invoice. Payment shall be made via electronic funds transfer (EFT) to the bank account nominated by the Psychologist or their practice in Australia Sydney. All amounts are quoted in Australian Dollars (AUD) inclusive of applicable Goods and Services Tax (GST) at 10%.
- Service delivery schedule: All in-person sessions and workshops shall be conducted at the buyer's premises located at 200 George Street, Sydney NSW 2000, Australia, or at such other location in Australia Sydney as mutually agreed in writing. Telehealth sessions shall be delivered via the buyer's approved secure platform.
- Confidentiality: The Psychologist shall comply with all obligations under the Privacy Act 1988 (Cth) and the Australian Privacy Principles. All client records, assessment data, and psychological reports shall be stored in accordance with NSW Health records retention guidelines and shall not be disclosed to any third party without written consent from the client, except where required by law.
- Scope of Services: The Psychologist shall provide only those services listed in Section 3 of this Purchase Order. Any additional services, emergency interventions, or extended sessions beyond the agreed quantities must be pre-approved in writing by the buyer's Requesting Manager before commencing.
- Termination: Either party may terminate this Purchase Order with 14 days' written notice. In the event of termination, the buyer shall pay for all services rendered up to the date of termination. The Psychologist shall provide a transition plan for any ongoing client cases to ensure continuity of care.
- Dispute Resolution: Any disputes arising from this Purchase Order shall be resolved in accordance with the Civil Procedure Act 2005 (NSW) and shall be subject to the exclusive jurisdiction of the courts of New South Wales, Australia Sydney.
- Compliance: The Psychologist warrants that all services delivered under this Purchase Order comply with the Australian Consumer Law (Schedule 2, Competition and Consumer Act 2010 (Cth)) and all applicable state and federal legislation governing the practice of psychology in Australia.
5. Acceptance and Authorisation
By signing below, both parties acknowledge and agree to the terms, conditions, and service specifications outlined in this Purchase Order for the provision of Psychologist services in Australia Sydney.
For and on behalf of the Buyer:Name: ______________________________
Title: Chief Financial Officer
Signature: ______________________________
Date: ______________________________ For and on behalf of the Psychologist / Supplier:
Name: Dr. Eleanor Whitfield
Title: Registered Psychologist, Whitfield Psychological Services
Signature: ______________________________
Date: ______________________________ ⬇️ Download as DOCX Edit online as DOCX
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