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Purchase Order Psychologist in Brazil Rio de Janeiro –Free Word Template Download with AI

Professional Psychological Services – Rio de Janeiro, Brazil PO No.: RJ-PSY-2025-0047 Date of Issue: 15 June 2025
Field Details
Company Name Horizonte Saúde Corporativa Ltda.
CNPJ 12.345.678/0001-90
Address Av. Atlântica, 1500 – Copacabana, Rio de Janeiro, RJ – CEP 22070-001, Brazil
Contact Person Dra. Mariana Costa – Director of Human Resources
Email [email protected]
Phone +55 (21) 3456-7890
Field Details
Professional Name Dr. Rafael Almeida Santos – Psychologist
CRP Registration CRP 05/67890 – Conselho Regional de Psicologia, 5ª Região (Rio de Janeiro)
CPF ***.456.789-**
Practice Address Rua Visconde de Pirajá, 890 – Ipanema, Rio de Janeiro, RJ – CEP 22410-001, Brazil
Specialization Clinical Psychology, Occupational Health Psychology, Cognitive-Behavioral Therapy
Email [email protected]
Phone +55 (21) 99876-5432

This Purchase Order is issued by Horizonte Saúde Corporativa Ltda. to formally engage the services of a licensed Psychologist operating in Brazil, Rio de Janeiro, for the provision of corporate mental health support, employee wellness assessments, and individual therapeutic sessions. The Psychologist shall deliver all services in compliance with the regulations established by the Conselho Federal de Psicologia (CFP) and the Conselho Regional de Psicologia (CRP) of the 5ª Região, which governs the state of Rio de Janeiro.

The scope of this Purchase Order encompasses the following professional activities to be performed by the Psychologist at the company's headquarters located in Rio de Janeiro, Brazil, and/or remotely via secure telehealth platforms approved by the CFP:

Item Description Qty Unit Price (BRL) Total (BRL)
01 Individual psychological assessment and therapeutic sessions (50 minutes each) – Psychologist in-person consultation at Rio de Janeiro office 120 R$ 350,00 R$ 42,000.00
02 Group mental health workshops (3 hours each) for employee wellness programs – Psychologist facilitation 12 R$ 1,800.00 R$ 21,600.00
03 Occupational stress risk assessment and report for 200 employees – Psychologist evaluation in compliance with NR-1 (Brazilian regulatory standard) 1 R$ 15,000.00 R$ 15,000.00
04 Monthly supervision and case management review – Psychologist reporting to HR Director 12 R$ 2,500.00 R$ 30,000.00
05 Emergency psychological first aid and crisis intervention (on-call availability, 24/7) – Psychologist standby in Rio de Janeiro 12 R$ 1,200.00 R$ 14,400.00
06 Annual psychological health report and strategic recommendations for corporate wellness policy – Psychologist authored document 1 R$ 8,000.00 R$ 8,000.00
TOTAL AMOUNT (BRL) R$ 131,000.00
TOTAL AMOUNT (USD – approximate at BRL 5.40/USD) USD 24,259.26

5.1 Validity: This Purchase Order is valid for a period of twelve (12) months from the date of issue, covering the period from 01 July 2025 to 30 June 2026. All services shall be rendered within the municipality of Rio de Janeiro, state of Rio de Janeiro, Brazil, unless otherwise agreed in writing.

5.2 Payment Terms: Payment shall be made via bank transfer (TED/PIX) to the Psychologist's designated account within fifteen (15) business days of receipt of the monthly invoice. The Purchase Order number must be referenced on all invoices submitted.

5.3 Professional Compliance: The Psychologist warrants that they hold a valid CRP registration (CRP 05/67890) and shall maintain all professional licenses, malpractice insurance, and ethical obligations as required by the CFP and applicable Brazilian legislation, including the Lei nº 4.119/1962 and the Código de Ética Profissional do Psicólogo.

5.4 Confidentiality: All patient records, session notes, and assessment data shall be treated with the strictest confidentiality in accordance with the Brazilian General Data Protection Law (LGPD – Lei Geral de Proteção de Dados, Lei nº 13.709/2018) and the CFP's ethical code. The Psychologist shall not disclose any information pertaining to employees of Horizonte Saúde Corporativa Ltda. without explicit written consent.

5.5 Cancellation and Termination: Either party may terminate this Purchase Order with thirty (30) days' written notice. In the event of early termination, the Psychologist shall be compensated for all services rendered up to the termination date.

5.6 Jurisdiction: This Purchase Order shall be governed by the laws of the Federative Republic of Brazil. Any disputes arising from this agreement shall be subject to the exclusive jurisdiction of the courts of Rio de Janeiro, RJ, Brazil.

5.7 Tax Obligations: The Psychologist is responsible for all applicable taxes, including IRPF (Imposto de Renda Pessoa Física) and ISS (Imposto Sobre Serviços) levied by the municipality of Rio de Janeiro. The purchasing entity shall withhold any legally mandated taxes at source.

By signing below, both parties acknowledge and agree to all terms set forth in this Purchase Order for the engagement of the Psychologist in Brazil, Rio de Janeiro. This document constitutes a binding agreement between the parties for the duration specified herein.

For the Purchasing Entity
Dra. Mariana Costa
Director of Human Resources
Horizonte Saúde Corporativa Ltda.
Rio de Janeiro, RJ – Brazil
Date: _______________
For the Service Provider
Dr. Rafael Almeida Santos
Psychologist – CRP 05/67890
Rio de Janeiro, RJ – Brazil
Date: _______________

PURCHASE ORDER NO. RJ-PSY-2025-0047 | Horizonte Saúde Corporativa Ltda. | Av. Atlântica, 1500 – Copacabana, Rio de Janeiro, RJ – Brazil

This document was generated in accordance with Brazilian commercial practices and the regulations of the Conselho Federal de Psicologia. All services described herein are to be performed within the jurisdiction of Rio de Janeiro, Brazil.

Page 1 of 1 | Confidential – For Internal Use Only

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