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Purchase Order Psychologist in Canada Montreal –Free Word Template Download with AI

PSYCHOLOGIST SERVICES   CANADA MONTREAL

Purchase Order No.: PO-2025-CM-04872 Date of Issue: June 12, 2025
Required By: July 1, 2025 Valid Until: September 12, 2025
Payment Terms: Net 30 Days Currency: Canadian Dollars (CAD)
Organization: Montreal Wellness & Corporate Health Inc.
Address: 1450 Rue Sainte-Catherine Ouest, Suite 3200, Canada Montreal, QC H3G 1Z4
Contact Person: Marc-André Tremblay, Director of Human Resources
Email: [email protected]
Phone: +1 (514) 555-0192
QST No.: 123456789QST0001
Organization: Cabinet de Psychologie du Centre-Ville, Inc.
Address: 890 Boulevard René-Lévesque Est, Bureau 1150, Canada Montreal, QC H2M 1V8
Lead Psychologist: Dr. Émilie Fortin, Ph.D., Psychologue (Ordre des psychologues du Québec)
Licence No.: OPQ-2019-44871
Contact Person: Dr. Émilie Fortin
Email: [email protected]
Phone: +1 (514) 555-0347
QST No.: 987654321QST0001

This Purchase Order is issued by Montreal Wellness & Corporate Health Inc. to engage the services of a licensed Psychologist operating in Canada Montreal for the provision of professional psychological assessment, counselling, and corporate mental health support. The Psychologist shall be fully registered with the Ordre des psychologues du Québec and shall comply with all applicable federal and provincial regulations governing the practice of psychology in the Province of Quebec, Canada.

Item # Description Qty Unit Unit Price (CAD) Total (CAD)
1 Individual psychological assessment and diagnostic evaluation conducted by a licensed Psychologist in Canada Montreal (per session, 60 minutes) 40 Session $185.00 $7,400.00
2 Group counselling and psychoeducation workshops for corporate employees facilitated by the Psychologist (per workshop, 2 hours, up to 15 participants) 12 Workshop $650.00 $7,800.00
3 Psychological screening and well-being survey design, administration, and reporting for the Canada Montreal office (one-time project) 1 Project $4,200.00 $4,200.00
4 Monthly mental health consultation and case management by the Psychologist for HR team (per hour) 24 Hour $150.00 $3,600.00
5 Written psychological reports and clinical summaries for employee assistance programme (per report) 30 Report $95.00 $2,850.00
6 Crisis intervention and emergency psychological support on-call service (per activation, up to 4 hours) 4 Activation $750.00 $3,000.00
Subtotal: $28,850.00
QST (5%): $1,442.50
GST (5%): $1,442.50
TOTAL AMOUNT DUE (CAD): $31,735.00

The Psychologist engaged under this Purchase Order shall deliver all services within the Canada Montreal metropolitan area, including but not limited to the buyer's primary office located on Rue Sainte-Catherine Ouest. All clinical sessions, workshops, and assessments shall be conducted in either French or English, as required by the employee, in accordance with the linguistic duality policies of the Province of Quebec. The Psychologist shall maintain strict confidentiality in compliance with the Personal Information Protection Act (PIPA) of Quebec and the Canadian Privacy Act. All records and reports generated under this Purchase Order shall be stored in accordance with the data retention policies of the Ordre des psychologues du Québec.

  1. Acceptance: This Purchase Order constitutes a binding agreement upon written acceptance by the Psychologist or their authorized representative. The supplier must return a signed copy within five (5) business days of receipt.
  2. Service Period: Services shall commence on July 1, 2025, and continue through June 30, 2026, unless terminated earlier by mutual written agreement.
  3. Compliance: The Psychologist warrants that they hold a valid licence issued by the Ordre des psychologues du Québec and that all services rendered in Canada Montreal shall conform to the Code of Ethics of the Ordre des psychologues du Québec and applicable Canadian federal and provincial legislation.
  4. Payment: Invoices shall be submitted monthly. Payment is due within thirty (30) days of the invoice date via electronic funds transfer (EFT) to the account designated by the supplier. Late payments shall accrue interest at the rate prescribed under the Quebec Interest Act.
  5. Confidentiality: The Psychologist shall treat all employee information as strictly confidential. No data shall be shared with the buyer beyond the scope of the written reports specified in this Purchase Order, and only with the written consent of the employee.
  6. Termination: Either party may terminate this Purchase Order with thirty (30) days' written notice. In the event of termination, the buyer shall pay for all services rendered up to the effective date of termination.
  7. Governing Law: This Purchase Order shall be governed by and construed in accordance with the Civil Code of Quebec and the laws of the Province of Quebec, Canada. Any disputes shall be resolved through arbitration in Canada Montreal in accordance with the rules of the Quebec Arbitration Association.
  8. Insurance: The Psychologist shall maintain professional liability insurance with a minimum coverage of CAD $2,000,000 per occurrence for the duration of this Purchase Order and shall provide a certificate of insurance upon request.
  9. Force Majeure: Neither party shall be liable for failure to perform obligations due to events beyond reasonable control, including but not limited to natural disasters, pandemics, or government-ordered closures affecting operations in Canada Montreal.
  10. Amendments: Any modifications to this Purchase Order must be made in writing and signed by both parties. Verbal agreements shall not be binding.

This Purchase Order has been reviewed and authorized by the undersigned on behalf of Montreal Wellness & Corporate Health Inc. The engagement of the Psychologist under this Purchase Order is subject to budget approval by the Finance Committee and compliance review by the Legal Department of the organization.

For the Buyer:

Montreal Wellness & Corporate Health Inc.

Marc-André Tremblay
Director of Human Resources
Date: _______________

For the Supplier / Psychologist:

Cabinet de Psychologie du Centre-Ville, Inc.

Dr. Émilie Fortin, Ph.D.
Lead Psychologist
Date: _______________

Purchase Order PO-2025-CM-04872 | Montreal Wellness & Corporate Health Inc. | Canada Montreal, QC

This document is the property of Montreal Wellness & Corporate Health Inc. Unauthorized reproduction or distribution is prohibited.

Page 1 of 1 | Generated: June 12, 2025

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