Purchase Order Psychologist in Canada Toronto –Free Word Template Download with AI
Professional Psychological Services — Canada Toronto Region
1. Purchasing OrganizationBuyer / Receiving Entity
Northlake Wellness & Corporate Health Inc.
2200 Yonge Street, Suite 1450
Toronto, Ontario M4P 1E4
Canada
Tel: (416) 555-0192
Email: [email protected]
Vendor / Service Provider
Dr. Elena Marchetti, Ph.D., CPsych
Registered Psychologist, College of Psychologists of Ontario
185 Bloor Street West, Suite 302
Toronto, Ontario M5S 2V3
Canada
Tel: (416) 555-0347
Email: [email protected]
2. Description of Services — Psychologist EngagementThis Purchase Order is issued by Northlake Wellness & Corporate Health Inc. to formally engage the services of a licensed Psychologist operating within the Canada Toronto metropolitan area. The Psychologist, Dr. Elena Marchetti, is a fully registered member in good standing with the College of Psychologists of Ontario (CPO) and holds a valid Ontario Health Insurance Plan (OHIP) billing number where applicable. The scope of this Purchase Order covers the provision of individual and group psychological assessment, therapeutic intervention, and corporate wellness consultation services to be delivered at the vendor's office in Canada Toronto or at the buyer's premises as mutually agreed upon.
3. Line Items & Pricing| # | Service Description | Quantity | Unit Rate (CAD) | Amount (CAD) | Delivery / Due Date |
|---|---|---|---|---|---|
| 1 | Individual psychological assessment and diagnostic evaluation (per session, 60 min) | 24 sessions | $220.00 | $5,280.00 | July 1 – Sep 30, 2025 |
| 2 | Group therapy facilitation for corporate wellness program (per session, 90 min) | 12 sessions | $450.00 | $5,400.00 | July 1 – Sep 30, 2025 |
| 3 | Psychological report and written clinical summary per client | 24 reports | $150.00 | $3,600.00 | Within 10 business days of final session |
| 4 | On-site corporate wellness workshop at buyer's Toronto office (half-day) | 2 workshops | $1,200.00 | $2,400.00 | Aug 15 & Sep 12, 2025 |
| 5 | Emergency consultation and crisis intervention (per occurrence, up to 4 hrs) | 4 occurrences | $300.00 | $1,200.00 | As needed, within 24 hrs |
| Subtotal | $17,880.00 | ||||
| HST (13% — Ontario, Canada) | $2,324.40 | ||||
| TOTAL AMOUNT DUE (CAD) | $20,204.40 | ||||
4.1 Scope and Compliance. The Psychologist shall perform all services in strict accordance with the Code of Ethics and Professional Conduct established by the College of Psychologists of Ontario. All clinical records shall be maintained in compliance with the Personal Information Protection and Electronic Documents Act (PIPEDA) and the Health Information Protection Act (HIPA) of Ontario, Canada.
4.2 Payment Terms. Payment for this Purchase Order shall be made within thirty (30) days of receipt of a valid invoice from the Psychologist. Invoices must reference Purchase Order number PO-2025-04871. Payment shall be processed via electronic funds transfer (EFT) to the bank account designated by the vendor in Canada Toronto.
4.3 Cancellation and Modification. Either party may cancel or modify this Purchase Order with a minimum of fourteen (14) calendar days' written notice. Sessions cancelled with less than forty-eight (48) hours' notice shall be billed at fifty percent (50%) of the applicable unit rate.
4.4 Confidentiality. The Psychologist acknowledges that all client information obtained in the course of this engagement is strictly confidential. No client-identifying information shall be disclosed to the buyer beyond the scope of the written clinical summaries specified in Line Item 3, and only with the client's informed written consent.
4.5 Governing Law. This Purchase Order shall be governed by and construed in accordance with the laws of the Province of Ontario and the federal laws of Canada applicable therein. Any disputes arising from this Purchase Order shall be subject to the exclusive jurisdiction of the courts of Canada Toronto.
4.6 Insurance and Liability. The Psychologist shall maintain professional liability insurance with a minimum coverage of CAD $2,000,000 per occurrence throughout the term of this Purchase Order. A certificate of insurance shall be provided to the buyer upon request.
4.7 Acceptance. This Purchase Order constitutes a binding agreement upon signature by both parties. The buyer reserves the right to audit service delivery records upon thirty (30) days' notice to ensure compliance with the terms outlined herein.
5. Authorization and AcceptanceAuthorized Signatory — Buyer
Name: Margaret Chen, Director of Procurement
Northlake Wellness & Corporate Health Inc.
Date: ____________________
Authorized Signatory — Psychologist / Vendor
Name: Dr. Elena Marchetti, Ph.D., CPsych
Toronto Psychology Group
Date: ____________________
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