Purchase Order Psychologist in Israel Jerusalem –Free Word Template Download with AI
| Role | Entity | Address | Contact |
|---|---|---|---|
| Buyer (Procuring Entity) | Jerusalem Municipal Health Authority | 12 King George Street, Israel Jerusalem, 9452001 | [email protected] |
| Supplier (Service Provider) | Dr. Miriam Levi, Licensed Clinical Psychologist | 45 Jaffa Road, Israel Jerusalem, 9477002 | [email protected] |
This Purchase Order is issued by the Jerusalem Municipal Health Authority to formally engage the services of a qualified Psychologist to provide comprehensive clinical and therapeutic services to residents and municipal employees within the Israel Jerusalem metropolitan area. The Psychologist engaged under this Purchase Order shall hold a valid license issued by the Israeli Ministry of Health and the Israeli Psychological Association, and shall demonstrate a minimum of ten (10) years of clinical experience in adult and adolescent psychotherapy, cognitive-behavioral therapy, trauma-informed care, and community mental health interventions.
The scope of services rendered by the Psychologist under this Purchase Order includes, but is not limited to: individual psychotherapy sessions, group therapeutic workshops, psychological assessments and diagnostic evaluations, crisis intervention support, referral coordination with psychiatric services in Israel Jerusalem, and quarterly progress reporting to the procuring authority. All services shall be delivered in accordance with the ethical standards established by the Israeli Psychological Association and the professional conduct guidelines of the Israeli Ministry of Health.
3. Itemized Services and Pricing| Item No. | Description of Service | Quantity | Unit Price (ILS) | Total (ILS) |
|---|---|---|---|---|
| 1 | Individual Psychotherapy Session (50 min) – Psychologist | 240 | 450.00 | 108,000.00 |
| 2 | Group Therapeutic Workshop (2 hours) – Psychologist | 48 | 1,200.00 | 57,600.00 |
| 3 | Comprehensive Psychological Assessment & Report | 60 | 1,800.00 | 108,000.00 |
| 4 | Crisis Intervention & Emergency Support (per incident) | 20 | 900.00 | 18,000.00 |
| 5 | Quarterly Progress Report to Israel Jerusalem Health Authority | 4 | 2,500.00 | 10,000.00 |
| 6 | Community Mental Health Outreach Program – Israel Jerusalem | 12 | 3,500.00 | 42,000.00 |
| Grand Total (VAT 18% included) | 343,600.00 | |||
4.1 This Purchase Order constitutes a binding agreement between the Buyer and the Supplier for the provision of professional psychological services. The Psychologist named herein shall perform all duties in full compliance with Israeli law, including the Mental Health Law (5731-1971), the Privacy Protection Law (5741-1981), and all applicable regulations of the Israeli Ministry of Health governing the practice of psychology in Israel Jerusalem.
4.2 The Psychologist shall maintain full professional liability insurance with a minimum coverage of ILS 2,000,000 per claim throughout the duration of this Purchase Order. Proof of insurance shall be submitted to the Buyer prior to the commencement of services.
4.3 All patient records, clinical notes, and assessment documents generated under this Purchase Order shall be stored in secure, encrypted facilities located within Israel Jerusalem and shall be subject to the Israeli Privacy Protection Law. No patient data shall be transferred outside of Israel without explicit written consent from the patient and approval from the Buyer's data protection officer.
4.4 The Psychologist shall adhere to the ethical code of conduct published by the Israeli Psychological Association. Any breach of ethical standards shall constitute grounds for immediate termination of this Purchase Order without penalty to the Buyer.
4.5 Payment shall be made on a monthly basis within thirty (30) days of receipt of an itemized invoice. Invoices must reference this Purchase Order number (PO-JER-2025-04871) and shall be submitted to the Jerusalem Municipal Health Authority accounts payable department.
4.6 The Psychologist shall provide a minimum of forty-eight (48) hours' written notice for any cancellation or rescheduling of sessions. Cancellations made within twenty-four (24) hours of a scheduled session shall be subject to a 50% fee as stipulated in this Purchase Order.
4.7 This Purchase Order shall remain in effect for a period of twelve (12) months from the date of issue, unless terminated earlier by either party in accordance with the termination clause (Section 5). Renewal shall require a new Purchase Order issued by the Buyer.
5. Termination ClauseEither party may terminate this Purchase Order by providing thirty (30) days' written notice to the other party. The Buyer reserves the right to terminate this Purchase Order immediately, without notice, in the event of: (a) material breach of any term herein by the Psychologist; (b) loss of professional license by the Israeli Ministry of Health; (c) conviction of a criminal offense; or (d) failure to maintain required insurance coverage. Upon termination, the Psychologist shall deliver all patient records and clinical documentation to the Buyer within fourteen (14) days.
6. Governing Law and JurisdictionThis Purchase Order shall be governed by and construed in accordance with the laws of the State of Israel. Any disputes arising from or in connection with this Purchase Order shall be subject to the exclusive jurisdiction of the competent courts in Israel Jerusalem. Both parties agree to attempt mediation through the Israeli Psychological Association's dispute resolution mechanism before initiating any legal proceedings.
For and on behalf of the Buyer:
Jerusalem Municipal Health Authority
Name:Title: Director of Procurement
Signature: _________________________
Date: _________________________
For and on behalf of the Supplier:
Dr. Miriam Levi, Licensed Clinical Psychologist
Name: Dr. Miriam LeviLicense No.: IL-PSY-2014-08832
Signature: _________________________
Date: _________________________ ⬇️ Download as DOCX Edit online as DOCX
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