Purchase Order Psychologist in Israel Tel Aviv –Free Word Template Download with AI
Purchase Order No.: PO-TLV-2025-04871
Date of Issue: 14 June 2025
Valid Until: 14 September 2025
Issuing Entity:
NeuroCognitive Wellness Center Ltd.
45 Allenby Street, Tel Aviv-Yafo
Israel, 6460200
VAT No.: 51-802-334-77
Buyer (Purchasing Entity):
NeuroCognitive Wellness Center Ltd., a private healthcare and wellness organization registered in the State of Israel, headquartered at 45 Allenby Street, Tel Aviv-Yafo, Israel. The Buyer is a licensed provider of mental health and cognitive wellness services operating within the greater Tel Aviv metropolitan area.
Supplier (Service Provider):
Dr. Miriam Levi, Licensed Clinical Psychologist, Registration No. 104-5521, issued by the Israeli Ministry of Health, Psychology Licensing Board. Practice address: 12 Herzl Street, Suite 304, Tel Aviv-Yafo, Israel, 6460200. The Psychologist holds a Doctorate in Clinical Psychology from Tel Aviv University and is a certified member of the Israeli Psychological Association (IPA).
This Purchase Order is issued by NeuroCognitive Wellness Center Ltd. to formally engage the services of Dr. Miriam Levi, a licensed Psychologist, to deliver a comprehensive suite of psychological assessment, therapeutic intervention, and corporate wellness consultation services. The engagement is structured under the regulatory framework governing mental health professionals in Israel, specifically in accordance with the Israeli Mental Health Law, 5726-1966, and the regulations of the Israeli Ministry of Health pertaining to the practice of clinical psychology in the Tel Aviv-Yafo municipality and surrounding districts.
The scope of services under this Purchase Order encompasses individual psychotherapy sessions, group cognitive-behavioral therapy workshops, psychological evaluation and diagnostic assessments, and ongoing consultation for the Buyer's corporate wellness program. All services shall be rendered at the Psychologist's registered practice location in Tel Aviv, Israel, or at the Buyer's premises as mutually agreed upon in writing.
| Item No. | Description of Service | Quantity / Duration | Unit Price (ILS) | Total (ILS) |
|---|---|---|---|---|
| 01 | Individual Psychotherapy Session (60 minutes) – Licensed Psychologist, Dr. Miriam Levi | 48 sessions | 850.00 | 40,800.00 |
| 02 | Group Cognitive-Behavioral Therapy Workshop (3 hours, up to 12 participants) | 8 workshops | 4,200.00 | 33,600.00 |
| 03 | Comprehensive Psychological Assessment and Diagnostic Report (per client) | 15 assessments | 2,800.00 | 42,000.00 |
| 04 | Corporate Wellness Consultation and Program Design – Tel Aviv Office | 12 hours | 1,100.00 | 13,200.00 |
| 05 | Emergency Psychological Crisis Intervention (on-call, per incident) | Up to 4 incidents | 3,500.00 | 14,000.00 |
| 06 | Supervisory Consultation for Junior Therapists (90 minutes) | 16 sessions | 950.00 | 15,200.00 |
| Subtotal (excl. VAT) | 158,800.00 | |||
| VAT (18%) – Israel | 28,584.00 | |||
| Grand Total (incl. VAT) | 187,384.00 | |||
All prices are denominated in Israeli New Shekels (ILS / ₪). VAT is applied at the standard Israeli rate of 18% as mandated by the Israel Tax Authority.
Payment for the services outlined in this Purchase Order shall be made in accordance with the following schedule: an initial deposit of 25% of the total Purchase Order value (₪46,846.00) is due within fourteen (14) calendar days of the date of issue. The remaining balance shall be invoiced in monthly installments corresponding to the services rendered during each calendar month, with payment due within thirty (30) days of invoice receipt. All payments shall be transferred via bank wire to the Psychologist's designated account at Bank Hapoalim, Tel Aviv branch, in accordance with Israeli banking regulations and anti-money-laundering requirements under the Prevention of Money Laundering Law, 5759-1999.
The Psychologist engaged under this Purchase Order shall adhere to the ethical code of conduct established by the Israeli Psychological Association and the professional standards set forth by the Israeli Ministry of Health. All clinical records, patient files, and assessment reports generated in Tel Aviv, Israel, shall be maintained in strict compliance with the Israeli Privacy Protection Law, 5741-1981, and the regulations of the Israeli Data Protection Authority. The Psychologist shall maintain full professional liability insurance with a minimum coverage of ₪2,000,000, issued by a licensed Israeli insurance carrier, for the entire duration of this Purchase Order.
Either party may terminate this Purchase Order with a written notice of thirty (30) days. In the event of early termination by the Buyer, the Psychologist shall be compensated for all services already rendered and for any non-recoverable commitments made in reliance on this Purchase Order. Cancellation of individual sessions must be provided at least forty-eight (48) hours in advance; failure to do so shall result in a 50% fee for the scheduled session. All disputes arising from this Purchase Order shall be resolved under the jurisdiction of the competent courts in Tel Aviv, Israel, in accordance with Israeli civil law.
By signing below, both parties acknowledge and accept all terms, conditions, and service specifications set forth in this Purchase Order. This document constitutes a binding agreement for the procurement of psychological services in Tel Aviv, Israel, and supersedes all prior verbal or written communications between the parties regarding the scope of engagement.
For the Buyer:
Name: Yossi Ben-David
Title: Director of Operations
NeuroCognitive Wellness Center Ltd.
Signature: _________________________
Date: _________________________
For the Supplier (Psychologist):
Name: Dr. Miriam Levi
Title: Licensed Clinical Psychologist
Registration No.: 104-5521
Signature: _________________________
Date: _________________________
This Purchase Order was prepared and issued in Tel Aviv, Israel. Document reference: PO-TLV-2025-04871. For questions regarding this Purchase Order, contact the Procurement Office at [email protected] or by telephone at +972-3-621-4400.
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