Purchase Order Speech Therapist in United States Houston –Free Word Template Download with AI
Date of Issue: June 12, 2025
Valid Until: September 12, 2025
Revision: 00
| Field | Details |
|---|---|
| Organization Name | Gulf Coast Regional Health Network, Inc. |
| Address | 4500 Medical Center Drive, Suite 700, United States Houston, Texas 77030 |
| Phone | (713) 555-0192 |
| [email protected] | |
| Tax ID (EIN) | 74-2839105 |
| Authorized Buyer | Margaret L. Chen, Director of Procurement |
| Field | Details |
|---|---|
| Provider Name | ClearVoice Speech & Language Therapy Group, LLC |
| Address | 2210 Westheimer Road, Floor 3, United States Houston, Texas 77098 |
| Phone | (281) 555-4478 |
| [email protected] | |
| Tax ID (EIN) | 75-9102347 |
| License Number | TX-SLP-2019-4482 (Texas State Board of Examiners of Speech-Language Pathologists) |
| Primary Contact | Dr. Alan R. Whitfield, CCC-SLP, Practice Owner |
This Purchase Order is issued by Gulf Coast Regional Health Network, Inc. to formally engage the services of a qualified Speech Therapist (also referred to as a Speech-Language Pathologist) to deliver in-clinic and telehealth speech therapy sessions to patients residing in and around the United States Houston metropolitan area. The Speech Therapist shall provide individualized assessment, diagnosis, and treatment plans for patients presenting with articulation disorders, language delays, voice disorders, fluency impairments, cognitive-communication deficits, and swallowing difficulties (dysphagia). All services rendered under this Purchase Order must comply with the standards set forth by the American Speech-Language-Hearing Association (ASHA) and the Texas Department of State Health Services.
| Item # | Description | Qty / Duration | Unit Rate (USD) | Extended Amount (USD) |
|---|---|---|---|---|
| 001 | Initial Speech Therapist Comprehensive Evaluation (per patient, 60 minutes) – United States Houston clinic location | 120 evaluations | $185.00 | $22,200.00 |
| 002 | Weekly Speech Therapist Treatment Session (45 minutes, in-person) – United States Houston | 1,440 sessions | $120.00 | $172,800.00 |
| 003 | Telehealth Speech Therapist Session (30 minutes, virtual) – serving patients across United States Houston and surrounding counties | 720 sessions | $95.00 | $68,400.00 |
| 004 | Speech Therapist Progress Report & Documentation (per patient, quarterly) | 360 reports | $45.00 | $16,200.00 |
| 005 | Speech Therapist On-Site Supervision & Staff Training (per 8-hour day, United States Houston facility) | 12 days | $650.00 | $7,800.00 |
| 006 | Emergency / After-Hours Speech Therapist Consultation (per occurrence) | 24 occurrences | $210.00 | $5,040.00 |
| SUBTOTAL | $292,440.00 | |||
| Applicable Texas Sales & Service Tax (8.25%) | $24,126.30 | |||
| TOTAL PURCHASE ORDER AMOUNT (USD) | $316,566.30 | |||
All in-person Speech Therapist services under this Purchase Order shall be delivered at the Gulf Coast Regional Health Network primary facility located at 4500 Medical Center Drive, United States Houston, Texas 77030, and at the satellite clinic on 2210 Westheimer Road, United States Houston, Texas 77098. Telehealth sessions may be conducted remotely but must serve patients whose primary residence falls within the United States Houston metropolitan statistical area (Harris, Fort Bend, Montgomery, and Brazoria counties). The Speech Therapist is expected to be available Monday through Friday, 8:00 AM to 6:00 PM Central Time, with a minimum of 32 clinical hours per week dedicated to direct patient care.
6.1 Payment Terms: Net 30 days from the date of invoice submission. Invoices must reference this Purchase Order number (PO-2025-HST-04872) and itemize services rendered by the Speech Therapist during the billing period. Payment shall be made via ACH transfer to the account designated by ClearVoice Speech & Language Therapy Group, LLC.
6.2 Performance Standards: The Speech Therapist must maintain current certification (CCC-SLP) and a valid Texas state license throughout the term of this Purchase Order. Failure to maintain licensure constitutes immediate grounds for termination.
6.3 Confidentiality: All patient records, clinical notes, and treatment data generated by the Speech Therapist in the United States Houston facilities are subject to HIPAA (Health Insurance Portability and Accountability Act) regulations. A signed Business Associate Agreement (BAA) is attached as Exhibit A to this Purchase Order.
6.4 Cancellation and Modification: Either party may modify or cancel this Purchase Order with 30 days' written notice. Cancellations of individual Speech Therapist sessions by the patient must be made at least 24 hours in advance to avoid no-show charges.
6.5 Insurance and Liability: The Speech Therapist and the provider entity shall maintain professional liability insurance with a minimum coverage of $2,000,000 per occurrence. Certificates of insurance must be provided prior to the commencement of services in United States Houston.
6.6 Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the State of Texas. Any disputes arising from this Purchase Order related to Speech Therapist services in United States Houston shall be resolved through binding arbitration in Harris County, Texas.
By signing below, both parties acknowledge that this Purchase Order constitutes a binding agreement for the provision of Speech Therapist services in United States Houston. The terms outlined herein supersede any prior verbal or written communications between the parties regarding the scope, pricing, or duration of the engagement.
For Gulf Coast Regional Health Network, Inc. (Buyer)Signature: ______________________________
Name: Margaret L. Chen
Title: Director of Procurement
Date: ______________________________ For ClearVoice Speech & Language Therapy Group, LLC (Seller)
Signature: ______________________________
Name: Dr. Alan R. Whitfield, CCC-SLP
Title: Practice Owner / Lead Speech Therapist
Date: ______________________________ Important Note: This Purchase Order is valid for a period of twelve (12) months from the date of execution. Upon expiration, a new Purchase Order must be issued to continue Speech Therapist services in United States Houston. All amendments to this document must be made in writing and signed by both parties. Questions regarding this Purchase Order should be directed to the Procurement Department at [email protected] or (713) 555-0192.
— End of Purchase Order PO-2025-HST-04872 —
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