Quotation Estimate Doctor General Practitioner in Chile Santiago –Free Word Template Download with AI
Doctor General Practitioner — Medical Consultation & Primary Care Services
Santiago, Chile — Metropolitan Region
Quotation Estimate No.: QEP-SCL-2025-0487Date of Issue: 15 June 2025
Valid Until: 15 July 2025 Prepared By: Dr. Carolina Reyes Mardones
Specialty: Doctor General Practitioner
Registration: C.M. Nº 148.732 — Colegio Médico de Chile
Location: Av. Providencia 1245, Of. 803, Santiago, Chile
| Company / Individual: | Corporación Salud Andina SpA |
| RUT: | 76.543.210-K |
| Address: | Av. Apoquindo 4560, Piso 12, Las Condes, Santiago, Chile |
| Contact Person: | Señor Ricardo Fuentes — HR Director |
| Email: | [email protected] |
| Phone: | +56 2 2345 6789 |
This Quotation Estimate is issued by Dr. Carolina Reyes Mardones, a licensed Doctor General Practitioner registered with the Colegio Médico de Chile, to provide comprehensive primary care medical services to the employees of Corporación Salud Andina SpA. The services will be delivered at the Doctor General Practitioner's clinic located in the Providencia commune of Santiago, Chile, and are designed to meet the occupational health requirements established under Chilean labor law (Código del Trabajo, Title I, Chapter II).
The Doctor General Practitioner will conduct routine medical examinations, preventive health screenings, chronic disease management consultations, and issue the corresponding medical certificates required by the employer. All services are performed in accordance with the clinical protocols established by the Ministerio de Salud de Chile and the guidelines of the Colegio Médico de Chile.
| Item # | Description of Service | Frequency | Unit Price (CLP) | Annual Total (CLP) |
|---|---|---|---|---|
| 01 | Initial comprehensive medical examination by Doctor General Practitioner (physical assessment, vital signs, medical history review) | 1x per employee | $38.000 | $38.000 |
| 02 | Semi-annual follow-up consultation with Doctor General Practitioner (30-minute session) | 2x per year | $32.000 | $64.000 |
| 03 | Preventive health screening panel (blood work, lipid profile, glucose, urinalysis, ECG) | 1x per year | $55.000 | $55.000 |
| 04 | Chronic disease management consultation (hypertension, diabetes, asthma) by Doctor General Practitioner | As needed (est. 4x/year) | $35.000 | $140.000 |
| 05 | Issuance of medical fitness certificate / aptitude report for workplace | 1x per year | $15.000 | $15.000 |
| 06 | Urgent same-day consultation with Doctor General Practitioner (limited to 2 per employee per year) | As needed | $42.000 | $84.000 |
| 07 | Annual occupational health report and statistical summary for employer compliance (Chilean labor regulations) | 1x per year | $120.000 | $120.000 |
| 08 | Coordination with specialist referrals within Santiago, Chile (cardiology, dermatology, orthopedics) — administrative fee | As needed | $18.000 | $36.000 |
| PER-EMPLOYEE ANNUAL TOTAL (CLP) | $552.000 | |||
| PROJECTED TOTAL FOR 45 EMPLOYEES (CLP) | $24.840.000 | |||
| APPLICABLE VAT (IVA) 19% (CLP) | $4.719.600 | |||
| GRAND TOTAL (CLP) | $29.559.600 | |||
* All prices are expressed in Chilean Pesos (CLP) and are subject to the standard 19% IVA (Impuesto al Valor Agregado) as mandated by the Servicio de Impuestos Internos de Chile. Prices do not include the cost of specialist consultations or laboratory work performed at third-party facilities in Santiago, Chile, which will be billed at cost with a 10% administrative surcharge.
- Validity: This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After this period, the Doctor General Practitioner reserves the right to revise pricing due to changes in supply costs, regulatory updates, or market conditions in Santiago, Chile.
- Payment Terms: Payment shall be made in quarterly installments (25% per quarter) via bank transfer to the account specified in the formal contract. A 2% late penalty per month will apply to overdue balances, in accordance with Chilean commercial law.
- Schedule: Consultations with the Doctor General Practitioner will be conducted Monday through Friday, between 08:00 and 18:00 hours, at the clinic in Providencia, Santiago. Emergency same-day appointments must be requested no later than 10:00 hours on the day of the visit.
- Confidentiality: All medical records and patient information are protected under Chilean Law Nº 21.719 on Access to Public Information and the professional secrecy obligations of the Colegio Médico de Chile. The Doctor General Practitioner will not disclose individual patient data to the employer beyond the scope of the fitness certificate.
- Cancellation: Either party may terminate the agreement with thirty (30) days written notice. In the event of early termination by the employer, a prorated refund of unused services will be issued within fifteen (15) business days.
- Regulatory Compliance: All services rendered by the Doctor General Practitioner comply with the standards set forth by the Superintendencia de Salud de Chile and the applicable regulations of the Ministerio de Salud. The Doctor General Practitioner maintains valid professional liability insurance (seguro de responsabilidad profesional) with a coverage of no less than CLP $500.000.000.
- Dispute Resolution: Any dispute arising from this Quotation Estimate or the subsequent contract shall be resolved through the courts of the Judicial District of Santiago, Chile, or by arbitration in Santiago in accordance with the rules of the Cámara de Comercio de Santiago.
- Force Majeure: Neither party shall be liable for delays or non-performance caused by events beyond reasonable control, including but not limited to natural disasters, public health emergencies declared by the Ministerio de Salud de Chile, or government-mandated closures.
By signing below, the requesting party acknowledges receipt of this Quotation Estimate and agrees to the terms, conditions, and pricing outlined herein. This document does not constitute a binding contract until a formal service agreement is executed by both parties. The Doctor General Practitioner in Santiago, Chile, will issue the formal contract within five (5) business days of written acceptance.
Dr. Carolina Reyes MardonesDoctor General Practitioner
C.M. Nº 148.732
Santiago, Chile Señor Ricardo Fuentes
HR Director
Corporación Salud Andina SpA
Santiago, Chile ⬇️ Download as DOCX Edit online as DOCX
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