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Quotation Estimate Doctor General Practitioner in France Paris –Free Word Template Download with AI

Doctor General Practitioner Services — France Paris

Medical Consultation & Primary Care Package

Quotation Reference: QTE-2025-0417-GRP
Date of Issue: 15 June 2025
Validity Period: 30 days from date of issue
Prepared By: Dr. Claire Fontaine, MD
Practice: Cabinet Médicale du Quartier Latin
Location: 12 Rue de l'Université, 75005 Paris, France

Service Provider (Doctor General Practitioner)

Name: Dr. Claire Fontaine, MD

Specialty: General Practice / Médecine Générale

Registration: Ordre des Médecins, Région Ile-de-France

Address: 12 Rue de l'Université, 75005 Paris, France

Telephone: +33 1 43 26 88 41

Email: [email protected]

Client / Patient

Name: Mr. James Whitfield

Address: 8 Avenue Foch, 75116 Paris, France

Telephone: +33 6 12 34 56 78

Email: [email protected]

Insurance: Sécurité Sociale + Complémentaire (AXA)

Ameli Number: 1 85 06 75 123 456 78

This Quotation Estimate outlines the comprehensive primary care services to be provided by the undersigned Doctor General Practitioner to the client, as registered and practising within the city of France Paris. The services below constitute a twelve-month primary care engagement, covering routine consultations, preventive screenings, chronic disease management, and administrative medical documentation. All services are delivered in accordance with the French Code de la Santé Publique and the ethical standards of the Ordre des Médecins.

Ref Service Description Frequency Unit Price (EUR) Annual Total (EUR) SS Reimbursement
01 General Consultation (Consultation Générale) — Doctor General Practitioner office visit, France Paris 6 visits / year €25.00 €150.00 €15.00 / visit
02 Extended Consultation (Consultation Prolongée) — complex cases, multi-morbidity review 2 visits / year €50.00 €100.00 €30.00 / visit
03 Preventive Health Screening — blood panel, cardiovascular risk assessment, age-appropriate cancer screening 1 / year €120.00 €120.00 €80.00
04 Chronic Disease Management Plan (e.g., hypertension, type 2 diabetes) — quarterly monitoring 4 visits / year €30.00 €120.00 €18.00 / visit
05 Medical Certificates & Administrative Documentation (work, travel, insurance) 3 / year €20.00 €60.00 Not covered
06 Home Visit (Visite à domicile) — Doctor General Practitioner, France Paris, within 75005 arrondissement 2 / year €45.00 €90.00 €27.00 / visit
07 Telemedicine Consultation (Téléconsultation) — video or phone follow-up 4 / year €25.00 €100.00 €15.00 / visit
08 Annual Health Summary & Referral Coordination to specialists in France Paris 1 / year €50.00 €50.00 Not covered
TOTAL ESTIMATED ANNUAL FEE (before Sécurité Sociale reimbursement) €790.00 —
ESTIMATED SÉCURITÉ SOCIALE REIMBURSEMENT (70%) −€462.00 —
ESTIMATED PATIENT OUT-OF-POCKET (before Complémentaire) €328.00 —
  • 4.1 This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. After this period, pricing may be revised to reflect changes in the French healthcare tariff grid (nomenclature des actes médicaux) or practice operating costs in France Paris.
  • 4.2 All fees listed are in Euros (EUR) and are inclusive of applicable French Value Added Tax (TVA) where legally required. Medical consultations performed by a Doctor General Practitioner registered with the Sécurité Sociale are generally exempt from TVA under Article 261 of the Code Général des Impôts.
  • 4.3 The Sécurité Sociale reimbursement percentages indicated are estimates based on the current 2025 tariff schedule. Actual reimbursement amounts are determined by the Caisse Primaire d'Assurance Maladie (CPAM) of Paris. The client's Complémentaire Santé (mutuelle) may further reduce the out-of-pocket amount.
  • 4.4 The Doctor General Practitioner reserves the right to adjust the scope of services if the client's medical condition requires additional consultations, specialist referrals, or diagnostic investigations beyond those listed in this Quotation Estimate. Any such additional services will be communicated in writing prior to delivery.
  • 4.5 Home visits within the 75005 arrondissement of France Paris are included at the standard rate. Visits to other arrondissements or outside the city of Paris will be subject to a supplementary travel surcharge of €0.50 per kilometre beyond 5 km.
  • 4.6 Cancellation of a scheduled consultation must be communicated at least 24 hours in advance. Late cancellations or no-shows may incur a fee of €25.00, as permitted under the French medical practice regulations.
  • 4.7 All medical records, consultation notes, and documentation generated by the Doctor General Practitioner are the property of the practice and are stored in compliance with the French Data Protection Act (Loi Informatique et Libertés) and GDPR regulations. The client retains the right to access their full medical file at any time.
  • 4.8 This Quotation Estimate does not constitute a binding contract until signed and countersigned by both parties. Acceptance of this estimate implies agreement to the terms set forth herein and to the general terms of the Cabinet Médicale du Quartier Latin, France Paris.

Payment for services rendered by the Doctor General Practitioner is due at the time of each consultation or within fourteen (14) days of the invoice date, whichever is earlier. Accepted payment methods include bank transfer (virement bancaire), credit/debit card, and cash. The client is encouraged to submit the Sécurité Sociale reimbursement form (feuille de soins) directly to the CPAM or via the Ameli online portal to expedite the reimbursement process. The practice in France Paris will provide all necessary documentation to facilitate this process.

By signing below, both parties acknowledge that this Quotation Estimate for Doctor General Practitioner services in France Paris has been reviewed, understood, and accepted in its entirety.

For the Service Provider

Dr. Claire Fontaine, MD
Doctor General Practitioner
Cabinet Médicale du Quartier Latin, France Paris

Signature & Date

For the Client

Mr. James Whitfield
Patient / Client

Signature & Date

Quotation Estimate QTE-2025-0417-GRP — Doctor General Practitioner Services — France Paris
Cabinet Médicale du Quartier Latin • 12 Rue de l'Université, 75005 Paris, France • SIRET: 812 345 678 00019
This document is generated for informational and administrative purposes. It does not replace a formal medical contract or insurance policy.

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