Quotation Estimate Doctor General Practitioner in Italy Rome –Free Word Template Download with AI

This Quotation Estimate is issued by Dr. Marco Antonelli, a Doctor General Practitioner registered with the Ordine dei Medici Chirurghi e Odontoiatri di Roma, to provide comprehensive primary care medical services to the above-named client residing in Rome, Italy. The Doctor General Practitioner will serve as the client's primary point of contact within the Italian National Health Service (Servizio Sanitario Nazionale – SSN) framework for all non-specialist medical needs, including preventive health assessments, diagnosis and management of acute and chronic conditions, prescription of medications, referrals to specialists, and coordination of ongoing care plans within the Rome metropolitan area.

Note: Where services are covered under the Italian SSN (Servizio Sanitario Nazionale) with a valid Tessera Sanitaria, the applicable co-payment (ticket) of € 25.00 per visit may apply in lieu of the full private fee, subject to the client's income bracket and regional regulations in Lazio. This Quotation Estimate reflects the full private-pay rate.

• 1. Validity: This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. Prices are subject to revision upon expiry in accordance with the tariff schedule published by the Ordine dei Medici di Roma.
• 2. Acceptance: The client shall confirm acceptance of this Quotation Estimate in writing (email or signed copy) within the validity period. Services commence upon receipt of the first payment instalment.
• 3. Payment: Payment is due within fifteen (15) days of invoice issuance. Accepted methods include bank transfer (IBAN: IT60 X054 2811 1000 0000 4321 098), credit/debit card, or cash at the Rome clinic. Late payments incur a 1.5% monthly surcharge as per Italian civil code (Art. 1284 c.c.).
• 4. Cancellation: Appointments with the Doctor General Practitioner may be cancelled or rescheduled with a minimum of 24 hours' notice. Cancellations within 24 hours are subject to a 50% fee of the scheduled consultation.
• 5. SSN Integration: The Doctor General Practitioner operates in compliance with the Lazio Regional Health Authority (Regione Lazio – Assessorato alla Salute) guidelines. The client retains the right to access SSN-covered services independently; this Quotation Estimate covers only the private supplementary services listed above.
• 6. Data Protection: All patient data is processed in strict compliance with the Italian Privacy Code (D.Lgs. 196/2003) and the EU General Data Protection Regulation (GDPR – Reg. UE 2016/679). The Doctor General Practitioner acts as Data Controller for all medical records maintained at the Rome practice.
• 7. Jurisdiction: This agreement is governed by the laws of the Italian Republic. Any disputes shall be resolved by the competent courts of Rome (Tribunale di Roma), Lazio, Italy.
• 8. Limitation of Liability: The Doctor General Practitioner provides services with the standard of care expected of a reasonably competent general practitioner in Italy. This Quotation Estimate does not constitute a guarantee of specific medical outcomes.

By signing below, both parties acknowledge and agree to the terms set forth in this Quotation Estimate for the Doctor General Practitioner services to be delivered in Rome, Italy.