Quotation Estimate Doctor General Practitioner in New Zealand Auckland –Free Word Template Download with AI
128 Victoria Street West, Auckland Central, Auckland 1010, New Zealand
Phone: +64 9 376 4521 | Email: [email protected]
Provider Number: 10045872 | NZBN: 9429045872136
Quotation EstimateQuotation Details
Quotation No.: QE-2025-04871
Date Issued: 14 June 2025
Valid Until: 14 July 2025 (30 days)
Currency: New Zealand Dollars (NZD)
Prepared For
Client Name: Mr. Jonathan T. Whitfield
Address: 45 Ponsonby Road, Ponsonby, Auckland 1011, New Zealand
Phone: +64 21 483 9927
Email: [email protected]
Dear Mr. Whitfield,
Thank you for your enquiry regarding comprehensive primary healthcare services. This Quotation Estimate has been prepared by our Doctor General Practitioner team at Auckland Central Medical Practice, serving the wider New Zealand Auckland community. The following document outlines the estimated costs for the medical services you have requested. All fees are quoted in New Zealand Dollars (NZD) and are subject to the terms and conditions stated herein.
Itemised Services & Estimated Costs| Ref | Description of Service | Quantity | Unit Price (NZD) | Total (NZD) |
|---|---|---|---|---|
| 01 | Initial Consultation with Doctor General Practitioner – Comprehensive health assessment, medical history review, and physical examination | 1 | $185.00 | $185.00 |
| 02 | Follow-up Consultation (30-minute appointment) – Review of initial findings, discussion of treatment plan, and prescription management | 2 | $145.00 | $290.00 |
| 03 | Full Blood Panel (FBC, U&E, LFT, Lipid Profile, HbA1c, Thyroid Function) – Laboratory processing and Doctor General Practitioner interpretation | 1 | $210.00 | $210.00 |
| 04 | Electrocardiogram (ECG) – 12-lead cardiac screening performed and reviewed by the Doctor General Practitioner on-site | 1 | $95.00 | $95.00 |
| 05 | Cholesterol & Metabolic Syndrome Management Plan – Ongoing monitoring programme (quarterly reviews for 12 months) | 4 | $120.00 | $480.00 |
| 06 | Prescription Issuance & Medication Review – Including any necessary referrals to Auckland District Health Board specialists | 1 | $65.00 | $65.00 |
| 07 | Health Certificate / Medical Clearance – For employment or insurance purposes, issued by the Doctor General Practitioner | 1 | $85.00 | $85.00 |
| 08 | Telehealth Follow-up Consultation – Remote video consultation with the Doctor General Practitioner for post-visit queries | 2 | $95.00 | $190.00 |
| 09 | Annual Health Check – Comprehensive yearly review including lifestyle counselling, immunisation status, and preventive screening as per New Zealand Ministry of Health guidelines | 1 | $165.00 | $165.00 |
| 10 | Administrative & Record-Keeping Fee – Digital health record management, after-hours phone access, and secure messaging via the Auckland Central Medical Practice portal | 1 | $45.00 | $45.00 |
| Subtotal (excl. GST): | $1,810.00 | |||
| GST (15%): | $271.50 | |||
| Total Estimated Cost (incl. GST): | $2,081.50 | |||
This Quotation Estimate is based on the services currently available at our Doctor General Practitioner clinic in Auckland Central, New Zealand Auckland. The estimated costs assume standard working hours (Monday to Friday, 8:00 AM – 5:00 PM). After-hours or weekend appointments may incur an additional 25% surcharge. Should any additional diagnostic tests, specialist referrals, or emergency interventions be required beyond the scope outlined above, a supplementary quotation will be issued prior to any additional treatment. All laboratory work is conducted through our partner facility at Auckland City Hospital. This estimate does not include costs for hospital admission, surgical procedures, or services provided by allied health professionals (physiotherapists, dietitians, etc.) unless explicitly stated.
Payment TermsPayment is due within 14 calendar days of the date of this Quotation Estimate. We accept EFT (bank transfer), credit/debit card (Visa, Mastercard, AMEX), and direct debit. A 2% late payment fee will apply to any outstanding balance exceeding the 14-day period. For clients eligible for ACC (Accident Compensation Corporation) cover or Health NZ subsidies, applicable rebates will be deducted from the total. Please provide your ACC number or Health NZ eligibility confirmation at the time of booking to ensure correct billing.
Terms & Conditions1. This Quotation Estimate is valid for 30 days from the date of issue. After this period, prices may be adjusted to reflect changes in service costs, laboratory fees, or New Zealand government health policy updates.
2. All services will be delivered by a registered Doctor General Practitioner holding a current New Zealand Medical Council (NZMC) registration and a valid provider number with the Ministry of Health.
3. Cancellations made less than 24 hours before a scheduled appointment will be subject to a 50% fee of the booked consultation rate.
4. This practice operates in full compliance with the New Zealand Privacy Act 2020. All patient records and health information are stored securely and will not be disclosed to third parties without written consent, except where required by law.
5. In the event of a medical emergency, the Doctor General Practitioner will arrange immediate transfer to the nearest Auckland hospital emergency department. Emergency transport costs are not included in this estimate.
6. This Quotation Estimate does not constitute a contract of service. A formal service agreement will be provided upon acceptance of this estimate.
7. Any disputes arising from this Quotation Estimate shall be resolved in accordance with the New Zealand Consumer Guarantees Act 1993 and the Health and Disability Commissioner Act 1994.
AcceptanceBy signing below, you acknowledge that you have read and understood this Quotation Estimate and agree to the terms and conditions outlined above. Your signature constitutes acceptance of the estimated costs for the Doctor General Practitioner services described herein.
Client Signature: Mr. Jonathan T. WhitfieldDate: ______________________ Authorised Practitioner: Dr. Sarah M. Chen, MBChB, MRCGP
Doctor General Practitioner – Auckland Central Medical Practice
NZMC Registration No. 2019-48732
Date: ______________________ ⬇️ Download as DOCX Edit online as DOCX
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