Quotation Estimate Midwife in Canada Toronto –Free Word Template Download with AI
1247 Yonge Street, Suite 305, Canada Toronto, ON M4W 2C7
Phone: (416) 555-0182 | Email: [email protected]
College of Midwives of Ontario (CMO) Licensed Practice | HST Reg. No.: 123456789RT0001
Quotation Estimate Professional Midwife Services — Canada TorontoQuotation Details
Quotation Estimate No.: QTE-2025-0487
Date Issued: June 12, 2025
Valid Until: July 12, 2025
Service Location: Canada Toronto, Ontario
Prepared By: Sarah Chen, C.M. (Certified Midwife)
Client Information
Client Name: [Client Full Name]
Address: [Client Address], Canada Toronto, ON
Phone: [Client Phone Number]
Email: [Client Email Address]
Expected Due Date: [DD/MM/YYYY]
This Quotation Estimate has been prepared by the Toronto Midwifery & Maternal Care Centre to provide a comprehensive and transparent financial overview of all professional Midwife services to be delivered to the client throughout the perinatal period. As a fully licensed and regulated practice operating under the College of Midwives of Ontario, our Midwife team is committed to delivering evidence-based, client-centred care within the community of Canada Toronto. This document outlines the estimated costs associated with each phase of midwifery care, from initial prenatal consultation through to postpartum follow-up, ensuring the client can make an informed decision regarding their maternity care plan in Canada Toronto.
The following Midwife services are included in this Quotation Estimate and are provided in accordance with the standards set by the College of Midwives of Ontario and the Ontario Health Insurance Plan (OHIP) coverage guidelines applicable in Canada Toronto:
- Prenatal Care: A minimum of 12 scheduled Midwife consultations throughout the pregnancy, including physical examinations, fetal monitoring, laboratory referrals, and nutritional counselling.
- Birth Planning & Education: Two dedicated sessions with the assigned Midwife to develop a personalized birth plan, discuss pain management options, and review emergency protocols available in Canada Toronto.
- Intrapartum (Labour & Birth) Care: Continuous one-on-one Midwife support during labour and delivery, whether at home, in a birthing centre, or at a partner hospital in Canada Toronto.
- Postpartum Care: A minimum of 6 postpartum Midwife visits within the first 12 weeks after birth, including newborn assessments, breastfeeding support, and maternal recovery monitoring.
- 24/7 On-Call Availability: The assigned Midwife remains accessible by phone and in-person throughout the entire perinatal period, consistent with the care standards expected in Canada Toronto.
| Service Item | Quantity | Unit Rate (CAD) | Estimated Total (CAD) |
|---|---|---|---|
| Prenatal Midwife Consultations (12 visits) | 12 | $185.00 | $2,220.00 |
| Birth Planning & Education Sessions | 2 | $250.00 | $500.00 |
| Intrapartum Midwife Care (Labour & Birth) | 1 | $1,800.00 | $1,800.00 |
| Postpartum Midwife Visits (6 visits) | 6 | $165.00 | $990.00 |
| Newborn Health Assessment (included in postpartum) | 1 | $0.00 | $0.00 |
| 24/7 On-Call Midwife Availability Fee | 1 | $350.00 | $350.00 |
| Travel & Transportation (within Canada Toronto) | 1 | $120.00 | $120.00 |
| Administrative & Record-Keeping Fees | 1 | $85.00 | $85.00 |
| Subtotal (Before OHIP Reimbursement) | $6,065.00 | ||
| Estimated OHIP Reimbursement (Ontario Coverage) | -$5,200.00 | ||
| Estimated Client Out-of-Pocket Balance | $865.00 | ||
- This Quotation Estimate is valid for thirty (30) days from the date of issue. After the expiry date, all rates listed herein are subject to revision based on current fee schedules in Canada Toronto.
- The assigned Midwife will be confirmed in writing within five (5) business days of the client's acceptance of this Quotation Estimate. In the event of a practice change, the client will be offered a seamless transition to another licensed Midwife within the same Canada Toronto practice network.
- All payments are due within fourteen (14) days of invoice issuance. The practice accepts EFT, Interac e-Transfer, and major credit cards. A 1.5% monthly late fee will apply to outstanding balances.
- Should the client require transfer to a hospital-based obstetric team due to medical complications, the Midwife will coordinate the transition and the remaining fees will be adjusted proportionally. The client will be responsible for any additional hospital or specialist charges not covered by this Quotation Estimate.
- This Quotation Estimate does not include costs for elective cesarean sections, epidural anaesthesia, or neonatal intensive care, which are billed separately by the respective hospital or specialist in Canada Toronto.
- All services are governed by the Health Professions Act (Ontario) and the Code of Ethics of the College of Midwives of Ontario. The client has the right to request a second opinion or change Midwife providers at any time.
- Confidentiality of all medical records and personal information is maintained in full compliance with the Personal Health Information Protection Act (PHIPA) of Ontario.
By signing below, the client acknowledges receipt of this Quotation Estimate for Midwife services in Canada Toronto, agrees to the terms and conditions outlined above, and authorizes the Toronto Midwifery & Maternal Care Centre to proceed with the outlined care plan. The client confirms that they have had the opportunity to ask questions regarding the scope of services, estimated costs, and the role of the Midwife in their perinatal care journey.
Client Signature: ___________________________
Printed Name: ___________________________
Date: ___________________________
Midwife / Authorized Representative: ___________________________
Printed Name: Sarah Chen, C.M.
Date: ___________________________
⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
GoGPT