Quotation Estimate Occupational Therapist in Canada Montreal –Free Word Template Download with AI
Professional Occupational Therapist Services
Montreal, Quebec, Canada
Canada Montreal – Licensed & CertifiedService Provider
Montreal Occupational Therapy Associates Inc.
4520 Rue Saint-Denis, Suite 310
Montreal, Quebec, Canada H2J 2K5
Phone: (514) 555-0187
Email: [email protected]
QOTC Registration No.: OT-2024-00873
Client / Recipient
Client Name: [To be completed]
Address: [To be completed]
City, Province, Postal Code: Montreal, QC, [To be completed]
Phone: [To be completed]
Email: [To be completed]
Referring Physician: [To be completed]
Quotation Estimate No.: QTE-2025-00412 | Date of Issue: June 12, 2025 | Valid Until: July 12, 2025 | Currency: CAD (Canadian Dollars)This Quotation Estimate has been prepared to provide a comprehensive and transparent financial overview of the Occupational Therapist services to be delivered in Canada Montreal. The purpose of this document is to outline the scope of professional care, the associated costs, and the terms under which the Occupational Therapist will provide therapeutic interventions tailored to the client's specific needs. All pricing reflected in this Quotation Estimate is based on the current fee schedule established by the Quebec Order of Occupational Therapists (Ordre des ergothérapeutes du Québec) and applicable Canadian provincial regulations governing allied health professionals in the Montreal metropolitan area.
The Occupational Therapist assigned to this engagement will deliver a full spectrum of therapeutic services designed to restore, maintain, or improve the client's functional independence in daily living activities. The services encompassed in this Quotation Estimate include but are not limited to the following clinical interventions:
| # | Service Description | Duration / Frequency | Unit Rate (CAD) | Quantity | Subtotal (CAD) |
|---|---|---|---|---|---|
| 1 | Initial Comprehensive Assessment by Occupational Therapist (functional evaluation, ADL analysis, goal setting) | 90 minutes – One-time | $285.00 | 1 | $285.00 |
| 2 | Individual Occupational Therapy Sessions (hand therapy, fine motor retraining, cognitive rehabilitation) | 60 minutes – Weekly | $195.00 | 12 | $2,340.00 |
| 3 | Home Environment Assessment & Adaptive Equipment Recommendation (conducted in Canada Montreal residential setting) | 120 minutes – One-time | $320.00 | 1 | $320.00 |
| 4 | Group Occupational Therapy Program (community reintegration, social skills, daily routine management) | 90 minutes – Bi-weekly | $145.00 | 8 | $1,160.00 |
| 5 | Progress Review & Treatment Plan Revision by Occupational Therapist | 45 minutes – Monthly | $120.00 | 3 | $360.00 |
| 6 | Discharge Summary, Final Report & Referral Coordination with Canadian healthcare network | 60 minutes – One-time | $175.00 | 1 | $175.00 |
| 7 | Travel & Logistics within Canada Montreal (metro area, up to 25 km radius) | Per visit | $25.00 | 25 | $625.00 |
| Subtotal (before tax): | $5,265.00 | ||||
| QST (Quebec Sales Tax – 9.975%): | $525.18 | ||||
| GST (Goods & Services Tax – 5%): | $263.25 | ||||
| TOTAL ESTIMATED COST (CAD): | $6,053.43 | ||||
The Occupational Therapist providing services under this Quotation Estimate holds a Master's degree in Occupational Therapy from a Canadian accredited institution and is fully registered with the Ordre des ergothérapeutes du Québec (OÉQ). All clinical practices are conducted in strict compliance with the Health Professions Act of Quebec, the Canadian Charter of Rights and Freedoms, and the privacy standards set forth by the Law Respecting the Protection of Personal Information in the Private Sector (LPPIPP). The Occupational Therapist maintains professional liability insurance with a minimum coverage of $5,000,000 CAD, as required for allied health practitioners operating in Canada Montreal.
4.1 Validity: This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. Should the client wish to proceed beyond this period, a revised Quotation Estimate reflecting any updated fee schedules or regulatory changes in Canada Montreal will be issued at no additional charge.
4.2 Payment Schedule: Payment is due within fifteen (15) business days of invoice issuance. A 20% deposit is required to confirm the engagement and secure the Occupational Therapist's schedule. The remaining balance shall be invoiced in monthly installments aligned with the treatment plan timeline.
4.3 Cancellation Policy: Appointments cancelled with less than 48 hours' notice will be subject to a 50% fee of the scheduled session rate. No-shows will be billed at the full session rate as outlined in this Quotation Estimate.
4.4 Insurance & Reimbursement: The client is advised to verify coverage with their private health insurance provider or applicable Canadian government health plan (RAMQ) prior to commencing services. The Occupational Therapist will provide detailed itemized receipts and clinical documentation to facilitate reimbursement claims.
4.5 Confidentiality: All clinical records, assessment data, and personal health information are protected under Canadian federal and Quebec provincial privacy legislation. No information will be disclosed to third parties without the client's written consent, except where mandated by law.
4.6 Scope Limitations: This Quotation Estimate covers the services explicitly listed in Section 2. Any additional interventions, emergency sessions, or extended therapy beyond the outlined plan will require a supplementary Quotation Estimate approved in writing by both parties.
4.7 Governing Law: This Quotation Estimate and any resulting professional engagement shall be governed by and interpreted in accordance with the Civil Code of Quebec and applicable federal Canadian legislation.
By signing below, the client acknowledges receipt of this Quotation Estimate, confirms understanding of the Occupational Therapist services described herein, and authorizes the commencement of treatment as outlined. The service provider confirms that all fees, terms, and conditions presented in this Quotation Estimate are accurate and binding upon acceptance.
Client SignatureName: _________________________
Date: _________________________ Occupational Therapist / Service Provider
Name: _________________________
OÉQ Registration No.: ___________
Date: _________________________ ⬇️ Download as DOCX Edit online as DOCX
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