Quotation Estimate Occupational Therapist in India New Delhi –Free Word Template Download with AI
| Client Name: | Mr. Rajesh Verma |
| Address: | 18-B, Hauz Khas Village, New Delhi, India – 110016 |
| Service Location: | India New Delhi (Home Visit / Clinic at Connaught Place) |
| Referring Physician: | Dr. S. Mehta, Neurologist, AIIMS New Delhi |
This Quotation Estimate is issued for a comprehensive Occupational Therapist intervention program to be delivered in India New Delhi. The Occupational Therapist, Dr. Ananya Sharma, holds a Master of Occupational Therapy (M.O.T.) from the National Institute of Occupational Therapy, New Delhi, and is registered with the Rehabilitation Council of India (RCI Registration No. RCI/OT/2019/0342). The program is designed to restore functional independence, improve fine and gross motor coordination, and retrain activities of daily living (ADLs) for a post-stroke patient aged 58 years.
The Occupational Therapist will conduct a thorough initial assessment covering upper-limb function, hand dexterity, cognitive processing, sensory integration, and psychosocial readiness. Based on the assessment findings, a personalized treatment plan will be formulated and executed over a period of twelve (12) weeks. All sessions will be conducted either at the client's residence in New Delhi or at the Occupational Therapist's clinic located in the heart of India New Delhi, at Connaught Place, depending on the client's mobility and preference.
| Sr. No. | Description of Service | Duration / Frequency | Amount (INR) |
|---|---|---|---|
| 1 | Initial Comprehensive Occupational Therapy Assessment (including ADL evaluation, cognitive screening, and home environment audit in India New Delhi) | 1 session (2 hours) | ₹ 3,500 |
| 2 | Individual Occupational Therapist Treatment Sessions – Upper Limb & Hand Function Training | 3 sessions/week × 12 weeks (36 sessions, 45 min each) | ₹ 54,000 |
| 3 | Activities of Daily Living (ADL) Retraining – Dressing, Feeding, Bathing, Cooking | 2 sessions/week × 12 weeks (24 sessions, 45 min each) | ₹ 36,000 |
| 4 | Cognitive Rehabilitation & Sensory Integration Therapy | 2 sessions/week × 8 weeks (16 sessions, 45 min each) | ₹ 24,000 |
| 5 | Home Modification Consultation & Adaptive Equipment Recommendation (India New Delhi area) | 1 visit (3 hours) | ₹ 5,000 |
| 6 | Family / Caregiver Training & Psychoeducation Workshop | 2 sessions (1 hour each) | ₹ 4,000 |
| 7 | Progress Review & Final Discharge Report with Follow-up Plan | 1 session (1.5 hours) | ₹ 2,500 |
| 8 | Travel & Transportation Charges within India New Delhi (NCR limits) | As applicable per visit | ₹ 6,000 |
| Sub-Total | ₹ 135,000 | ||
| Applicable GST (18%) | ₹ 24,300 | ||
| GRAND TOTAL (INR) | ₹ 159,300 | ||
- A 30% advance payment (₹ 47,790) is due upon acceptance of this Quotation Estimate to confirm the booking of the Occupational Therapist's schedule.
- The remaining 70% balance shall be payable in two equal monthly installments at the end of Week 6 and Week 12 of the program.
- Payments may be made via bank transfer, UPI, or demand draft to the account details provided in the attached payment schedule. All transactions are processed in Indian Rupees (INR) as per the regulations of India New Delhi financial authorities.
- A 5% late payment surcharge will apply to any installment not received within 7 days of the due date.
- This Quotation Estimate is valid for thirty (30) days from the date of issue. After the expiry date, the Occupational Therapist reserves the right to revise the pricing due to potential changes in service costs in India New Delhi.
- All Occupational Therapist sessions are subject to the client's medical fitness as certified by the referring physician. The Occupational Therapist shall not be held liable for pre-existing medical conditions unrelated to the therapy program.
- Rescheduling of sessions must be communicated at least 24 hours in advance. Cancellations made within 12 hours will be charged at 50% of the session fee.
- The Occupational Therapist will maintain strict confidentiality of all patient records in compliance with the Digital Personal Data Protection Act, 2023, applicable in India New Delhi and across the nation.
- Any additional services beyond the scope outlined in this Quotation Estimate (e.g., extended therapy, group sessions, or specialized equipment procurement) will be quoted separately in writing.
- This Quotation Estimate does not constitute a guarantee of specific medical outcomes. The Occupational Therapist will provide best-practice care in accordance with the standards set by the Rehabilitation Council of India.
- Disputes, if any, arising from this Quotation Estimate shall be resolved through amicable negotiation, failing which they shall be subject to the jurisdiction of the competent courts in New Delhi, India.
By signing below, the client acknowledges receipt of this Quotation Estimate for Occupational Therapist services in India New Delhi and agrees to the terms, conditions, and pricing outlined herein. The Occupational Therapist will commence the initial assessment within five (5) working days of receiving the advance payment and signed acceptance.
| Client / Authorized Signatory | Occupational Therapist / Service Provider |
|---|---|
|
Name: _________________________ Signature: _________________________ Date: _________________________ |
Name: Dr. Ananya Sharma, M.O.T. Signature: _________________________ Date: _________________________ |
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