Quotation Estimate Occupational Therapist in Venezuela Caracas –Free Word Template Download with AI
Professional Occupational Therapist Services
Caracas, Venezuela
Document No. QTE-2025-0047
This Quotation Estimate is issued by Centro de Terapia Ocupacional del Este, C.A., a licensed and registered healthcare provider specializing in Occupational Therapist services. Our practice is located at Av. Francisco de Miranda, Torre Empresarial, Piso 12, Chacao, Caracas, Venezuela. We hold a valid RIF (Registro de Información Fiscal) number J-40123456-7 and are accredited by the Colegio de Fisioterapeutas y Terapeutas Ocupacionales de Venezuela.
| Field | Details |
|---|---|
| Client Name / Organization | Clínica San Rafael, C.A. |
| Address | Calle 48, Los Palos Grandes, Caracas, Venezuela |
| Contact Person | Dr. Alejandro Fuentes, Director Médico |
| Phone / Email | +58 212-555-0147 / [email protected] |
This Quotation Estimate covers the provision of comprehensive Occupational Therapist services to be delivered in Venezuela Caracas over a period of twelve (12) months. The Occupational Therapist will be responsible for the assessment, planning, and execution of therapeutic programs designed to restore, maintain, or improve the functional capacity of patients in areas of fine motor skills, sensory integration, cognitive rehabilitation, adaptive equipment training, and daily living activities. All services will be conducted in compliance with the Venezuelan health regulations established by the Ministerio del Poder Popular para la Salud and the applicable standards of the Colegio de Terapeutas Ocupacionales.
| Item No. | Description of Service | Frequency | Unit Cost (USD) | Monthly Total (USD) |
|---|---|---|---|---|
| 01 | Initial comprehensive Occupational Therapist assessment and functional evaluation per patient | One-time | $180.00 | $1,800.00 |
| 02 | Individual Occupational Therapy sessions (60 minutes each) – fine motor, sensory, and cognitive rehabilitation | 3x per week | $45.00 | $5,850.00 |
| 03 | Group Occupational Therapy sessions (90 minutes) – adaptive activities and social integration | 2x per week | $35.00 | $2,800.00 |
| 04 | Home-based Occupational Therapist visits in the Caracas metropolitan area (Chacao, Baruta, El Hatillo) | 1x per week | $65.00 | $2,600.00 |
| 05 | Adaptive equipment consultation, prescription, and training (wheelchairs, orthoses, assistive devices) | As needed | $120.00 | $1,200.00 |
| 06 | Monthly progress reports and interdisciplinary team meetings with the clinical staff in Caracas | Monthly | $250.00 | $2,500.00 |
| 07 | Emergency Occupational Therapist consultation (after-hours, weekends) | As needed | $95.00 | $950.00 |
| TOTAL MONTHLY ESTIMATE | $17,700.00 | |||
| TOTAL ANNUAL ESTIMATE (12 months) | $212,400.00 | |||
- This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After this period, pricing may be subject to revision due to currency fluctuations in the Venezuelan market.
- All payments shall be made in United States Dollars (USD) via bank transfer to the account designated by Centro de Terapia Ocupacional del Este, C.A., in accordance with the regulations of the Banco Central de Venezuela (BCV).
- Payment terms: 50% of the monthly fee is due on the 1st of each month, and the remaining 50% is due on the 15th. Late payments will incur a surcharge of 2% per month.
- The Occupational Therapist assigned to this contract shall hold a minimum of five (5) years of post-graduate clinical experience and a valid license issued by the Venezuelan Ministry of Health.
- All services will be rendered in Venezuela Caracas, primarily at the client's facility in Los Palos Grandes, with home visits limited to the eastern metropolitan districts.
- Cancellation or modification of services requires a written notice of at least fifteen (15) business days. Early termination before the twelve-month period will result in a penalty of 10% of the remaining contract value.
- The provider shall maintain professional liability insurance with a minimum coverage of USD 500,000, as required by Venezuelan healthcare regulations.
- Confidentiality of all patient records and clinical data is guaranteed in accordance with the Venezuelan Ley Orgánica de Salud and applicable data protection standards.
By signing below, both parties acknowledge and agree to the terms outlined in this Quotation Estimate for Occupational Therapist services to be provided in Venezuela Caracas. This document does not constitute a binding contract until a formal service agreement is executed by both parties.
For the ProviderDr. María Elena Rodríguez, OT
Centro de Terapia Ocupacional del Este, C.A.
Date: _______________ For the Client
Dr. Alejandro Fuentes
Clínica San Rafael, C.A.
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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