Quotation Estimate Physiotherapist in Australia Melbourne –Free Word Template Download with AI
Physiotherapist Professional Services — Australia Melbourne
Ref: QTE-MEL-2025-04872 | Date of Issue: 14 June 2025 | Valid Until: 14 July 2025
Australia Melbourne — Registered Physiotherapist PracticePrepared By (Physiotherapist)
Dr. Sarah Mitchell, MPT, AICM
Principal Physiotherapist
Melbourne Physiotherapy & Rehabilitation Centre
Level 3, 42 Collins Street, Melbourne VIC 3000
Australia Melbourne
ABN: 54 123 456 789
Phone: +61 3 9123 4567
Email: [email protected]
Prepared For (Client)
Mr. James Anderson
18 Harbour View Drive
St Kilda, Melbourne VIC 3182
Australia Melbourne
Phone: +61 4 1234 5678
Email: [email protected]
Medicare Number: On File
This Quotation Estimate has been prepared by our registered Physiotherapist at the Melbourne Physiotherapy & Rehabilitation Centre to provide Mr. James Anderson with a comprehensive, itemised breakdown of the anticipated costs associated with a structured physiotherapy rehabilitation programme. As a licensed Physiotherapist operating in Australia Melbourne, we are committed to full transparency in all financial matters. This Quotation Estimate covers a twelve-week treatment plan designed to address the client's diagnosed lumbar disc herniation and associated lower-back pain, as confirmed by the referring general practitioner on 2 June 2025.
The following services will be delivered by our senior Physiotherapist team at our Australia Melbourne clinic. Each session is conducted by a qualified Physiotherapist who holds current registration with the Physiotherapy Board of Australia and is a member of the Australian Institute of Manual Therapists. The programme is tailored to the individual needs of the client and will be reviewed bi-weekly to ensure optimal progress.
| Item No. | Service Description | Frequency | Duration (min) | Unit Price (AUD) | Subtotal (AUD) |
|---|---|---|---|---|---|
| 01 | Initial Comprehensive Physiotherapist Assessment & Treatment Plan | Once | 60 | $185.00 | $185.00 |
| 02 | Manual Therapy & Soft Tissue Mobilisation (Physiotherapist-led) | 2x / week × 12 weeks | 45 | $145.00 | $3,480.00 |
| 03 | Therapeutic Exercise & Core Stabilisation Programme | 2x / week × 12 weeks | 45 | $135.00 | $3,240.00 |
| 04 | Electrotherapy & Modalities (Ultrasound, TENS, Iontophoresis) | 1x / week × 12 weeks | 30 | $95.00 | $1,140.00 |
| 05 | Bi-Weekly Progress Review & Plan Adjustment by Lead Physiotherapist | 6 sessions | 30 | $110.00 | $660.00 |
| 06 | Home Exercise Programme (HEP) Customisation & Digital Access | Once | — | $75.00 | $75.00 |
| 07 | Final Discharge Assessment & Referral Report to GP | Once | 45 | $120.00 | $120.00 |
| TOTAL ESTIMATED COST (AUD, incl. GST) | $8,900.00 | ||||
Please be advised that, as a registered Physiotherapist in Australia Melbourne, a portion of the fees outlined in this Quotation Estimate may be eligible for Medicare rebate under the Chronic Disease Management (CDM) plan or the Better Access initiative, provided the client holds a valid referral from their GP. The current Medicare rebate for a Physiotherapist consultation in Australia Melbourne is approximately $62.00 per eligible session. The client is responsible for the gap between the rebate and the fee charged. Additionally, many private health insurance providers in Australia Melbourne offer allied health extras that may further reduce out-of-pocket expenses. We recommend the client confirm their specific coverage with their insurer prior to commencing treatment.
- This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After this period, fees may be subject to revision based on current Physiotherapist market rates in Australia Melbourne.
- Payment is due within fourteen (14) days of each invoice. We accept EFT, credit card (Visa, Mastercard, Amex), and HICAPS on-the-spot claiming for eligible Medicare and private health sessions.
- A 20% deposit is required to secure the initial Physiotherapist assessment appointment. The balance is payable in weekly instalments aligned with the treatment schedule.
- Appointments cancelled with less than 24 hours' notice will incur a 50% session fee. No-shows will be charged the full session fee as stated in this Quotation Estimate.
- All services are delivered in accordance with the Physiotherapy Board of Australia's Code of Conduct and the Privacy Act 1988 (Cth). Client records are stored securely at our Australia Melbourne facility.
- This Quotation Estimate is an estimate only and does not constitute a binding contract. Final charges may vary slightly depending on the clinical progression and any additional interventions recommended by the treating Physiotherapist during the programme.
- Any disputes arising from this Quotation Estimate shall be resolved in accordance with the Australian Consumer Law and the Victorian Civil and Administrative Tribunal (VCAT) jurisdiction in Australia Melbourne.
By signing below, the client acknowledges receipt of this Quotation Estimate and agrees to the terms and conditions outlined above. The treating Physiotherapist will commence the programme on the agreed start date, subject to availability at our Australia Melbourne clinic.
| Role | Name | Signature | Date |
|---|---|---|---|
| Client | Mr. James Anderson | ||
| Physiotherapist (Authorising Practitioner) | Dr. Sarah Mitchell, MPT, AICM |
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