Quotation Estimate Physiotherapist in Brazil Brasília –Free Word Template Download with AI
Physiotherapist Services | Professional Rehabilitation & Physical Therapy
Brasília, Distrito Federal – Brazil
Document Reference: QE-BR-2025-0047
| Company Name: | Brasília Physiotherapy & Rehabilitation Center |
| Address: | Quadra 3, Bloco B, Sala 12, Asa Sul, Brasília – DF, Brazil, CEP 70300-000 |
| CNPJ: | 12.345.678/0001-90 |
| Lead Physiotherapist: | Dr. Mariana Costa, CREFITO-DF 123456-P |
| Contact: | [email protected] | +55 (61) 3333-4444 |
| Client Name: | _______________________________ |
| CNPJ / CPF: | _______________________________ |
| Address: | _______________________________, Brasília – DF, Brazil |
| Contact Person: | _______________________________ |
This Quotation Estimate outlines the comprehensive physiotherapy services to be delivered by our licensed Physiotherapist team at our facility located in the heart of Brazil Brasília, the federal capital. The program is designed to address post-surgical rehabilitation, chronic pain management, sports injury recovery, and general mobility improvement. All sessions are conducted in accordance with the standards set by the Conselho Federal de Fisioterapia e Terapia Ocupacional (CREFITO) and follow evidence-based clinical protocols.
The Physiotherapist assigned to this program holds a minimum of eight years of clinical experience in Brasília and is certified in manual therapy, electrotherapy, aquatic rehabilitation, and orthopedic assessment. Every treatment plan is individualized after a thorough initial evaluation conducted in our state-of-the-art clinic in the Asa Sul district of Brazil Brasília.
| Item | Description | Qty | Unit Price (R$) | Total (R$) |
|---|---|---|---|---|
| 1 | Initial Comprehensive Assessment by Physiotherapist (60 min) | 1 | 350.00 | 350.00 |
| 2 | Individual Physiotherapy Session – Manual Therapy & Exercise (50 min) | 20 | 280.00 | 5,600.00 |
| 3 | Electrotherapy & TENS Application Session (40 min) | 10 | 220.00 | 2,200.00 |
| 4 | Aquatic Physiotherapy – Pool Rehabilitation (45 min) | 8 | 320.00 | 2,560.00 |
| 5 | Post-Session Home Exercise Program & Digital Follow-up | 1 | 450.00 | 450.00 |
| 6 | Progress Re-evaluation by Physiotherapist (45 min) | 2 | 250.00 | 500.00 |
| 7 | Custom Orthopedic Brace / Support (if clinically indicated) | 1 | 890.00 | 890.00 |
| Subtotal | R$ 12,550.00 | |||
| Applicable Tax (ISS – Brasília Municipal Tax, 5%) | R$ 627.50 | |||
| Grand Total – Quotation Estimate | R$ 13,177.50 | |||
5.1 Validity: This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After this period, prices may be adjusted to reflect changes in operational costs in Brazil Brasília.
5.2 Payment Terms: Payment shall be made in three (3) equal installments: 40% upon acceptance of this Quotation Estimate, 30% at the midpoint of the treatment program, and 30% upon completion. Accepted methods include bank transfer (TED/PIX), credit card (up to 3 installments), or corporate invoice.
5.3 Scheduling: The Physiotherapist will coordinate session times with the client within the first five business days. Sessions are available Monday through Saturday, 07:00 to 20:00, at our Brasília facility. Rescheduling must be requested at least 24 hours in advance.
5.4 Cancellation Policy: Cancellations made less than 24 hours before a scheduled session will be charged at 50% of the session fee. No-shows will be charged in full.
5.5 Clinical Confidentiality: All patient records and treatment data are handled in strict compliance with Brazil's General Data Protection Law (LGPD – Lei Geral de Proteção de Dados, Law No. 13.709/2018).
5.6 Scope Limitation: This Quotation Estimate covers the services explicitly listed in Section 4. Any additional procedures, extended sessions, or emergency interventions will be subject to a separate written estimate approved by the client prior to execution.
5.7 Governing Law: This agreement is governed by the civil and commercial laws of the Federal District of Brazil Brasília, and any disputes shall be resolved in the competent courts of Brasília – DF.
Note: This Quotation Estimate does not constitute a binding contract until formally signed by both parties. The Physiotherapist reserves the right to modify the treatment plan based on clinical progress, and any such modifications will be communicated in writing with updated pricing if applicable.By signing below, both parties acknowledge and agree to the terms, conditions, and pricing outlined in this Quotation Estimate for Physiotherapist services in Brazil Brasília.
ProviderBrasília Physiotherapy & Rehabilitation Center
Name: Dr. Mariana Costa
CREFITO-DF 123456-P
Date: _______________ Client
Name: _________________________
CNPJ / CPF: _________________________
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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