Quotation Estimate Physiotherapist in Canada Vancouver –Free Word Template Download with AI
1288 West Georgia Street, Suite 402, Vancouver, British Columbia, Canada V6E 1Y2
Phone: (604) 555-0187 | Email: [email protected] | Reg. No.: BCPTA-2024-0873
Quotation EstimateQuotation Details
Quotation No.: QE-2025-0417
Date Issued: June 12, 2025
Valid Until: July 12, 2025
Prepared By: Dr. Margaret Chen, DPT, OCS
Professional Physiotherapist – BCPTA CertifiedClient Information
Client Name: Mr. James A. Thornton
Address: 4521 Oakridge Avenue, Vancouver, BC, Canada V6M 2B3
Phone: (604) 555-3321
Insurance Provider: Blue Cross Canada – Policy #BC-992847
Dear Mr. Thornton,
Thank you for contacting Coastal Physiotherapy & Rehabilitation Centre for your physiotherapy needs. This Quotation Estimate has been prepared following your initial consultation on June 8, 2025, during which our lead Physiotherapist, Dr. Margaret Chen, assessed your post-surgical knee rehabilitation requirements. This document outlines the comprehensive scope of services, associated costs, and terms applicable to your treatment plan within the Canada Vancouver metropolitan area. All pricing reflects current 2025 rates established by the Physiotherapy Association of British Columbia and aligns with the regulatory standards governing licensed physiotherapists operating in the Province of British Columbia.
The following Quotation Estimate covers a structured 12-week rehabilitation programme designed and supervised by a registered Physiotherapist in accordance with the Physiotherapy Act (British Columbia). The treatment plan is tailored to your specific clinical presentation and will be delivered at our Vancouver clinic or, where indicated, at your residence in the greater Vancouver area.
| # | Service Description | Frequency | Duration | Unit Rate (CAD) | Total (CAD) |
|---|---|---|---|---|---|
| 1 | Initial Comprehensive Assessment & Treatment Plan Development by a licensed Physiotherapist | One-time | 60 minutes | $185.00 | $185.00 |
| 2 | Manual Therapy & Joint Mobilization Sessions (knee, hip, and surrounding musculature) | 2x per week | 45 min / session | $145.00 | $1,740.00 |
| 3 | Therapeutic Exercise & Progressive Strengthening Programme | 2x per week | 45 min / session | $135.00 | $1,620.00 |
| 4 | Electrotherapy & Modalities (TENS, ultrasound, cryotherapy, laser therapy) | 1x per week | 30 min / session | $95.00 | $380.00 |
| 5 | Functional Movement Re-training & Gait Analysis | 1x per week | 45 min / session | $125.00 | $500.00 |
| 6 | Home Exercise Programme Design & Weekly Progress Review | 1x per week | 20 min / session | $65.00 | $260.00 |
| 7 | Mid-Programme Re-assessment (Week 6) by the supervising Physiotherapist | One-time | 45 minutes | $110.00 | $110.00 |
| 8 | Final Discharge Assessment & Return-to-Activity Clearance Report | One-time | 60 minutes | $150.00 | $150.00 |
| 9 | Physiotherapist Supervised Home Visit (Weeks 3 & 9) – Vancouver Metro Area | 2 visits | 45 min / visit | $175.00 | $350.00 |
| 10 | Custom Orthotic & Bracing Consultation (in partnership with Vancouver orthotics provider) | One-time | 30 minutes | $85.00 | $85.00 |
| TOTAL ESTIMATED COST (CAD) | $5,380.00 | ||||
| Estimated HST (5% – British Columbia) | $269.00 | ||||
| GRAND TOTAL (CAD) | $5,649.00 | ||||
Please note that this Quotation Estimate is provided for your financial planning purposes. A significant portion of the services listed above may be covered under your Blue Cross Canada policy. Our billing team in Vancouver will submit all claims directly to your insurer on your behalf. The client is responsible only for applicable deductibles, co-payments, and any services not covered by the plan. All invoices will be itemized in accordance with the Canadian Medical Association Fee Schedule and the specific tariff rates approved for licensed Physiotherapist services in British Columbia. No payment is due until the first treatment session has been completed and the client has reviewed the itemized receipt.
- This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After the expiry date, rates may be adjusted to reflect any changes in the Physiotherapy Association of British Columbia fee schedule or applicable tax rates in Canada.
- All physiotherapy services will be delivered by a registered Physiotherapist holding an active licence with the College of Physiotherapists of British Columbia. In the event of a scheduled absence, a qualified substitute physiotherapist of equivalent or higher standing will be assigned, and you will be notified at least 24 hours in advance.
- The treatment programme described in this estimate is based on the clinical findings at the time of the initial assessment. Should the supervising Physiotherapist determine that additional sessions, modalities, or specialist referrals are clinically necessary, a revised Quotation Estimate will be issued and must be approved by the client in writing before any additional services are rendered.
- Cancellations or rescheduling of appointments must be made at least 24 hours in advance. Late cancellations or no-shows will be subject to a fee of 50% of the scheduled session rate, in compliance with standard practice for physiotherapy clinics in the Canada Vancouver region.
- All client health information, treatment records, and progress documentation will be maintained in strict accordance with the Personal Information Protection Act (PIPA) of British Columbia and the federal Privacy Act of Canada. Records will be retained for a minimum of seven years as required by provincial regulation.
- Payment is due within fourteen (14) days of the date of each monthly consolidated invoice. Accepted payment methods include Interac e-Transfer, Visa, Mastercard, American Express, and certified cheque. A 2% late-payment surcharge will apply to balances outstanding beyond the due date.
- This Quotation Estimate does not constitute a guarantee of specific clinical outcomes. The Physiotherapist will exercise professional judgement throughout the programme and may modify the treatment plan as the client's condition evolves.
- Any disputes arising from this estimate or the services rendered shall be governed by the laws of the Province of British Columbia and the federal laws of Canada applicable therein. The parties agree to attempt mediation through the College of Physiotherapists of British Columbia before pursuing formal legal action.
By signing below, the client acknowledges receipt of this Quotation Estimate, confirms understanding of the scope of Physiotherapist services to be provided in the Canada Vancouver area, and authorizes Coastal Physiotherapy & Rehabilitation Centre to commence the outlined treatment programme on the agreed start date of June 20, 2025.
Client Signature:
Mr. James A. ThorntonDate: ______________________
Physiotherapist / Authorized Representative:
Dr. Margaret Chen, DPT, OCSCoastal Physiotherapy & Rehabilitation Centre
Date: ______________________ ⬇️ Download as DOCX Edit online as DOCX
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