Quotation Estimate Physiotherapist in France Lyon –Free Word Template Download with AI
12 Rue de la République, 69002 Lyon, France
Tel: +33 4 72 00 00 00 | Email: [email protected]
SIRET: 123 456 789 00012 | ADELI: 69930123456
Quotation EstimateQuotation Details
Quotation No.: QE-2025-0847
Date Issued: 15 June 2025
Valid Until: 15 July 2025
Prepared By: Dr. Marie Laurent, DPT
Location: France Lyon, 69002
Client Information
Client Name: [Client Full Name]
Address: [Client Address], Lyon, France
Phone: [Client Phone Number]
Email: [Client Email Address]
Referring Physician: [Physician Name]
Dear Valued Client,
Thank you for considering the professional services of our Physiotherapist team at Clinique Physio Lyon. This Quotation Estimate has been carefully prepared to outline the full scope of physiotherapy services that will be provided to you in our facility located in the heart of France Lyon. We are committed to delivering the highest standard of rehabilitative care, and this document serves as a transparent and detailed financial overview of the treatment plan recommended by our senior Physiotherapist.
Please review this Quotation Estimate thoroughly. All pricing reflects the current rates applicable to physiotherapy services in the France Lyon metropolitan area and is compliant with the French national health insurance (Assurance Maladie) reimbursement framework. Should you have any questions regarding any line item, our administrative team in France Lyon is available to provide clarification at no additional cost.
Scope of Services – Physiotherapist Treatment PlanThe following Quotation Estimate encompasses a comprehensive physiotherapy programme designed and supervised by a licensed Physiotherapist registered with the Ordre des Masseurs-Kinésithérapeutes in the Rhône department. The treatment plan is tailored to your specific clinical needs and will be conducted at our clinic in France Lyon, 69002, with access to modern therapeutic equipment and a dedicated rehabilitation suite.
| Ref | Service Description | Quantity | Unit Price (EUR) | Total (EUR) |
|---|---|---|---|---|
| 01 | Initial Assessment & Diagnostic Evaluation by Senior Physiotherapist (60 min) | 1 | 85.00 | 85.00 |
| 02 | Manual Therapy & Joint Mobilisation Sessions (45 min each) | 10 | 65.00 | 650.00 |
| 03 | Therapeutic Exercise & Strengthening Programme (45 min each) | 10 | 60.00 | 600.00 |
| 04 | Electrotherapy & Modalities (TENS, Ultrasound, Laser) (30 min each) | 6 | 45.00 | 270.00 |
| 05 | Postural Re-education & Ergonomic Counselling (45 min each) | 4 | 55.00 | 220.00 |
| 06 | Progress Review & Treatment Plan Adjustment by Physiotherapist (30 min) | 3 | 40.00 | 120.00 |
| 07 | Home Exercise Programme Design & Written Instruction Sheet | 1 | 35.00 | 35.00 |
| 08 | Final Discharge Assessment & Medical Report to Referring Physician | 1 | 50.00 | 50.00 |
| 09 | Administrative Fee – Quotation Estimate Processing & Insurance Filing (France Lyon) | 1 | 25.00 | 25.00 |
| TOTAL ESTIMATED COST (Before Tax) | 2,055.00 | |||
| TVA (20% French Value Added Tax) | 411.00 | |||
| GRAND TOTAL (EUR) | 2,466.00 | |||
This Quotation Estimate has been structured to align with the French national health insurance reimbursement schedule (Nomenclature des Actes de Kinésithérapie). As a registered Physiotherapist operating in France Lyon, our clinic is accredited to submit claims directly to the Caisse Primaire d'Assurance Maladie (CPAM) of the Rhône department. The base reimbursement rate (participation de l'Assurance Maladie) will be applied to eligible sessions, and the remaining balance will be covered by your supplementary health insurance (mutuelle) or paid directly by you. Our administrative team in France Lyon will handle all insurance paperwork on your behalf to ensure a seamless reimbursement process.
Terms & Conditions of This Quotation Estimate- This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. After this period, pricing may be subject to revision based on current market rates in France Lyon.
- All services described herein will be performed by a qualified and licensed Physiotherapist or under the direct supervision of one. No treatment will be delegated to unqualified personnel.
- The total number of sessions outlined in this Quotation Estimate is an estimate based on the initial clinical assessment. The treating Physiotherapist reserves the right to adjust the treatment plan based on your clinical progress. Any additional sessions will be communicated in writing prior to commencement and will be billed at the same unit rates specified above.
- Payment is due within fourteen (14) days of the date of this Quotation Estimate or upon completion of the treatment programme, whichever is earlier. Accepted payment methods include bank transfer (virement), credit card, and direct debit. Cheques payable to Clinique Physio Lyon, France Lyon, are also accepted.
- Cancellations must be communicated at least 48 hours in advance. Sessions cancelled with less than 48 hours' notice will be charged at 50% of the session fee. No-shows will be charged in full.
- This Quotation Estimate does not constitute a medical diagnosis or a guarantee of specific clinical outcomes. The Physiotherapist will provide the best available evidence-based care in accordance with French physiotherapy practice standards and the code of ethics of the Ordre des Masseurs-Kinésithérapeutes.
- All personal health data processed in connection with this Quotation Estimate and the subsequent treatment is handled in strict compliance with the French Data Protection Act and the European General Data Protection Regulation (GDPR). Data is stored securely at our clinic in France Lyon and is never shared with third parties without your explicit written consent.
- Any disputes arising from this Quotation Estimate shall be resolved under the jurisdiction of the Tribunal Judiciaire de Lyon, France Lyon, in accordance with French civil law.
By signing below, the client acknowledges receipt of this Quotation Estimate and agrees to the terms and conditions outlined above. The client confirms that the recommended Physiotherapist treatment plan is appropriate for their condition and authorises Clinique Physio Lyon to proceed with the services described in this document at the rates specified.
Client SignatureName: ___________________________
Date: ___________________________ Physiotherapist / Clinic Representative
Dr. Marie Laurent, DPT
Clinique Physio Lyon, France Lyon
Date: ___________________________ ⬇️ Download as DOCX Edit online as DOCX
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