Quotation Estimate Physiotherapist in Japan Tokyo –Free Word Template Download with AI
| Quotation Estimate No.: | QTE-TOKYO-2025-04782 | Date of Issue: | 15 June 2025 |
| Valid Until: | 15 July 2025 (30 days) | Currency: | Japanese Yen (JPY) |
| Prepared By: | Dr. Kenji Tanaka, Licensed Physiotherapist | License No.: | PT-JP-2019-00347 |
| Clinic Address: | Shinjuku Wellness Physiotherapy Center, 4-2-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan Tokyo | ||
| Client Name: | [Client / Organization Name to be inserted] | ||
This Quotation Estimate is issued by Shinjuku Wellness Physiotherapy Center to provide a comprehensive and transparent breakdown of all professional Physiotherapist services to be delivered within the metropolitan area of Japan Tokyo. The purpose of this document is to outline the scope of physiotherapy treatment, associated costs, scheduling commitments, and all applicable terms governing the engagement. This Quotation Estimate is prepared in accordance with the standards set forth by the Japan Association of Physical Therapists and complies with all regulatory requirements of the Tokyo Metropolitan Government Health Bureau.
2. Scope of Physiotherapist ServicesThe following services will be provided by a certified Physiotherapist operating under the supervision and clinical protocols of our clinic located in the heart of Japan Tokyo. Each session is designed to address musculoskeletal conditions, post-surgical rehabilitation, sports injury recovery, chronic pain management, and general mobility improvement. All treatments are conducted in a fully equipped facility that meets the highest standards of clinical hygiene and patient safety as mandated for healthcare providers in the Tokyo region.
| Item No. | Service Description | Duration | Frequency | Unit Price (JPY) | Subtotal (JPY) |
|---|---|---|---|---|---|
| 01 | Initial Comprehensive Assessment & Physiotherapist Consultation | 60 min | 1 session | 12,000 | 12,000 |
| 02 | Manual Therapy & Joint Mobilization (per session) | 45 min | 10 sessions | 9,500 | 95,000 |
| 03 | Therapeutic Exercise & Strengthening Program | 45 min | 10 sessions | 8,000 | 80,000 |
| 04 | Electrotherapy (TENS, Ultrasound, Iontophoresis) | 30 min | 8 sessions | 7,500 | 60,000 |
| 05 | Post-Surgical Rehabilitation Program (Japan Tokyo protocol) | 60 min | 12 sessions | 11,000 | 132,000 |
| 06 | Home Exercise Prescription & Follow-Up Review | 30 min | 4 sessions | 6,000 | 24,000 |
| 07 | Specialist Referral Coordination (if required within Japan Tokyo network) | As needed | 1 time | 5,000 | 5,000 |
| 08 | Progress Documentation & Final Discharge Report | 30 min | 1 session | 8,000 | 8,000 |
| TOTAL ESTIMATED COST (before tax) | 416,000 | ||||
| Consumption Tax (10%) | 41,600 | ||||
| GRAND TOTAL (JPY) | 457,600 | ||||
- This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. Any services commenced after the expiry date will be subject to re-evaluation and a revised Quotation Estimate will be issued.
- All Physiotherapist services described herein are to be performed at our clinic premises in Shinjuku-ku, Japan Tokyo, unless a home-visit arrangement is separately agreed upon in writing (an additional travel surcharge of JPY 3,000 per visit will apply).
- Payment is due within fourteen (14) days of the date of this Quotation Estimate. Acceptable payment methods include bank transfer (to a Japanese domestic account), credit card (Visa, Mastercard, JCB), and cash at the clinic reception.
- A 20% deposit is required to secure the client's appointment schedule with the assigned Physiotherapist. The remaining balance is payable upon completion of the treatment program.
- Cancellations must be made at least 24 hours in advance. Late cancellations or no-shows will incur a fee of 50% of the session rate.
- This Quotation Estimate does not constitute a medical diagnosis. The Physiotherapist reserves the right to modify the treatment plan based on clinical assessment findings during the initial consultation in Japan Tokyo.
- All patient records and treatment data are handled in strict compliance with the Act on the Protection of Personal Information (APPI) of Japan and the Tokyo Metropolitan Medical Association's data privacy guidelines.
- The Physiotherapist providing services holds valid professional liability insurance with a coverage limit of JPY 100,000,000, as required for all licensed practitioners operating in Japan Tokyo.
By signing below, the client acknowledges receipt of this Quotation Estimate and agrees to the terms, conditions, and estimated costs outlined for the Physiotherapist services to be rendered in Japan Tokyo. This signature constitutes formal acceptance of the quotation and authorizes the clinic to schedule the treatment program accordingly.
Client / Authorized Representative Signature Name: ______________________________ Date: ______________________________ Physiotherapist / Clinic Director Signature Name: Dr. Kenji Tanaka, PT Date: ______________________________ ⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
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