Quotation Estimate Physiotherapist in New Zealand Wellington –Free Word Template Download with AI
142 Lambton Quay, Te Aro, Wellington 6011, New Zealand
Phone: +64 4 382 5567 | Email: [email protected]
Provider Number: 20-0458912 | NZ Physiotherapy Association Member
Quotation EstimateQuotation Details
Quotation Estimate No.: QE-2025-WLG-0347
Date of Issue: 12 June 2025
Valid Until: 12 July 2025 (30 days)
Prepared By: Sarah Mitchell, MSc Physiotherapy
Service Location: New Zealand Wellington
Client Information
Client Name: Mr. James T. Henderson
Address: 28 Khandallah Avenue, Khandallah, Wellington 6024
Phone: +64 21 987 4321
Email: [email protected]
Referring Physician: Dr. A. Patel, Wellington Hospital
Dear Mr. Henderson,
Thank you for contacting the Wellington Physiotherapy & Rehabilitation Centre regarding your post-operative rehabilitation needs. Following your initial consultation on 5 June 2025, we are pleased to present this Quotation Estimate for a comprehensive Physiotherapist-led rehabilitation programme tailored to your specific clinical requirements. This Quotation Estimate has been prepared in accordance with the standards set by the New Zealand Physiotherapy Association and reflects current market rates for Physiotherapist services in the New Zealand Wellington region.
The following Quotation Estimate covers a structured twelve-week rehabilitation programme delivered by a registered Physiotherapist. The programme is designed to restore full functional mobility following your anterior cruciate ligament (ACL) reconstruction surgery. All sessions will be conducted at our New Zealand Wellington clinic facility, which is fully equipped with modern therapeutic equipment, hydrotherapy access, and dedicated strength and conditioning areas.
| # | Service Description | Frequency | Duration | Unit Rate (NZD) | Total (NZD) |
|---|---|---|---|---|---|
| 1 | Initial Comprehensive Physiotherapist Assessment & Treatment Plan Development | One-time | 60 minutes | $245.00 | $245.00 |
| 2 | Manual Therapy & Joint Mobilisation Sessions (Physiotherapist-led) | 2x per week | 45 minutes | $185.00 | $2,960.00 |
| 3 | Therapeutic Exercise & Progressive Strengthening Programme | 2x per week | 45 minutes | $175.00 | $2,800.00 |
| 4 | Proprioception & Balance Rehabilitation (Physiotherapist-supervised) | 1x per week | 45 minutes | $175.00 | $1,400.00 |
| 5 | Functional Movement & Sport-Specific Return-to-Play Training | 1x per week | 60 minutes | $210.00 | $1,680.00 |
| 6 | Hydrotherapy / Aquatic Physiotherapy Sessions | 1x per week | 45 minutes | $195.00 | $1,560.00 |
| 7 | Progress Review & Programme Adjustment (Physiotherapist consultation) | Monthly (x3) | 30 minutes | $120.00 | $360.00 |
| 8 | Final Discharge Assessment & Home Exercise Programme Documentation | One-time | 45 minutes | $165.00 | $165.00 |
| 9 | Custom Orthotic / Bracing Fitting & Adjustment (if clinically indicated) | As required | 30 minutes | $95.00 | $190.00 |
| Subtotal (NZD) | $11,360.00 | ||||
| GST (15%) | $1,704.00 | ||||
| Grand Total (NZD, inclusive of GST) | $13,064.00 | ||||
The lead Physiotherapist assigned to your case, Sarah Mitchell, holds a Master of Science in Physiotherapy from the University of Otago, is a registered member of the New Zealand Physiotherapy Association, and has over fourteen years of clinical experience in musculoskeletal and post-surgical rehabilitation. All supporting Physiotherapist staff at our New Zealand Wellington clinic are fully registered and maintain current professional indemnity insurance in compliance with New Zealand health regulations.
- This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. Pricing is subject to change after the validity period expires.
- Payment is due within fourteen (14) days of invoice issuance. A 50% deposit is required to secure your booking and commence the Physiotherapist programme.
- Accepted payment methods include bank transfer (NZD), credit card (Visa, Mastercard, American Express), and direct debit. All transactions are processed in New Zealand Dollars.
- Should any sessions be cancelled with less than twenty-four (24) hours' notice, a 50% fee of the scheduled Physiotherapist session rate will be applied.
- This Quotation Estimate does not include the cost of any additional imaging (X-ray, MRI, ultrasound) or specialist referrals that may be recommended during the course of treatment.
- Accident Compensation Corporation (ACC) claims: If your injury is ACC-eligible, a portion or all of the Physiotherapist services may be covered. Our New Zealand Wellington administration team will assist with all ACC paperwork and claims processing at no additional charge.
- Private health insurance: We accept direct billing for most major New Zealand private health insurers. Please provide your insurance details prior to commencing treatment.
- All Physiotherapist services are delivered in accordance with the Health and Disability Commissioner's Code of Health and Disability Services Consumers' Rights.
- This Quotation Estimate is non-transferable and is prepared specifically for the named client.
- Any variations to the scope of services outlined in this Quotation Estimate will be communicated in writing and require client written approval before additional charges are incurred.
By signing below, you acknowledge that you have read and understood this Quotation Estimate for Physiotherapist services and agree to the terms and conditions outlined above. Your signature constitutes acceptance of this Quotation Estimate and authorises the Wellington Physiotherapy & Rehabilitation Centre to commence the described rehabilitation programme.
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