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Quotation Estimate Physiotherapist in Peru Lima –Free Word Template Download with AI

Av. Javier Prado Este 1245, San Isidro, Lima, Peru

Tel: +51 1 456 7890 | Email: [email protected]

RUC: 20587432190 | Registro de Profesionales: N° 004521-MINSA

Licensed Physiotherapist Practice – Peru Lima
Quotation Estimate

Quotation Details

Quotation No.: QE-2025-00847

Date Issued: June 12, 2025

Valid Until: July 12, 2025 (30 days)

Service Location: Peru Lima – San Isidro District

Client Information

Client Name: [Full Name / Company Name]

Document No.: [DNI / RUC]

Address: [Street, District, Lima, Peru]

Contact: [Phone / Email]

1. Purpose of This Quotation Estimate

This Quotation Estimate is issued by Rehabilitación Integral del Pacífico S.A.C. to provide a comprehensive and transparent breakdown of professional Physiotherapist services to be delivered in Peru Lima. The purpose of this document is to outline the scope of physiotherapy treatment, associated costs, session schedules, and all applicable terms governing the engagement. This Quotation Estimate serves as a formal proposal for the client to review, approve, and authorize the commencement of Physiotherapist services within the Lima metropolitan area, Peru.

2. Scope of Physiotherapist Services

The following Physiotherapist services are included in this Quotation Estimate. All treatments will be administered by a certified and licensed Physiotherapist registered with the Peruvian Ministry of Health (MINSA) and the Colegio de Fisioterapeutas del Perú. The Physiotherapist will conduct an initial comprehensive assessment, develop a personalized treatment plan, and provide ongoing therapeutic interventions tailored to the client's specific medical condition and recovery goals.

Item Description Qty Unit Price (PEN) Subtotal (PEN)
01 Initial Physiotherapist Assessment & Clinical Evaluation (60 min) 1 180.00 180.00
02 Manual Therapy & Joint Mobilization Sessions (45 min each) 12 150.00 1,800.00
03 Therapeutic Exercise & Rehabilitation Program (45 min each) 12 140.00 1,680.00
04 Electrotherapy & Modalities (TENS, Ultrasound, Laser) (30 min each) 8 120.00 960.00
05 Postural Re-education & Ergonomic Consultation (60 min) 2 200.00 400.00
06 Progress Review & Treatment Plan Adjustment (30 min) 3 100.00 300.00
07 Home Exercise Program & Patient Education Materials 1 80.00 80.00
08 Physiotherapist Home Visit in Peru Lima (within 10 km radius) 4 250.00 1,000.00
TOTAL ESTIMATED COST (Peruvian Soles – PEN) 6,400.00
3. Treatment Schedule & Logistics in Peru Lima

All Physiotherapist sessions outlined in this Quotation Estimate will be conducted at our clinic located in the San Isidro district of Peru Lima, or at the client's residence within the Lima metropolitan area as specified in Item 08. The Physiotherapist will coordinate a weekly schedule of three (3) sessions per week over a period of four (4) weeks, totaling approximately sixteen (16) in-clinic sessions plus four (4) home visits. The Physiotherapist will maintain detailed clinical records in accordance with Peruvian health regulations and will provide a final discharge report upon completion of the treatment program.

4. Payment Terms

4.1 – A 50% advance payment (PEN 3,200.00) is required upon acceptance of this Quotation Estimate to reserve the Physiotherapist's schedule.

4.2 – The remaining 50% balance (PEN 3,200.00) shall be paid in two equal installments: 25% at the midpoint of the treatment program and 25% upon completion of all sessions.

4.3 – Accepted payment methods: Bank transfer (BCP, Interbank, BBVA Peru), corporate check, or cash at the clinic in Peru Lima. All payments are subject to the applicable Peruvian VAT (IGV) of 18%, which is included in the prices stated above.

4.4 – Late payments exceeding fifteen (15) calendar days will incur a monthly interest rate of 1.5% as per Peruvian commercial law.

5. Terms & Conditions

5.1 – This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After this period, prices may be subject to revision based on market conditions in Peru Lima.

5.2 – The Physiotherapist reserves the right to modify the treatment plan if the client's clinical condition changes during the course of therapy. Any additional sessions beyond the scope of this Quotation Estimate will be billed separately at the rates indicated in the itemized table.

5.3 – The client agrees to attend all scheduled Physiotherapist sessions. Cancellations must be made at least twenty-four (24) hours in advance. No-shows or late cancellations will be charged at 50% of the session fee.

5.4 – This Quotation Estimate does not constitute a guarantee of specific medical outcomes. The Physiotherapist will exercise professional judgment and best clinical practice in accordance with the standards set by the Peruvian College of Physiotherapists.

5.5 – All personal health information will be handled in strict confidentiality in compliance with Peru's Data Protection Law (Ley N° 29733).

5.6 – This Quotation Estimate is governed by the laws of the Republic of Peru. Any disputes arising from this agreement shall be resolved in the courts of Lima, Peru.

6. Acceptance & Authorization

By signing below, the client acknowledges receipt of this Quotation Estimate for Physiotherapist services in Peru Lima and authorizes the commencement of treatment as described herein. The Physiotherapist and the client agree to the terms, conditions, and payment schedule outlined in this document.

Client Signature
Name: _________________________
DNI / RUC: _________________________
Date: _________________________
Physiotherapist / Authorized Representative
Name: _________________________
Professional License: _________________________
Date: _________________________

Rehabilitación Integral del Pacífico S.A.C. | Quotation Estimate QE-2025-00847 | Peru Lima

This document is generated electronically and is valid without a physical stamp. For inquiries, contact our office in San Isidro, Lima, Peru.

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