Quotation Estimate Physiotherapist in Philippines Manila –Free Word Template Download with AI
Professional Physiotherapist Services | Philippines Manila
Document No. QTE-PHT-2025-0472
This Quotation Estimate is formally issued by Manila Physiotherapy & Rehabilitation Center to provide a comprehensive and transparent breakdown of costs associated with professional Physiotherapist services to be rendered in the Philippines Manila metropolitan area. This document serves as the official pricing reference for the client and outlines all fees, session structures, and ancillary charges that will apply throughout the duration of the prescribed Physiotherapist treatment program. All figures presented in this Quotation Estimate are quoted in Philippine Pesos (PHP) and are subject to the terms and conditions stated herein.
The following Physiotherapist services have been recommended based on the initial clinical assessment conducted on June 10, 2025, at our facility in Philippines Manila. The treatment plan addresses the client's diagnosed condition of chronic lower back pain with associated lumbar disc herniation (L4-L5) and includes a structured rehabilitation program spanning twelve (12) weeks.
| Item No. | Service Description | Frequency | Duration | Unit Rate (PHP) | Quantity | Subtotal (PHP) |
|---|---|---|---|---|---|---|
| 01 | Initial Comprehensive Physiotherapist Assessment & Treatment Planning | One-time | 60 min | 2,500.00 | 1 | 2,500.00 |
| 02 | Manual Therapy & Joint Mobilization (Physiotherapist-led) | 3x / week | 45 min | 1,800.00 | 36 | 64,800.00 |
| 03 | Therapeutic Exercise & Core Stabilization Program | 3x / week | 45 min | 1,500.00 | 36 | 54,000.00 |
| 04 | Electrotherapy (TENS, Ultrasound, Iontophoresis) | 2x / week | 30 min | 1,200.00 | 24 | 28,800.00 |
| 05 | Soft Tissue Massage & Myofascial Release | 2x / week | 30 min | 1,400.00 | 24 | 33,600.00 |
| 06 | Progressive Re-evaluation by Lead Physiotherapist | Monthly | 30 min | 1,000.00 | 3 | 3,000.00 |
| 07 | Home Exercise Program (HEP) Customization & Follow-up Consultation | Bi-weekly | 20 min | 800.00 | 6 | 4,800.00 |
| 08 | Final Discharge Assessment & Maintenance Plan (Physiotherapist Report) | One-time | 45 min | 2,000.00 | 1 | 2,000.00 |
| TOTAL ESTIMATED COST (PHP) | 193,500.00 | |||||
| Description | Amount (PHP) |
|---|---|
| Subtotal of All Physiotherapist Services | 193,500.00 |
| VAT (12% as per BIR regulations, Philippines Manila jurisdiction) | 23,220.00 |
| Facility & Equipment Usage Fee (Philippines Manila branch) | 5,000.00 |
| Medical Records & Documentation Fee | 1,500.00 |
| GRAND TOTAL (PHP) | 223,220.00 |
To facilitate budgeting and ensure continuity of care, this Quotation Estimate proposes the following installment structure for the total Physiotherapist program fee:
| Installment | Due Date | Amount (PHP) | Remarks |
|---|---|---|---|
| 1st (Down Payment) | Upon acceptance of this Quotation Estimate | 74,406.67 | 30% of Grand Total |
| 2nd | End of Week 4 | 74,406.67 | 30% of Grand Total |
| 3rd | End of Week 8 | 74,406.66 | 30% of Grand Total |
| 4th (Final) | End of Week 12 | 0.00 | Balance settled via installments |
- This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After the expiration date, all rates for Physiotherapist services in Philippines Manila are subject to revision based on prevailing market conditions and operational costs.
- All Physiotherapist services will be delivered by licensed and board-certified Physiotherapists registered with the Professional Regulation Commission (PRC) of the Philippines and the Philippine Association of Physiotherapists (PAP).
- The client is required to provide a minimum of forty-eight (48) hours' notice for any rescheduling or cancellation of a Physiotherapist session. Cancellations within this window will incur a 50% session fee.
- Payment may be made via bank transfer (BDO, BPI, Metrobank), credit/debit card, or cash at our Philippines Manila office. A 2% surcharge applies to credit card transactions.
- This Quotation Estimate does not include costs for diagnostic imaging (MRI, X-ray, CT scan), laboratory tests, or pharmaceutical prescriptions, which will be billed separately if required by the attending Physiotherapist.
- The treatment program may be modified at the discretion of the lead Physiotherapist based on the client's clinical progress. Any additional sessions beyond the twelve-week plan will be billed at the per-session rates stated in this document.
- All personal health information collected during the Physiotherapist assessment and treatment will be handled in strict accordance with the Data Privacy Act of 2012 (Republic Act No. 10173) of the Philippines.
- This Quotation Estimate is non-transferable and is issued exclusively for the named client. Any change in patient requires a new assessment and a revised Quotation Estimate.
By signing below, the client acknowledges receipt of this Quotation Estimate and agrees to the terms, conditions, and pricing structure outlined for the Physiotherapist services to be rendered in Philippines Manila. The treatment program shall commence within five (5) business days of the receipt of the first installment payment.
Prepared by:Dr. Maria Santos, RPT, MPT
Lead Physiotherapist
Manila Physiotherapy & Rehabilitation Center Accepted by (Client):
Mr. Juan Dela Cruz
Date: _________________________ ⬇️ Download as DOCX Edit online as DOCX
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