Quotation Estimate Physiotherapist in Russia Saint Petersburg –Free Word Template Download with AI

Document Details

Client Information

Scope of Physiotherapist Services

This Quotation Estimate is issued by NeuroRehab Saint Petersburg to provide a comprehensive and transparent breakdown of costs for professional Physiotherapist services to be delivered at our licensed facility in Russia Saint Petersburg. The treatment plan has been developed following an initial clinical assessment conducted on 10 June 2025, during which our senior Physiotherapist evaluated the client's musculoskeletal condition, range of motion, pain levels, and functional limitations. The following services are included in this Quotation Estimate:

Itemized Cost Breakdown

Terms and Conditions of This Quotation Estimate

• This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After the expiration date, all prices listed herein are subject to revision based on current market rates in Russia Saint Petersburg.
• All Physiotherapist services described in this document will be performed at our registered clinic located at 12 Nevsky Prospekt, Building 4, Saint Petersburg, Russia. The facility operates Monday through Saturday, 08:00 to 20:00 local time.
• The assigned Physiotherapist holds a valid license issued by the Ministry of Health of the Russian Federation and is a registered member of the Russian Association of Physiotherapists (RAP). All practitioners on staff maintain continuing professional development certifications.
• Payment terms: 50% advance payment upon acceptance of this Quotation Estimate, with the remaining 50% due upon completion of the final treatment session. Payment may be made via bank transfer to the account of NeuroRehab Saint Petersburg LLC or by cash at the clinic reception.
• Rescheduling of any Physiotherapist appointment must be made no fewer than 24 hours in advance. Cancellations made within 24 hours will be subject to a 50% session fee.
• This Quotation Estimate does not constitute a medical prescription. All treatment protocols will be adjusted by the supervising Physiotherapist based on the client's clinical progress and any changes in condition during the course of therapy.
• The client acknowledges that the services described herein are provided in compliance with all applicable healthcare regulations of the Russian Federation and the specific municipal health codes of Saint Petersburg.
• Confidentiality: All patient records, assessment data, and treatment notes generated during the course of this Physiotherapist engagement are protected under Federal Law No. 323-FZ "On the Basics of Health Protection of Citizens in the Russian Federation" and will not be disclosed to third parties without written consent.
• Any additional services not explicitly listed in this Quotation Estimate will be quoted separately and require prior written approval from the client before commencement.

Acceptance and Authorization

By signing below, the client confirms acceptance of this Quotation Estimate for Physiotherapist services to be rendered in Russia Saint Petersburg and agrees to all terms and conditions outlined above. The treatment program will commence on the date specified by mutual agreement between the client and the assigned Physiotherapist.