Quotation Estimate Physiotherapist in United Kingdom London –Free Word Template Download with AI
142 Marylebone High Street, London W1U 4NP, United Kingdom
Telephone: +44 (0)20 7946 0821 | Email: [email protected]
Company Registration No. 08472915 | VAT No. GB 294 8173 62
Quotation EstimateQuotation Details
Quotation No.: QTE-2025-04871
Date Issued: 12 June 2025
Valid Until: 12 July 2025 (30 days)
Prepared By: Sarah Whitfield, Lead Physiotherapist
Client Details
Client Name: Mr. James A. Harrington
Address: 27 Kensington Gardens, London W8 6PT, United Kingdom
Telephone: +44 (0)7700 900342
Referring GP: Dr. Emily Chen, Harley Street Medical Practice
Dear Mr. Harrington,
Thank you for contacting Thames Physiotherapy & Rehabilitation Centre regarding your physiotherapy requirements. Following your initial assessment consultation on 5 June 2025, our senior Physiotherapist has prepared this Quotation Estimate to outline the full scope of treatment, associated costs, and service terms for your ongoing rehabilitation programme. This document has been prepared in accordance with the standards set by the Chartered Society of Physiotherapy and complies with all applicable regulations within the United Kingdom London metropolitan area.
Scope of Physiotherapy ServicesThis Quotation Estimate covers a comprehensive physiotherapy rehabilitation programme designed to address your diagnosed bilateral rotator cuff tendinopathy and associated shoulder impingement syndrome. The treatment plan has been developed by our specialist Physiotherapist team and is tailored to your individual clinical presentation, functional goals, and recovery timeline. All services are delivered at our fully equipped clinic in central London, United Kingdom, and include access to our hydrotherapy pool, electrotherapy suite, and dedicated exercise rehabilitation gymnasium.
| Item No. | Description of Service | Frequency | Duration | Unit Price (GBP) | Total (GBP) |
|---|---|---|---|---|---|
| 01 | Initial Comprehensive Assessment & Treatment Plan (60 minutes) – conducted by a senior Physiotherapist with 15+ years of orthopaedic experience | One-off | 60 min | £120.00 | £120.00 |
| 02 | Manual Therapy & Soft Tissue Mobilisation Sessions (45 minutes) – including joint mobilisation, myofascial release, and therapeutic massage | 2x per week | 45 min | £85.00 | £1,700.00 |
| 03 | Therapeutic Exercise & Strengthening Programme (45 minutes) – progressive resistance training, scapular stabilisation, and functional movement retraining | 2x per week | 45 min | £80.00 | £1,600.00 |
| 04 | Electrotherapy & Modalities (20 minutes) – including ultrasound, TENS, cryotherapy, and interferential current as clinically indicated | 2x per week | 20 min | £45.00 | £900.00 |
| 05 | Hydrotherapy Pool Sessions (30 minutes) – supervised aquatic exercise in our 25-metre heated pool | 1x per week | 30 min | £65.00 | £650.00 |
| 06 | Progress Review & Reassessment (30 minutes) – conducted by the treating Physiotherapist to adjust the programme | Monthly | 30 min | £55.00 | £165.00 |
| 07 | Home Exercise Programme & Patient Education Materials (printed and digital) | One-off | — | £35.00 | £35.00 |
| 08 | GP Report & Discharge Summary (written clinical report to referring physician) | One-off | — | £40.00 | £40.00 |
| Subtotal (12-week programme) | £5,210.00 | ||||
| VAT (20%) | £1,042.00 | ||||
| Grand Total (GBP) | £6,252.00 | ||||
- Payment Schedule: The total amount of £6,252.00 (inclusive of VAT) may be settled in full upon acceptance of this Quotation Estimate, or in three equal monthly instalments of £2,084.00, with the first payment due within 14 days of the quotation date.
- Accepted Payment Methods: Bank transfer (BACS/CHAPS), debit or credit card (Visa, Mastercard, American Express), or direct debit. All transactions are processed in British Pounds Sterling (GBP) in accordance with United Kingdom financial regulations.
- Cancellation Policy: Appointments may be cancelled or rescheduled with a minimum of 24 hours' notice. Cancellations made within 24 hours or no-shows will incur a fee of 50% of the session rate. This policy is standard practice for private physiotherapy providers in London, United Kingdom.
- Insurance & NHS Referral: This Quotation Estimate is for private treatment only. Should you wish to claim reimbursement through a private health insurance provider, please note that our clinic is registered with Bupa, AXA Health, Aviva Health, Vitality, and Cigna. A detailed itemised receipt will be provided for each session.
- Validity: This Quotation Estimate remains valid for 30 calendar days from the date of issue. After this period, pricing may be subject to revision in line with current market rates for physiotherapy services in the United Kingdom London area.
- Regulatory Compliance: All physiotherapy services are delivered by registered members of the Health and Care Professions Council (HCPC) and the Chartered Society of Physiotherapy. Our clinic holds full professional indemnity insurance of £5,000,000 and public liability insurance of £10,000,000, as required for healthcare providers operating in London, United Kingdom.
- Data Protection: Your personal and medical data will be processed in strict accordance with the UK General Data Protection Regulation (UK GDPR) and the Data Protection Act 2018. Clinical records will be retained for a minimum of 8 years in line with NHS and private sector guidelines.
By signing below, you confirm that you have read, understood, and accept the terms and conditions set out in this Quotation Estimate. You authorise Thames Physiotherapy & Rehabilitation Centre to commence the physiotherapy programme as described, and you agree to the payment schedule outlined above. This document constitutes a binding agreement between the parties for the provision of physiotherapy services in London, United Kingdom.
Client SignatureMr. James A. Harrington
Date: ______________________ Authorised Representative
Sarah Whitfield, Lead Physiotherapist
Thames Physiotherapy & Rehabilitation Centre
Date: ______________________ ⬇️ Download as DOCX Edit online as DOCX
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