Quotation Estimate Psychiatrist in India Mumbai –Free Word Template Download with AI

This Quotation Estimate is issued by the undersigned Psychiatrist practice located in India Mumbai to provide a comprehensive, itemized breakdown of all professional psychiatric services, diagnostic assessments, therapeutic interventions, and associated costs for the client named above. This document serves as a formal financial proposal and does not constitute a binding contract until signed and accepted by both parties. All rates quoted herein are exclusive of applicable Goods and Services Tax (GST) at the prevailing rate of 18% as per the Indian taxation framework for healthcare services in India Mumbai.

The following Psychiatrist services have been recommended following the initial referral and preliminary evaluation conducted at our clinic in India Mumbai. The treatment plan encompasses a structured, multi-week engagement designed to address the client's diagnosed condition of Generalized Anxiety Disorder (GAD) with comorbid mild depressive episodes, as confirmed during the intake assessment.

• Advance Payment: 25% of the total Quotation Estimate amount (₹ 12,803) is due upon signing and acceptance of this document to confirm the booking of the Psychiatrist's schedule in India Mumbai.
• Mid-Treatment Payment: 40% of the total (₹ 20,485) is due at the completion of Week 6 of the therapy programme.
• Final Payment: The remaining 35% (₹ 17,924) is due upon completion of the 12th session and submission of the final discharge summary.
• Accepted Payment Modes: NEFT/RTGS, UPI, Credit/Debit Card, and Cheque (drawn on any bank branch in India Mumbai). Cash payments exceeding ₹ 10,000 are not accepted as per Indian financial regulations.
• Overdue Charges: A late payment penalty of 2% per month will apply to any outstanding balance beyond 15 days of the due date.

• This Quotation Estimate is valid for a period of 30 calendar days from the date of issue. Beyond this period, the Psychiatrist reserves the right to revise fees based on prevailing market rates in India Mumbai.
• All psychiatric consultations and therapy sessions are conducted at the clinic premises in India Mumbai unless otherwise agreed in writing for tele-consultation via a HIPAA-equivalent secure platform.
• Client confidentiality is maintained in strict accordance with the Indian Medical Council (Professional Conduct) Regulations and the Mental Healthcare Act, 2017 of India. No information from this Quotation Estimate or the treatment records shall be disclosed to third parties without written consent, except where mandated by law.
• The client may cancel or reschedule any session with a minimum of 24 hours' prior notice. Cancellations made within 24 hours will be charged at 50% of the session fee.
• This Quotation Estimate does not guarantee a specific clinical outcome. The Psychiatrist will exercise professional judgment in modifying the treatment plan as clinically indicated during the course of therapy in India Mumbai.
• In the event of the Psychiatrist's unavailability due to medical leave or professional obligations, an equally qualified substitute Psychiatrist from the same practice in India Mumbai will be assigned, and the client will be informed in advance.
• Disputes arising from this Quotation Estimate shall be subject to the exclusive jurisdiction of the courts in India Mumbai, Maharashtra, India.

By signing below, the client acknowledges receipt of this Quotation Estimate for Psychiatrist services in India Mumbai, agrees to the terms, conditions, and payment schedule outlined herein, and authorizes the commencement of the recommended treatment plan.