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Quotation Estimate Psychiatrist in Iran Tehran –Free Word Template Download with AI

Professional Psychiatrist Services — Iran Tehran

Ref. No: QTE-IRN-TEH-2025-0472  |  VALID QUOTATION

Provider Information

Clinic Name: Tehran Advanced Psychiatric Care Center

Address: Valiasr Street, District 1, Tehran, Iran

Phone: +98 21 8876 5432

Email: [email protected]

License No.: IRN-PSY-2019-00347

Client Information

Client Name: [Full Name / Organization]

Address: [Client Address, Tehran, Iran]

Phone: [Client Phone Number]

Email: [Client Email Address]

National ID: [Client National ID]

Quotation Details

Date of Issue: June 15, 2025

Quotation Valid Until: July 15, 2025 (30 days)

Prepared By: Dr. Alireza Mohammadi, MD, PhD (Psychiatrist)

Service Location: Iran Tehran, Valiasr Street Clinic

Payment Terms

Currency: Iranian Rial (IRR) / USD

Payment Method: Bank Transfer / In-Clinic Payment

Due Date: Within 7 days of service delivery

Bank: Bank Melli Iran, Branch Tehran Central

This Quotation Estimate outlines the comprehensive psychiatric services to be provided by a licensed Psychiatrist at the Tehran Advanced Psychiatric Care Center, located in the heart of Iran Tehran. The services are designed to address a wide range of mental health conditions including but not limited to major depressive disorder, generalized anxiety disorder, bipolar disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and schizophrenia spectrum disorders. All psychiatric evaluations and treatment plans will be conducted in accordance with the Iranian Ministry of Health and Medical Education guidelines and international psychiatric standards.

Item No. Service Description Quantity / Duration Unit Price (IRR) Total (IRR)
01 Initial Psychiatrist Consultation & Comprehensive Psychiatric Assessment (90 minutes) 1 session 1,200,000 1,200,000
02 Follow-up Psychiatrist Therapy Sessions (60 minutes each) 12 sessions 900,000 10,800,000
03 Psychological Testing & Diagnostic Battery (MMPI-2, WAIS-IV, BDI, BAI) 1 package 2,500,000 2,500,000
04 Psychiatric Medication Management & Prescription (monthly review) 3 months 600,000 1,800,000
05 Family Psychoeducation & Counseling Sessions (Iran Tehran clinic) 4 sessions 750,000 3,000,000
06 Emergency Psychiatrist Consultation (after-hours, Iran Tehran) 1 session 1,800,000 1,800,000
07 Written Psychiatric Report & Medical Certificate (for employer/insurance) 2 reports 400,000 800,000
08 Home Visit Psychiatrist Service (within Tehran city limits) 2 visits 1,500,000 3,000,000
TOTAL QUOTATION ESTIMATE AMOUNT 24,900,000 IRR
Approximate USD Equivalent (at 1 USD = 900,000 IRR) ~27.67 USD
  • This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. After the expiration date, pricing for the Psychiatrist services may be subject to revision based on prevailing market conditions in Iran Tehran.
  • All psychiatric services described in this document will be performed by a board-certified Psychiatrist holding a valid license issued by the Iranian Ministry of Health and Medical Education. The treating Psychiatrist is Dr. Alireza Mohammadi, MD, PhD, with over fifteen years of clinical experience in Iran Tehran.
  • Payment for services rendered shall be made in Iranian Rial (IRR) via bank transfer to the account specified above, or in person at the clinic reception in Iran Tehran. International clients may arrange payment in USD through designated international banking channels.
  • Cancellations of scheduled Psychiatrist appointments must be made at least twenty-four (24) hours in advance. Late cancellations or no-shows will incur a fee of 50% of the scheduled session rate.
  • All patient records, psychiatric assessments, and treatment plans are strictly confidential in accordance with Iranian medical privacy laws (Law on Protection of Patient Rights, 2014). No information will be disclosed without written consent from the patient or their legal guardian.
  • This Quotation Estimate does not constitute a binding contract until both parties have signed and dated the acceptance section below. Upon acceptance, a formal service agreement will be generated referencing this Quotation Estimate number.
  • The Psychiatrist reserves the right to refer the patient to a specialist psychiatrist or a psychiatric hospital in Iran Tehran if the clinical presentation requires a higher level of care, inpatient admission, or specialized intervention beyond the scope of outpatient services listed herein.
  • Medication costs, laboratory tests, and neuroimaging (MRI, CT, EEG) are not included in this Quotation Estimate and will be billed separately at the prevailing rates of the contracted laboratories and imaging centers in Tehran.
  • Any disputes arising from the services described in this Quotation Estimate shall be resolved through the Tehran Medical Disputes Arbitration Board in accordance with Iranian civil law.

By signing below, the client acknowledges receipt of this Quotation Estimate for Psychiatrist services in Iran Tehran and agrees to the terms, conditions, and pricing outlined in this document. The provider confirms that all listed services will be delivered by a qualified Psychiatrist at the specified location in Tehran, Iran.

Client Signature
Name / Date
Provider (Psychiatrist) Signature
Dr. Alireza Mohammadi, MD, PhD / Date

Tehran Advanced Psychiatric Care Center — Valiasr Street, District 1, Tehran, Iran

Quotation Estimate Ref: QTE-IRN-TEH-2025-0472  |  This document is generated electronically and is valid without a physical stamp.

© 2025 Tehran Advanced Psychiatric Care Center. All rights reserved.

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