Quotation Estimate Psychiatrist in Philippines Manila –Free Word Template Download with AI
Professional Psychiatrist Services — Philippines Manila
Ref. No: QTE-PSY-2025-04187 | Valid for 30 Days
Service Provider
Manila Mind Wellness Center
128 Ayala Avenue, Makati City
Philippines Manila, 1226
Tel: +63 (2) 8887-4521
Email: [email protected]
PRC License No. 1284756
Client / Recipient
Mr. / Ms. [Client Full Name]
[Client Address]
Philippines Manila
Tel: [Client Phone Number]
Email: [Client Email Address]
Quotation Details
Date Issued: June 15, 2025
Quotation No.: QTE-PSY-2025-04187
Valid Until: July 15, 2025
Prepared By: Dr. Elena M. Santos, MD, Board-Certified Psychiatrist
Payment Terms
Method: Bank Transfer / Cash / GCash
Due Date: 5 business days from acceptance
Currency: Philippine Peso (PHP)
Bank: BDO Unibank, Makati Branch
Scope of Psychiatrist Services — Philippines ManilaThis Quotation Estimate is issued by Manila Mind Wellness Center to provide a comprehensive and transparent breakdown of professional Psychiatrist services available within the Philippines Manila metropolitan area. The services outlined below are designed to address a wide range of mental health conditions including but not limited to clinical depression, generalized anxiety disorders, bipolar disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and substance use disorders. All Psychiatrist consultations and treatments are conducted in full compliance with the Philippine Mental Health Act (Republic Act No. 10175) and the standards set forth by the Philippine Board of Psychiatry and Neurology.
Itemized Quotation Estimate Breakdown| No. | Service Description | Frequency / Duration | Unit Rate (PHP) | Amount (PHP) | Remarks |
|---|---|---|---|---|---|
| 1 | Initial Comprehensive Psychiatrist Consultation & Psychiatric Evaluation | One-time (60 min) | 3,500.00 | 3,500.00 | Includes full history, mental status exam |
| 2 | Follow-up Psychiatrist Consultation (Standard) | 12 sessions (45 min each) | 2,500.00 | 30,000.00 | Bi-weekly schedule, Philippines Manila clinic |
| 3 | Psychiatric Medication Management & Prescription Renewal | 12 sessions (included) | 1,200.00 | 14,400.00 | Includes lab work coordination |
| 4 | Cognitive Behavioral Therapy (CBT) — Psychiatrist Supervised | 8 sessions (50 min each) | 2,000.00 | 16,000.00 | Delivered by licensed psychologist under Psychiatrist oversight |
| 5 | Psychological Assessment & Diagnostic Testing (MMPI-2, WAIS-IV) | One-time (3 hrs) | 8,500.00 | 8,500.00 | Written report within 5 business days |
| 6 | Emergency / After-Hours Psychiatrist Consultation (Telehealth) | Up to 3 sessions | 4,000.00 | 12,000.00 | Available 7 days/week, Philippines Manila coverage |
| 7 | Family / Couples Psychiatric Counseling Session | 4 sessions (60 min each) | 3,000.00 | 12,000.00 | Includes up to 4 family members per session |
| 8 | Annual Psychiatric Health Maintenance & Wellness Check | One-time (45 min) | 2,800.00 | 2,800.00 | Includes medication review and lifestyle guidance |
| 9 | Medical Records Management & Confidential File Maintenance | Annual | 1,500.00 | 1,500.00 | Digital and physical records, Philippines Manila facility |
| 10 | Referral Coordination (Neurologist, Psychologist, Social Worker) | As needed (up to 3 referrals) | 800.00 | 2,400.00 | Within Philippines Manila network of specialists |
| Subtotal: | 103,100.00 | ||||
| VAT (12%): | 12,372.00 | ||||
| TOTAL QUOTATION ESTIMATE AMOUNT: | PHP 115,472.00 | One Hundred Fifteen Thousand Four Hundred Seventy-Two Philippine Pesos | |||
- This Quotation Estimate is valid for thirty (30) calendar days from the date of issuance. Beyond this period, the Psychiatrist service rates may be adjusted in accordance with prevailing market conditions in the Philippines Manila healthcare sector.
- All Psychiatrist consultations and therapeutic sessions must be scheduled at least 48 hours in advance through our Philippines Manila clinic reception or online booking portal.
- Cancellations made less than 24 hours before a scheduled Psychiatrist appointment will incur a 50% fee of the session rate. No-shows will be charged the full session fee.
- Client confidentiality is strictly maintained in accordance with the Philippine Data Privacy Act (Republic Act No. 10173) and the ethical standards of the Philippine Psychiatric Association.
- Payment is due within five (5) business days from the date of acceptance of this Quotation Estimate. Late payments shall accrue a 1.5% monthly interest charge.
- This Quotation Estimate does not constitute a guarantee of specific treatment outcomes. The Psychiatrist reserves the right to modify the treatment plan based on clinical assessment and the client's evolving mental health needs.
- All services are rendered at the Manila Mind Wellness Center located in the Philippines Manila area, or via secure telehealth platforms as indicated in the itemized breakdown.
- In the event of a psychiatric emergency, the client or their authorized representative may contact our after-hours Psychiatrist line at +63 (2) 8887-4522 available 24/7 within the Philippines Manila coverage zone.
By signing below, the client acknowledges receipt and acceptance of this Quotation Estimate for Psychiatrist services in the Philippines Manila. The client agrees to all terms, conditions, and payment obligations as stated herein.
Client / Authorized Representative
Name: _________________________
Signature: _________________________
Date: _________________________
Service Provider
Dr. Elena M. Santos, MD
Board-Certified Psychiatrist
Signature: _________________________
Date: _________________________
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