Quotation Estimate Psychiatrist in South Africa Johannesburg –Free Word Template Download with AI
Professional Psychiatrist Services
Serving the South Africa Johannesburg Metropolitan Area
Dr. Thabo Mokoena, MBChB, MMed (Psych)
Johannesburg Psychiatric & Mental Health Clinic
142 Rivonia Road, Sandton
Johannesburg, 2196
South Africa
Tel: +27 11 447 8230
Email: [email protected]
HPCSA Reg. No: 0048291-CP Quotation Estimate Reference: QE-2025-0714
Date Issued: 14 July 2025
Valid Until: 14 August 2025 (30 days)
Currency: South African Rand (ZAR)
This Quotation Estimate is issued by the Johannesburg Psychiatric & Mental Health Clinic in response to the client's request for a comprehensive assessment of professional Psychiatrist services available within the South Africa Johannesburg region. The purpose of this document is to provide a transparent, itemised breakdown of all anticipated costs associated with psychiatric consultation, diagnostic evaluation, therapeutic intervention, and ongoing medication management. All pricing is quoted in South African Rand (ZAR) and reflects the current fee schedule as approved by the Health Professions Council of South Africa (HPCSA) and aligned with the Medical Schemes Act, 1998.
The Psychiatrist named in this Quotation Estimate, Dr. Thabo Mokoena, is a fully registered and accredited specialist in adult and adolescent psychiatry with over twelve years of clinical practice in the South Africa Johannesburg metropolitan area. All services described herein are delivered in compliance with the National Health Act, 2003, and the Mental Health Care Act, 17 of 2002, as applicable in South Africa.
| Ref | Description of Psychiatrist Service | Duration | Frequency | Unit Cost (ZAR) | Total (ZAR) |
|---|---|---|---|---|---|
| 01 | Initial Comprehensive Psychiatric Assessment – full clinical interview, mental state examination, and diagnostic formulation conducted by the Psychiatrist in the South Africa Johannesburg clinic | 90 min | Once | R 2,850.00 | R 2,850.00 |
| 02 | Psychological and Neuropsychological Testing (administered and interpreted by the Psychiatrist team) | 120 min | Once | R 3,400.00 | R 3,400.00 |
| 03 | Follow-up Psychiatrist Consultation – review of diagnostic findings, discussion of treatment plan, and medication prescription | 45 min | Monthly × 6 | R 1,650.00 | R 9,900.00 |
| 04 | Individual Cognitive-Behavioural Therapy (CBT) sessions facilitated under Psychiatrist supervision | 50 min | Weekly × 12 | R 1,200.00 | R 14,400.00 |
| 05 | Psychiatric Medication Management – prescription, dosage adjustment, and side-effect monitoring by the Psychiatrist | 30 min | Monthly × 6 | R 950.00 | R 5,700.00 |
| 06 | Family Psychoeducation Session – one session with immediate family members to support the patient's recovery in the South Africa Johannesburg community | 60 min | Once | R 1,800.00 | R 1,800.00 |
| 07 | Written Psychiatric Report and Treatment Plan – formal clinical documentation for medical aid or occupational purposes | — | Once | R 1,500.00 | R 1,500.00 |
| 08 | Urgent / After-Hours Psychiatrist Telephone Consultation (included in package, up to 3 calls) | 20 min each | As needed | R 750.00 | R 2,250.00 |
| Subtotal | R 41,800.00 | ||||
| VAT (15%) | R 6,270.00 | ||||
| Grand Total (Quotation Estimate Amount) | R 48,070.00 | ||||
The following terms govern the acceptance and execution of this Quotation Estimate for Psychiatrist services in South Africa Johannesburg:
- This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. Should the client wish to proceed after the expiry date, the Psychiatrist reserves the right to re-evaluate and adjust the pricing to reflect any changes in the South Africa Johannesburg healthcare fee schedule.
- All fees are payable in South African Rand (ZAR). Payment may be made via EFT to the clinic's designated bank account, debit/credit card, or directly through the client's registered medical aid scheme where benefits apply.
- Medical aid claims will be submitted on the client's behalf by the clinic's billing department. The client is responsible for any co-payment, gap cover shortfall, or non-covered items as determined by the relevant medical aid scheme in South Africa.
- The Psychiatrist will maintain strict confidentiality in accordance with the Protection of Personal Information Act (POPIA), 2013, and the HPCSA's ethical guidelines. No clinical information will be disclosed without the client's written consent, except where required by law.
- Cancellations of scheduled Psychiatrist appointments must be made at least 24 hours in advance. Late cancellations or no-shows will incur a fee of 50% of the session cost.
- This Quotation Estimate does not constitute a guarantee of specific clinical outcomes. The Psychiatrist will exercise professional clinical judgement in determining the most appropriate course of treatment for the patient.
- Any additional services not itemised in this Quotation Estimate (e.g., inpatient psychiatric admission, emergency intervention, or referral to a specialist in the South Africa Johannesburg area) will be quoted separately in writing prior to commencement.
- This Quotation Estimate is non-transferable and is issued exclusively to the named client.
| Payment | Due Date | Amount (ZAR) | Notes |
|---|---|---|---|
| Deposit (30%) | Upon acceptance | R 14,421.00 | Secures initial appointment slot |
| Second instalment (40%) | Week 4 of treatment | R 19,228.00 | Covers CBT and follow-up sessions |
| Final balance (30%) | Week 12 of treatment | R 14,421.00 | Settles remaining services and report |
By signing below, the client acknowledges receipt of this Quotation Estimate for Psychiatrist services in South Africa Johannesburg, accepts the terms and conditions outlined herein, and authorises the Johannesburg Psychiatric & Mental Health Clinic to commence the services described.
Client Signature:
Name: James van der Merwe | Date: _______________Authorised Representative (Clinic):
Dr. Thabo Mokoena, Psychiatrist | Date: _______________ ⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
GoGPT