Quotation Estimate Psychiatrist in Sri Lanka Colombo –Free Word Template Download with AI
Professional Psychiatrist Services — Sri Lanka Colombo
Ref: QE/PSY/2025/0047 | Date: 15 June 2025 | Valid Until: 15 July 2025
1. Purpose of This Quotation EstimateThis Quotation Estimate is issued by Colombo Mind & Wellness Centre to provide a comprehensive, transparent, and itemised breakdown of all professional Psychiatrist services to be rendered in Sri Lanka Colombo. The purpose of this document is to outline the scope of psychiatric care, associated diagnostic procedures, therapeutic interventions, and all ancillary costs so that the client may make an informed decision regarding engagement of our Psychiatrist team. All pricing is quoted in Sri Lankan Rupees (LKR) and is subject to the terms and conditions stated herein. This Quotation Estimate reflects current market rates for psychiatric services in the Sri Lanka Colombo metropolitan area as of the date of issue.
2. Scope of Psychiatrist ServicesThe following services are included in this Quotation Estimate for the engagement of a licensed Psychiatrist practising in Sri Lanka Colombo. Each line item represents a distinct service or deliverable. The Psychiatrist assigned to this case will hold a valid registration with the Sri Lanka Medical Council and a minimum of ten (10) years of clinical experience in adult and adolescent psychiatry.
| No. | Service / Item Description | Qty / Duration | Unit Rate (LKR) | Amount (LKR) |
|---|---|---|---|---|
| 1 | Initial Comprehensive Psychiatric Assessment & Consultation (90 minutes) conducted by a senior Psychiatrist at the Colombo clinic | 1 session | 18,500 | 18,500 |
| 2 | Follow-up Psychiatric Review Sessions (45 minutes each) — scheduled bi-weekly for the first three months | 6 sessions | 12,000 | 72,000 |
| 3 | Psychological & Neuropsychological Testing Battery (including MMSE, PHQ-9, GAD-7, BDI, and cognitive screening) | 1 package | 25,000 | 25,000 |
| 4 | Prescription & Medication Management (including initial pharmacological plan, dosage titration, and quarterly medication review) | 3 months | 8,000 | 24,000 |
| 5 | Cognitive Behavioural Therapy (CBT) — structured sessions delivered by a Psychiatrist-supervised clinical psychologist | 12 sessions | 10,500 | 126,000 |
| 6 | Family / Caregiver Psychoeducation Workshop (2-hour group session for up to 5 family members) | 1 session | 15,000 | 15,000 |
| 7 | Written Psychiatric Report & Diagnostic Summary (suitable for insurance, employment, or legal purposes in Sri Lanka Colombo) | 1 report | 12,000 | 12,000 |
| 8 | Emergency / After-hours Psychiatric Consultation (telephone or in-person, available 24/7 within Sri Lanka Colombo district) | 1 call-out | 22,000 | 22,000 |
| 9 | Home Visit by Psychiatrist (for patients unable to travel to the Colombo clinic; within 15 km radius) | 2 visits | 16,000 | 32,000 |
| 10 | Administrative & Record-Keeping Fee (file management, secure digital storage, and annual record retrieval) | 1 year | 5,000 | 5,000 |
| Subtotal | LKR 351,500 |
| VAT @ 18% (Sri Lanka standard rate) | LKR 63,270 |
| Prescription & Diagnostic Consumables (estimated) | LKR 18,000 |
| Grand Total (Inclusive of VAT) | LKR 432,770 |
- This Quotation Estimate constitutes a formal offer for professional Psychiatrist services and does not constitute a binding contract until signed and countersigned by both parties.
- Payment is due within fourteen (14) days of acceptance. A 50% advance payment is required to secure the initial Psychiatrist consultation slot in Sri Lanka Colombo.
- All services shall be delivered in accordance with the Sri Lanka Medical Council's Code of Ethics and the Mental Health Act No. 14 of 2021 of Sri Lanka.
- Client confidentiality is strictly maintained. No psychiatric records, diagnostic findings, or treatment details will be disclosed to any third party without written consent, in compliance with Sri Lankan data protection regulations.
- Cancellations of scheduled Psychiatrist sessions must be communicated at least 24 hours in advance. Late cancellations or no-shows will incur a fee of 50% of the session rate.
- This Quotation Estimate covers outpatient psychiatric services only. Inpatient admission, electroconvulsive therapy (ECT), or surgical interventions are not included and will be subject to a separate Quotation Estimate.
- The Psychiatrist reserves the right to refer the client to a specialist sub-field (e.g., child psychiatry, forensic psychiatry, addiction psychiatry) if clinically indicated. Any additional referral fees will be communicated prior to engagement.
- All services are to be conducted at the Colombo Mind & Wellness Centre premises, 42 Galle Road, Colombo 03, Sri Lanka Colombo, unless otherwise agreed in writing for home-visit or telepsychiatry sessions.
- Disputes arising from this Quotation Estimate shall be resolved through mediation under the jurisdiction of the Colombo District Court, Sri Lanka.
| Milestone | Due Date | Amount (LKR) |
|---|---|---|
| Advance (upon acceptance of this Quotation Estimate) | Within 7 days of signing | 216,385 |
| Second instalment (after completion of 6 CBT sessions) | Week 8 | 116,385 |
| Final balance (upon completion of all services) | Week 14 | 100,000 |
By signing below, the client acknowledges receipt of this Quotation Estimate for Psychiatrist services in Sri Lanka Colombo and agrees to the terms, conditions, and pricing outlined herein.
Client Signature: ___________________________
Name: ___________________________
Date: ___________________________
Authorised Representative (Colombo Mind & Wellness Centre):
Dr. Nimal Perera, MBBS, MRCPsych
Senior Psychiatrist & Director
Signature: ___________________________
Date: ___________________________
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