Quotation Estimate Psychiatrist in United Arab Emirates Abu Dhabi –Free Word Template Download with AI
Professional Psychiatrist Services — United Arab Emirates Abu Dhabi
| Quotation Estimate No. | QE-PSY-2025-04871 | Date of Issue | 15 June 2025 |
| Validity Period | 30 Calendar Days from Date of Issue | Currency | United Arab Emirates Dirham (AED) |
| Prepared By | Dr. Khalid Al Mansoori, Consultant Psychiatrist | Clinic | Al Noor Mental Health Centre, Abu Dhabi |
| Client Name | [Client / Referring Physician Name] | Client Reference | [Client File / Insurance Policy No.] |
| Service Location | Al Noor Mental Health Centre, Khalifa City, United Arab Emirates Abu Dhabi, P.O. Box 45210 | ||
This Quotation Estimate is issued by Al Noor Mental Health Centre, a licensed psychiatric facility operating in the United Arab Emirates Abu Dhabi emirate, to provide a comprehensive and transparent breakdown of all anticipated costs associated with the delivery of professional Psychiatrist services. This document serves as a formal financial proposal and does not constitute a binding contract until both parties have reviewed, accepted, and executed the terms outlined herein. All pricing is quoted in United Arab Emirates Dirhams (AED) and is subject to the regulatory fee structures established by the Department of Health – Abu Dhabi (DoH-AD).
2. Scope of Psychiatrist ServicesThe following Psychiatrist services are included in this Quotation Estimate and are to be delivered at our facility located in the United Arab Emirates Abu Dhabi metropolitan area. Each service has been assessed based on the client's preliminary clinical presentation and the recommended course of treatment as determined by the attending Consultant Psychiatrist.
| Ref. | Description of Psychiatrist Service | Duration / Frequency | Unit Rate (AED) | Estimated Total (AED) |
|---|---|---|---|---|
| 01 | Initial Comprehensive Psychiatric Assessment & Diagnostic Evaluation (including clinical interview, mental status examination, and review of medical history) | 90 minutes / One-time | 1,200.00 | 1,200.00 |
| 02 | Follow-up Psychiatrist Consultation Sessions (ongoing therapeutic management, medication review, and progress monitoring) | 45 min / 8 sessions | 850.00 | 6,800.00 |
| 03 | Psychological Testing & Psychometric Battery Administration (cognitive, personality, and mood assessments) | 3 hours / One-time | 2,500.00 | 2,500.00 |
| 04 | Prescription & Medication Management (including initial pharmacotherapy plan, dosage adjustments, and side-effect monitoring) | Included in sessions | 400.00 | 3,200.00 |
| 05 | Psychiatric Crisis Intervention & Emergency Consultation (24/7 availability within Abu Dhabi jurisdiction) | As required / Up to 2 visits | 1,800.00 | 3,600.00 |
| 06 | Family Psychoeducation & Supportive Counseling Sessions (involving immediate family members in the treatment plan) | 60 min / 3 sessions | 700.00 | 2,100.00 |
| 07 | Comprehensive Discharge Summary & Ongoing Care Plan Documentation | One-time | 500.00 | 500.00 |
| 08 | Administrative & Regulatory Compliance Fees (DoH-AD licensing, record-keeping, and data protection under UAE Federal Decree-Law No. 45 of 2021) | One-time | 350.00 | 350.00 |
| TOTAL ESTIMATED COST (AED) | 20,250.00 | |||
- This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. Beyond this period, all rates are subject to revision in accordance with prevailing fee schedules in the United Arab Emirates Abu Dhabi healthcare market.
- All Psychiatrist services described herein are to be rendered by a board-certified Consultant Psychiatrist registered with the Department of Health – Abu Dhabi and the UAE Medical Council. The attending Psychiatrist holds a valid UAE Medical License and is a member of the Abu Dhabi Psychiatric Society.
- Payment terms: A deposit of twenty-five percent (25%) of the total estimated amount is due upon acceptance of this Quotation Estimate. The remaining balance shall be settled in two equal installments, with the final payment due upon completion of the treatment plan or at the sixty-day mark, whichever occurs first.
- Accepted payment methods include bank transfer to the clinic's designated corporate account, credit/debit card (Visa, Mastercard), and approved health insurance claims processed through the Abu Dhabi Health Services Company (SEHA) or the client's private insurer.
- Client confidentiality is strictly maintained in full compliance with UAE Federal Decree-Law No. 45 of 2021 on the Protection of Personal Data and the Abu Dhabi Health Data Protection Regulations. No clinical records, diagnostic findings, or treatment details pertaining to the Psychiatrist-client relationship shall be disclosed to any third party without written consent, except where mandated by UAE law.
- Should the clinical course of treatment necessitate additional sessions, extended hospitalization, or specialized interventions beyond the scope of this Quotation Estimate, a supplementary Quotation Estimate shall be issued and require the client's written approval prior to any additional services being rendered.
- This Quotation Estimate does not guarantee a specific clinical outcome. The Psychiatrist's professional judgment regarding the necessity, duration, and type of treatment shall be guided by established clinical guidelines and the individual needs of the patient.
- All services are subject to the availability of the attending Psychiatrist and the operational hours of the facility in the United Arab Emirates Abu Dhabi. Appointments are scheduled in accordance with UAE working hours (Sunday to Thursday, 8:00 AM to 8:00 PM), with emergency services available on a 24/7 basis.
- Any cancellation of a scheduled Psychiatrist appointment must be communicated at least twenty-four (24) hours in advance. Late cancellations or no-shows will incur a fee of fifty percent (50%) of the scheduled session rate.
- This Quotation Estimate is governed by the laws of the United Arab Emirates and the specific regulations of the Abu Dhabi emirate. Any disputes arising from this document shall be subject to the exclusive jurisdiction of the courts of Abu Dhabi, UAE.
By signing below, the client acknowledges that they have received, reviewed, and understood this Quotation Estimate for Psychiatrist services to be provided in the United Arab Emirates Abu Dhabi. The client agrees to the terms, conditions, and estimated costs outlined in this document and authorizes the commencement of the described treatment plan.
Client / Authorized RepresentativeName: ______________________________
Signature: ______________________________
Date: ______________________________ Dr. Khalid Al Mansoori
Consultant Psychiatrist, Al Noor Mental Health Centre
UAE Medical License No.: 2025-AD-PSY-08842
Signature: ______________________________
Date: ______________________________ ⬇️ Download as DOCX Edit online as DOCX
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