Quotation Estimate Psychiatrist in United Kingdom London –Free Word Template Download with AI
127 Harley Street, Marylebone, London W1G 8AP, United Kingdom
Telephone: +44 (0)20 7946 0821 | Email: [email protected]
Company Registration No. 09876543 | VAT No. GB 123 4567 89
GMC Registered | CQC Registered Provider
Quotation EstimateQuotation Details
Quotation Estimate No.: QTE-2025-LON-0487
Date of Issue: 14 June 2025
Valid Until: 14 July 2025 (30 days)
Prepared By: Dr. Eleanor Whitmore, Consultant Psychiatrist
Service Location: United Kingdom London
Client / Patient Details
Name: Mr. James A. Harrington
NHS Number: 485 777 3456
Address: 44 Kensington Gardens, London W8 7PT, United Kingdom
Referring GP: Dr. Sarah Mitchell, 220 Bayswater Road, London
Insurance Provider: Bupa Private Health (Policy No. BUP-9928471)
This Quotation Estimate has been prepared by Thames Valley Psychiatric Services Ltd. to provide a comprehensive and transparent breakdown of all anticipated costs associated with the psychiatric care and treatment services to be delivered to the above-named client. All services described herein will be provided by a fully qualified and GMC-registered Psychiatrist operating within the metropolitan area of United Kingdom London, in full compliance with the Mental Health Act 1983 (as amended), the Care Quality Commission (CQC) regulatory standards, and the General Medical Council (GMC) Good Medical Practice guidelines.
Scope of Services – Psychiatrist Consultation & Treatment ProgrammeThe following Quotation Estimate encompasses a structured psychiatric assessment and ongoing treatment plan. The treating Psychiatrist, Dr. Eleanor Whitmore (GMC No. 7452891), holds a higher specialist qualification in Adult Psychiatry and has over fifteen years of clinical experience in the provision of psychiatric services across the United Kingdom London region. All consultations will take place at our private clinic premises on Harley Street, London, or via secure video consultation as agreed upon by the patient.
| Ref | Description of Service | Duration | Frequency | Unit Cost (GBP) | Total (GBP) |
|---|---|---|---|---|---|
| 01 | Initial Comprehensive Psychiatric Assessment – full clinical history, mental state examination, risk assessment, and formulation by the Consultant Psychiatrist | 90 minutes | One-off | £450.00 | £450.00 |
| 02 | Psychiatric Follow-Up Consultation – review of treatment progress, medication management, and therapeutic adjustment by the Psychiatrist | 45 minutes | Monthly (x6) | £275.00 | £1,650.00 |
| 03 | Psychopharmacological Review & Medication Prescribing – detailed review of current and proposed psychotropic medication, including blood monitoring coordination | 30 minutes | Quarterly (x2) | £185.00 | £370.00 |
| 04 | Psychiatric Report & Written Formulation – comprehensive clinical report for referring GP, employer, or insurance purposes, prepared by the treating Psychiatrist | — | One-off | £320.00 | £320.00 |
| 05 | Urgent / Out-of-Hours Psychiatrist Consultation – availability for acute psychiatric concerns within the United Kingdom London service area (maximum 2 sessions) | 30 minutes | As required (x2) | £220.00 | £440.00 |
| 06 | Administrative & Record-Keeping Fee – secure electronic health record management, data protection compliance (UK GDPR), and correspondence handling | — | Per annum | £95.00 | £95.00 |
| 07 | Travel & Logistics Allowance – covers the Psychiatrist's travel within the United Kingdom London metropolitan area for home visits or secondary clinic locations if required | — | Per annum | £120.00 | £120.00 |
| TOTAL ESTIMATED COST (Excluding VAT) | £3,445.00 | ||||
| VAT @ 20% (where applicable) | £689.00 | ||||
| GRAND TOTAL (Including VAT) | £4,134.00 | ||||
- This Quotation Estimate is a good-faith projection of costs based on the current clinical presentation and anticipated treatment trajectory. Should the treating Psychiatrist determine that additional sessions, specialist referrals, or extended monitoring are clinically necessary, a supplementary Quotation Estimate will be issued prior to any additional charges being incurred.
- All psychiatric services are delivered in accordance with the NHS Constitution principles and the Equality Act 2010. The Psychiatrist is bound by strict professional confidentiality under the Data Protection Act 2018 and UK GDPR regulations.
- Medication costs, laboratory blood tests, and any inpatient or day-case psychiatric admission are not included in this Quotation Estimate and will be itemised separately if required.
- Services are provided within the United Kingdom London service area, defined as the Greater London region and the M25 orbital motorway boundary. Travel beyond this area will be subject to an additional mileage charge of £0.65 per mile.
- This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. Should the client wish to proceed after the expiry date, the Quotation Estimate must be revalidated in writing by the practice.
- Payment is due within fourteen (14) calendar days of the date of each individual invoice, which will be issued following each consultation or service delivery.
- Accepted payment methods include: bank transfer (BACS/CHAPS), direct debit, and major credit/debit cards (Visa, Mastercard, American Express). A 1.5% surcharge applies to card payments.
- For insurance-billed services, the Psychiatrist's practice will submit claims directly to the client's insurer. The client remains responsible for any co-payment, excess, or non-covered elements as specified in their policy terms.
- Late payments will incur a statutory interest charge of 4% above the Bank of England base rate, calculated on a daily basis from the due date until paid in full.
- Appointments with the Psychiatrist may be cancelled or rescheduled free of charge provided a minimum of forty-eight (48) hours' written notice is given.
- Cancellations made with less than forty-eight hours' notice, or failure to attend a scheduled appointment without prior notice, will be subject to a fee of 50% of the session cost as outlined in this Quotation Estimate.
By signing below, the client (or authorised representative) acknowledges receipt of this Quotation Estimate and agrees to the terms, conditions, and estimated costs set out herein for the provision of psychiatric services by the named Psychiatrist at the practice location in United Kingdom London. This acceptance does not constitute a binding contract for the full treatment period; rather, it authorises the commencement of the initial assessment and the first cycle of follow-up consultations as detailed above.
Client / Authorised Representative Signature:Name: ______________________________
Date: ______________________________ Practising Psychiatrist / Practice Manager Signature:
Name: Dr. Eleanor Whitmore, MBBS, MRCPsych
Date: ______________________________ ⬇️ Download as DOCX Edit online as DOCX
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