Quotation Estimate Psychologist in Australia Melbourne –Free Word Template Download with AI
Professional Psychological Services — Australia Melbourne
Dr. Eleanor Whitfield, Registered Psychologist (AHPRA No. PSY-2019-48732)
142 Collins Street, Level 8, Melbourne VIC 3000, Australia
Phone: +61 3 9421 5678 | Email: [email protected]
This Quotation Estimate has been prepared by Dr. Eleanor Whitfield, a fully registered Psychologist operating in Australia Melbourne, to provide Mr. James A. Thornton with a comprehensive and transparent breakdown of the professional psychological services to be delivered. This document outlines the scope of work, itemised fees, applicable Australian Goods and Services Tax (GST), and all relevant terms governing the engagement. The Psychologist services described herein are designed to meet the clinical and therapeutic needs of the client in accordance with the Australian Health Practitioner Regulation Agency (AHPRA) standards and the Psychology Board of Australia's Code of Conduct.
The following Psychologist services are included in this Quotation Estimate for delivery at the Melbourne, Australia practice location or via secure telehealth consultation as agreed upon by both parties:
- Initial Comprehensive Psychological Assessment: A 120-minute session encompassing clinical interview, cognitive and emotional screening, and formulation of a preliminary treatment plan.
- Individual Psychotherapy Sessions: A series of 50-minute weekly sessions utilising evidence-based modalities including Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), and trauma-informed care.
- Psychological Report and Documentation: Preparation of a detailed written report suitable for submission to the client's General Practitioner, employer, or legal representative as required.
- Follow-Up and Progress Review: Two additional 30-minute review sessions to evaluate therapeutic progress and adjust the treatment plan accordingly.
- After-Hours Telephone Consultation: Up to two 15-minute telephone check-ins per month for urgent clinical concerns between scheduled sessions.
| Item No. | Description of Psychologist Service | Duration | Quantity | Unit Price (AUD) | Subtotal (AUD) |
|---|---|---|---|---|---|
| 01 | Initial Comprehensive Psychological Assessment | 120 min | 1 | $320.00 | $320.00 |
| 02 | Individual Psychotherapy Session (CBT / ACT) | 50 min | 12 | $185.00 | $2,220.00 |
| 03 | Psychological Report and Clinical Documentation | — | 1 | $450.00 | $450.00 |
| 04 | Follow-Up and Progress Review Session | 30 min | 2 | $110.00 | $220.00 |
| 05 | After-Hours Telephone Consultation (per month) | 15 min | 4 | $45.00 | $180.00 |
| 06 | Standardised Psychometric Test Administration & Scoring | 90 min | 1 | $275.00 | $275.00 |
| Subtotal (Excluding GST) | $3,665.00 | ||||
| GST @ 10% (Australian Taxation Office) | $366.50 | ||||
| TOTAL ESTIMATED COST (Incl. GST) | $4,031.50 | ||||
This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. Payment for all Psychologist services is due within fourteen (14) days of the invoice date. The client may elect to pay in full upon commencement or via a fortnightly instalment plan of $251.97 (inclusive of GST) over the duration of the engagement. All payments are to be made by bank transfer to the practice account held at the National Australia Bank, Melbourne VIC, Australia, or via the secure online payment portal provided by the practice. A late payment surcharge of 2% per month may apply to outstanding balances in accordance with Victorian consumer credit regulations.
- This Quotation Estimate is a good-faith estimate of costs and is not a binding contract until both parties have signed and returned a copy of this document.
- All Psychologist services will be delivered in strict compliance with the Privacy Act 1988 (Cth) and the Australian Privacy Principles. Client records will be stored securely in Melbourne, Australia, and retained for a minimum of seven (7) years as required by the Psychology Board of Australia.
- The Psychologist reserves the right to refer the client to a psychiatrist or allied health professional if the clinical presentation warrants additional specialist intervention. Any such referral fees are not included in this Quotation Estimate.
- Cancellations must be provided at least 24 hours in advance. Sessions cancelled with less than 24 hours' notice will be charged at 50% of the standard session fee.
- This Quotation Estimate does not include costs associated with court appearances, expert witness testimony, or additional psychometric assessments beyond those itemised above. Such services will be quoted separately.
- All services are subject to the Psychologist's availability. In the event of extended leave or illness, the practice will make reasonable efforts to provide continuity of care through a colleague Psychologist in Melbourne, Australia, with the client's written consent.
- GST is applicable as this practice is registered for GST purposes with the Australian Taxation Office. A Tax Invoice will be issued upon payment.
- This Quotation Estimate is governed by the laws of the State of Victoria, Australia. Any disputes shall be resolved through the Victorian Civil and Administrative Tribunal (VCAT).
By signing below, the client acknowledges that they have read, understood, and agree to the terms set out in this Quotation Estimate for Psychologist services in Australia Melbourne. The Psychologist confirms that the fees and scope of work described herein accurately reflect the professional services to be provided.
Client Signature: Mr. James A. ThorntonDate: ______________________ Psychologist Signature: Dr. Eleanor Whitfield
AHPRA Registration No. PSY-2019-48732
Date: ______________________ ⬇️ Download as DOCX Edit online as DOCX
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