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Quotation Estimate Psychologist in Australia Sydney –Free Word Template Download with AI

12 Harbour View Lane, Surry Hills, Australia Sydney, NSW 2010

ABN: 48 123 456 789 | AHPRA Registration: PSY0001234567

Phone: +61 2 9371 4567 | Email: [email protected]

Quotation Estimate

Quotation Details

Quotation No.: QTE-2025-04872

Date Issued: 14 June 2025

Valid Until: 14 July 2025 (30 days)

Prepared By: Dr. Eleanor Whitfield, Registered Psychologist

Australia Sydney

Client Information

Client Name: Mr. James A. Richardson

Address: 45 Parramatta Road, Glebe, Australia Sydney, NSW 2007

Phone: +61 412 345 678

Email: [email protected]

Referral Source: GP – Dr. Sarah Chen, Glebe Medical Practice

This Quotation Estimate has been prepared by Sydney Mind & Wellbeing Psychology Centre to provide Mr. James A. Richardson with a comprehensive and transparent breakdown of the professional services to be delivered by a Registered Psychologist operating in Australia Sydney. This document outlines the scope of psychological assessment, therapeutic intervention, and ongoing support services that will be provided over an agreed treatment period. All fees quoted herein comply with the current fee schedules established by the Australian Health Practitioner Regulation Agency (AHPRA) and the Psychology Board of Australia.

Please note that this Quotation Estimate is a good-faith projection of costs based on the initial clinical assessment conducted on 10 June 2025. The Psychologist reserves the right to adjust the scope of services should the clinical presentation require additional interventions not initially anticipated. Any such adjustments will be communicated in writing prior to implementation.

The following services will be delivered by Dr. Eleanor Whitfield, a fully registered Psychologist with over twelve years of clinical experience in Australia Sydney. All sessions will be conducted at our Surry Hills clinic or via secure telehealth platform, in accordance with the client's preference and clinical needs.

  • Comprehensive Psychological Assessment: Administration and interpretation of standardised psychometric instruments including the Beck Depression Inventory-II (BDI-II), Generalized Anxiety Disorder-7 (GAD-7), and the Wechsler Adult Intelligence Scale (WAIS-IV) to establish a baseline diagnostic profile.
  • Cognitive Behavioural Therapy (CBT): Structured therapeutic sessions targeting anxiety, stress management, and maladaptive thought patterns, delivered in accordance with evidence-based protocols recognised by the Psychology Board of Australia.
  • Mindfulness-Based Stress Reduction (MBSR): Guided mindfulness exercises and psychoeducation sessions designed to enhance emotional regulation and resilience.
  • Progress Review and Case Formulation: Mid-treatment review at session eight to evaluate therapeutic progress, adjust the treatment plan, and document outcomes for the referring General Practitioner.
  • Final Report and Discharge Summary: A comprehensive written report detailing the Psychologist's clinical findings, interventions delivered, treatment outcomes, and recommendations for ongoing self-management strategies.
Item No. Description of Service Duration / Qty Unit Rate (AUD) Subtotal (AUD)
01 Initial Intake & Comprehensive Psychological Assessment (includes psychometric battery administration and interpretation) 1 session / 120 min $320.00 $320.00
02 Cognitive Behavioural Therapy (CBT) – Individual Session (includes pre-session preparation and post-session documentation) 10 sessions / 50 min each $240.00 $2,400.00
03 Mindfulness-Based Stress Reduction (MBSR) – Group Session (minimum 4 participants, maximum 8) 4 sessions / 90 min each $95.00 $380.00
04 Mid-Treatment Progress Review & Case Formulation Update (includes written progress note to GP) 1 session / 60 min $180.00 $180.00
05 Final Discharge Report & Comprehensive Clinical Summary (written report, 8–12 pages, including recommendations) 1 report $250.00 $250.00
06 Telehealth Consultation (in lieu of in-person session, if required due to travel or medical reasons) 2 sessions / 50 min each $220.00 $440.00
07 After-Hours Emergency Psychologist Callback (available 7 days, 6:00 PM – 8:00 AM, Australia Sydney time zone) Per occurrence $150.00 $0.00

Subtotal: $4,970.00 AUD

Goods and Services Tax (GST) @ 10%: $497.00 AUD

Total Quotation Estimate: $5,467.00 AUD

This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. Payment is due within fourteen (14) days of the date of each invoice issued following the completion of the corresponding service. The Psychologist accepts payment via direct bank transfer (EFT), credit card (Visa, Mastercard, American Express), or HICAPS on-the-spot claiming for eligible Medicare and private health insurance items.

Where the client holds a valid Medicare Mental Health Treatment Plan (MHTP) issued by their General Practitioner, a rebate of up to $96.45 per eligible session (2025 rate) will be applied at the time of service. The client is responsible for any gap between the Medicare rebate and the Psychologist's professional fee. Private health insurance rebates, where applicable under the client's policy, will be processed directly with the insurer.

A cancellation fee of 50% of the session fee applies to appointments cancelled with less than twenty-four (24) hours' notice. No-show appointments will be charged in full. This policy is consistent with standard practice among Psychologists operating in Australia Sydney.

All services described in this Quotation Estimate are delivered in strict compliance with the Psychology Board of Australia's Standards for Psychologists, the Australian Privacy Principles (APPs) under the Privacy Act 1988 (Cth), and the relevant provisions of the Health Records Act 2001 (NSW). The Psychologist maintains professional indemnity insurance with a minimum cover of $10,000,000 AUD and is registered with the Australian Health Practitioner Regulation Agency (AHPRA).

Client records are stored in accordance with the retention requirements of the NSW Health Records Act and are accessible only to authorised personnel. In the event of a clinical emergency, the Psychologist will follow the established crisis referral protocol in coordination with the client's General Practitioner and, where necessary, the nearest emergency psychiatric service in Australia Sydney.

By signing below, the client acknowledges that they have read, understood, and agree to the terms, conditions, and fees set out in this Quotation Estimate. The client confirms that the Psychologist has explained the scope of services, the expected duration of treatment, and the associated costs in a manner that is clear and accessible.

Client Name (Print): ______________________________

Signature: ______________________________

Date: ______________________________


Psychologist Name (Print): Dr. Eleanor Whitfield, AHPRA Reg. No. PSY0001234567

Signature: ______________________________

Date: ______________________________

Sydney Mind & Wellbeing Psychology Centre | 12 Harbour View Lane, Surry Hills, Australia Sydney, NSW 2010

This Quotation Estimate is issued in accordance with the professional standards of the Psychology Board of Australia. All fees are quoted in Australian Dollars (AUD) inclusive of GST where applicable.

© 2025 Sydney Mind & Wellbeing Psychology Centre. All rights reserved. | ABN 48 123 456 789

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