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Quotation Estimate Psychologist in Canada Toronto –Free Word Template Download with AI

Professional Psychological Services — Canada Toronto

Document No. QT-2025-04871

Prepared By (Psychologist)

Dr. Margaret A. Thompson, Ph.D., CPsych

Registered Psychologist, College of Psychologists of Ontario

Thompson Psychological Services Inc.

1200 Bay Street, Suite 450, Toronto, ON M5G 2E1, Canada

Phone: (416) 555-0192 | Email: [email protected]

Prepared For (Client)

Mr. James R. Caldwell

487 Queen Street West, Unit 12B

Toronto, ON M5V 2A5, Canada

Phone: (416) 555-0347

Email: [email protected]

Quotation Details

Date of Issue: June 12, 2025

Valid Until: July 12, 2025 (30 days)

Currency: Canadian Dollars (CAD)

Service Location

Primary Office: Toronto, Ontario, Canada

Telehealth Option: Available across Canada

Referral Source: Dr. Alan Whitfield, Family Medicine

This Quotation Estimate outlines the comprehensive psychological services to be provided by a licensed Psychologist operating in Canada Toronto. The services are designed to address the client's documented needs for cognitive-behavioural therapy, stress management, and ongoing mental health support. All services will be delivered in accordance with the standards set forth by the College of Psychologists of Ontario and the regulatory framework governing psychological practice in the Province of Ontario, Canada.

The Psychologist named in this Quotation Estimate holds a Doctor of Philosophy (Ph.D.) in Clinical Psychology from the University of Toronto and has maintained active registration with the College of Psychologists of Ontario since 2008. With over seventeen years of clinical experience in Canada Toronto, the Psychologist specializes in adult anxiety disorders, workplace stress, and trauma-informed care.

# Service Description Duration / Frequency Unit Rate (CAD) Total (CAD)
1 Initial Comprehensive Psychological Assessment (includes intake interview, standardized testing, and diagnostic evaluation) 1 session × 120 min $285.00 $285.00
2 Written Psychological Assessment Report (detailed findings, diagnostic impressions, and treatment recommendations) 1 report $450.00 $450.00
3 Individual Cognitive-Behavioural Therapy (CBT) Sessions — Phase I (initial 6 sessions) 6 sessions × 50 min $195.00 $1,170.00
4 Individual Cognitive-Behavioural Therapy (CBT) Sessions — Phase II (ongoing 6 sessions) 6 sessions × 50 min $195.00 $1,170.00
5 Stress Management & Mindfulness-Based Intervention Workshop (group setting, Canada Toronto community centre) 1 workshop × 3 hrs $120.00 $120.00
6 Telehealth Follow-Up Consultation (video conference, available anywhere in Canada) 2 sessions × 30 min $95.00 $190.00
7 Emergency After-Hours Psychologist Availability (on-call retainer for crisis support within Canada Toronto) 12-month retainer $75.00 $75.00
8 Annual Progress Review & Treatment Plan Revision (in-person, Toronto office) 1 session × 60 min $150.00 $150.00
Subtotal $3,610.00
HST (13% — Ontario, Canada) $469.30
Grand Total (CAD) $4,079.30
  1. This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. After the expiry date, the Psychologist reserves the right to revise fees to reflect current market rates in Canada Toronto.
  2. Payment is due within fourteen (14) days of the date of each service rendered. The Psychologist accepts payment via Interac e-Transfer, credit card (Visa, Mastercard, Amex), and certified cheque.
  3. A deposit of twenty-five percent (25%) of the total Quotation Estimate amount is required to secure the initial assessment appointment. The remaining balance shall be invoiced on a monthly basis as services are delivered.
  4. Cancellations must be provided at least forty-eight (48) hours in advance. Late cancellations or no-shows will be subject to a fee of fifty percent (50%) of the scheduled session rate.
  5. All services provided by the Psychologist are subject to the professional standards and ethical guidelines of the College of Psychologists of Ontario. Confidentiality is maintained in accordance with the Personal Health Information Protection Act (PHIPA) of Ontario, Canada.
  6. This Quotation Estimate does not constitute a guarantee of specific therapeutic outcomes. The Psychologist will provide evidence-based interventions tailored to the client's individual needs as assessed during the initial evaluation.
  7. Should the client require services beyond the scope outlined in this Quotation Estimate, a supplementary estimate will be issued prior to the commencement of additional services.
  8. This Quotation Estimate is non-transferable and is issued specifically for the named client. Any change in client identity requires a new Quotation Estimate from the Psychologist.
  9. Disputes arising from this Quotation Estimate shall be governed by the laws of the Province of Ontario and the federal laws of Canada applicable therein. The Psychologist's office in Canada Toronto shall serve as the primary jurisdiction for any mediation or arbitration proceedings.

By signing below, the client acknowledges receipt of this Quotation Estimate and authorizes the Psychologist to commence the services described herein. The client confirms that they have had the opportunity to review all terms, fees, and conditions outlined in this document and agrees to be bound by them.

Client Signature
Name: James R. Caldwell
Date: ______________________
Psychologist Signature
Name: Dr. Margaret A. Thompson, Ph.D., CPsych
Date: ______________________

Thompson Psychological Services Inc. | 1200 Bay Street, Suite 450, Toronto, ON M5G 2E1, Canada

Quotation Estimate No. QT-2025-04871 | Issued June 12, 2025 | This document is confidential and intended solely for the named recipient.

For inquiries regarding this Quotation Estimate, please contact the Psychologist's office at (416) 555-0192 during regular business hours (Monday to Friday, 9:00 AM – 5:00 PM EST).

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