Quotation Estimate Psychologist in Colombia Medellín –Free Word Template Download with AI
Professional Psychological Services — Colombia, Medellín
Document No. QTE-MDE-2025-0472 Date of Issue: June 12, 2025Valid Until: July 12, 2025
Currency: Colombian Peso (COP) Prepared By: Dra. Valentina Restrepo M.
License No.: 1123456-PSY
City: Medellín, Antioquia, Colombia
This Quotation Estimate is issued by Dra. Valentina Restrepo M., a licensed Psychologist registered with the Colombian Ministry of Health and Social Welfare (Ministerio de Salud y Protección Social). The professional practice is located at Calle 43A #43D-12, El Poblado, Medellín, Antioquia, Colombia. The Psychologist holds a Master's degree in Clinical Psychology from Universidad de Antioquia and has over twelve years of experience providing therapeutic services to individuals, couples, and families within the Medellín metropolitan area and surrounding regions of Colombia.
| Field | Details |
|---|---|
| Client Name / Organization | ____________________________ |
| NIT / Cédula | ____________________________ |
| Address | Medellín, Antioquia, Colombia |
| Contact Email | ____________________________ |
| Phone | ____________________________ |
The following Quotation Estimate outlines the comprehensive psychological services to be rendered by the Psychologist to the client. All sessions will be conducted in accordance with the ethical guidelines established by the Colombian Psychological Association (Asociación Colombiana de Psicología) and applicable national regulations governing mental health practice in Colombia. The services are tailored to the specific needs of the client and may include individual therapy, group sessions, psychological assessments, and follow-up consultations.
| Item | Description | Qty | Unit Price (COP) | Subtotal (COP) |
|---|---|---|---|---|
| 1 | Initial Psychological Assessment & Intake Session (90 min) | 1 | 280,000 | 280,000 |
| 2 | Individual Psychotherapy Session (50 min) — Cognitive Behavioral Approach | 12 | 220,000 | 2,640,000 |
| 3 | Psychological Evaluation & Diagnostic Report (written, 15 pages) | 1 | 450,000 | 450,000 |
| 4 | Family Therapy Session (75 min) — up to 5 participants | 4 | 350,000 | 1,400,000 |
| 5 | Follow-up Consultation & Treatment Plan Review (40 min) | 2 | 180,000 | 360,000 |
| 6 | Emergency Psychological Support (phone or in-person, up to 30 min) | 2 | 150,000 | 300,000 |
| 7 | Written Progress Report for Employer or Insurance (per report) | 2 | 120,000 | 240,000 |
| TOTAL ESTIMATED AMOUNT (COP) | 5,670,000 | |||
| TOTAL ESTIMATED AMOUNT (USD approx.) | $1,380.00 | |||
Payment for the services described in this Quotation Estimate shall be made in Colombian Pesos (COP) via bank transfer to the account of the Psychologist at Bancolombia, or by cash at the office located in Medellín. A 30% advance payment is required to confirm the initial assessment appointment. The remaining balance is due within fifteen (15) calendar days following the completion of the full treatment cycle. Late payments will incur a monthly interest rate of 1.5% in accordance with Colombian commercial law. All prices are exclusive of applicable VAT (IVA) where legally required.
- This Quotation Estimate is valid for thirty (30) days from the date of issue. After this period, prices and availability of the Psychologist's schedule may be subject to change.
- All sessions must be conducted at the professional office in Medellín, Colombia, unless a telehealth arrangement is mutually agreed upon in writing. Telehealth sessions will be conducted via encrypted video platforms compliant with Colombian data protection law (Ley 1581 de 2012).
- The Psychologist reserves the right to refer the client to a psychiatrist or other specialist if the clinical presentation warrants it. Referral costs are not included in this Quotation Estimate.
- Confidentiality is strictly maintained in accordance with the Colombian Code of Ethics for Psychologists and applicable national legislation. Session notes and diagnostic reports are stored securely and are accessible only to the client and authorized parties.
- Cancellations must be made at least 24 hours in advance. Sessions cancelled with less than 24 hours' notice will be charged at 50% of the session fee.
- This Quotation Estimate does not constitute a binding contract until both parties sign and a formal service agreement is executed.
- The Psychologist is registered with the Colombian Ministry of Health and carries professional liability insurance with Seguros Bolívar, policy number SB-PSY-2025-8841.
By signing below, the client acknowledges receipt of this Quotation Estimate for psychological services in Colombia, Medellín, and agrees to the terms, conditions, and pricing outlined herein. The Psychologist confirms availability to deliver the services as described during the validity period of this document.
Client SignatureName: ________________________
Date: ________________________ Psychologist Signature
Dra. Valentina Restrepo M.
License No. 1123456-PSY
Date: ________________________ ⬇️ Download as DOCX Edit online as DOCX
Create your own Word template with our GoGPT AI prompt:
GoGPT