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Quotation Estimate Psychologist in Italy Rome –Free Word Template Download with AI

Professional Psychological Services — Italy Rome

Document Reference: QE-ROME-2025-0472

Service Provider

Dr. Elena Marchetti, Ph.D.

Clinical Psychologist & Psychotherapist

Albo degli Psicologi del Lazio — Reg. N. 18472

Via del Corso, 142 — 00187 Rome, Italy

Tel: +39 06 4871 2234

Email: [email protected]

VAT (P.IVA): IT02458710583

Client / Recipient

Mr. James A. Whitfield

Private Client — Individual Care Plan

Via Nazionale, 88 — 00184 Rome, Italy

Tel: +39 333 456 7890

Email: [email protected]

Quotation Estimate Date: 14 June 2025

Validity Period: 30 days from the date of issue (expires 14 July 2025)

Service Location: Private Practice, Via del Corso 142, 00187 Rome, Italy

Currency: Euro (EUR) — all prices inclusive of 22% Italian VAT (IVA)

Language of Service: English / Italian (bilingual sessions available)

This Quotation Estimate is issued by Dr. Elena Marchetti, a licensed Psychologist registered with the Regional Order of Psychologists of Lazio, to provide comprehensive psychological assessment, therapeutic intervention, and ongoing mental health support to the client. All services will be delivered at the private practice located in the historic centre of Italy Rome, in full compliance with the Italian Code of Professional Conduct for Psychologists (Codice Deontologico degli Psicologi, 2014) and the General Data Protection Regulation (GDPR) as applied within the Italian legal framework.

The proposed care plan encompasses initial diagnostic evaluation, a structured series of psychotherapeutic sessions, periodic progress reviews, and a final discharge summary. The Psychologist will employ evidence-based modalities including Cognitive Behavioural Therapy (CBT), Psychodynamic Psychotherapy, and Mindfulness-Based Stress Reduction (MBSR), tailored to the individual needs of the client as identified during the initial assessment phase.

Ref. Description of Service Duration / Qty Unit Price (EUR) Total (EUR)
01 Initial Psychological Assessment & Diagnostic Interview (comprehensive evaluation including clinical history, psychometric testing, and risk assessment) 1 session × 90 min €180.00 €180.00
02 Psychotherapeutic Session — CBT / Psychodynamic modality (individual one-to-one session conducted by the Psychologist at the Rome practice) 12 sessions × 60 min €120.00 €1,440.00
03 Psychometric Testing & Standardised Assessment (administration and interpretation of validated instruments: MMPI-2, Beck Depression Inventory, State-Trait Anxiety Inventory) 1 package €250.00 €250.00
04 Progress Review & Care Plan Adjustment (quarterly review meeting with the Psychologist to evaluate therapeutic outcomes and modify the treatment protocol) 3 sessions × 45 min €90.00 €270.00
05 Written Clinical Report & Discharge Summary (formal report in English and Italian, suitable for referral to a general practitioner or employer in Italy Rome) 1 document €150.00 €150.00
06 Emergency / Urgent Consultation (out-of-schedule session available within 48 hours, limited to 2 occurrences per quarter) 2 sessions × 60 min €140.00 €280.00
07 Administrative & Record-Keeping Fee (filing, GDPR-compliant data storage, and annual record maintenance at the practice in Rome, Italy) 1 year €60.00 €60.00
Subtotal (excl. VAT): €2,630.00
VAT 22% (IVA): €578.60
TOTAL AMOUNT DUE (incl. VAT): €3,208.60
Note: This Quotation Estimate is valid for a single client and a single treatment cycle. Any additional sessions, supplementary assessments, or referrals to other specialists (e.g., psychiatrist, neuropsychologist) in the Rome, Italy area will be subject to a separate written estimate. Prices are fixed for the duration of the 30-day validity period and will not be subject to mid-cycle adjustment.

3.1 Acceptance. This Quotation Estimate becomes a binding service agreement upon written acceptance by the client (signature below or email confirmation) and the issuance of a formal invoice by the Psychologist's practice in Rome, Italy.

3.2 Payment Schedule. The initial assessment fee (Ref. 01) is due at the time of the first appointment. The remaining balance shall be invoiced in two equal instalments: 50% due at the commencement of the therapeutic phase (Ref. 02) and 50% due at the midpoint of the treatment cycle. Payment may be made via bank transfer (IBAN: IT60 X054 2811 1000 0000 0123 456), credit/debit card, or in-person at the practice. A 1.5% monthly late-payment interest rate applies to overdue balances in accordance with Italian civil law (Codice Civile, Art. 1284).

3.3 Cancellation Policy. Sessions must be cancelled or rescheduled with a minimum of 48 hours' written notice. Cancellations made within 48 hours or no-shows will be charged at 75% of the session fee. This policy applies to all services rendered by the Psychologist at the Rome, Italy location.

3.4 Confidentiality & Data Protection. All clinical records, session notes, and psychometric data are handled in strict accordance with the Italian Data Protection Code (D.Lgs. 196/2003 as amended by D.Lgs. 101/2018) and the EU GDPR. The client's personal and health data will be stored securely at the practice in Rome, Italy, and will not be disclosed to any third party without the client's explicit written consent, except where mandated by Italian law.

3.5 Professional Liability. The Psychologist maintains professional indemnity insurance (RC Professionale) with a coverage limit of €1,000,000 per claim, as required by the Albo degli Psicologi del Lazio. The insurance policy number and insurer details are available upon request.

3.6 Governing Law. This agreement is governed by the laws of the Italian Republic. Any disputes arising from this Quotation Estimate shall be resolved by the competent courts of Rome, Italy, or by binding arbitration in accordance with the rules of the Camera Arbitrale di Roma.

3.7 Scope Limitation. The services described in this Quotation Estimate are limited to psychological assessment and psychotherapy. They do not include psychiatric medication management, hospitalisation, or emergency psychiatric intervention. In the event that the Psychologist determines that the client requires psychiatric care, a referral to a qualified psychiatrist in the Rome, Italy area will be provided at no additional cost.

By signing below, the client acknowledges that they have read, understood, and agree to all terms set forth in this Quotation Estimate for psychological services provided by a licensed Psychologist in Italy Rome. The client confirms that the information provided during the initial consultation is accurate and complete.

For the Service Provider

Dr. Elena Marchetti, Ph.D.

Clinical Psychologist

Signature & Date

For the Client

Mr. James A. Whitfield

Private Client

Signature & Date

This Quotation Estimate was prepared by the office of Dr. Elena Marchetti, Psychologist, located in Rome, Italy. Document QE-ROME-2025-0472. This document is valid for 30 days from the date of issue. For any queries regarding this estimate, please contact the practice at +39 06 4871 2234 or [email protected]. © 2025 Studio di Psicologia Dr. E. Marchetti — Rome, Italy. All rights reserved.

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