Quotation Estimate Psychologist in New Zealand Auckland –Free Word Template Download with AI
This Quotation Estimate has been prepared by Dr. Sarah Mitchell, a fully registered Psychologist practising in New Zealand Auckland, to provide a comprehensive and transparent breakdown of professional psychological services to be delivered to the client named above. This document outlines the scope of work, itemised fees, applicable taxes, and the terms and conditions governing the engagement. All rates quoted are in New Zealand Dollars (NZD) and are inclusive of the Psychologist's professional expertise, clinical assessment, and therapeutic intervention as described herein.
The services described in this Quotation Estimate are designed to meet the specific mental health and psychological well-being needs of the client within the Auckland metropolitan area. As a registered Psychologist in New Zealand Auckland, Dr. Mitchell adheres to the Code of Ethics and Conduct established by the Psychologists Board of New Zealand and operates in full compliance with the Health and Disability Commissioner Act 1993 and the Privacy Act 2020.
2. Itemised Services and Fees| Item | Description of Service | Duration / Qty | Unit Rate (NZD) | Subtotal (NZD) | GST (15%) |
|---|---|---|---|---|---|
| 1 | Initial Psychological Assessment & Intake Session (comprehensive clinical interview, history review, and preliminary diagnostic formulation) | 1 session (90 min) | $320.00 | $320.00 | $48.00 |
| 2 | Standardised Psychological Testing & Battery Administration (including WAIS-IV, BDI-II, BAI, and MMPI-2-R as clinically indicated) | 1 session (120 min) | $450.00 | $450.00 | $67.50 |
| 3 | Individual Psychotherapy / Counselling Sessions (CBT, EMDR, or integrative modality as recommended by the Psychologist) | 8 sessions (60 min each) | $250.00 | $2,000.00 | $300.00 |
| 4 | Comprehensive Written Psychological Report (diagnostic formulation, treatment recommendations, and fitness-for-work or court-ordered assessment as applicable) | 1 report (up to 15 pages) | $680.00 | $680.00 | $102.00 |
| 5 | Follow-Up Review Session (progress evaluation, treatment plan adjustment, and discharge planning) | 1 session (60 min) | $250.00 | $250.00 | $37.50 |
| 6 | Telephone / Video Consultation (for clients unable to attend in person at the Auckland CBD or Ponsonby clinic) | 2 sessions (45 min each) | $180.00 | $360.00 | $54.00 |
| 7 | Urgent / Out-of-Hours Appointment Surcharge (if required outside standard business hours, 8:00 AM – 5:00 PM, Mon–Fri) | 1 session (60 min) | $375.00 | $375.00 | $56.25 |
| TOTAL ESTIMATED COST (Inclusive of 15% GST) | $4,435.00 | $665.25 | |||
| GRAND TOTAL (NZD) | $5,100.25 | ||||
Payment for all services outlined in this Quotation Estimate is due within fourteen (14) calendar days of the date of issue unless otherwise agreed in writing between the Psychologist and the client. Payment may be made via bank transfer to the practice account held at ANZ Bank, Auckland CBD, or by EFTPOS at the time of each session. A 2% late payment surcharge will apply to any outstanding balance exceeding the fourteen-day period. The client acknowledges that this Quotation Estimate is a good-faith projection of costs and that final invoicing may vary by up to 10% depending on the clinical complexity encountered during the course of treatment.
4. Cancellation and Rescheduling PolicyCancellations must be provided at least twenty-four (24) hours in advance of the scheduled appointment. Failure to provide adequate notice will result in a fee of 50% of the session rate being charged. Rescheduling is permitted up to two (2) times per month at no additional cost. In the event of a Psychologist's illness or emergency, the client will be notified as soon as practicable and offered the earliest available alternative appointment at no charge.
5. Confidentiality and PrivacyAll information disclosed during the course of psychological services is held in strict confidence in accordance with the Privacy Act 2020 and the Psychologists Board of New Zealand Code of Ethics. Clinical records are stored securely at the practice located in Auckland, New Zealand, and are retained for a minimum of seven (7) years in compliance with New Zealand health record-keeping legislation. Information will not be disclosed to third parties without the written consent of the client, except where required by law (e.g., court order, mandatory reporting obligations under the Child, Youth and Family Act 1989).
6. Acceptance and AuthorisationBy signing below, the client acknowledges that they have read, understood, and accepted the terms set out in this Quotation Estimate. The client further confirms that the Psychologist identified herein is a duly registered practitioner in New Zealand Auckland and that the services described are appropriate for their clinical needs. This Quotation Estimate does not constitute a binding contract until countersigned by both parties.
Client Signature
Mr. James T. Henderson
Date: ____________________
Psychologist Signature
Dr. Sarah Mitchell, PhD
Date: ____________________
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