Quotation Estimate Psychologist in Peru Lima –Free Word Template Download with AI

Quotation Estimate No.:	QTE-PSY-2025-04782
Date of Issue:	June 15, 2025
Valid Until:	July 15, 2025 (30 calendar days)
Prepared By:	Dr. María Elena Quispe Rojas – Licensed Psychologist (Colegio de Psicólogos del Perú, Reg. N° 12847)
Practice Location:	Av. Javier Prado Este 1245, Of. 803, San Isidro, Lima, Peru
Client Name:	[Client Full Name / Organization]
Client RUC / DNI:	[Tax Identification Number]
Client Address:	[Client Address, Lima, Peru]
Contact Email:	[[email protected]]

This Quotation Estimate is formally issued by Dr. María Elena Quispe Rojas, a certified and licensed Psychologist operating in the metropolitan area of Peru Lima, to provide the prospective client with a comprehensive and transparent breakdown of professional psychological services, associated fees, and applicable terms. This document serves as a non-binding estimate of costs and does not constitute a final invoice or contractual obligation until both parties execute a formal service agreement. All pricing referenced herein reflects the current market rates for psychological care in the Lima region of Peru as of the date of issue.

The following services are offered by the Psychologist and are available to individuals, couples, families, and corporate clients residing in or operating within Peru Lima and its surrounding districts (Miraflores, Surco, La Molina, Barranco, San Borja, and other districts of Lima Metropolitana):

Item	Service Description	Duration	Frequency	Unit Price (PEN)	Subtotal (PEN)
01	Initial Psychological Assessment & Intake Session (comprehensive evaluation, history review, diagnostic formulation)	90 min	One-time	350.00	350.00
02	Individual Psychotherapy Session (CBT, psychodynamic, or integrative approach as determined by the Psychologist)	50 min	Weekly (12 sessions)	280.00	3,360.00
03	Couples / Family Therapy Session (structured intervention for relational dynamics)	75 min	Bi-weekly (6 sessions)	420.00	2,520.00
04	Psychological Report & Written Evaluation (formal diagnostic report for legal, academic, or corporate purposes)	—	One-time	600.00	600.00
05	Corporate Mental Health Workshop (on-site delivery at client's office in Lima, group of up to 30 participants)	3 hours	One-time	1,800.00	1,800.00
06	Follow-up & Progress Review Session (post-treatment check-in)	40 min	One-time	200.00	200.00
07	Urgent / Crisis Intervention Consultation (available within 24 hours, Lima metropolitan area)	60 min	As needed (est. 2)	380.00	760.00
TOTAL ESTIMATED AMOUNT (before IGV 18%)				9,590.00
IGV (Impuesto General a las Ventas) – 18%				1,726.20
GRAND TOTAL (PEN – Peruvian Soles)				11,316.20

3.1 Payment shall be made in Peruvian Soles (PEN) via bank transfer to the account of the Psychologist's registered practice, or by cash / debit card at the office located in San Isidro, Lima, Peru. A formal invoice (Factura) or receipt (Boleta) compliant with SUNAT regulations in Peru will be issued upon each payment.

3.2 A 50% advance payment is required to confirm the initial assessment and secure the first therapy block. The remaining balance is due in two equal installments: 50% at the midpoint of the treatment plan and 50% upon completion of the final session.

3.3 Corporate clients may request a 30-day net payment term upon presentation of a valid purchase order and RUC verification. Late payments are subject to a 2% monthly surcharge in accordance with Peruvian commercial law.

3.4 Cancellation of a scheduled session must be communicated at least 24 hours in advance. Sessions cancelled with less than 24 hours' notice or no-shows will be billed at 50% of the session fee.

The Psychologist providing these services holds a Master's degree in Clinical Psychology from the Universidad Nacional Mayor de San Marcos (Lima, Peru), is registered with the Colegio de Psicólogos del Perú, and maintains active professional liability insurance. All services are delivered in strict compliance with the Peruvian Code of Ethics for Psychologists (Resolución N° 001-2019-COPSI) and the data protection provisions of Ley N° 29733 (Ley de Protección de Datos Personales) applicable in Peru Lima. Client confidentiality is maintained at all times, and no records will be shared without written consent, except where mandated by Peruvian law.

This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. Should the client wish to proceed, a signed copy of this document or a formal service contract must be returned to the Psychologist's office in Lima, Peru, within the validity period. Prices are subject to revision upon expiration. This estimate does not guarantee a specific therapeutic outcome, as psychological treatment is inherently individualized and contingent upon the client's active participation and clinical progress.

Note: All services described in this Quotation Estimate are to be rendered at the Psychologist's office in San Isidro, Lima, Peru, unless otherwise agreed in writing. Telehealth sessions (via secure video platform) are available at the same rate for clients residing in Lima or other regions of Peru who prefer remote consultation.

Prepared by (Psychologist):

Dr. María Elena Quispe Rojas

Colegio de Psicólogos del Perú – Reg. N° 12847

Signature & Date

Accepted by (Client):

[Client Full Name]

RUC / DNI: [Number]

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