Quotation Estimate Psychologist in Senegal Dakar –Free Word Template Download with AI

Quotation Estimate Ref: QE-2025-0472

Quotation Details

Quotation Estimate No.: QE-2025-0472

Date of Issue: 15 June 2025

Valid Until: 15 July 2025

Currency: XOF (West African CFA Franc)

Client Information

Client Name: [Client / Organization Name]

Address: [Street, District], Dakar, Senegal

Contact Person: [Name & Title]

Email: [[email protected]]

This Quotation Estimate is issued by Dakar Psychological Services & Wellness Center to provide a comprehensive breakdown of professional psychological services to be delivered in Senegal Dakar. Our licensed Psychologist, Dr. Awa Ndiaye (Registration No. PSY-SN-2014-0089), will provide individualized therapeutic interventions tailored to the client's specific mental health needs. All services will be conducted in compliance with the Senegalese Ministry of Health regulations and the ethical standards of the Senegalese Association of Clinical Psychologists.

The Psychologist engaged under this Quotation Estimate holds a Doctorate in Clinical Psychology from the Université Cheikh Anta Diop de Dakar and possesses over twelve years of practice in the Senegal Dakar metropolitan area. Services may be rendered in French, Wolof, or English, depending on the client's preference, ensuring full cultural and linguistic sensitivity throughout the therapeutic process.

#	Service Description	Duration / Qty	Unit Price (XOF)	Subtotal (XOF)	Notes
1	Initial Psychologist Assessment & Intake Session (comprehensive psychological evaluation, history review, and diagnostic formulation)	1 session (120 min)	75,000	75,000	Conducted at Dakar office
2	Individual Psychotherapy Sessions (CBT, psychodynamic, or integrative approach as determined by the Psychologist)	12 sessions (60 min each)	55,000	660,000	Weekly schedule, flexible timing
3	Psychological Testing & Standardized Assessment (MMPI-2, WAIS-IV, BDI-II, and relevant projective instruments)	1 package	180,000	180,000	Includes written report
4	Family / Couples Counseling (if applicable, up to 4 participants per session)	4 sessions (90 min each)	85,000	340,000	Optional add-on
5	Written Psychological Report & Treatment Plan (formal document for employer, court, or insurance purposes)	1 report	120,000	120,000	Delivered within 10 business days
6	Emergency / Crisis Intervention (24/7 phone consultation by the assigned Psychologist)	12-month access	45,000	45,000	Up to 3 calls per month
7	Home Visit / On-site Consultation within Dakar, Senegal (if client cannot travel to the office)	2 visits	95,000	190,000	Within Dakar city limits
8	Administrative & Record-Keeping Fee (file management, secure storage, and regulatory compliance in Senegal)	1 package	30,000	30,000	Per Senegalese data law
Subtotal:				1,640,000 XOF
VAT (18% – Senegal standard rate):				295,200 XOF
TOTAL AMOUNT DUE:				1,935,200 XOF

Payment for this Quotation Estimate shall be made in accordance with the following schedule. The client agrees to remit payment via bank transfer to the designated account of Dakar Psychological Services & Wellness Center, or by certified cheque payable to the center. All transactions are processed in XOF in accordance with Senegalese banking regulations.

30% Advance Payment: Due upon acceptance of this Quotation Estimate (580,560 XOF).
40% Mid-Program Payment: Due after completion of Session 6 (774,080 XOF).
30% Final Payment: Due upon delivery of the final Psychological Report and completion of all sessions (580,560 XOF).
Late payments shall incur a penalty of 2% per month, in compliance with Senegalese commercial law.

This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After the expiry date, pricing may be subject to revision.
The assigned Psychologist reserves the right to refer the client to a psychiatrist or specialist if clinical judgment deems it necessary. Referral fees, if any, are not included in this estimate.
All sessions are subject to a 24-hour cancellation notice. Cancellations made within 24 hours will be charged at 50% of the session fee.
Confidentiality is maintained in strict accordance with the Senegalese Code of Medical Ethics and the professional code of conduct of the Senegalese Association of Clinical Psychologists. Records are stored securely in Dakar and are subject to the client's right of access.
The Psychologist will not provide services in a state of emergency that requires immediate hospitalization without coordinating with the nearest medical facility in Senegal Dakar (e.g., Hôpital Principal de Dakar, Hôpital Aristide Le Dantec).
This Quotation Estimate does not constitute a binding contract until signed and countersigned by both parties. Upon signature, it becomes a service agreement governed by the laws of the Republic of Senegal.
Any disputes arising from this Quotation Estimate shall be resolved through amicable negotiation, failing which they shall be submitted to the competent courts of Dakar, Senegal.

By signing below, the client acknowledges receipt of this Quotation Estimate and agrees to the terms, conditions, and pricing outlined herein for the psychological services to be provided by the designated Psychologist in Senegal Dakar.

For the Client:

Name: ___________________________

Signature: _________________________

Date: _____________________________

For Dakar Psychological Services & Wellness Center:

Name: Dr. Awa Ndiaye, Psychologist

Signature: _________________________

Date: _____________________________

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