Quotation Estimate Radiologist in Brazil Rio de Janeiro –Free Word Template Download with AI
Professional Radiologist Services — Brazil, Rio de Janeiro
Document Reference: QE-RJ-2025-04782
| Quotation Estimate Date: | June 15, 2025 | Validity Period: | 30 calendar days from issue date |
| Service Provider: | Dr. Helena Vasconcelos, MD, PhD — Board-Certified Radiologist | Registration: | COREN-RJ No. 48.291.337 | CRM-RJ No. 112.847 |
| Service Location: | Av. Atlântica, 1500 — Copacabana, Rio de Janeiro, RJ, Brazil | Contact: | +55 (21) 3456-7890 | [email protected] |
| Client / Requesting Party: | Clínica Vida Plena Ltda. — CNPJ: 12.345.678/0001-90 | Client Address: | Rua das Laranjeiras, 890 — Laranjeiras, Rio de Janeiro, RJ, Brazil |
This Quotation Estimate is formally issued to provide a comprehensive and transparent breakdown of costs associated with the engagement of a Radiologist for diagnostic imaging interpretation, consultation, and related medical services to be rendered in Brazil, Rio de Janeiro. This document serves as a binding financial proposal between the undersigned Radiologist and the requesting client, outlining all fees, deliverables, and conditions applicable to the professional services described herein. The Quotation Estimate has been prepared in accordance with the regulatory standards established by the Conselho Federal de Medicina (CFM) and the local medical board of the state of Rio de Janeiro.
The following services are included in this Quotation Estimate for the Radiologist engagement in Brazil, Rio de Janeiro. All diagnostic interpretations will be performed in compliance with the Brazilian Health Regulatory Agency (ANVISA) guidelines and the ethical code of the Federal Medical Council.
| # | Service Description | Quantity | Unit Price (BRL) | Subtotal (BRL) | Duration |
|---|---|---|---|---|---|
| 01 | Comprehensive CT Scan Interpretation — Radiologist review of multi-slice CT images (head, chest, abdomen, pelvis) with written diagnostic report in Portuguese and English | 120 reports | R$ 480,00 | R$ 57,600,00 | 4 months |
| 02 | MRI Interpretation — Radiologist analysis of magnetic resonance imaging studies (neuro, musculoskeletal, abdominal) with detailed radiological findings | 80 reports | R$ 620,00 | R$ 49,600,00 | 4 months |
| 03 | Urgent / Emergency Radiologist Consultation — On-call availability for critical imaging interpretation within 2 hours, 24/7 coverage in Rio de Janeiro | 24 shifts | R$ 1,200,00 | R$ 28,800,00 | 4 months |
| 04 | Mammography & Breast Imaging Interpretation — Radiologist specialist review with BI-RADS classification and follow-up recommendations | 150 reports | R$ 390,00 | R$ 58,500,00 | 4 months |
| 05 | Ultrasound Guidance & Interpretation — Radiologist-performed and interpreted ultrasound examinations (abdominal, vascular, obstetric) | 60 sessions | R$ 550,00 | R$ 33,000,00 | 4 months |
| 06 | Interdepartmental Clinical Consultation — Radiologist participation in multidisciplinary tumor board meetings and case discussions at the client facility in Rio de Janeiro | 16 sessions | R$ 850,00 | R$ 13,600,00 | 4 months |
| 07 | Quality Assurance & Peer Review — Monthly Radiologist audit of 10% of all imaging reports for accuracy, completeness, and regulatory compliance | 4 months | R$ 3,500,00 | R$ 14,000,00 | 4 months |
| TOTAL ESTIMATED COST (Quotation Estimate) | R$ 255,100,00 | 4 months | |||
- Validity: This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After this period, the Radiologist reserves the right to revise pricing due to market fluctuations, exchange rate changes, or updated fee schedules published by the Conselho Regional de Medicina do Rio de Janeiro (CREMERJ).
- Payment Terms: Payment shall be made in monthly installments of R$ 63,775,00, due on the 5th business day of each month via bank transfer (TED/PIX) to the account specified in the formal service contract. A 2% monthly interest penalty applies to overdue balances in accordance with Brazilian commercial law.
- Taxation: All amounts in this Quotation Estimate are inclusive of applicable Brazilian taxes (ISS — Imposto Sobre Serviços, as levied by the municipality of Rio de Janeiro). The Radiologist shall issue a Nota Fiscal Eletrônica (NF-e) for each monthly billing cycle.
- Scope Limitations: This Quotation Estimate covers the Radiologist's professional interpretation and consultation services only. It does not include the cost of imaging equipment, contrast agents, patient preparation, or facility overhead, which remain the responsibility of the client institution in Rio de Janeiro.
- Confidentiality: The Radiologist shall comply with all provisions of the Brazilian General Data Protection Law (LGPD — Lei Geral de Proteção de Dados, Law No. 13.709/2018) and the CFM Code of Medical Ethics regarding patient data confidentiality and record-keeping.
- Liability & Insurance: The Radiologist maintains professional liability insurance (Seguro de Responsabilidade Civil Profissional) with a minimum coverage of R$ 2,000,000,00, valid throughout the service period in Brazil, Rio de Janeiro.
- Termination: Either party may terminate the service agreement with thirty (30) days written notice. In the event of early termination, the client shall be invoiced for all services rendered up to the termination date as per this Quotation Estimate.
- Governing Law: This Quotation Estimate and any resulting service contract shall be governed by the laws of the Federative Republic of Brazil, with jurisdiction vested in the courts of the city of Rio de Janeiro, state of Rio de Janeiro.
By signing below, the client acknowledges receipt of this Quotation Estimate for Radiologist services in Brazil, Rio de Janeiro, and confirms that the terms, pricing, and scope of work described herein are acceptable. This Quotation Estimate does not constitute a final contract but serves as the financial basis for the subsequent formal Service Agreement (Contrato de Prestação de Serviços Médicos) to be executed by both parties.
Service Provider (Radiologist)
Dr. Helena Vasconcelos, MD, PhDCRM-RJ No. 112.847
Date: _______________
Client Representative
Clínica Vida Plena Ltda.Authorized Signatory
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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