Quotation Estimate Radiologist in South Africa Johannesburg –Free Word Template Download with AI
142 Rivonia Road, Sandton, Johannesburg, 2196, South Africa
Telephone: +27 (0)11 447 8200 | Email: [email protected]
Registration No: 2019/123456/21 | HPCSA Practitioner No: 00456789
Quotation EstimateQuotation Details
Quotation No: QTE-2025-JHB-0487
Date of Issue: 14 June 2025
Valid Until: 14 July 2025 (30 days)
Prepared By: Dr. Thandiwe Mokoena, Consultant Radiologist
Client / Recipient
Client Name: [Client / Hospital / Medical Aid]
Address: [Street Address, Suburb, Johannesburg, South Africa]
Contact Person: [Name & Title]
Reference No: [Internal Reference]
This Quotation Estimate is issued by MedScan Radiology & Imaging Centre, a fully accredited radiology practice located in the heart of Johannesburg, South Africa, in respect of the professional services of a Radiologist and associated diagnostic imaging procedures. This document constitutes a formal Quotation Estimate and does not constitute a binding contract until accepted in writing by the client. All pricing is quoted in South African Rand (ZAR) and is subject to the terms and conditions set out herein.
The following Quotation Estimate covers the professional services rendered by a qualified and HPCSA-registered Radiologist at our Johannesburg facility. The Radiologist will perform, interpret, and report on all diagnostic imaging studies as specified below. All services are delivered in compliance with the South African Health Professions Council (HPCSA) regulations and the National Health Act (Act No. 61 of 2003) applicable in South Africa Johannesburg.
| No. | Description of Radiologist Service | Modality | Quantity | Unit Rate (ZAR) | Amount (ZAR) |
|---|---|---|---|---|---|
| 1.1 | Consultation and clinical assessment by Consultant Radiologist prior to imaging procedure | General | 1 | R 1 250.00 | R 1 250.00 |
| 1.2 | Computed Tomography (CT) scan of the head and brain with contrast – performed and interpreted by Radiologist | CT | 1 | R 4 850.00 | R 4 850.00 |
| 1.3 | Magnetic Resonance Imaging (MRI) of the lumbar spine with and without gadolinium contrast – Radiologist interpretation | MRI | 1 | R 6 200.00 | R 6 200.00 |
| 1.4 | Ultrasound examination of the abdomen and pelvis – performed by Radiologist | Ultrasound | 1 | R 2 450.00 | R 2 450.00 |
| 1.5 | Digital Mammography (bilateral) with tomosynthesis – Radiologist reading and reporting | Mammography | 1 | R 3 100.00 | R 3 100.00 |
| 1.6 | Fluoroscopic-guided interventional procedure (biopsy) – performed by Interventional Radiologist | Interventional | 1 | R 7 500.00 | R 7 500.00 |
| 1.7 | Written radiology report and findings communicated to referring physician within 24 hours | Reporting | 6 | R 350.00 | R 2 100.00 |
| 1.8 | Emergency / after-hours Radiologist on-call availability (provisional allocation for 12 months) | On-call | 12 | R 1 800.00 | R 21 600.00 |
| 1.9 | Second opinion / peer review by senior Consultant Radiologist (if requested) | Review | 2 | R 950.00 | R 1 900.00 |
| Subtotal (Professional Radiologist Fees) | R 50 950.00 |
| VAT @ 15% (as per South African VAT Act, No. 89 of 1991) | R 7 642.50 |
| TOTAL QUOTATION ESTIMATE (Incl. VAT) | R 58 592.50 |
| Amount in words: Fifty-Eight Thousand Five Hundred and Ninety-Two Rand and Fifty Cents |
- This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. Thereafter, pricing may be revised to reflect current market rates applicable to Radiologist services in Johannesburg, South Africa.
- All services are to be performed at the MedScan Radiology & Imaging Centre premises in Sandton, Johannesburg, or at such other location in the greater Johannesburg metropolitan area as mutually agreed in writing.
- The Radiologist named in this Quotation Estimate is a full-time member of the Health Professions Council of South Africa (HPCSA) and holds a valid scope of practice for diagnostic and interventional radiology.
- Payment terms: 50% deposit upon acceptance of this Quotation Estimate; the remaining 50% to be settled within fourteen (14) days of the final radiology report being issued. Late payments shall attract interest at the rate of 1.5% per month as per the National Credit Act.
- Medical aid / insurance claims: This Quotation Estimate may be submitted to the client's medical aid scheme for pre-authorisation. The client remains ultimately responsible for any co-payment, gap, or non-covered amounts.
- All imaging studies and radiology reports are the intellectual property of the Radiologist and MedScan Radiology & Imaging Centre. The client is granted a non-exclusive licence to use the reports for their own medical purposes.
- Confidentiality: All patient information is handled in strict accordance with the Protection of Personal Information Act (POPIA), No. 4 of 2013, as applicable in South Africa.
- Liability: The Radiologist and the practice shall not be held liable for any consequential loss arising from the interpretation of imaging studies, provided that all procedures are performed in accordance with accepted radiological practice in Johannesburg and South Africa.
- Disputes arising from this Quotation Estimate shall be resolved in the Magistrate's Court of Johannesburg, South Africa, which shall have exclusive jurisdiction.
- This Quotation Estimate does not constitute a guarantee of any specific diagnostic outcome. The Radiologist will exercise all reasonable professional skill and care in the performance of the services described herein.
By signing below, the client acknowledges and accepts this Quotation Estimate for Radiologist services as set out in this document. The Quotation Estimate becomes a binding agreement upon countersignature by both parties.
For and on behalf of MedScan Radiology & Imaging Centre
Dr. Thandiwe Mokoena – Consultant Radiologist
Signature: ___________________________
Date: ___________________________
For and on behalf of the Client
Name: ___________________________
Signature: ___________________________
Date: ___________________________
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