Quotation Estimate Speech Therapist in Japan Kyoto –Free Word Template Download with AI

Quotation Estimate

Quotation Details

Quotation No.: QTE-KYO-2025-0342

Date Issued: 15 June 2025

Valid Until: 15 July 2025

Prepared By: Dr. Haruki Tanaka, Certified Speech Therapist

Service Location: Japan Kyoto

Client Information

Client Name: [Client Full Name]

Address: [Client Address], Kyoto, Japan

Contact: [Phone Number]

Email: [Email Address]

Referral Source: [Hospital / Clinic / Self-Referral]

This Quotation Estimate is issued by the Kyoto Speech & Language Therapy Centre to provide a comprehensive and transparent breakdown of professional Speech Therapist services to be delivered within the Japan Kyoto metropolitan area. This document outlines the scope of therapy, associated costs, scheduling expectations, and all applicable terms governing the engagement. The Speech Therapist services described herein are designed to address a range of communication disorders, including articulation difficulties, language processing challenges, fluency disorders, voice pathologies, and swallowing (dysphagia) management, all tailored to the individual needs of the client as assessed during the initial diagnostic consultation.

Itemized Service Breakdown

No.	Service Description	Duration / Frequency	Unit Price (JPY)	Total (JPY)	Notes
1	Initial Comprehensive Assessment by Speech Therapist (includes oral-motor examination, standardized language testing, and diagnostic report)	1 session / 90 min	¥25,000	¥25,000	One-time fee
2	Individual Speech Therapy Sessions (articulation, phonological, or language intervention)	12 sessions / 50 min each	¥12,000	¥144,000	2x per week
3	Fluency / Stuttering Therapy Program (Cognitive-Behavioural approach)	8 sessions / 50 min each	¥13,500	¥108,000	1x per week
4	Dysphagia (Swallowing) Evaluation & Treatment	6 sessions / 60 min each	¥15,000	¥90,000	Includes videofluoroscopy coordination
5	Parent / Caregiver Training & Home Program Guidance	4 sessions / 45 min each	¥8,000	¥32,000	Conducted in Japan Kyoto clinic
6	Progress Review & Re-assessment (mid-program and final)	2 sessions / 60 min each	¥10,000	¥20,000	Written report included
7	Customized Home Exercise Materials & Digital Resources	1 package	¥15,000	¥15,000	Printed + USB delivery
8	Travel & Logistics within Japan Kyoto (clinic-to-clinic referrals, imaging centre visits)	As required	¥5,000	¥5,000	Flat fee
TOTAL ESTIMATED COST (Before Tax)				¥439,000
Consumption Tax (10%)				¥43,900
GRAND TOTAL				¥482,900

Note: This Quotation Estimate assumes the client will attend all scheduled sessions at our Japan Kyoto facility located in Higashiyama-ku. Should the client require home-visit Speech Therapist services within the Kyoto city limits, an additional travel surcharge of ¥3,000 per visit will apply and will be itemized separately upon request. Scope of Speech Therapist Services

The Speech Therapist assigned to this engagement, Dr. Haruki Tanaka, holds a national certification from the Japanese Society of Speech-Language Pathology and Audiology (JSSPA) and possesses over twelve years of clinical experience in the Japan Kyoto region. The therapy program outlined in this Quotation Estimate is evidence-based and will be adjusted at each progress review to reflect the client's evolving needs. All sessions will be conducted in Japanese, with English-language support available upon prior arrangement at no additional cost. The Speech Therapist will maintain detailed session notes and provide a comprehensive final report suitable for submission to the client's primary care physician, employer, or educational institution as required.

Terms & Conditions of This Quotation Estimate

Validity: This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. Prices are subject to revision after the expiry date due to potential changes in material costs or regulatory adjustments within Japan Kyoto.
Payment Terms: A deposit of 30% (¥144,870) is due upon acceptance of this Quotation Estimate. The remaining balance is payable in two equal instalments: 50% at the midpoint of the therapy program and 50% upon completion. Payment may be made via bank transfer to our Japan Kyoto account, credit card, or cash at the clinic reception.
Cancellation Policy: Sessions cancelled with less than 48 hours' notice will be charged at 50% of the session fee. No-shows will be charged in full. Up to two reschedules per month are permitted without charge.
Insurance & Reimbursement: This Quotation Estimate reflects private-pay rates. If the client holds National Health Insurance (NHI) coverage in Japan, a portion of the Speech Therapist fees may be eligible for reimbursement. Our Japan Kyoto billing office will assist the client in preparing all necessary documentation for insurance claims.
Confidentiality: All clinical records, assessment data, and session notes are protected under Japan's Act on the Protection of Personal Information (APPI). The Speech Therapist and all clinic staff are bound by strict confidentiality obligations.
Liability: The Kyoto Speech & Language Therapy Centre shall not be held liable for outcomes that fall outside the reasonable scope of Speech Therapist intervention. The client acknowledges that therapy progress is individual and may vary.
Governing Law: This Quotation Estimate and any resulting agreement shall be governed by the laws of Japan, with jurisdiction in the Kyoto District Court, Japan Kyoto.
Amendments: Any modifications to the scope, duration, or cost of services must be documented in a written addendum signed by both parties. Verbal agreements do not alter the terms of this Quotation Estimate.

Acceptance & Authorization

By signing below, the client acknowledges receipt of this Quotation Estimate, confirms understanding of the Speech Therapist services to be provided in Japan Kyoto, and authorizes the Kyoto Speech & Language Therapy Centre to commence the outlined therapy program upon receipt of the initial deposit.

Client Signature
Name: _________________________
Date: _________________________ Authorized Representative – Kyoto Speech & Language Therapy Centre
Name: Dr. Haruki Tanaka
Date: _________________________ ⬇️ Download as DOCX Edit online as DOCX

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