Invoice Dentist in Australia Melbourne –Free Word Template Download with AI
Level 4, 123 Collins Street
Melbourne VIC 3000, Australia
Phone: (03) 9123 4567
Email: [email protected]
ABN: 12 345 678 901
Invoice Number: INV-2023-8942
Date Issued: 24 October 2023
Due Date: 24 November 2023
Payment Status: Outstanding
Bill To:
Mr. James Anderson
45 Chapel Street
South Yarra VIC 3141
Australia
Phone: 0412 345 678
Email: [email protected]
Health Fund: Bupa Private Health Insurance
Member ID: BUP-99887766
| Description of Dental Services | Item Number | Quantity | Amount (AUD) |
|---|---|---|---|
|
Comprehensive Dental Examination Includes full oral health assessment, review of medical history, and discussion of treatment options tailored to patient needs in Melbourne. |
02100 | 1 | $185.00 |
|
Full Mouth Radiographs (X-Rays) Digital panoramic and periapical X-rays to assess bone structure and tooth integrity. |
03100 | 1 | $220.00 |
|
Professional Scale and Clean Ultrasonic scaling and polishing to remove plaque and tartar buildup, ensuring gum health. |
04100 | 1 | $245.00 |
|
Composite Resin Filling (Posterior Tooth) Tooth #30: Removal of decay and restoration with tooth-colored composite material. |
05200 | 1 | $310.00 |
|
Root Canal Treatment (Single Root) Tooth #19: Endodontic therapy to remove infected pulp, clean canals, and seal the tooth. |
06300 | 1 | $850.00 |
|
Porcelain Crown Preparation and Temporary Tooth #19: Preparation of tooth structure and placement of temporary crown while permanent is fabricated. |
07400 | 1 | $650.00 |
|
Fluoride Treatment Application of high-concentration fluoride varnish to strengthen enamel and prevent future decay. |
08500 | 1 | $45.00 |
Payment Instructions and Terms
Thank you for choosing Melbourne City Dental for your oral healthcare needs. This invoice reflects the services rendered during your recent visit. As per Australian tax regulations, Goods and Services Tax (GST) has been applied to all eligible items.
Payment Methods: We accept EFTPOS, Visa, Mastercard, American Express, and direct bank transfer. For bank transfers, please use the following details:
Bank: Commonwealth Bank of Australia
BSB: 062-000
Account Name: Melbourne City Dental Pty Ltd
Account Number: 12345678
Reference: INV-2023-8942
Health Fund Rebates: If you have private health insurance, you may be eligible for a rebate. We can process this directly at the time of treatment if you provide your membership card, or you can claim it directly from your fund. The estimated rebate shown above is for informational purposes only and is subject to your specific policy limits.
Due Date: Payment is due within 30 days of the invoice date. Late payments may incur a 2% monthly interest charge in accordance with Victorian consumer law. Please contact our office if you require a payment plan or have any questions regarding this invoice.
Next Appointment: Please schedule your follow-up visit for crown placement within the next two weeks. Call us at (03) 9123 4567 or book online at melbournecitydental.com.au.
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