Invoice Dietitian in Thailand Bangkok –Free Word Template Download with AI
Professional Clinical Nutrition & Lifestyle Consulting
123 Sukhumvit Soi 31, Khlong Toei Nuea
Watthana District, Bangkok 10110, Thailand
Tel: +66 2 123 4567 | Email: [email protected]
VAT Registration No: 010555900000000
Invoice #: INV-BKK-2023-0892
Date: October 24, 2023
Due Date: November 07, 2023
Bill To: Mr. Somchai JirapongseExecutive Director
Global Logistics Solutions Ltd.
456 Rama IV Road, Pathum Wan
Bangkok 10330, Thailand
Phone: +66 89 123 4567
Email: [email protected]
| # | Description of Dietitian Services | Qty | Unit Price (THB) | Total (THB) |
|---|---|---|---|---|
| 1 |
Initial Comprehensive Nutritional Assessment In-depth consultation conducted at our Bangkok clinic. Includes medical history review, body composition analysis (InBody), blood work interpretation, and lifestyle evaluation tailored to the client's schedule in Thailand. |
1 | 4,500.00 | 4,500.00 |
| 2 |
Customized Meal Planning (Monthly) Development of a culturally appropriate diet plan incorporating local Thai ingredients and international options available in Bangkok. Includes grocery lists and macro-nutrient breakdowns. |
1 | 3,000.00 | 3,000.00 |
| 3 |
Follow-up Consultations (Video/In-Person) Four weekly 45-minute sessions to monitor progress, adjust caloric intake, and provide behavioral coaching. Sessions conducted via Zoom or at the Sukhumvit office. |
4 | 2,500.00 | 10,000.00 |
| 4 |
Supplement Protocol Review Analysis of current vitamin and mineral intake. Recommendations for supplements available in Thailand pharmacies, ensuring compliance with local health regulations. |
1 | 1,500.00 | 1,500.00 |
| 5 |
Emergency Dietary Guidance Access Priority email and LINE messaging support for urgent dietary questions during business hours in Bangkok (09:00 - 18:00 ICT). |
1 | 1,000.00 | 1,000.00 |
Payment Instructions
Please remit payment via bank transfer to the following account within 14 days of the invoice date. Please include the Invoice Number as the reference.
Bank Name: Kasikorn Bank (KBank)
Account Name: Bangkok Wellness Dietetics Co., Ltd.
Account Number: 123-4-56789-0
SWIFT Code: KASITHBK
Branch: Sukhumvit 21 Branch, Bangkok
Note: For international transfers, please ensure the amount covers any intermediary bank fees. The final amount received must be 21,400.00 THB.
Terms, Conditions, and Professional Notes
1. Professional Scope: The services rendered by our licensed Dietitian are for nutritional counseling and education purposes only. They do not constitute medical diagnosis or treatment of acute medical conditions unless explicitly stated in a separate medical agreement. Clients in Thailand should continue to consult their primary care physicians for medical issues.
2. Confidentiality: All personal health information, dietary habits, and medical history shared during these sessions are strictly confidential and protected under Thai privacy laws and professional ethical standards.
3. Cancellation Policy: Appointments must be cancelled at least 24 hours in advance. Late cancellations or no-shows will be charged at 50% of the session fee.
4. VAT Compliance: This invoice includes the standard 7% Value Added Tax (VAT) as required by the Revenue Department of Thailand. This document serves as a valid tax receipt for corporate expense claims.
5. Late Payments: Invoices not paid by the due date may be subject to a late fee of 1.5% per month on the outstanding balance.
6. Dietary Adherence: The success of the diet plan depends on the client's adherence to the recommendations provided. The Dietitian is not liable for health outcomes resulting from the client's failure to follow the prescribed nutritional guidelines or from undisclosed medical conditions.
7. Local Context: Meal plans are designed considering the availability of fresh produce, street food options, and restaurant menus commonly found in Bangkok. Clients are encouraged to communicate any specific dietary restrictions related to religious beliefs or allergies common in the region.
Authorized Signature (Provider)
Dr. Ananya S.
Dr. Ananya Somboon, RD, PhD
Lead Clinical Dietitian
Bangkok Wellness Dietetics
Received By (Client)
Name: __________________________
Date: __________________________
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