Invoice Doctor General Practitioner in Spain Valencia –Free Word Template Download with AI
C/ Colón, 45, 2ºA
46004 Valencia, Spain
Phone: +34 960 123 456
Email: [email protected]
NIF: 12345678Z
Medical License: COL-VA-98765
Collegiate Body: Colegio Oficial de Médicos de Valencia
Invoice Number: INV-2023-10-045
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Bill To
Mr. James Anderson
C/ Russafa, 12, 3ºB
46006 Valencia, Spain
NIF/ID: X-9876543-Y
Insurance Provider: Sanitas International
Policy Number: POL-ES-55443322
Service Location
Private Medical Clinic Valencia
C/ Colón, 45, 2ºA
46004 Valencia, Spain
Services rendered in accordance with the regulations of the Generalitat Valenciana.
| # | Description of Medical Services | Date | Qty | Unit Price (€) | Total (€) |
|---|---|---|---|---|---|
| 1 |
Initial Consultation - General Practitioner Comprehensive medical history review, physical examination, and preliminary diagnosis. Conducted at the Valencia clinic. Includes assessment of chronic conditions and lifestyle recommendations. |
2023-10-20 | 1 | 65.00 | 65.00 |
| 2 |
Follow-up Consultation Review of test results and adjustment of treatment plan. Discussion regarding medication efficacy and side effects. |
2023-10-22 | 1 | 45.00 | 45.00 |
| 3 |
Medical Certificate Issuance Official medical certificate for employment purposes, signed by a licensed Doctor General Practitioner in Valencia, Spain. Includes stamp from the Colegio Oficial de Médicos. |
2023-10-23 | 1 | 30.00 | 30.00 |
| 4 |
Prescription Management Electronic prescription submission to the Valencian Health System (SIS) and private pharmacy coordination. |
2023-10-20 | 1 | 15.00 | 15.00 |
| 5 |
Administrative Fee - Insurance Coordination Processing of pre-authorization and documentation required by the patient's international insurance provider for services rendered in Spain. |
2023-10-24 | 1 | 25.00 | 25.00 |
Terms and Conditions
1. Payment is due within 30 days of the invoice date. Late payments may incur a statutory interest charge as per Spanish Law 3/2004 on Late Payment in Commercial Transactions.
2. This invoice is issued by a licensed Doctor General Practitioner registered with the Colegio Oficial de Médicos de Valencia. All medical services were performed in compliance with the professional standards of the Valencian Community.
3. For insurance claims, please submit this invoice along with the detailed medical report to your provider. The NIF (12345678Z) must be included for tax purposes in Spain.
4. If you have any questions regarding this invoice or the medical services provided, please contact the clinic directly at +34 960 123 456 or via email.
5. Bank Transfer Details:
Bank: Banco Santander
IBAN: ES91 2100 0418 4502 0005 1332
BIC/SWIFT: BSCHESMM
Reference: INV-2023-10-045
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