Invoice Doctor General Practitioner in United Kingdom London –Free Word Template Download with AI
GMC Registered | CQC Rated Outstanding
INVOICE
Bill FromDr. Eleanor Sterling, MBBS, MRCP
Doctor General Practitioner
London City Medical Practice
42 Harley Street, Marylebone
London, W1G 9QD
United Kingdom
Email: [email protected]
Phone: +44 (0)20 7123 4567
Bill ToMr. Jonathan H. Reynolds
15 Kensington Gardens Square
Kensington, London, W2 4BH
United Kingdom
NHS Number: 485 772 991 002
Private Insurance: AXA PPP Healthcare (Policy: AXA-882190)
Description of Medical Services Rendered| Item | Service Description | Date of Service | Quantity | Amount (GBP) |
|---|---|---|---|---|
| 1 |
Comprehensive General Practitioner Consultation Initial assessment and diagnosis for respiratory symptoms. Includes full medical history review, physical examination, and formulation of a treatment plan. Conducted at our London clinic. |
10 Oct 2023 | 1 | £150.00 |
| 2 |
Private Blood Test Panel & Analysis Full Blood Count (FBC), Urea & Electrolytes (U&E), Liver Function Tests (LFTs), and Thyroid Function Tests (TFTs). Includes sample collection, laboratory processing fees, and Doctor General Practitioner interpretation of results. |
12 Oct 2023 | 1 | £120.00 |
| 3 |
Follow-up Consultation Review of blood test results and adjustment of medication. Discussion of long-term management strategy for hypertension. |
18 Oct 2023 | 1 | £100.00 |
| 4 |
Private Referral Letter to Specialist Drafting and submission of a detailed referral letter to a Consultant Cardiologist at a private hospital in London, United Kingdom, based on GP assessment. |
18 Oct 2023 | 1 | £75.00 |
| 5 |
Medical Certificate for Employer Issuance of a formal fit note and medical certificate confirming temporary incapacity for work due to illness, compliant with UK employment law standards. |
10 Oct 2023 | 1 | £45.00 |
| 6 |
Prescription Dispensing Fee Supply of private prescription medications (Amoxicillin 500mg, Amlodipine 5mg) dispensed directly by the London City Medical Practice pharmacy. |
10 Oct 2023 | 1 | £35.00 |
| Subtotal: | £525.00 |
| VAT (20%): | £105.00 |
| Total Due: | £630.00 |
Payment Instructions
Please ensure payment is made within 30 days of the invoice date to avoid late fees. As this is a private medical service provided by a Doctor General Practitioner outside of the standard NHS framework, payment is required directly by the patient or their private insurance provider.
Bank Transfer Details:
Bank Name: Barclays Bank UK PLC
Account Name: London City Medical Practice Ltd
Sort Code: 20-45-67
Account Number: 12345678
IBAN: GB29 BARC 2045 6712 3456 78
SWIFT/BIC: BARCGB22
Please quote Invoice Number INV-LON-2023-8942 in the payment reference.
Terms, Conditions, and Important Notes- Private Services: This Invoice covers private medical services rendered by Dr. Eleanor Sterling, a Doctor General Practitioner registered with the General Medical Council (GMC). These services are distinct from NHS-funded care and are billed at standard London private practice rates.
- Insurance Claims: If you are claiming reimbursement through private health insurance (e.g., Bupa, AXA, Aviva), please forward this original Invoice along with the clinical report to your provider. Our practice is located in London, United Kingdom, and accepts direct billing from major insurers upon prior authorization.
- Confidentiality: All patient information contained within this document and associated medical records is strictly confidential and handled in accordance with the UK General Data Protection Regulation (UK GDPR) and the Data Protection Act 2018.
- Disputes: Any discrepancies regarding the charges listed on this Invoice must be reported in writing within 14 days of receipt. Please contact our billing department at [email protected].
- Late Payments: Interest may be charged on overdue amounts at a rate of 4% above the Bank of England base rate, in accordance with the Late Payment of Commercial Debts (Interest) Act 1998.
- Cancellation Policy: Appointments cancelled with less than 24 hours' notice may incur a cancellation fee of 50% of the consultation cost, as this time is reserved exclusively for the patient.
Authorized By:
Dr. Eleanor Sterling
Doctor General Practitioner
GMC Number: 1234567
Patient Acknowledgement:
Name: _________________________
Signature: _____________________
Date: __________________________
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