Invoice Midwife in Israel Jerusalem –Free Word Template Download with AI
Professional Midwife: Sarah Cohen, BSc, CM
License No: 12345-IL
Address: 15 King David Street, Jerusalem, Israel 94101
Phone: +972-2-555-1234
Email: [email protected]
VAT ID: 512345678
Invoice Number: INV-2024-0892
Date Issued: October 15, 2024
Due Date: November 15, 2024
Service Period: August 1, 2024 - October 10, 2024
Billed To:
Client Name: Rachel and David Levi
Address: 42 Nachlaot Street, Jerusalem, Israel 94251
Phone: +972-50-123-4567
Email: [email protected]
National Insurance ID: 123456789
| Service Description | Date(s) of Service | Quantity | Unit Price (ILS) | Total (ILS) |
|---|---|---|---|---|
| Initial Consultation and Comprehensive Health Assessment in Jerusalem | August 1, 2024 | 1 | 350.00 | 350.00 |
| Prenatal Care Visits (Monthly Monitoring and Education) | August 15 - September 20, 2024 | 4 | 275.00 | 1,100.00 |
| Bi-Weekly Prenatal Checkups (Third Trimester) | September 25 - October 5, 2024 | 3 | 275.00 | 825.00 |
| Weekly Prenatal Visits (Final Weeks) | October 8 - October 10, 2024 | 2 | 275.00 | 550.00 |
| Birth Plan Development and Counseling Session | September 10, 2024 | 1 | 200.00 | 200.00 |
| Home Birth Attending Services (Full Attendance) | October 10, 2024 | 1 | 2,500.00 | 2,500.00 |
| Postpartum Care Visits (First Two Weeks) | October 12 - October 24, 2024 | 4 | 225.00 | 900.00 |
| Newborn Care and Developmental Assessment | October 15, 2024 | 1 | 175.00 | 175.00 |
| Lactation Support and Breastfeeding Consultation | October 13, 2024 | 1 | 200.00 | 200.00 |
| Emergency On-Call Availability (Monthly Fee) | August - October 2024 | 3 | 150.00 | 450.00 |
| Medical Records Documentation and Reporting | August - October 2024 | 1 | 100.00 | 100.00 |
| Subtotal: | 7,350.00 ILS |
| VAT (17%): | 1,249.50 ILS |
| Total Amount Due: | 8,599.50 ILS |
Payment Terms and Notes:
1. Payment is due within 30 days of the invoice date. Please make payments in Israeli New Shekels (ILS).
2. Bank Transfer Details: Bank Hapoalim, Branch: Jerusalem Central, Account Number: 987654321, SWIFT: POALILIT.
3. This invoice covers midwifery services provided in accordance with the regulations of the Israeli Ministry of Health and the Midwives Association of Israel.
4. All prenatal, birth, and postpartum care services were delivered in compliance with professional standards practiced in Jerusalem, Israel.
5. In the event of any discrepancies or questions regarding this invoice, please contact the midwife directly within 14 days of receipt.
6. Late payments may incur a monthly interest charge of 1.5% as per Israeli commercial law.
7. This document serves as an official record of midwifery services rendered and may be used for insurance reimbursement purposes.
8. The midwife maintains confidentiality of all medical information in accordance with Israeli privacy laws and professional ethics.
Midwife Signature Client Acknowledgment ⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
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