Invoice Occupational Therapist in Belgium Brussels –Free Word Template Download with AI
123 Avenue Louise
1050 Brussels, Belgium
Tel: +32 2 123 45 67
Email: [email protected]
VAT Number: BE 0123.456.789
Professional Services
Bill To:
Mr. Jean Dupont
45 Rue de la Loi
1040 Brussels, Belgium
National Registry Number: 12345678901
Service Overview
This Invoice details the professional services rendered by a licensed Occupational Therapist based in Brussels, Belgium. The services provided are in accordance with the regulations set forth by the Belgian Federal Public Service Health, Food Chain Safety and Environment. The Occupational Therapist has conducted a comprehensive assessment and therapeutic intervention plan tailored to the client's specific needs, focusing on enhancing daily living skills, cognitive rehabilitation, and ergonomic adaptations within the home and workplace environments in Brussels.
| Description of Service | Quantity | Unit Price (EUR) | Total (EUR) |
|---|---|---|---|
|
Initial Comprehensive Assessment Full evaluation of physical, cognitive, and psychosocial functioning. Includes home visit in Brussels municipality. |
1 | 120.00 | 120.00 |
|
Individual Therapy Sessions (Standard) 45-minute sessions focusing on fine motor skills, ADL training, and sensory integration. Conducted at Brussels Occupational Therapy Center. |
6 | 85.00 | 510.00 |
|
Ergonomic Workplace Assessment On-site evaluation of office setup in Brussels. Recommendations for posture, equipment, and workflow optimization. |
1 | 150.00 | 150.00 |
|
Cognitive Rehabilitation Program Specialized sessions targeting memory, attention, and executive function. Includes take-home exercises. |
4 | 95.00 | 380.00 |
|
Home Adaptation Consultation Assessment of home environment for accessibility and safety. Report provided to client and relevant Belgian insurance providers. |
1 | 130.00 | 130.00 |
|
Therapeutic Equipment Prescription & Training Selection and training on use of assistive devices. Coordination with local suppliers in Brussels. |
2 | 60.00 | 120.00 |
|
Progress Report & Insurance Documentation Detailed clinical report for Belgian health insurance reimbursement purposes. |
1 | 45.00 | 45.00 |
Payment Instructions & Terms
Bank Transfer Details:
Bank Name: KBC Bank Brussels
Account Holder: Brussels Occupational Therapy Center
IBAN: BE68 5390 0754 7034
BIC/SWIFT: KREDBEBB
Reference: Please use Invoice Number INV-2023-10-045 as payment reference.
Payment is due within 30 days from the date of this Invoice. Late payments may incur a statutory interest rate as per Belgian law. Please note that this Invoice is issued in accordance with the VAT regulations of Belgium. The Occupational Therapist services listed may be partially reimbursable by your Belgian health insurance fund (Mutuelle/Ziekenfonds). Please retain this document for your records and for submission to your insurance provider.
If you have any questions regarding this Invoice or the services provided by our Occupational Therapist in Brussels, please contact our billing department at the email or phone number listed above. We appreciate your prompt payment and trust in our professional care.
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