Invoice Occupational Therapist in Brazil Brasília –Free Word Template Download with AI
CNPJ: 34.567.890/0001-12
CRETO-DF: 12345
Quadra 702, Bloco A, Sala 305, Asa Norte
Brasília - DF, 70710-010, Brazil
Email: [email protected] | Phone: +55 (61) 3333-4444
Invoice Number: #INV-2023-0892
Date of Issue: October 24, 2023
Due Date: November 07, 2023
Service Period: October 01, 2023 - October 31, 2023
Bill To (Client)
Mr. Carlos Eduardo Silva
SCIA 307, Lote 15, Setor de Indústria e Abastecimento
Brasília - DF, 71200-030, Brazil
CPF: 123.456.789-00
Email: [email protected]
Service Location
Home Care Service
Provided at Client's Residence
Brasília - DF, Brazil
Note: Travel time within the Federal District limits included in hourly rate.
| # | Description of Occupational Therapy Services | Quantity | Unit Price (BRL) | Total (BRL) |
|---|---|---|---|---|
| 1 |
Initial Comprehensive Evaluation Assessment of functional abilities, sensory processing, and environmental barriers within the Brasília residence. Includes history taking and goal setting aligned with ICF standards. |
1 | R$ 350,00 | R$ 350,00 |
| 2 |
Individual Occupational Therapy Sessions (Neurological Rehabilitation) Targeted interventions for motor recovery and cognitive retraining following stroke. Focus on Activities of Daily Living (ADLs) and instrumental ADLs. |
8 | R$ 220,00 | R$ 1.760,00 |
| 3 |
Ergonomic Home Adaptation Consultation Analysis of home environment in Brasília residence to recommend safety modifications and assistive devices for independent mobility. |
1 | R$ 400,00 | R$ 400,00 |
| 4 |
Caregiver Training and Education Instruction for family members on transfer techniques, positioning, and therapeutic exercises to support patient progress between sessions. |
2 | R$ 180,00 | R$ 360,00 |
| 5 |
Progress Report and Documentation Detailed clinical report submitted to referring physician and insurance provider, documenting functional gains and updated treatment plan. |
1 | R$ 150,00 | R$ 150,00 |
Payment Instructions & Terms
Bank Transfer (Pix/TED):
Bank: Banco do Brasil
Agency: 1234-5
Account: 98765-4
Pix Key: [email protected]
Terms:
- Payment is due within 14 days of the invoice date.
- Late payments will incur a penalty of 2% plus interest of 1% per month.
- This invoice represents professional services rendered by a licensed Occupational Therapist in accordance with the regulations of the Federal Council of Occupational Therapy (CFTO).
- All services were performed in compliance with the ethical code of the profession in Brazil.
Occupational Therapist
CRETO-DF: 12345
Brasília, Brazil ⬇️ Download as DOCX Edit online as DOCX
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