Invoice Occupational Therapist in Indonesia Jakarta –Free Word Template Download with AI
Professional Occupational Therapy Services
Jl. Sudirman No. 45, Kuningan, Setiabudi
Jakarta Selatan, 12950, Indonesia Jakarta
Telp: +62 21 555 0199 | Email: [email protected]
NPWP: 01.234.567.8-901.000
#INV-JKT-2023-0892
Bill To:
Mr. Budi Santoso
Residential Address:
Jl. Kemang Raya No. 12B
Jakarta Selatan, 12730, Indonesia Jakarta
National ID (NIK): 3171012345670001
This document serves as a formal Invoice for professional healthcare services rendered by a licensed Occupational Therapist based in Indonesia Jakarta. The services detailed below are designed to improve the client's functional independence, focusing on fine motor skills, cognitive rehabilitation, and daily living activities, in accordance with the standards of practice set by the Indonesian Association of Occupational Therapists (PERKAPI).
| No. | Description of Occupational Therapy Services | Qty | Unit Price (IDR) | Total (IDR) |
|---|---|---|---|---|
| 1 |
Initial Comprehensive Assessment Evaluation of physical and cognitive capabilities by a senior Occupational Therapist in our Jakarta clinic. Includes history taking, functional analysis, and goal setting. |
1 | 1,500,000 | 1,500,000 |
| 2 |
Individual Therapy Sessions (Fine Motor Rehabilitation) 10 sessions of one-on-one therapy focusing on hand dexterity, grip strength, and coordination exercises tailored for post-stroke recovery. |
10 | 750,000 | 7,500,000 |
| 3 |
Activities of Daily Living (ADL) Training 5 sessions dedicated to retraining essential life skills such as dressing, grooming, and feeding techniques to maximize independence at home. |
5 | 750,000 | 3,750,000 |
| 4 |
Ergonomic Home Assessment Consultation Virtual consultation by the Occupational Therapist to advise on home modifications and assistive devices suitable for the client's environment in Jakarta. |
1 | 1,000,000 | 1,000,000 |
| 5 |
Therapeutic Equipment Rental (Hand Grips & Splints) Monthly rental fee for customized orthotics and strengthening tools provided by the clinic for home use. |
1 | 500,000 | 500,000 |
Payment Instructions & Terms
Please remit payment within 14 days of the invoice date to avoid late fees. As this Invoice pertains to medical services in Indonesia Jakarta, payments are accepted via bank transfer to the following account:
Bank: Bank Central Asia (BCA)
Account Name: PT. Jakarta Rehab & Wellness
Account Number: 123-456-7890
Reference: Please use Invoice #INV-JKT-2023-0892 as the transfer reference.
For insurance claims, please contact our billing department. We accept major Indonesian health insurance providers (BPJS Kesehatan, Allianz, Prudential, etc.). Please ensure your policy covers Occupational Therapy services.
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