Invoice Occupational Therapist in Netherlands Amsterdam –Free Word Template Download with AI
Practitioner: Dr. Elena van der Berg, MSc OT
Address: Herengracht 450, 1017 CA Amsterdam, Netherlands
Phone: +31 20 555 0123
Email: [email protected]
KVK (Chamber of Commerce): 65432109
BTW (VAT Number): NL854321097B01
Professional Occupational Therapy Services
Bill To:
Client Name: Jan Pieter de Vries
Address: Keizersgracht 123, 1015 CJ Amsterdam, Netherlands
Insurance Provider: Zilveren Kruis
Policy Number: ZK-987654321
Referral Code: REF-2023-OT-456
| Description of Occupational Therapy Services | Date | Duration | Rate (EUR) | Amount (EUR) |
|---|---|---|---|---|
| Initial Comprehensive Assessment and Functional Evaluation in Amsterdam clinic setting | Oct 02, 2023 | 90 min | €120.00 | €120.00 |
| Individual Occupational Therapy Session: Upper limb rehabilitation and ADL training | Oct 05, 2023 | 60 min | €95.00 | €95.00 |
| Individual Occupational Therapy Session: Cognitive rehabilitation and memory strategies | Oct 09, 2023 | 60 min | €95.00 | €95.00 |
| Home Visit Assessment in Amsterdam residential area for environmental adaptation | Oct 12, 2023 | 120 min | €150.00 | €150.00 |
| Individual Occupational Therapy Session: Ergonomic workstation setup and pain management | Oct 16, 2023 | 60 min | €95.00 | €95.00 |
| Individual Occupational Therapy Session: Fine motor skills development and sensory integration | Oct 19, 2023 | 60 min | €95.00 | €95.00 |
| Professional consultation with referring physician in Amsterdam healthcare network | Oct 20, 2023 | 30 min | €60.00 | €60.00 |
| Subtotal: | €710.00 |
| VAT (21%): | €149.10 |
| Total Amount Due: | €859.10 |
Payment Instructions and Terms
This Invoice is issued in accordance with Dutch healthcare regulations and the professional standards of the Dutch Association of Occupational Therapists (NVvO). All services provided by our Occupational Therapist are delivered in compliance with the quality requirements established for healthcare professionals practicing in Amsterdam and throughout the Netherlands.
Payment is due within 30 days from the date of this Invoice. Please include the Invoice number (INV-2023-10-089) as reference when making your payment. Late payments may incur interest charges in accordance with Dutch commercial law.
If you have private health insurance coverage in the Netherlands, please submit this Invoice to your insurance provider for reimbursement. Our Occupational Therapy services are recognized by major Dutch insurance companies including Zilveren Kruis, Menzis, VGZ, and CZ. For basic insurance packages, please note that additional occupational therapy sessions may require a referral from your general practitioner (huisarts).
Bank Transfer Details
Bank Name: ING Bank N.V.
Account Holder: Amsterdam Occupational Therapy Center B.V.
IBAN: NL91 INGB 0001 2345 67
BIC/SWIFT: INGBNL2A
Reference: INV-2023-10-089
Service Description
The Occupational Therapy services detailed in this Invoice were provided by a licensed Occupational Therapist registered with the Dutch Healthcare Inspectorate (IGZ). Our practice specializes in helping individuals regain independence in daily activities through evidence-based interventions tailored to each client's unique needs. Services include functional assessments, rehabilitation programs, adaptive equipment recommendations, environmental modifications, and ongoing therapeutic support.
All therapy sessions conducted in Amsterdam follow the Dutch healthcare quality standards and are documented in accordance with privacy regulations (AVG/GDPR). Our Occupational Therapist maintains professional liability insurance and adheres to the ethical guidelines established by the Dutch healthcare profession.
For any questions regarding this Invoice or the services provided, please contact our billing department at [email protected] or call +31 20 555 0123 during business hours (Monday-Friday, 9:00-17:00 CET).
⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
GoGPT