Invoice Occupational Therapist in Philippines Manila –Free Word Template Download with AI
Unit 405, Medical Arts Center, Ayala Avenue
Makati City, Metro Manila, Philippines 1226
TIN: 000-123-456-000
Email: [email protected]
Phone: +63 (2) 8888-1234
Invoice Number: INV-2023-10-0045
Date Issued: October 26, 2023
Due Date: November 09, 2023
Bill To:
Mr. Juan Dela Cruz
123 Rizal Street, Barangay San Antonio
Quezon City, Metro Manila, Philippines 1105
Mobile: +63 917 123 4567
Service Period:
From: October 01, 2023
To: October 31, 2023
Referral Code: OT-MNL-REF-99
| # | Description of Occupational Therapy Services | Qty | Unit Price (PHP) | Total (PHP) |
|---|---|---|---|---|
| 1 |
Initial Comprehensive Evaluation Detailed assessment of functional limitations, sensory processing, and motor skills conducted by a licensed Occupational Therapist in Manila. Includes history taking and goal setting. |
1 | 4,500.00 | 4,500.00 |
| 2 |
Individual Therapy Sessions (Neurological Rehabilitation) One-on-one sessions focusing on fine motor coordination, cognitive retraining, and activities of daily living (ADL) adaptation. |
8 | 2,500.00 | 20,000.00 |
| 3 |
Ergonomic Workplace Assessment On-site evaluation of the client's workspace in Manila to prevent repetitive strain injuries and improve productivity. Includes written report. |
1 | 5,000.00 | 5,000.00 |
| 4 |
Therapeutic Equipment Prescription & Fitting Consultation and fitting for adaptive devices (splints, grips) necessary for home use. |
1 | 3,200.00 | 3,200.00 |
| 5 |
Family Education and Caregiver Training Session dedicated to training family members on how to assist the patient with daily routines and therapy exercises at home. |
2 | 1,500.00 | 3,000.00 |
| Subtotal: | 35,700.00 |
| Discount (5% Loyalty): | (1,785.00) |
| Adjustable Value Added Tax (12%): | 4,009.80 |
| TOTAL DUE: | 37,924.80 |
Payment Terms and Conditions
Payment is due within 14 days of the invoice date. Please make checks payable to "Manila Integrated Occupational Therapy Services" or use the bank details below.
Bank Transfer Details:
Bank: BDO Unibank
Account Name: MIOTS Manila Inc.
Account Number: 1234-5678-9012
Reference: Invoice INV-2023-10-0045
Professional Disclaimer:
The services rendered by our Occupational Therapist are based on the clinical judgment required to improve the patient's quality of life. This invoice covers professional fees only. Any third-party insurance claims must be filed by the patient using the detailed receipt provided upon payment.
Legal Compliance:
This invoice is issued in accordance with the Bureau of Internal Revenue (BIR) regulations of the Philippines.
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