Invoice Occupational Therapist in Russia Saint Petersburg –Free Word Template Download with AI
Specialized Occupational Therapy Center
191023, Russia, Saint Petersburg
Nevsky Prospect, 120, Building 4, Office 305
INN: 7805123456 | KPP: 780501001
Phone: +7 (812) 555-01-99
Email: [email protected]
Invoice Number: INV-RU-2023-0892
Date of Issue: October 24, 2023
Due Date: November 07, 2023
Service Period: October 01, 2023 - October 23, 2023
Bill To
Client Name: Elena Volkova
Address: 197110, Russia, Saint Petersburg
Ulitsa Tolstogo, 45, Apt 12
Phone: +7 (921) 123-45-67
Email: [email protected]
Service Location
Location: In-Clinic Session
NeuroRehab Pro Center
Nevsky Prospect, 120, Building 4
Saint Petersburg, Russia
Referring Physician: Dr. A. Petrov
Service Overview and Clinical Context
This Invoice represents the professional fees for comprehensive Occupational Therapy services rendered by a licensed Occupational Therapist based in Russia, Saint Petersburg. The services provided are tailored to enhance the client's functional independence, cognitive processing, and physical rehabilitation capabilities.
In accordance with the healthcare standards of Saint Petersburg, the treatment plan focuses on neuro-rehabilitation following a mild traumatic brain injury. The Occupational Therapist has implemented a structured regimen involving fine motor skill restoration, sensory integration techniques, and activities of daily living (ADL) training. The goal is to facilitate the client's return to their previous level of occupational performance within their home and community environment in Saint Petersburg.
All sessions were conducted in compliance with the Federal Law of the Russian Federation "On the Fundamentals of Protection of the Health of Citizens in the Russian Federation." The Occupational Therapist utilized evidence-based practices to ensure optimal recovery outcomes. This document serves as the official financial record for these medical services.
| # | Description of Services | Quantity (Hours/Units) | Unit Price (RUB) | Total (RUB) |
|---|---|---|---|---|
| 1 |
Initial Occupational Therapy Assessment Comprehensive evaluation of motor skills, cognitive function, and environmental barriers in Saint Petersburg residence. |
2.0 | 4,500.00 | 9,000.00 |
| 2 |
Individual Neuro-Rehabilitation Sessions One-on-one therapy focusing on fine motor coordination and sensory processing. |
10.0 | 3,500.00 | 35,000.00 |
| 3 |
ADL Training and Home Safety Consultation Training in Activities of Daily Living (dressing, grooming) and home modification advice. |
4.0 | 3,000.00 | 12,000.00 |
| 4 |
Cognitive Rehabilitation Therapy Targeted exercises for memory, attention, and executive function restoration. |
6.0 | 3,800.00 | 22,800.00 |
| 5 |
Therapeutic Equipment Provision Rental of adaptive utensils and splinting materials for home use. |
1.0 | 5,500.00 | 5,500.00 |
| 6 |
Progress Report and Physician Consultation Detailed clinical report submitted to the referring doctor in Saint Petersburg. |
1.0 | 2,500.00 | 2,500.00 |
Payment Terms and Banking Information
Payment Method: Bank Transfer (SWIFT/SEPA) or Cash at Clinic.
Due Date: Payment is due within 14 days of the invoice date.
Late Fees: A late fee of 0.5% per day will be applied to overdue balances in accordance with Russian civil law.
Bank Details for Transfer:
Bank Name: Sberbank of Russia, JSC
Branch: Saint Petersburg Main Branch
Account Number: 40702810938000012345
BIC: 044525225
SWIFT Code: SABRRUMM
Beneficiary: NeuroRehab Pro LLC
Authorized Signature (Provider)
Dr. Ivan Sokolov, OT
Licensed Occupational Therapist
License No: RU-OT-78-9921
Client Acceptance
Signature:
Date:
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