Invoice Occupational Therapist in Thailand Bangkok –Free Word Template Download with AI
Occupational Therapy Specialist Clinic
123 Sukhumvit Road, Khlong Toei Nuea
Watthana District, Thailand Bangkok 10110
Tax ID: 0-123-456789-01-2
Phone: +66 2 123 4567 | Email: [email protected]
Invoice #: INV-2023-10-045
Date: October 24, 2023
Due Date: November 24, 2023
Payment Terms: Net 30
Bill To:
Mr. Somchai Jitmuang
456 Rama IV Road, Pathum Wan
Thailand Bangkok 10330
Email: [email protected]
Phone: +66 89 123 4567
Service Location:
Wellness & Rehabilitation Center
123 Sukhumvit Road, Khlong Toei Nuea
Watthana District, Thailand Bangkok 10110
Primary Care Provider: Dr. Ananya Smith, OTD
Service Overview
This Invoice details the professional services rendered by our certified Occupational Therapist team at our clinic in Thailand Bangkok. The services provided are designed to enhance the patient's ability to perform daily activities, improve motor skills, and facilitate recovery from injury or illness in accordance with the standards of practice recognized in Thailand.
The treatment plan focuses on holistic rehabilitation, integrating physical therapy techniques with cognitive behavioral strategies. Our Occupational Therapist has worked closely with the patient to develop a customized regimen aimed at restoring independence and quality of life. All sessions were conducted at our facility in Thailand Bangkok, utilizing state-of-the-art equipment and therapeutic environments.
| Description of Services | Code | Qty | Unit Price (THB) | Total (THB) |
|---|---|---|---|---|
|
Initial Comprehensive Evaluation Assessment of functional limitations, history taking, and goal setting by Senior Occupational Therapist. |
OT-INIT | 1 | 2,500.00 | 2,500.00 |
|
Individual Occupational Therapy Session (60 mins) One-on-one therapy focusing on fine motor skills, upper extremity strengthening, and adaptive strategies for ADLs. |
OT-IND-60 | 8 | 1,800.00 | 14,400.00 |
|
Ergonomic Assessment & Home Modification Consultation Review of patient's home environment in Thailand Bangkok to recommend safety modifications. |
OT-ERGO | 1 | 3,000.00 | 3,000.00 |
|
Therapeutic Handwriting & Cognitive Training Specialized exercises to improve handwriting legibility and cognitive processing speed. |
OT-COG | 4 | 1,500.00 | 6,000.00 |
|
Provision of Adaptive Equipment Supply of specialized utensils and dressing aids prescribed by the Occupational Therapist. |
OT-EQUIP | 1 | 1,200.00 | 1,200.00 |
Payment Instructions
Please remit payment within 30 days of the invoice date. Payments can be made via bank transfer to the following account located in Thailand Bangkok:
- Bank Name: Kasikorn Bank (KBank)
- Branch: Sukhumvit 24 Branch
- Account Name: Wellness & Rehabilitation Center Co., Ltd.
- Account Number: 123-4-56789-0
- SWIFT Code: KASITHBK
Please reference the Invoice number (INV-2023-10-045) in your payment description to ensure proper allocation of funds. For international payments, please contact our finance department regarding currency conversion fees.
Terms and Conditions
- All services provided by our Occupational Therapist are subject to the professional standards and regulations of the Ministry of Public Health in Thailand.
- This Invoice is valid for payment within 30 days. Late payments may incur a penalty fee of 1.5% per month on the outstanding balance.
- Insurance claims should be submitted directly by the patient or their representative. We can provide a detailed breakdown of services upon request.
- Any disputes regarding the services rendered in Thailand Bangkok must be raised in writing within 14 days of receiving this invoice.
- Prices are quoted in Thai Baht (THB) and include all applicable taxes unless otherwise stated.
Authorized Signature
Dr. Ananya Smith, OTD
Lead Occupational Therapist
Received By
Date: _______________
Signature: _______________
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