Invoice Optometrist in Canada Montreal –Free Word Template Download with AI
1234 Rue Sainte-Catherine Ouest, Suite 500
Montreal, Quebec, Canada H3G 1P5
Phone: (514) 555-0199 | Email: [email protected]
Business Number: 123456789 RC0001
Invoice #: INV-2023-10-45
Date: October 24, 2023
Due Date: November 24, 2023
Bill To:
Mr. Jean-Pierre Tremblay
567 Avenue du Parc
Montreal, Quebec, Canada H2V 4E1
Insurance: Sun Life Financial
Policy #: SL-99887766
Service Details:
Service Date: October 24, 2023
Provider: Dr. Sarah Chen, O.D.
License: O.R.O.Q. #8842
Location: Montreal, Canada
| Description of Services | Quantity | Unit Price (CAD) | Total (CAD) |
|---|---|---|---|
|
Comprehensive Eye Examination Includes refraction, binocular vision assessment, and ocular health screening performed by a licensed optometrist in Montreal. |
1 | 150.00 | 150.00 |
|
Premium Anti-Reflective Coating Applied to prescription lenses to reduce glare from digital screens and night driving, essential for urban environments. |
1 | 85.00 | 85.00 |
|
High-Index Polycarbonate Lenses (1.67) Thinner, lighter lenses for stronger prescriptions, ensuring comfort and durability. |
2 | 120.00 | 240.00 |
|
Designer Titanium Frame Model: Aviator Classic. Lightweight, hypoallergenic, and durable frame selected in-store. |
1 | 220.00 | 220.00 |
|
Blue Light Filtering Treatment Digital eye strain protection for prolonged computer use. |
1 | 45.00 | 45.00 |
|
Dispensing Fee Professional fee for lens edging, frame adjustment, and quality control. |
1 | 35.00 | 35.00 |
Payment Terms and Conditions
This invoice represents the total cost for optometric services and optical goods provided by Montreal Vision Care Optometry. Payment is due within 30 days of the invoice date. Late payments may incur a 1.5% monthly interest charge. Please make cheques payable to "Montreal Vision Care Optometry" or pay via Interac e-Transfer to [email protected].
Insurance Claims: As per Canadian regulations, please submit this invoice to your insurance provider for reimbursement. We can also process direct billing for major providers if your plan allows. Please note that eye examinations are covered annually by the Quebec Health Insurance Plan (RAMQ) for children under 18 and seniors over 65.
Warranty: All frames come with a 1-year manufacturer warranty against defects. Lenses are guaranteed against manufacturing errors for 12 months. Adjustments are free of charge for the lifetime of the frame.
Thank you for choosing our optometrist services in Montreal, Canada. We are committed to providing you with the highest standard of eye care.
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