Invoice Optometrist in Colombia Medellín –Free Word Template Download with AI
NIT: 900.123.456-7
Address: Carrera 43A # 3 Sur - 10, El Poblado
City: Medellín, Antioquia, Colombia
Phone: +57 (4) 444-5555
Email: [email protected]
License: RES-1234567890 (Ministry of Health)
Invoice Number: FAC-2023-00892
Date of Issue: October 24, 2023
Due Date: October 31, 2023
Payment Method: Bank Transfer / Credit Card
Bill To (Patient Information)
Carlos Andrés Rodríguez López 1.098.765.432-1 Calle 73 # 45 - 12, Laureles Medellín, Colombia [email protected] +57 300 123 4567| # | Description of Optometric Services / Products | Quantity | Unit Price (COP) | Total (COP) | Tax (19%) |
|---|---|---|---|---|---|
| 1 |
Comprehensive Eye Examination Includes visual acuity test, refraction, tonometry, and retinal evaluation. |
1 | 150,000 | 150,000 | 28,500 |
| 2 |
Premium Anti-Reflective Lenses High-index 1.67 lenses with blue light filter and UV protection. |
1 | 450,000 | 450,000 | 85,500 |
| 3 |
Titanium Bifocal Frame Lightweight titanium frame, model "Medellín Classic". |
1 | 320,000 | 320,000 | 60,800 |
| 4 |
Glaucoma Screening Test Perimetry and optic nerve assessment. |
1 | 80,000 | 80,000 | 15,200 |
| 5 |
Eye Health Consultation Detailed analysis of results and prescription advice. |
1 | 50,000 | 50,000 | 9,500 |
| Subtotal: | $1,050,000 |
| IVA (19% Tax): | $199,500 |
| Total Amount Due: | $1,249,500 COP |
Payment Instructions & Terms
Please make payments to the following bank account in Colombia:
Bank: Bancolombia
Account Type: Current Account (Cuenta Corriente)
Account Number: 123-456789-00
Account Holder: Medellín Vision Optometry Center S.A.S.
Reference: FAC-2023-00892
Payment is due within 7 days from the date of issue. Late payments may incur a 2% monthly interest rate as per Colombian commercial law.
Important Notes for the Patient
This invoice serves as official documentation for your optometric services and purchases at our clinic in Medellín. All services are performed by licensed optometrists registered with the Colombian Ministry of Health.
Your prescription is valid for one year from the date of examination. Please bring this invoice and your prescription to any authorized optical shop in Colombia for lens fabrication if you choose not to purchase frames here.
For any questions regarding this invoice or your eye health, please contact our billing department at [email protected] or visit us at our clinic in El Poblado, Medellín.
This document is issued in accordance with the tax regulations of the Republic of Colombia. The IVA (Value Added Tax) rate of 19% applies to all services and products unless otherwise specified by law. This invoice is valid for tax deduction purposes for individuals and companies registered in the Colombian tax system.
Medellín Vision Optometry Center guarantees the quality of all lenses and frames sold. A warranty of 6 months is provided against manufacturing defects. This warranty does not cover damage caused by misuse or accidents.
By accepting these services, the patient agrees to the terms and conditions outlined in the patient consent form signed at the time of the appointment. All personal data collected is handled in accordance with Law 1581 of 2012 on Personal Data Protection in Colombia.
Authorized SignatureDr. María Fernanda Gómez
Lead Optometrist Patient Signature
Carlos Andrés Rodríguez López
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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