Invoice Optometrist in Germany Frankfurt –Free Word Template Download with AI
Dr. med. Hans Müller, Optometrist
Zeil 102, 60313 Frankfurt am Main, Germany
Phone: +49 69 12345678
Email: [email protected]
VAT ID (USt-IdNr.): DE123456789
Handelsregister: HRB 98765 Frankfurt am Main
Invoice No: INV-2023-10-045
Date: October 24, 2023
Due Date: November 24, 2023
Reference: Patient ID #88421
Bill To:
Sarah Schmidt
Bockenheimer Landstraße 50
60325 Frankfurt am Main, Germany
Health Insurance: TK (Techniker Krankenkasse)
Policy Number: TK-99887766
| # | Description of Services | Quantity | Unit Price (EUR) | Total (EUR) |
|---|---|---|---|---|
| 1 |
Comprehensive Ophthalmological Examination Includes visual acuity testing, refraction, and ocular health assessment performed by a certified Optometrist in Frankfurt. |
1 | 120.00 | 120.00 |
| 2 |
Advanced Digital Retinal Imaging High-resolution fundus photography for early detection of diabetic retinopathy and macular degeneration. |
1 | 85.00 | 85.00 |
| 3 |
Prescription Eyewear (Premium Lenses) Bifocal lenses with anti-reflective coating and blue light filter. Frame: Titanium alloy, model "Frankfurt Classic". |
1 | 350.00 | 350.00 |
| 4 |
Contact Lens Fitting & Consultation Specialized fitting for toric soft contact lenses including follow-up adjustment. |
1 | 95.00 | 95.00 |
| 5 |
Visual Field Test (Perimetry) Automated perimetry to assess peripheral vision and detect glaucoma indicators. |
1 | 60.00 | 60.00 |
Payment Instructions
Please transfer the total amount due to the following bank account within 30 days of the invoice date:
Bank Name: Commerzbank AG Frankfurt
Account Holder: Frankfurt Vision Care GmbH
IBAN: DE89 5004 0000 0012 3456 78
BIC: COBADEFFXXX
Reference: INV-2023-10-045
Note: In accordance with German tax law (UStG), late payments may incur interest at the statutory rate. Please ensure your reference number is included to facilitate quick processing.
Terms and Conditions:
This invoice is issued by Frankfurt Vision Care, a registered Optometrist practice located in Frankfurt am Main, Germany. All services rendered are subject to the German Civil Code (BGB) and the German Commercial Code (HGB). Prices include the statutory value-added tax (VAT) of 19% as per §14 UStG. The patient acknowledges that the examination and treatment were performed according to the current standard of care in optometry and ophthalmology.
Data Privacy Notice: In compliance with the General Data Protection Regulation (GDPR) and the German Federal Data Protection Act (BDSG), your personal data is processed solely for billing and medical record-keeping purposes. Your data will be stored securely and deleted after the statutory retention period of 10 years for medical records and 6 years for commercial documents.
Insurance Information: The amount deducted for insurance coverage is an estimate based on the provided policy details from Techniker Krankenkasse (TK). If the actual reimbursement differs, the patient is responsible for the difference. Please contact our billing department if you have questions regarding your coverage.
Complaints Procedure: Should you have any complaints regarding the services provided by our Optometrist team, please contact our practice manager directly. We are committed to resolving any issues promptly and professionally.
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