Invoice Optometrist in United Arab Emirates Abu Dhabi –Free Word Template Download with AI
License No: DHA-OC-12345678
TRN: 100123456700003
P.O. Box 8899, Al Reem Island
Abu Dhabi, United Arab Emirates
Tel: +971 2 555 0199 | Email: [email protected]
Invoice #: INV-2023-0045
Date: October 24, 2023
Due Date: November 24, 2023
Bill To:
Mr. Ahmed Al Maktoum
Emirates ID: 784-1985-1234567-8
Al Khalidiya Street, Block C
Abu Dhabi, United Arab Emirates
Mobile: +971 50 123 4567
Insurance Details (If Applicable):
Provider: Daman Insurance
Policy No: DAM-99887766
Group ID: CORP-AD-555
Authorization Ref: AUTH-2023-889
| # | Description of Optometry Services | HSN/SAC Code | Qty | Unit Price (AED) | Total (AED) |
|---|---|---|---|---|---|
| 1 | Comprehensive Eye Examination & Refraction Test (Optometrist Consultation) | 993311 | 1 | 350.00 | 350.00 |
| 2 | Digital Retinal Imaging (Fundus Photography) for Diabetic Screening | 993312 | 1 | 200.00 | 200.00 |
| 3 | Prescription Eyewear: High-Index Anti-Reflective Lenses (Pair) | 900311 | 1 | 850.00 | 850.00 |
| 4 | Premium Titanium Eyeglass Frame | 900319 | 1 | 450.00 | 450.00 |
| 5 | Glaucoma Screening (Tonometry & Visual Field Test) | 993313 | 1 | 150.00 | 150.00 |
Terms, Conditions, and Regulatory Compliance
This invoice serves as a formal request for payment for optometry services rendered in Abu Dhabi, United Arab Emirates. As per the Federal Decree-Law No. (8) of 2017 on Value Added Tax, a 5% VAT has been applied to all taxable supplies of goods and services. The Tax Registration Number (TRN) listed above is valid and active with the Federal Tax Authority (FTA).
Payment Terms: Payment is due within 30 days from the date of this invoice. Late payments may incur a penalty of 2% per month on the outstanding balance. We accept payments via bank transfer, credit card, or cash at our Abu Dhabi clinic.
Bank Details:
Bank Name: Emirates NBD
Account Name: Abu Dhabi Vision Care Center LLC
IBAN: AE07 0331 2345 6789 0123 456
SWIFT: ENBD AEAD
Refund Policy: In accordance with UAE consumer protection laws, refunds for prescription eyewear are subject to a 14-day return policy, provided the items are unused and accompanied by this original invoice. Medical examination fees are non-refundable once the service has been performed by the licensed Optometrist.
Privacy Notice: Your personal health information is processed in strict compliance with the UAE Data Protection Law and the regulations set forth by the Department of Health – Abu Dhabi (DoH). This invoice contains sensitive data and should be handled with confidentiality.
Authorized Signature
Dr. Sarah Johnson, OD
Lead Optometrist
Received By
Date: _______________
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