Invoice Orthodontist in Australia Melbourne –Free Word Template Download with AI
Level 4, 123 Collins Street
Melbourne VIC 3000, Australia
Phone: (03) 9123 4567
Email: [email protected]
ABN: 12 345 678 901
Provider Number: 987654321
Invoice Number: INV-2023-8942
Date Issued: 24 October 2023
Due Date: 24 November 2023
Payment Status: Pending
Bill To:
Mr. James Anderson
45 Chapel Street
South Yarra VIC 3141, Australia
Phone: 0400 123 456
Email: [email protected]
Payment Details:
Bank: Commonwealth Bank of Australia
BSB: 062-000
Account Name: Melbourne Orthodontic Specialists Pty Ltd
Account Number: 1234 5678
Reference: INV-2023-8942
| Description of Orthodontic Services | Item Code | Quantity | Unit Price (AUD) | Total (AUD) |
|---|---|---|---|---|
|
Initial Comprehensive Orthodontic Consultation Includes clinical examination, diagnostic records, and treatment planning discussion. |
ORT-001 | 1 | $250.00 | $250.00 |
|
Diagnostic Records Package Panoramic X-ray, Cephalometric X-ray, and digital intraoral photography. |
ORT-002 | 1 | $350.00 | $350.00 |
|
Fixed Appliance Therapy (Braces) - Upper Arch Placement of self-ligating brackets and archwires. Includes all adjustment appointments for the duration of treatment. |
ORT-101 | 1 | $4,500.00 | $4,500.00 |
|
Fixed Appliance Therapy (Braces) - Lower Arch Placement of self-ligating brackets and archwires. Includes all adjustment appointments for the duration of treatment. |
ORT-102 | 1 | $4,500.00 | $4,500.00 |
|
Intermaxillary Elastics Custom-cut elastics for bite correction and alignment refinement. |
ORT-205 | 1 | $150.00 | $150.00 |
|
Emergency Orthodontic Visit Repair of loose bracket and wire adjustment. |
ORT-301 | 1 | $120.00 | $120.00 |
|
Retention Phase - Fixed Retainers Bonded wire retainers for upper and lower anterior teeth to maintain alignment post-treatment. |
ORT-401 | 1 | $600.00 | $600.00 |
Important Notes & Terms:
This invoice represents the fees for orthodontic services rendered by Melbourne Orthodontic Specialists, a leading provider of dental care in Australia Melbourne. As per Australian tax regulations, Goods and Services Tax (GST) is applicable to all services provided.
Payment Terms: Payment is due within 30 days of the invoice date. Late payments may incur interest charges at the rate of 1.5% per month. We accept payments via bank transfer, credit card, and direct debit.
Health Insurance: While orthodontic treatment is generally not covered by Medicare, many private health insurance funds in Australia offer extras cover for orthodontics. We recommend contacting your provider to claim your rebate. Please note that the estimated rebate listed above is subject to your specific policy limits.
Treatment Plan: This invoice covers the initial phase of your comprehensive orthodontic treatment plan. Regular follow-up appointments are scheduled every 4-6 weeks to monitor progress and make necessary adjustments to your braces.
Contact Us: If you have any questions regarding this invoice or your treatment plan, please do not hesitate to contact our billing department at (03) 9123 4567 or email us at [email protected]. We are committed to providing exceptional orthodontic care in Melbourne, Australia.
⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
GoGPT