Invoice Orthodontist in Switzerland Zurich –Free Word Template Download with AI
Dr. med. dent. Elena Müller, FHO
Bahnhofstrasse 45, 8001 Zurich, Switzerland
Tel: +41 44 123 45 67 | Email: [email protected]
VAT ID: CHE-123.456.789 MWST
Invoice No: ZH-2023-10-089
Date: October 24, 2023
Due Date: November 24, 2023
Reference: Patient ID #8842-A
Bill To:
Mr. Lukas Weber
Seefeldstrasse 112
8008 Zurich, Switzerland
Insurance Provider: Helsana AG
Policy Number: 9988776655
Case Reference: Ortho-Correction-2023
Service Overview
This invoice pertains to the specialized orthodontic care provided at our Zurich clinic. As a leading provider of dental alignment services in Switzerland, we adhere to the highest standards of the Swiss Dental Association. The following charges reflect the comprehensive treatment plan agreed upon for the correction of malocclusion and alignment of the dental arch. This invoice covers the initial consultation, diagnostic imaging, and the commencement of fixed appliance therapy.
| # | Description of Orthodontic Services | Code (ZAHN) | Qty | Unit Price (CHF) | Total (CHF) |
|---|---|---|---|---|---|
| 1 |
Initial Orthodontic Consultation & Diagnosis Comprehensive examination of the patient's dental structure, discussion of treatment options, and formulation of a personalized orthodontic plan. Includes review of medical history relevant to dental health in Zurich. |
01.01 | 1 | 180.00 | 180.00 |
| 2 |
Diagnostic Imaging & Records Panoramic X-ray (OPG), Cephalometric radiograph, and digital intraoral scanning. These diagnostics are crucial for precise treatment planning in complex orthodontic cases. |
02.05 | 1 | 250.00 | 250.00 |
| 3 |
Preparatory Dental Work Professional prophylaxis and minor interproximal reduction (IPR) to create necessary space for alignment. Performed by certified dental hygienists under the supervision of the lead Orthodontist. |
03.10 | 1 | 150.00 | 150.00 |
| 4 |
Placement of Fixed Orthodontic Appliances (Braces) Bonding of high-quality stainless steel brackets to both upper and lower arches. Includes the insertion of the initial archwire. This is the primary phase of active orthodontic treatment. |
04.20 | 1 | 1,200.00 | 1,200.00 |
| 5 |
Custom Orthodontic Elastics & Accessories Provision of intermaxillary elastics and ligatures required for bite correction. These materials are essential for guiding the jaw into the correct position during the treatment phase. |
05.05 | 3 | 45.00 | 135.00 |
| 6 |
First Adjustment Appointment Follow-up visit to adjust archwires and monitor tooth movement. Includes patient education on oral hygiene maintenance while wearing braces in Zurich. |
06.01 | 1 | 120.00 | 120.00 |
Payment Instructions & Terms
Bank Transfer (Recommended):
Please transfer the total amount of CHF 1,191.70 to the following account:
Bank: UBS Switzerland AG
Account Name: Zurich Precision Orthodontics
IBAN: CH93 0076 2011 6238 5295 7
Reference: ZH-2023-10-089
Terms: Payment is due within 30 days of the invoice date. Late payments may incur a statutory interest rate of 5% per annum as per Swiss Code of Obligations. Please note that this invoice is subject to Swiss tax laws. If you have any questions regarding this invoice or your orthodontic treatment plan, please contact our billing department in Zurich immediately.
Authorized Signature:
Dr. med. dent. Elena Müller
Lead Orthodontist
⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
GoGPT