Invoice Orthodontist in Turkey Istanbul –Free Word Template Download with AI
Levent Mahallesi, Büyükdere Caddesi No: 123
Şişli, 34394 Istanbul, Turkey
Phone: +90 (212) 555 0199
Email: [email protected]
Tax ID (Vergi No): 123 456 78 90
Chamber of Dentistry Registration: IST-98765
INVOICE
Invoice Number: INV-TR-2023-8842
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Currency: Turkish Lira (TRY)
Bill To (Patient Information)|
Mr. John Doe 456 Maple Street, Apt 4B New York, NY 10001 United States Passport No: A12345678 |
Payment Method: Bank Transfer / Credit Card Referral Code: MED-TOUR-2023 Treatment Plan ID: TP-ORTH-9921 |
The following invoice details the comprehensive orthodontic treatment provided at our clinic in Istanbul, Turkey. This document serves as an official record of the medical procedures, diagnostic assessments, and appliance fabrication costs associated with the patient's corrective dental care. All services were performed in accordance with the standards set by the Turkish Dental Association and international orthodontic guidelines.
| Item | Description of Service | Quantity | Unit Price (TRY) | Total (TRY) |
|---|---|---|---|---|
| 1 |
Initial Orthodontic Consultation & Diagnostic Assessment Comprehensive examination including panoramic X-rays, cephalometric analysis, and digital intraoral scanning to determine the severity of malocclusion and plan the treatment strategy. |
1 | 1,500.00 | 1,500.00 |
| 2 |
Pre-Treatment Dental Hygiene & Preparation Professional scaling and polishing to ensure optimal oral health prior to the placement of orthodontic appliances. |
1 | 800.00 | 800.00 |
| 3 |
Custom Clear Aligner Fabrication (Invisalign® Style) Design and manufacturing of a full series of custom-made, transparent aligners tailored to the patient's specific dental anatomy for gradual teeth straightening. |
1 | 25,000.00 | 25,000.00 |
| 4 |
Orthodontic Attachments & IPR Procedures Placement of composite attachments on teeth to facilitate movement and Interproximal Reduction (IPR) to create necessary space for alignment. |
1 | 2,200.00 | 2,200.00 |
| 5 |
Monthly Monitoring & Adjustment Visits (6 Months) Regular follow-up appointments in Istanbul to monitor progress, ensure aligner fit, and adjust the treatment plan as necessary. |
6 | 500.00 | 3,000.00 |
| 6 |
Post-Treatment Retainer Fabrication Custom-fitted Essix retainers to maintain the new alignment of teeth following the completion of the active orthodontic phase. |
2 | 1,200.00 | 2,400.00 |
| Subtotal: | 34,900.00 TRY |
| Value Added Tax (KDV - 1% Medical Rate): | 349.00 TRY |
| Grand Total: | 35,249.00 TRY |
1. Payment Deadline: The total amount of 35,249.00 TRY is due within 30 days of the invoice date. Late payments may incur a penalty fee of 2% per month.
2. Bank Transfer Details: For international transfers from outside Turkey, please use the following IBAN:
TR00 0006 2000 1234 5678 9000 01
Bank Name: Garanti BBVA, Istanbul Branch.
SWIFT/BIC Code: GARATRIS
3. Currency Fluctuation: While this invoice is issued in Turkish Lira (TRY), prices were calculated based on the exchange rate valid on the date of service. If payment is made in USD or EUR, the equivalent amount will be calculated based on the bank's exchange rate on the day of receipt.
4. Medical Tourism Note: This invoice is valid for insurance reimbursement claims. Golden Smile Orthodontics is a certified provider in Istanbul, Turkey, specializing in high-quality dental care for international patients. Please retain this document for your records and any necessary visa or medical documentation requirements.
Authorized Signature
Dr. Ahmet Yilmaz, DDS, MS
Head Orthodontist
Patient Acknowledgement
Signature & Date
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