Invoice Physiotherapist in Brazil Brasília –Free Word Template Download with AI
Professional Physiotherapy Services
Address: SIA Trecho 4, Lote 500, Asa Norte
Brasília, DF - Brazil, CEP: 71200-030
CNPJ: 12.345.678/0001-90
Phone: +55 (61) 3333-4444
Email: [email protected]
Invoice Number: INV-2024-0892
Date Issued: October 15, 2024
Due Date: October 30, 2024
Payment Terms: Net 15 Days
Billed To:
Client Name: Maria Silva Santos
CPF: 123.456.789-00
Address: SQS 308 Bloco A, Asa Sul
City: Brasília, DF - Brazil
CEP: 70376-530
Phone: +55 (61) 99999-8888
Email: [email protected]
Physiotherapy Services Rendered
This invoice represents the professional physiotherapy services provided by our licensed physiotherapist team at Brasília Physiotherapy Center. All treatments were conducted in accordance with Brazilian health regulations and professional standards established by the Federal Council of Physiotherapy and Occupational Therapy (COFFITO).
| Service Description | Code (CBHPM) | Date | Quantity | Unit Price (BRL) | Total (BRL) |
|---|---|---|---|---|---|
| Initial Physiotherapy Assessment and Evaluation | 93010.01-0 | September 20, 2024 | 1 | R$ 250.00 | R$ 250.00 |
| Manual Therapy Session - Lumbar Region | 93015.02-8 | September 25, 2024 | 1 | R$ 180.00 | R$ 180.00 |
| Electrotherapy Treatment (TENS) | 93020.03-5 | September 25, 2024 | 1 | R$ 120.00 | R$ 120.00 |
| Therapeutic Exercise Program - Core Strengthening | 93025.04-2 | October 02, 2024 | 1 | R$ 160.00 | R$ 160.00 |
| Manual Therapy Session - Lumbar Region | 93015.02-8 | October 02, 2024 | 1 | R$ 180.00 | R$ 180.00 |
| Postural Reeducation Session | 93030.05-9 | October 09, 2024 | 1 | R$ 170.00 | R$ 170.00 |
| Therapeutic Exercise Program - Flexibility | 93025.04-2 | October 09, 2024 | 1 | R$ 160.00 | R$ 160.00 |
| Follow-up Assessment and Progress Evaluation | 93010.02-8 | October 15, 2024 | 1 | R$ 200.00 | R$ 200.00 |
| Subtotal: | R$ 1,420.00 |
| Discount: | R$ 0.00 |
| Total Amount Due: | R$ 1,420.00 |
Payment Instructions
Payment for this invoice can be made through the following methods:
- Bank Transfer (TED/DOC): Banco do Brasil, Agency: 1234-5, Account: 67890-1, CNPJ: 12.345.678/0001-90
- Pix: CPF/CNPJ: 12.345.678/0001-90
- Credit Card: Available in person at our Brasília clinic (up to 3 installments)
Please include the invoice number (INV-2024-0892) as the payment reference. Late payments may incur a penalty of 2% plus interest of 1% per month, in accordance with Brazilian commercial law.
Important Notes:
1. This invoice is issued in compliance with Brazilian tax regulations and the National Health Surveillance Agency (ANVISA) guidelines for physiotherapy services.
2. All physiotherapy treatments were performed by licensed professionals registered with the Regional Council of Physiotherapy and Occupational Therapy of the Federal District (CREFITO-DF).
3. The services described in this invoice were provided at our clinic located in Brasília, Federal District, Brazil, and are subject to local and federal health regulations.
4. For insurance reimbursement purposes, please retain this invoice along with your medical prescription and treatment records.
5. If you have any questions regarding this invoice or the physiotherapy services provided, please contact our billing department at [email protected] or call +55 (61) 3333-4444.
6. This document serves as an official record of the physiotherapy services rendered and may be required for tax purposes in Brazil.
Authorized SignatureBrasília Physiotherapy Center Physiotherapist
Dr. João Oliveira
CREFITO-DF: 12345-F ⬇️ Download as DOCX Edit online as DOCX
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