Invoice Physiotherapist in France Paris –Free Word Template Download with AI
Dr. Sophie Laurent, Physiotherapist
12 Avenue de la République
75011 Paris, France
Tel: +33 1 43 55 67 89
Email: [email protected]
SIRET: 852 963 741 00012 | TVA Intracommunautaire: FR 12 852963741
Ordre des Masseurs-Kinésithérapeutes de Paris: N°75-1234
Invoice Number: INV-2023-10-045
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Payment Terms: Net 30 Days
Billed To (Patient)
Mr. Jean-Pierre Dubois
45 Rue de Rivoli
75004 Paris, France
Sécurité Sociale N°: 1 85 04 750 123456 78
Mutuelle: Groupama Santé Premium
Service Details
Treatment Period: October 1, 2023 - October 20, 2023
Diagnosis Code (CIM-10): M54.5 (Low Back Pain)
Referring Physician: Dr. Marc Lefebvre
Prescription Date: September 15, 2023
| # | Description of Physiotherapy Services | Date | Qty | Unit Price (€) | Total (€) |
|---|---|---|---|---|---|
| 1 | Initial Assessment & Postural Analysis (Consultation Initiale) | Oct 02, 2023 | 1 | 45.00 | 45.00 |
| 2 | Manual Therapy Session: Deep Tissue Massage & Joint Mobilization (Mains Libres) | Oct 05, 2023 | 1 | 35.00 | 35.00 |
| 3 | Electrotherapy: TENS & Ultrasound for Pain Management | Oct 07, 2023 | 1 | 30.00 | 30.00 |
| 4 | Therapeutic Exercise Program: Core Strengthening & Flexibility | Oct 10, 2023 | 1 | 35.00 | 35.00 |
| 5 | Manual Therapy Session: Myofascial Release Techniques | Oct 12, 2023 | 1 | 35.00 | 35.00 |
| 6 | Hydrotherapy Session (Aquatic Rehabilitation) | Oct 14, 2023 | 1 | 40.00 | 40.00 |
| 7 | Progress Evaluation & Treatment Plan Adjustment | Oct 17, 2023 | 1 | 30.00 | 30.00 |
| 8 | Final Session: Functional Training & Ergonomic Advice | Oct 20, 2023 | 1 | 35.00 | 35.00 |
Important Information Regarding This Invoice
This invoice represents the fees for physiotherapy services rendered in Paris, France, in accordance with the French National Health Insurance (Assurance Maladie) regulations and the tariff grid established by the Ordre National des Masseurs-Kinésithérapeutes. As a registered Physiotherapist in France, Dr. Sophie Laurent adheres to the strict professional standards required for medical billing in the Paris region.
Payment Instructions: Please remit payment via bank transfer to the account details below or by credit card in our clinic located in the 11th arrondissement of Paris. If you are utilizing a complementary health insurance plan (Mutuelle), please submit this invoice along with your "Feuille de Soins" to your provider for reimbursement of the remaining balance after the base Sécurité Sociale contribution.
Bank Details:
Bank: BNP Paribas Paris Centre
IBAN: FR76 3000 1007 9412 3456 7890 123
BIC: BNPAFRPP
Reference: INV-2023-10-045
Legal Notice: Under French law, this invoice must be retained for a period of ten years. Any disputes regarding the services provided or the billing accuracy must be raised within thirty days of the invoice date. This document serves as the official record of the therapeutic relationship between the patient and the physiotherapist for the specified period.
Thank you for trusting Paris Kiné Excellence with your rehabilitation needs. We are committed to providing high-quality, evidence-based physiotherapy care to help you regain mobility and improve your quality of life in the heart of Paris.
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