Invoice Physiotherapist in United Arab Emirates Abu Dhabi –Free Word Template Download with AI
License No: DHA-PT-2023-8842
Al Reem Island, Tower A, Level 3, Office 304
Abu Dhabi, United Arab Emirates
Tel: +971 2 555 0199 | Email: [email protected]
VAT Registration: AE 100 234 567 8000
Invoice Number: INV-AD-2023-1045
Date of Issue: October 24, 2023
Due Date: November 07, 2023
Payment Terms: Net 14 Days
Bill To:
Mr. Ahmed Al-Mansoori
Emirates ID: 784-1985-1234567-8
Residence: Khalifa City A, Villa 45
Abu Dhabi, United Arab Emirates
Mobile: +971 50 123 4567
Email: [email protected]
Service Details:
Treating Physiotherapist: Sarah Johnson, MSc PT
License No: DHA-PT-9921
Diagnosis Code (ICD-10): M54.5 (Low Back Pain)
Treatment Plan Ref: TP-2023-089
Insurance Provider: Daman Insurance
Policy Number: DAM-GRP-55421
| # | Description of Physiotherapy Services | Date of Service | Qty | Unit Price (AED) | Total (AED) |
|---|---|---|---|---|---|
| 1 |
Initial Comprehensive Assessment Full musculoskeletal evaluation, posture analysis, and range of motion testing conducted by a licensed Physiotherapist in Abu Dhabi. |
Oct 10, 2023 | 1 | 350.00 | 350.00 |
| 2 |
Manual Therapy Session Soft tissue mobilization and joint manipulation techniques to alleviate lower back stiffness. |
Oct 12, 2023 | 1 | 250.00 | 250.00 |
| 3 |
Therapeutic Exercise Program Guided core strengthening and flexibility exercises tailored for lumbar stability. |
Oct 14, 2023 | 1 | 200.00 | 200.00 |
| 4 |
Electrotherapy (TENS/Interferential) Pain management modality applied during session to reduce inflammation. |
Oct 14, 2023 | 1 | 100.00 | 100.00 |
| 5 |
Follow-up Physiotherapy Consultation Progress review and adjustment of treatment plan in accordance with UAE health standards. |
Oct 19, 2023 | 1 | 250.00 | 250.00 |
| 6 |
Ultrasound Therapy Deep heat therapy to promote tissue healing in the lumbar region. |
Oct 19, 2023 | 1 | 120.00 | 120.00 |
Terms and Conditions & Important Notes:
- Currency: All amounts are quoted in United Arab Emirates Dirhams (AED).
- VAT Compliance: This Invoice is issued in compliance with the Federal Tax Authority regulations of the United Arab Emirates. The VAT rate applied is 5%.
- Payment Methods: Payments can be made via bank transfer, credit card, or cash at our Abu Dhabi clinic. For bank transfers, please reference the Invoice Number.
- Insurance Claims: If paying out-of-pocket, please retain this Invoice for reimbursement claims with your insurance provider. We accept direct billing for major UAE insurers.
- Physiotherapy Standards: All services listed were performed by a licensed Physiotherapist registered with the Department of Health (DoH) Abu Dhabi.
- Disputes: Any discrepancies regarding this Invoice must be reported within 7 days of the issue date.
- Privacy: Your personal health information is treated with strict confidentiality in accordance with UAE health data protection laws.
Bank Details for Transfer:
Bank Name: Emirates NBD
Account Name: Abu Dhabi Advanced Physiotherapy Center LLC
IBAN: AE07 0331 2345 6789 0123 456
Branch: Al Reem Island
Abu Dhabi Advanced Physiotherapy Center Received By
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