Invoice Psychiatrist in China Shanghai –Free Word Template Download with AI
Shanghai Mind & Wellness Psychiatry Clinic
1288 Nanjing West Road, Jing'an District
Shanghai, People's Republic of China
Tax ID: 91310106MA1K3X7Y8Z
Invoice Number: SH-PSY-2023-00459
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Currency: CNY (Chinese Yuan)
Bill To:Mr. David Chen
International Business Consultant
Room 1502, Tower A, Lujiazui Finance Center
Pudong New Area, Shanghai, China
Email: [email protected]
Phone: +86 138 0000 1234
Service Provider:Dr. Li Wei, MD, PhD
Senior Psychiatrist
Licence No: SH-PSY-2015-8892
Specialization: Cognitive Behavioral Therapy & Anxiety Disorders
Description of Services RenderedThis invoice details the professional psychiatric services provided by Dr. Li Wei at the Shanghai Mind & Wellness Psychiatry Clinic. These services were conducted in accordance with the medical standards and regulations set forth by the National Health Commission of the People's Republic of China. The treatments focused on comprehensive mental health assessment, diagnosis, and therapeutic intervention tailored to the patient's specific needs within the context of living and working in Shanghai.
| Item | Description of Service | Date | Unit Price (CNY) | Total (CNY) |
|---|---|---|---|---|
| 1 | Initial Psychiatric Consultation: Comprehensive intake interview, medical history review, and mental status examination. This session established the baseline for diagnosis and treatment planning. | Oct 10, 2023 | 800.00 | 800.00 |
| 2 | Psychological Assessment Battery: Administration and interpretation of standardized psychometric tests (including HADS and GAD-7) to evaluate anxiety and depression levels. | Oct 10, 2023 | 600.00 | 600.00 |
| 3 | Follow-up Therapy Session (CBT): Cognitive Behavioral Therapy session focusing on stress management techniques and coping strategies for workplace anxiety. | Oct 17, 2023 | 600.00 | 600.00 |
| 4 | Medication Management Review: Evaluation of current pharmacological treatment, dosage adjustment, and discussion of potential side effects. | Oct 24, 2023 | 400.00 | 400.00 |
| 5 | Medical Report Generation: Preparation of a detailed clinical summary and treatment plan for insurance reimbursement purposes. | Oct 24, 2023 | 300.00 | 300.00 |
| Subtotal: | 2,700.00 CNY |
| VAT (6%): | 162.00 CNY |
| Total Amount Due: | 2,862.00 CNY |
Payment Methods: Payment can be made via bank transfer, Alipay, or WeChat Pay. Please reference the Invoice Number (SH-PSY-2023-00459) in your transaction details.
Bank Details:
Bank Name: Bank of China, Shanghai Branch
Account Name: Shanghai Mind & Wellness Psychiatry Clinic Co., Ltd.
Account Number: 6222 0210 0123 4567 890
SWIFT Code: BKCHCNBJ300
Confidentiality: All patient information contained within this invoice and associated medical records is strictly confidential and protected under the Personal Information Protection Law (PIPL) of the People's Republic of China.
Validity: This invoice is valid for reimbursement purposes with international health insurance providers and local Chinese social medical insurance schemes, subject to their specific policy terms.
Authorized Signature:
Dr. Li WeiDate Signed:
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