Invoice Psychiatrist in Egypt Cairo –Free Word Template Download with AI
Specialized Mental Health Services
15th of May Street, Zamalek District
Cairo Governorate, Egypt
Tax ID: EG-998877665544
Phone: +20 2 1234 5678 | Email: [email protected]
Invoice Number: INV-2023-CAI-0892
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Payment Terms: Net 30 Days
Bill To:
Mr. Ahmed Hassan Ibrahim
Apartment 402, The Heights Building
New Cairo, Fifth Settlement
Cairo, Egypt
Mobile: +20 100 123 4567
Insurance / Third Party Payer (If Applicable):
AXA Mansoura Insurance Company
Policy Number: AXA-PSY-2023-554
Claims Department
Cairo, Egypt
| # | Description of Psychiatric Services | Date of Service | Quantity / Hours | Unit Price (EGP) | Total (EGP) |
|---|---|---|---|---|---|
| 1 |
Initial Comprehensive Psychiatric Evaluation Including diagnostic assessment, medical history review, and formulation of treatment plan in accordance with DSM-5 standards. |
Oct 10, 2023 | 1 Session | 2,500.00 | 2,500.00 |
| 2 |
Cognitive Behavioral Therapy (CBT) Session Individual therapy session focusing on anxiety management and cognitive restructuring techniques. |
Oct 17, 2023 | 1 Hour | 1,800.00 | 1,800.00 |
| 3 |
Psychopharmacology Management Consultation Medication review, dosage adjustment, and monitoring of side effects for ongoing treatment. |
Oct 24, 2023 | 1 Session | 1,500.00 | 1,500.00 |
| 4 |
Psychological Testing & Assessment Battery Administration and interpretation of standardized psychological tests (MMPI-2, Beck Depression Inventory). |
Oct 12, 2023 | 1 Package | 3,000.00 | 3,000.00 |
| 5 |
Family Therapy Session Group session involving immediate family members to discuss support strategies and communication improvement. |
Oct 20, 2023 | 1.5 Hours | 2,200.00 | 3,300.00 |
Payment Instructions & Banking Details
Please make payment in Egyptian Pounds (EGP) via bank transfer to the following account:
Bank Name: National Bank of Egypt (NBE)
Branch: Zamalek Branch, Cairo
Account Name: Nile Valley Psychiatry Center
Account Number: 10012345678901
IBAN: EGP000019000100012345678901
Cheques should be made payable to "Nile Valley Psychiatry Center". Cash payments are accepted at the clinic reception in Cairo.
Terms and Conditions
- This invoice represents professional psychiatric services rendered in Cairo, Egypt, in accordance with the regulations of the Egyptian Syndicate of Psychiatrists.
- Payment is due within 30 days of the invoice date. Late payments may incur a penalty fee of 2% per month.
- All medical records and psychological assessments remain the property of the clinic but will be shared with the patient or authorized insurance provider upon request.
- Confidentiality is strictly maintained as per Egyptian medical privacy laws.
- Any disputes regarding this invoice should be resolved amicably or through the competent courts in Cairo Governorate.
Authorized Signature:
Dr. Sarah El-SayedChief Psychiatrist
Nile Valley Psychiatry Center ⬇️ Download as DOCX Edit online as DOCX
Create your own Word template with our GoGPT AI prompt:
GoGPT