Invoice Psychiatrist in France Marseille –Free Word Template Download with AI
Member of the French Medical Council (Ordre des Médecins)
Invoice Number: INV-2023-10-045
Date of Issue: October 24, 2023
Due Date: November 24, 2023
From (Provider)
Dr. Jean-Pierre Valentin
Cabinet de Psychiatrie Méditerranée
12 Avenue du Prado
13008 Marseille, France
SIRET: 823 456 789 00012
TVA Intracommunautaire: FR 12 823456789
Email: [email protected]
Phone: +33 4 91 00 00 00
Bill To (Client)
Global Health Insurance Solutions Ltd.
Attn: Claims Department
45 Rue Paradis
13001 Marseille, France
Client Reference: GHIS-FR-8821
Description of Psychiatric Services Rendered
| Ref | Service Description | Date | Qty | Unit Price (€) | Total (€) |
|---|---|---|---|---|---|
| 01 |
Initial Psychiatric Consultation & Assessment Comprehensive diagnostic evaluation including clinical history, mental status examination, and risk assessment conducted at the Marseille clinic. |
Oct 02, 2023 | 1 | 140.00 | 140.00 |
| 02 |
Psychopharmacological Management Session Medication review, dosage adjustment, and monitoring of side effects for ongoing treatment plan. |
Oct 09, 2023 | 1 | 90.00 | 90.00 |
| 03 |
Cognitive Behavioral Therapy (CBT) Session One-hour individual psychotherapy session focused on anxiety management and cognitive restructuring techniques. |
Oct 16, 2023 | 1 | 110.00 | 110.00 |
| 04 |
Psychiatric Emergency Consultation Urgent assessment and stabilization provided outside of standard hours due to acute symptom exacerbation. |
Oct 18, 2023 | 1 | 180.00 | 180.00 |
| 05 | Medical Report & Administrative DocumentationOct 20, 2023 | 1 | 75.00 | 75.00 |
Important Notes & Payment Terms
This invoice represents the professional fees for psychiatric services rendered by Dr. Jean-Pierre Valentin in Marseille, France. All services were provided in accordance with the ethical standards of the French Medical Council and local healthcare regulations.
Payment Methods: Payment is expected within 30 days of the invoice date. Please make payments via bank transfer to the following account:
Bank: Crédit Agricole Provence Côte d'Azur
IBAN: FR76 3000 4000 0000 0000 0000 000
BIC: AGRIFRPP
Reference: INV-2023-10-045
Please note that the amount due reflects the balance after the standard reimbursement from the French National Health Insurance (Sécurité Sociale). Any remaining balance is the responsibility of the patient or their supplementary private insurance (Mutuelle). Late payments may incur a penalty interest rate as per French law.
For any questions regarding this invoice or the psychiatric care provided, please contact the administrative office at the Marseille clinic during business hours (Monday to Friday, 9:00 AM - 5:00 PM).
Authorized Signature
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