Invoice Psychiatrist in Japan Osaka –Free Word Template Download with AI

Bill To: Mr. John Smith 4-5-6 Namba, Chuo-ku Osaka 542-0076, Japan Patient ID: #OSK-2023-8892 Invoice Details: Invoice Number: INV-2023-10-045 Date of Issue: October 25, 2023 Due Date: November 25, 2023 Service Period: October 1, 2023 - October 31, 2023 Service Description: This invoice represents the professional fees for psychiatric consultation, cognitive behavioral therapy, and medication management provided by a licensed Psychiatrist at our Osaka clinic. All services were rendered in accordance with the ethical guidelines of the Japanese Psychiatric Society and local regulations in Osaka.

#	Description of Psychiatric Services	Quantity	Unit Price (JPY)	Total (JPY)
1	Initial Comprehensive Psychiatric Evaluation Detailed clinical interview, history taking, and diagnostic assessment conducted by Dr. Tanaka in Osaka.	1	¥30,000	¥30,000
2	Individual Psychotherapy Sessions (CBT) Four 60-minute sessions focusing on anxiety management and cognitive restructuring.	4	¥15,000	¥60,000
3	Psychopharmacology Management Medication review, prescription adjustment, and monitoring of side effects.	2	¥10,000	¥20,000
4	Psychological Testing & Assessment Administration and interpretation of standardized psychological scales.	1	¥25,000	¥25,000
5	Administrative & Documentation Fee Preparation of medical reports and insurance documentation compliant with Japan Osaka health standards.	1	¥5,000	¥5,000

Subtotal: ¥140,000 Consumption Tax (10%): ¥14,000 Insurance Deductible (If Applicable): - ¥0 TOTAL DUE: ¥154,000 Payment Instructions:
Please remit payment within 30 days of the invoice date. Payments can be made via bank transfer to the following account located in Osaka:

Bank Name: Mizuho Bank, Umeda Branch
Account Type: Ordinary Account
Account Number: 1234567
Account Name: Osaka Advanced Psychiatry Co., Ltd.
Reference: Please include Invoice Number INV-2023-10-045 in the transfer memo.

Terms and Conditions:

1. This invoice is issued by a licensed Psychiatrist operating under the laws of Japan. All services provided in Osaka are subject to the confidentiality agreements outlined in the initial patient consent form.

2. Late payments may incur a penalty fee of 1.5% per month on the outstanding balance.

3. If you have any questions regarding this invoice or the psychiatric services rendered, please contact our billing department immediately.

4. This document serves as an official receipt for tax purposes in Japan.

5. In the event of a dispute, the laws of Osaka, Japan shall govern this transaction.

Authorized Signature
Dr. Kenji Tanaka, M.D.
Chief Psychiatrist Received By
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX

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