Invoice Psychiatrist in Morocco Casablanca –Free Word Template Download with AI
Specialist Psychiatrist | MD, PhD
Order of Physicians of Morocco (OMP) No: 12345
123 Boulevard Mohammed V, Maarif
Casablanca 20250, Morocco
Tel: +212 522-000-000 | Email: [email protected]
Invoice Number: INV-2023-10-045
Date of Issue: October 24, 2023
Due Date: November 07, 2023
Currency: Moroccan Dirham (MAD)
Bill ToPatient Name: Mr. Karim Bennani
Address: 45 Rue Abou Faris Al Marini, Anfa
City: Casablanca, Morocco
Insurance Provider: CNSS / Mutualité Sociale Agricole (MSA)
Policy Number: CNSS-99887766
Description of Services Rendered| # | Date | Service Description | Quantity | Unit Price (MAD) | Total (MAD) |
|---|---|---|---|---|---|
| 1 | Oct 10, 2023 | Initial Psychiatric Consultation & Comprehensive Diagnostic Assessment in Casablanca. | 1 | 600.00 | 600.00 |
| 2 | Oct 17, 2023 | Cognitive Behavioral Therapy (CBT) Session - Individual Treatment. | 1 | 450.00 | 450.00 |
| 3 | Oct 24, 2023 | Psychopharmacological Management & Medication Review. | 1 | 400.00 | 400.00 |
| 4 | Oct 24, 2023 | Psychological Testing Battery (Anxiety & Depression Scales). | 1 | 350.00 | 350.00 |
Please remit payment within 14 days of the invoice date. Payments can be made via bank transfer or cash at the clinic located in Casablanca.
Bank Name: Attijariwafa Bank
Account Name: Dr. Amine El Fassi
IBAN: MA65 0115 1000 0000 0000 0000
BIC: ATJMMA22
Reference: INV-2023-10-045
1. Validity: This invoice is valid for payment within 30 days from the date of issue. Late payments may incur a penalty fee of 1.5% per month in accordance with Moroccan commercial law.
2. Services: All psychiatric services listed herein were performed by a licensed Psychiatrist registered with the Order of Physicians of Morocco. The treatments provided adhere to the medical standards of Casablanca and international psychiatric guidelines.
3. Confidentiality: Patient data and medical records associated with this invoice are strictly confidential and protected under Moroccan health privacy laws.
4. Disputes: Any disputes regarding this invoice must be raised in writing within 7 days of receipt. Failure to do so will be considered acceptance of the charges.
5. Jurisdiction: This invoice is subject to the laws of the Kingdom of Morocco. Any legal proceedings will be settled in the courts of Casablanca.
6. Insurance: This document serves as proof of service for insurance reimbursement claims. Please retain a copy for your records.
7. Currency: All amounts are quoted in Moroccan Dirhams (MAD). Foreign currency payments will be converted at the prevailing exchange rate on the date of transaction.
8. Accuracy: The provider guarantees the accuracy of the services rendered and the charges applied. Errors will be corrected upon notification.
9. Follow-up: This invoice covers the specific sessions listed. Future psychiatric consultations or therapy sessions will be billed separately.
10. Receipt: Upon full payment, a formal receipt will be issued confirming the settlement of this invoice.
Authorized Signature
Dr. Amine El FassiPsychiatrist
Casablanca, Morocco
Thank you for your trust.
This invoice is generated electronically and is valid without a physical signature if accompanied by the official seal of the practice.
Dr. Amine El Fassi | Specialist Psychiatrist | Casablanca, Morocco
Tel: +212 522-000-000 | Email: [email protected]
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