Invoice Psychologist in Brazil São Paulo –Free Word Template Download with AI
CRP 06/123456 (Regional Council of Psychology - São Paulo)
Av. Paulista, 1000, 15th Floor, Suite 1502
Bela Vista, São Paulo - SP, Brazil
CEP: 01310-100
CNPJ: 12.345.678/0001-90 | CPF: 123.456.789-00
Email: [email protected]
Invoice Number: #SP-2023-0892
Date of Issue: October 25, 2023
Due Date: November 05, 2023
Issued By (Psychologist)Dr. Elena Silva
Specialist in Cognitive Behavioral Therapy
Member of the Brazilian Association of Psychology
Bill To (Client)Roberto Mendes
Rua Augusta, 500, Apt 42
Consolação, São Paulo - SP, Brazil
CEP: 01305-000
CPF: 987.654.321-00
| # | Description of Psychological Services | Quantity | Unit Price (BRL) | Total (BRL) |
|---|---|---|---|---|
| 1 |
Individual Psychotherapy Session (CBT) Clinical consultation conducted in São Paulo. Focus on anxiety management and cognitive restructuring. Session duration: 50 minutes. Compliant with ethical standards of the Federal Council of Psychology (CFP). |
4 | R$ 250.00 | R$ 1,000.00 |
| 2 |
Psychological Assessment Report Comprehensive diagnostic evaluation including application of standardized psychometric tests (WAIS-IV, BDI-II). Analysis of results and written report for clinical use. |
1 | R$ 800.00 | R$ 800.00 |
| 3 |
Telehealth Consultation Remote psychological support session via secure video platform. Follow-up on treatment plan adjustments. Duration: 50 minutes. |
2 | R$ 200.00 | R$ 400.00 |
| Subtotal: | R$ 2,200.00 |
| Discount: | R$ 0.00 |
| Tax (ISS - São Paulo): | R$ 110.00 |
| Total Due: | R$ 2,310.00 |
Payment Instructions
Please pay the total amount of R$ 2,310.00 (Two thousand, three hundred and ten Brazilian Reais) by the due date.
Bank Transfer (PIX):
Key: 123.456.789-00 (CPF)
Bank Slip (Boleto Bancário):
Barcode: 23793.34101 60000.000003 00000.000004 1 89000023100
Note: Boleto processing may take up to 2 business days.
Terms and Conditions
This invoice represents payment for professional psychological services rendered in accordance with the Code of Ethics and Professional Conduct of Psychologists in Brazil. All sessions were conducted with strict adherence to confidentiality principles as mandated by the Federal Council of Psychology (CFP).
The services described above were provided by a licensed Psychologist registered with the Regional Council of Psychology of São Paulo (CRP 06). The ISS tax has been calculated based on the current municipal rates applicable in the city of São Paulo for professional services.
In case of late payment, a penalty of 2% plus interest of 1% per month will be applied, in accordance with Brazilian consumer protection laws. This document serves as proof of payment for tax and accounting purposes.
Disclaimer: This invoice is a formal request for payment for psychological services. It does not contain any confidential clinical information about the client's treatment, diagnoses, or personal history, in compliance with data protection laws (LGPD - Lei Geral de Proteção de Dados) and professional ethical standards. For clinical records, please contact the psychologist's office directly with proper identification.
Dr. Elena Silva
Psychologist - CRP 06/123456
São Paulo, Brazil
Client Acknowledgment
Roberto Mendes
Date: _______________
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