Invoice Psychologist in China Shanghai –Free Word Template Download with AI
Professional Psychological Services
Room 1205, Tower B, Jing'an Kerry Centre
1515 West Nanjing Road, Jing'an District
Shanghai, China 200040
Tel: +86 21 6288 9900 | Email: [email protected]
Unified Social Credit Code: 91310106MA1FL8XXXX
Invoice Number: INV-SH-2023-10-045
Date of Issue: October 24, 2023
Due Date: November 07, 2023
Service Period: October 01, 2023 - October 23, 2023
Bill To (Client)Mr. Jonathan Sterling
Expat Health & Wellness Program
188 Huaihai Middle Road
Huangpu District, Shanghai, China 200021
Tax ID / VAT Number: 91310101MA1KXXXXXX
Pay From (Provider)Dr. Elena Zhang, Ph.D.
Licensed Clinical Psychologist
License No: SH-PY-2019-00882
Bank: Bank of China, Shanghai Branch
Account Name: Shanghai Mind & Wellness Center Co., Ltd.
Account Number: 4528 8899 0011 2233
SWIFT Code: BKCHCNBJ300
Description of Psychological Services Rendered| # | Service Description | Date | Hours | Rate (CNY) | Amount (CNY) |
|---|---|---|---|---|---|
| 1 |
Initial Clinical Assessment & Intake Evaluation Comprehensive psychological evaluation conducted in Shanghai. Includes history taking, cognitive screening, and formulation of a personalized treatment plan tailored to the client's specific mental health needs within the context of living in China. |
Oct 02 | 1.5 | 1,200.00 | 1,800.00 |
| 2 |
Individual Psychotherapy Session (CBT Focus) Cognitive Behavioral Therapy session addressing anxiety management and cultural adjustment stress. Conducted by a licensed Psychologist specializing in cross-cultural psychology in Shanghai. |
Oct 05 | 1.0 | 1,000.00 | 1,000.00 |
| 3 |
Individual Psychotherapy Session (CBT Focus) Continuation of therapeutic intervention focusing on coping mechanisms and emotional regulation strategies. |
Oct 12 | 1.0 | 1,000.00 | 1,000.00 |
| 4 |
Individual Psychotherapy Session (CBT Focus) Review of progress, reinforcement of cognitive restructuring techniques, and planning for relapse prevention. |
Oct 19 | 1.0 | 1,000.00 | 1,000.00 |
| 5 |
Psychological Report Generation & Consultation Preparation of a detailed clinical summary report for the client's employer or insurance provider, adhering to confidentiality standards and regulations applicable in Shanghai, China. Includes administrative time for secure documentation handling. |
Oct 23 | 1.0 | 800.00 | 800.00 |
Amount in Words: Five Thousand Seven Hundred Thirty-Six Chinese Yuan Renminbi Only.
Terms and Conditions of Payment
1. Payment Deadline: Payment is due within 14 days of the invoice date. Late payments may incur a penalty fee of 1.5% per month on the outstanding balance.
2. Currency: All amounts are quoted in Chinese Yuan Renminbi (CNY/RMB). Payments made in foreign currency will be converted at the prevailing exchange rate on the date of receipt.
3. Bank Charges: Any bank transfer fees or intermediary bank charges incurred during the transaction are the responsibility of the payer.
4. Confidentiality: As a licensed Psychologist operating in Shanghai, all clinical information shared during sessions is strictly confidential and protected under Chinese law and international ethical standards, unless disclosure is required by law.
5. Disputes: Any disputes arising from this invoice shall be resolved through negotiation. If unresolved, they shall be submitted to the People's Court in the district where the service provider is located in Shanghai.
6. Validity: This invoice is valid for tax deduction purposes in China. Please retain this document for your financial records.
Authorized Signature:
__________________________
Dr. Elena Zhang
Lead Psychologist & Director
Shanghai Mind & Wellness Center
[Official Company Seal / Financial Stamp to be affixed here]
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