Invoice Psychologist in India Bangalore –Free Word Template Download with AI
Registered Clinical Psychologist Practice
123, 4th Floor, Prestige Towers, MG Road
Bangalore, Karnataka - 560001
India
Email: [email protected] | Phone: +91-80-1234-5678
Invoice #: MH-2023-10-045
Date: October 24, 2023
Due Date: November 07, 2023
Service Provider (Psychologist)
Dr. Ananya Sharma, Ph.D.
Clinical Psychologist & Psychotherapist
Registration No: KPC-2015-8901 (Karnataka Psychology Council)
GSTIN: 29ABCDE1234F1Z5
Bank: HDFC Bank
Account No: 50100012345678
IFSC: HDFC0001234
Bill To (Client)
Mr. Rajesh Kumar
45, Indiranagar 1st Stage
Bangalore, Karnataka - 560038
India
Email: [email protected]
Phone: +91-98765-43210
| Description of Services | Session ID | Date | Qty (Hrs) | Rate (INR) | Amount (INR) |
|---|---|---|---|---|---|
|
Initial Clinical Assessment & Diagnostic Interview Comprehensive psychological evaluation conducted at our Bangalore clinic. Includes history taking, behavioral observation, and preliminary diagnosis formulation. |
SESS-001 | Oct 10, 2023 | 1.5 | 2,500.00 | 3,750.00 |
|
Individual Psychotherapy Session (CBT) Cognitive Behavioral Therapy session focusing on anxiety management and cognitive restructuring techniques. |
SESS-002 | Oct 17, 2023 | 1.0 | 2,000.00 | 2,000.00 |
|
Individual Psychotherapy Session (CBT) Continuation of therapy plan. Focus on exposure therapy exercises and homework review. |
SESS-003 | Oct 24, 2023 | 1.0 | 2,000.00 | 2,000.00 |
|
Psychometric Testing Administration Administration and scoring of standardized psychological tests (Beck Anxiety Inventory, MMPI-2) relevant to the client's case in Bangalore. |
TEST-001 | Oct 10, 2023 | 1.0 | 1,500.00 | 1,500.00 |
|
Detailed Clinical Report Generation Preparation of a comprehensive psychological report summarizing findings, diagnosis, and treatment recommendations for the client's records. |
RPT-001 | Oct 25, 2023 | 1.0 | 2,500.00 | 2,500.00 |
Terms and Conditions & Important Notes
- Payment Terms: Payment is due within 15 days of the invoice date. Late payments may incur a penalty of 2% per month.
- Currency: All amounts are quoted in Indian Rupees (INR).
- GST Compliance: This invoice is generated in accordance with the Goods and Services Tax (GST) regulations of India. The GSTIN provided above is valid for tax deduction at source (TDS) if applicable.
- Confidentiality: As a licensed Psychologist practicing in Bangalore, all services rendered are subject to strict client confidentiality protocols as per the Indian Psychologists Council guidelines.
- Cancellation Policy: Appointments cancelled less than 24 hours in advance may be charged at 50% of the session fee.
- Disputes: Any disputes regarding this invoice shall be subject to the jurisdiction of the courts in Bangalore, Karnataka, India.
- Refunds: Refunds for unused sessions are subject to the specific treatment plan agreement signed at the onset of therapy.
Thank you for trusting Mindful Horizons Psychology with your mental health journey.
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