Invoice Psychologist in India Mumbai –Free Word Template Download with AI
Licensed Clinical Psychologist Services
405, Harmony Heights, Linking Road,
Bandra West, Mumbai, Maharashtra 400050,
India
Phone: +91 22 2648 7890
Email: [email protected]
GSTIN: 27AABCM1234F1Z5
Registration No: MH/PSY/2018/4567
Invoice No: MW-2024-0892
Date: 15th January 2024
Due Date: 30th January 2024
| Bill To: |
Mr. Rajesh Kumar Sharma Flat 302, Sunrise Apartments, Andheri East, Mumbai, Maharashtra 400069, India Phone: +91 98765 43210 Email: [email protected] GSTIN: 27ABCDE1234F1Z9 |
| Patient ID: | MW-PAT-2024-0156 |
| Treatment Period: | 1st January 2024 to 15th January 2024 |
| Consultant: | Dr. Priya Mehta, M.Phil Clinical Psychology, RCI Registered |
Client Information & Service Context
This invoice pertains to professional psychological services rendered by a registered clinical psychologist operating under the regulatory framework of the Rehabilitation Council of India (RCI). The services were provided at our Mumbai clinic located in Bandra West, adhering to the highest standards of ethical practice as mandated by the Indian Psychological Society and relevant healthcare regulations in Maharashtra.
The treatment plan involves cognitive-behavioral therapy sessions aimed at addressing anxiety management, stress reduction, and emotional well-being. All sessions conducted in Mumbai comply with confidentiality standards and data protection norms applicable in India.
| # | Description of Psychological Services | Date | Qty | Rate (INR) | Amount (INR) |
|---|---|---|---|---|---|
| 1 |
Initial Clinical Assessment & Diagnostic Evaluation Comprehensive psychological assessment including clinical interview, standardized testing, and formulation of treatment plan. Conducted at Mumbai clinic premises. |
01-Jan-2024 | 1 | 3,500.00 | 3,500.00 |
| 2 |
Individual Psychotherapy Session (CBT) One-on-one cognitive behavioral therapy session focusing on anxiety management techniques. Duration: 60 minutes. |
05-Jan-2024 | 1 | 2,500.00 | 2,500.00 |
| 3 |
Individual Psychotherapy Session (CBT) Continuation of cognitive behavioral therapy with emphasis on cognitive restructuring and behavioral activation strategies. |
08-Jan-2024 | 1 | 2,500.00 | 2,500.00 |
| 4 |
Individual Psychotherapy Session (CBT) Session focused on stress management techniques, mindfulness practices, and relapse prevention planning. |
12-Jan-2024 | 1 | 2,500.00 | 2,500.00 |
| 5 |
Psychological Test Battery Administration & Scoring Administration and interpretation of standardized psychological assessment tools including Beck Anxiety Inventory and Depression Scale. |
01-Jan-2024 | 1 | 1,800.00 | 1,800.00 |
| 6 |
Clinical Report Preparation Detailed psychological assessment report with diagnostic impressions, treatment recommendations, and progress notes for medical records. |
15-Jan-2024 | 1 | 1,500.00 | 1,500.00 |
| Subtotal: | ₹14,300.00 |
| GST @ 18% (Healthcare Services): | ₹2,574.00 |
| Professional Service Charge: | ₹0.00 |
| TOTAL AMOUNT DUE: | ₹16,874.00 |
Payment Instructions
Please make payment within 15 days of invoice date. Payment can be made through the following methods:
- Bank Transfer (NEFT/RTGS/IMPS):
Account Name: MindWell Psychology Clinic Pvt. Ltd.
Bank: HDFC Bank, Bandra West Branch, Mumbai
Account Number: 50200012345678
IFSC Code: HDFC0001234
MICR: 400240002 - UPI Payment: mindwellpsychology@hdfcbank
- Cheque: Payable to "MindWell Psychology Clinic Pvt. Ltd." drawn on any Mumbai bank
- Credit/Debit Card: Available at clinic premises only
Note: Please quote Invoice Number MW-2024-0892 while making payment.
Important Notes & Terms
1. This invoice is issued in accordance with the Goods and Services Tax (GST) regulations applicable in India. The GSTIN mentioned above is valid and registered under the Maharashtra GST jurisdiction.
2. All psychological services rendered by our registered psychologist comply with the ethical guidelines established by the Rehabilitation Council of India (RCI) and the Indian Psychological Society.
3. Payment is due within 15 days from the invoice date. Late payments may attract interest at 1.5% per month on the outstanding amount as per applicable Indian commercial laws.
4. This invoice serves as an official receipt for tax purposes and insurance claims. Please retain this document for your records. For insurance reimbursement, a detailed clinical report can be provided upon request.
5. All patient information and clinical details are maintained with strict confidentiality as per the Information Technology Act, 2000, and applicable healthcare privacy regulations in India.
6. For any queries regarding this invoice or billing discrepancies, please contact our Mumbai office at +91 22 2648 7890 or email [email protected] during business hours (Monday to Saturday, 10:00 AM to 7:00 PM IST).
7. This invoice is computer-generated and does not require a physical signature to be valid. However, a signed copy can be provided upon request for official purposes.
Authorized Signatory
Dr. Priya Mehta
Lead Clinical Psychologist
RCI Registration: MH/PSY/2018/4567
For MindWell Psychology Clinic
Accounts Department
Mumbai, Maharashtra, India
Date: 15th January 2024
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