Invoice Psychologist in Ivory Coast Abidjan –Free Word Template Download with AI
Ordre des Psychologues de Côte d'Ivoire (OPCI) License #2023-ABJ-492
Immeuble Les Cocotiers, 4th Floor, Office 402
Cocody Angré, Abidjan, Ivory Coast
Email: [email protected] | Phone: +225 07 00 00 00 00
Invoice Number: INV-2023-10-045
Date of Issue: October 24, 2023
Due Date: November 07, 2023
Bill From (Psychologist)
Dr. Aya Koné
Licensed Clinical Psychologist
Specialization: Cognitive Behavioral Therapy & Trauma
Tax ID (NIF): CI-ABJ-9988776655
RCCM: AB-2018-B-12345
Bill To (Client)
M. Jean-Marc Kouassi
Plateau, Abidjan, Ivory Coast
Client ID: CL-8821
Insurance Provider: Sanofi Assurances (Optional)
| # | Description of Psychological Services | Date of Service | Hours | Rate (XOF) | Total (XOF) |
|---|---|---|---|---|---|
| 1 |
Initial Clinical Intake Assessment Comprehensive evaluation of mental health status, history taking, and formulation of a preliminary treatment plan. Conducted at the Cocody clinic in Abidjan. |
Oct 02, 2023 | 1.5 | 45,000 | 67,500 |
| 2 |
Individual Psychotherapy Session (CBT) Cognitive Behavioral Therapy session focusing on anxiety management techniques and cognitive restructuring. |
Oct 09, 2023 | 1.0 | 35,000 | 35,000 |
| 3 |
Individual Psychotherapy Session (CBT) Follow-up session reviewing coping strategies and behavioral experiments. |
Oct 16, 2023 | 1.0 | 35,000 | 35,000 |
| 4 |
Psychological Testing & Evaluation Administration and scoring of standardized psychological instruments (e.g., Beck Depression Inventory) to monitor progress. |
Oct 16, 2023 | 0.5 | 20,000 | 10,000 |
| 5 |
Individual Psychotherapy Session Focus on relapse prevention planning and consolidation of therapeutic gains. |
Oct 23, 2023 | 1.0 | 35,000 | 35,000 |
Terms and Conditions of Service
This invoice represents the professional fees for psychological services rendered by Dr. Aya Koné, a licensed Psychologist operating within the jurisdiction of Abidjan, Ivory Coast. All services were provided in accordance with the ethical guidelines set forth by the Ordre des Psychologues de Côte d'Ivoire.
Payment Instructions: Payment is due within 14 days of the invoice date. Please make payments in West African CFA Francs (XOF). Payments can be made via mobile money (Orange Money, MTN MoMo), bank transfer to Ecobank Côte d'Ivoire (Account ending in 4455), or cash at the clinic located in Cocody.
Confidentiality: As a mental health professional in Ivory Coast, strict confidentiality is maintained regarding all client records and sessions, except in cases mandated by law. This invoice contains only billing information and does not disclose the specific nature of the diagnosis or treatment details to protect client privacy.
Late Fees: A late fee of 5% will be applied to invoices not paid within 30 days of the due date. Please contact the office immediately if you anticipate any difficulty in meeting the payment deadline.
Thank you for trusting our practice with your mental health needs. We are committed to providing high-quality psychological care in Abidjan.
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