Invoice Psychologist in Japan Kyoto –Free Word Template Download with AI
Professional Psychological Services
123 Higashiyama-ku, Sannenzaka
Kyoto, Japan 605-0862
Tel: +81-75-555-0199
Email: [email protected]
Corporate Number: 123-45-6789012
Tax Invoice
Bill To: Mr. Hiroshi Tanaka45-2 Shimogyo-ku, Nishikigawa
Kyoto, Japan 600-8001
Japan Client ID: KYT-2023-8842
| # | Description of Psychological Services | Date | Qty | Amount (JPY) |
|---|---|---|---|---|
| 1 |
Individual Cognitive Behavioral Therapy (CBT) Session One-on-one clinical session conducted at the Kyoto Mind & Wellness Clinic. Focus on anxiety management and cognitive restructuring techniques. Includes pre-session assessment and post-session documentation. |
Oct 05, 2023 | 1 | ¥15,000 |
| 2 |
Psychological Assessment & Evaluation Comprehensive psychological evaluation including standardized testing (MMPI-2 and WAIS-IV). Administration, scoring, and interpretation of results by a licensed clinical psychologist in Kyoto. |
Oct 12, 2023 | 1 | ¥45,000 |
| 3 |
Individual Psychotherapy Session (Psychodynamic) Deep-dive therapeutic session focusing on interpersonal relationships and emotional regulation. Conducted in a private consultation room in the Higashiyama district. |
Oct 19, 2023 | 1 | ¥15,000 |
| 4 |
Written Clinical Report & Consultation Preparation of a detailed clinical summary report for the client's personal records or referral to other healthcare providers in Japan. Includes diagnostic impressions and treatment recommendations. |
Oct 22, 2023 | 1 | ¥10,000 |
| 5 |
Group Therapy Session: Stress Management Participation in a facilitated group therapy session focused on mindfulness and stress reduction techniques tailored for professionals working in the Kyoto metropolitan area. |
Oct 26, 2023 | 1 | ¥8,000 |
Payment Instructions
Please remit payment by the due date to avoid late fees. Payments can be made via bank transfer or credit card.
Bank Transfer Details:
Bank Name: Mizuho Bank, Kyoto Main Branch
Account Type: Ordinary Account
Account Number: 1234567
Account Name: Kyoto Mind & Wellness Clinic Co., Ltd.
SWIFT Code: MHCBJPJT
Credit Card:
Please contact our billing department to arrange payment via Visa, Mastercard, or JCB.
Terms and Conditions
- Confidentiality: All services provided by our Psychologist are subject to strict confidentiality agreements in accordance with Japanese medical ethics and privacy laws.
- Cancellation Policy: Appointments cancelled less than 24 hours in advance may be subject to a 50% cancellation fee.
- Late Payments: Invoices not paid by the due date will incur a late fee of 1.5% per month on the outstanding balance.
- Disputes: Any disputes regarding this invoice must be raised within 14 days of the invoice date.
- Scope of Practice: Services rendered are for psychological support and therapy. This invoice does not cover psychiatric medication management unless explicitly stated.
Dr. Sarah Jenkins
Lead Clinical Psychologist
License No: KYT-PSY-998877 Received By (Client)
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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