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Invoice Psychologist in Japan Tokyo –Free Word Template Download with AI

3-14-7 Shinjuku, Shinjuku-ku, Tokyo 160-0022, Japan

Tel: +81-3-5555-0199 | Email: [email protected]

Corporate Number: 1234567890123

Professional Psychological Services

Billed To:
Mr. Kenji Tanaka
2-5-12 Shibuya, Shibuya-ku, Tokyo 150-0002, Japan
Email: [email protected]
Phone: +81-90-1234-5678
Invoice Number: INV-2023-10-042
Date of Issue: October 25, 2023
Due Date: November 10, 2023
Service Period: October 1, 2023 – October 21, 2023

Dear Mr. Tanaka,

This document serves as the official Invoice for the professional psychological counseling and therapeutic services rendered by our licensed Psychologist team at the Shinjuku Clinical Psychology Center. As a premier mental health facility located in the heart of Japan Tokyo, we are committed to providing high-quality, culturally sensitive, and evidence-based psychological care.

The services detailed below were conducted in accordance with the ethical guidelines of the Japanese Association of Clinical Psychology and the specific treatment plan agreed upon during our initial consultation. This invoice reflects the professional fees for sessions conducted both in-person at our Tokyo clinic and via secure telehealth platforms, ensuring accessibility and continuity of care for our clients residing in the Tokyo metropolitan area.

# Description of Service Date Quantity (Hours) Unit Price (JPY) Total (JPY)
1 Initial Psychological Assessment & Intake
Comprehensive evaluation conducted by a licensed Psychologist to determine clinical needs, history, and treatment goals. Includes standardized testing and diagnostic formulation.
Oct 01, 2023 1.5 ¥25,000 ¥37,500
2 Cognitive Behavioral Therapy (CBT) Session
Individual therapy session focusing on stress management and anxiety reduction techniques tailored for the fast-paced environment of Tokyo.
Oct 05, 2023 1.0 ¥15,000 ¥15,000
3 Cognitive Behavioral Therapy (CBT) Session
Follow-up session reviewing coping strategies and progress.
Oct 12, 2023 1.0 ¥15,000 ¥15,000
4 Psychological Report Generation
Preparation of a detailed clinical summary for the client's personal records, outlining progress and future recommendations.
Oct 15, 2023 1.0 ¥10,000 ¥10,000
5 Telehealth Counseling Session
Secure video consultation conducted by the assigned Psychologist to ensure continuity of care while the client was traveling within the Kanto region.
Oct 19, 2023 1.0 ¥15,000 ¥15,000

Subtotal: ¥92,500

Consumption Tax (10%): ¥9,250

Total Amount Due: ¥101,750

Payment Instructions

Please remit payment by the due date listed above. We accept the following payment methods common in Japan:

  • Bank Transfer (Fukkin):
    Bank: Mizuho Bank, Shinjuku Branch
    Account Type: Ordinary (Futsu)
    Account Number: 1234567
    Account Name: Shinjuku Clinical Psychology Center
  • Credit Card: Visa, Mastercard, JCB (Please contact billing to arrange)
  • Convenience Store Payment (Konbini): Available upon request via Pay-easy.

Note: Please include the Invoice Number (INV-2023-10-042) in your payment reference to ensure proper allocation.

Important Notes & Privacy Policy

Confidentiality: In accordance with the Japanese Act on the Protection of Personal Information and the ethical standards of the Psychologist profession, all information contained within this invoice and the associated treatment records is strictly confidential. This document is intended solely for the use of the client named above.

Insurance: Please note that unless specifically arranged through a corporate wellness program or specific health insurance provider, psychological counseling services in Japan are often considered self-pay (Jiko-bouho). This invoice represents the out-of-pocket cost for these specialized services.

Late Payments: To maintain the operational integrity of our clinic in Tokyo, late payments may incur a service fee of 1.5% per month after the due date.

Thank you for trusting our team of Psychologists with your mental health and well-being. We look forward to continuing our work together to support your journey toward improved psychological health.

Authorized By:

Dr. Yuki Sato

Senior Clinical Psychologist

Licence No: 12345678

Signature / Stamp (Hanko)
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