Invoice Psychologist in Malaysia Kuala Lumpur –Free Word Template Download with AI
Registered Clinical Psychologist Services
Lot 12-3, Menara KL Sentral, Jalan Stesen Sentral 5
Brickfields, 50470 Kuala Lumpur, Malaysia
Tel: +603-2188 9900 | Email: [email protected]
Company Reg No: 201801023456 (134567-X)
Malaysian Medical Council (MMC) Reg No: P12345
Invoice Number: MH-INV-2023-10-045
Date of Issue: 24 October 2023
Due Date: 24 November 2023
Payment Reference: REF-KL-PSY-9988
Bill To:
Mr. Tan Wei Ming
Unit 15-2, The Gardens Residence
Mid Valley City, 59200
Kuala Lumpur, Malaysia
IC No: 850101-10-XXXX
Service Period:
From: 01 October 2023
To: 31 October 2023
Location: Consultation Room B, Kuala Lumpur
Therapist: Dr. Sarah Lim, Clinical Psychologist
| # | Description of Psychological Services | Date | Qty | Unit Price (MYR) | Total (MYR) |
|---|---|---|---|---|---|
| 1 |
Initial Clinical Assessment & Diagnostic Interview Comprehensive psychological evaluation conducted in Kuala Lumpur. Includes history taking, symptom assessment, and formulation of treatment plan. |
02 Oct 2023 | 1 | RM 450.00 | RM 450.00 |
| 2 |
Cognitive Behavioral Therapy (CBT) Session Individual therapy session focusing on anxiety management techniques. Duration: 60 minutes. |
09 Oct 2023 | 1 | RM 350.00 | RM 350.00 |
| 3 |
Cognitive Behavioral Therapy (CBT) Session Individual therapy session focusing on cognitive restructuring. Duration: 60 minutes. |
16 Oct 2023 | 1 | RM 350.00 | RM 350.00 |
| 4 |
Cognitive Behavioral Therapy (CBT) Session Individual therapy session focusing on behavioral activation. Duration: 60 minutes. |
23 Oct 2023 | 1 | RM 350.00 | RM 350.00 |
| 5 |
Psychological Report Writing Preparation of detailed clinical report for employer/insurance purposes regarding fitness to work. |
25 Oct 2023 | 1 | RM 600.00 | RM 600.00 |
| Subtotal: | RM 2,100.00 |
| Service Tax (6%): | RM 126.00 |
| Discount (Corporate Package): | - RM 100.00 |
| TOTAL DUE: | RM 2,126.00 |
Payment Instructions & Terms
Bank Transfer Details:
Bank Name: Maybank Berhad
Account Name: Mindful Horizons Psychology Clinic Sdn Bhd
Account Number: 5634 1234 5678
Branch: Kuala Lumpur City Centre
Terms:
- Payment is due within 30 days of the invoice date.
- Please quote the Invoice Number (MH-INV-2023-10-045) as the payment reference.
- Late payments may incur a penalty of 1.5% per month on the outstanding balance.
- This invoice is valid for tax deduction purposes under Malaysian tax laws.
Clinical Notes & Confidentiality
This invoice represents professional services rendered by a registered Psychologist in Malaysia. All clinical interactions, assessments, and reports are conducted in strict adherence to the Code of Ethics of the Malaysian Psychological Society (MPS) and the Data Privacy Act 2010 of Malaysia.
The services listed above were provided at our Kuala Lumpur clinic. Any personal health information contained within associated clinical records is confidential and will not be disclosed to third parties without the explicit written consent of the patient, except where required by law.
If you have any questions regarding this invoice or the services provided, please contact our billing department at +603-2188 9900 or email [email protected].
Authorized Signature
Dr. Sarah Lim
Clinical Psychologist
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