Invoice Psychologist in Pakistan Karachi –Free Word Template Download with AI
Clinical Psychologist & Psychotherapist
Member: Pakistan Psychological Society (PPS)
Registration No: PPS-KHI-2024-889
Office: 4th Floor, Clifton Heights, Block 5
Clifton, Karachi, Sindh, Pakistan
Email: [email protected]
Phone: +92 21 3587 4400
Invoice Number: INV-KHI-2024-0056
Date of Issue: October 24, 2024
Due Date: November 07, 2024
Service Period: October 01, 2024 - October 24, 2024
Bill To:
Mr. Ahmed Khan
Flat 12-B, Sea View Apartments
Defence Housing Authority (DHA), Phase 6
Karachi, Sindh, Pakistan
Phone: +92 300 1234567
Email: [email protected]
| # | Description of Psychological Services | Date | Qty | Rate (PKR) | Total (PKR) |
|---|---|---|---|---|---|
| 1 |
Initial Clinical Assessment & Diagnosis Comprehensive intake interview, psychological history review, and preliminary diagnostic evaluation conducted at Clifton office. Includes review of patient history relevant to anxiety disorders. |
Oct 02, 2024 | 1 | 8,500.00 | 8,500.00 |
| 2 |
Individual Psychotherapy Session (CBT) Cognitive Behavioral Therapy session focusing on cognitive restructuring and exposure techniques. Duration: 60 minutes. |
Oct 09, 2024 | 1 | 5,000.00 | 5,000.00 |
| 3 |
Individual Psychotherapy Session (CBT) Continuation of treatment plan. Focus on behavioral activation and coping mechanism development. Duration: 60 minutes. |
Oct 16, 2024 | 1 | 5,000.00 | 5,000.00 |
| 4 |
Psychological Testing & Evaluation Administration and scoring of standardized psychological instruments (Beck Anxiety Inventory, MMPI-2) to assess current mental health status. |
Oct 16, 2024 | 1 | 12,000.00 | 12,000.00 |
| 5 |
Individual Psychotherapy Session (CBT) Review of test results and adjustment of therapeutic interventions. Duration: 60 minutes. |
Oct 23, 2024 | 1 | 5,000.00 | 5,000.00 |
Payment Information
Amount Due: PKR 40,120.00 (Forty Thousand One Hundred Twenty Pakistani Rupees Only)
Payment Method: Bank Transfer / JazzCash / EasyPaisa
Bank Name: Meezan Bank Limited
Branch: Clifton Branch, Karachi
Account Title: Dr. Ayesha Siddiqui
Account Number: 0123456789012
IBAN: PK36MEZN0000001234567890
SWIFT Code: MEZNPKKK
Please quote the Invoice Number (INV-KHI-2024-0056) in the payment remarks.
Terms and Conditions:
- Confidentiality: All psychological records and session details are strictly confidential and protected under the laws of Pakistan and the ethical code of the Pakistan Psychological Society.
- Cancellation Policy: A 24-hour notice is required for rescheduling or cancelling appointments. Late cancellations may incur a fee of 50% of the session rate.
- Payment Terms: Payment is due within 14 days of the invoice date. Late payments may be subject to a penalty of 2% per month.
- Validity: This invoice is valid for 30 days from the date of issue.
- Disputes: Any disputes regarding this invoice should be raised within 7 days of receipt. All legal matters are subject to the jurisdiction of the courts in Karachi, Sindh, Pakistan.
- Medical Records: A copy of this invoice and the associated psychological report will be kept in the patient's file for a minimum of 7 years as per regulatory requirements.
Important Note:
This document serves as an official financial record for the psychological services rendered. It is intended for personal records, insurance claims, or reimbursement purposes. The services provided are based on clinical judgment and professional standards practiced in Karachi.
Authorized Signature
Dr. Ayesha Siddiqui
Clinical Psychologist
Received By (Client)
Name: ______________________
Date: ______________________
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