Invoice Psychologist in South Korea Seoul –Free Word Template Download with AI
Licensed Clinical Psychologist Services
123 Gangnam-daero, Gangnam-gu
Seoul, South Korea 06000
Tel: +82-2-555-0199 | Email: [email protected]
Business Registration No: 123-45-67890
Bill To (Client)Mr. James Anderson
45 Itaewon-ro, Yongsan-gu
Seoul, South Korea 04346
Email: [email protected]
Phone: +82-10-1234-5678
Service Provider (Psychologist)Dr. Min-Ji Park, Ph.D.
Licensed Clinical Psychologist
License No: PSY-SEOUL-88291
Member: Korean Psychological Association
Specialization: Cognitive Behavioral Therapy (CBT)
Description of Professional Services RenderedThe following invoice details the professional psychological services provided by Dr. Min-Ji Park at the Seoul Mind & Wellness Center. These services were conducted in accordance with the ethical standards of the Korean Psychological Association and local regulations governing mental health practice in Seoul, South Korea. All sessions were conducted either in-person at the Gangnam-gu clinic or via secure telehealth platforms approved for medical use in South Korea.
| Item | Service Description | Date(s) | Qty | Unit Price (KRW) | Total (KRW) |
|---|---|---|---|---|---|
| 1 |
Initial Clinical Assessment & Intake Comprehensive psychological evaluation including history taking, symptom assessment, and diagnostic formulation. This session established the treatment plan tailored to the client's needs within the cultural context of living in Seoul. |
Oct 02, 2023 | 1 | 150,000 | 150,000 |
| 2 |
Individual Psychotherapy Session (CBT) 50-minute individual therapy session focusing on anxiety management and cognitive restructuring. Conducted in English to ensure clear communication and therapeutic alliance. |
Oct 09, 2023 | 1 | 120,000 | 120,000 |
| 3 |
Individual Psychotherapy Session (CBT) Continuation of treatment plan. Focus on behavioral activation and stress reduction techniques applicable to daily life in Seoul. |
Oct 16, 2023 | 1 | 120,000 | 120,000 |
| 4 |
Psychological Testing Administration Administration and scoring of standardized psychological instruments (e.g., Beck Depression Inventory, GAD-7) to monitor progress and adjust therapeutic interventions. |
Oct 16, 2023 | 1 | 80,000 | 80,000 |
| 5 |
Individual Psychotherapy Session (CBT) Review of testing results and integration into therapy. Discussion of coping strategies for expatriate adjustment and workplace stress. |
Oct 23, 2023 | 1 | 120,000 | 120,000 |
| Subtotal: | 590,000 KRW |
| Value Added Tax (VAT) 10%: | 59,000 KRW |
| Total Amount Due: | 649,000 KRW |
Please remit payment within 14 days of the invoice date. Late payments may incur a 2% monthly interest charge as per South Korean commercial regulations.
Bank Transfer Details:
Bank Name: Shinhan Bank
Branch: Gangnam Branch
Account Name: Seoul Mind & Wellness Center Co., Ltd.
Account Number: 100-000-000000
SWIFT Code: SHBKKRSE
Note: Please include Invoice Number INV-2023-10-045 in the transfer reference.
Terms, Conditions, and Confidentiality Notice- Confidentiality: All information contained within this invoice and the associated psychological services is strictly confidential. In accordance with the Personal Information Protection Act of South Korea and the ethical guidelines for psychologists, client data is protected and will not be disclosed to third parties without written consent, except where required by law.
- Cancellation Policy: Appointments cancelled or missed without at least 24 hours' notice are subject to a cancellation fee equivalent to 50% of the session rate. This policy ensures the efficient allocation of the psychologist's time.
- Scope of Practice: The services provided by Dr. Min-Ji Park are strictly psychological in nature. This invoice does not cover psychiatric medication management or medical procedures, which fall under the jurisdiction of licensed medical doctors in South Korea.
- Dispute Resolution: Any disputes arising from this invoice or the services rendered shall be resolved through amicable negotiation. If unresolved, disputes shall be subject to the jurisdiction of the courts in Seoul, South Korea.
- Insurance: If you are using international health insurance or a Korean national health insurance plan that covers psychological services, please submit this invoice along with the detailed clinical report (if required) to your provider for reimbursement.
Authorized Signature (Psychologist)
Min-Ji Park
Dr. Min-Ji Park, Ph.D.
Seoul Mind & Wellness Center
Client Acknowledgement
(Optional: Sign to acknowledge receipt of invoice)
__________________________
Date: ______________
⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
GoGPT