Invoice Psychologist in Spain Madrid –Free Word Template Download with AI
Clinical Psychologist
Calle de Serrano, 45, 2ºB
28001, Madrid, Spain
NIF: 12345678Z
Professional License No: M-12345 (Colegio Oficial de Psicólogos de Madrid)
Email: [email protected]
Phone: +34 91 123 45 67
Invoice Number: INV-2023-10-042
Date of Issue: October 25, 2023
Due Date: November 09, 2023
Service Period: October 01, 2023 - October 31, 2023
Bill To:
Mr. Alejandro Fernandez
Calle de Alcalá, 102, 3ºA
28009, Madrid, Spain
NIF: 98765432A
Payment Method:
Bank Transfer (SEPA)
Bank: Banco Santander
IBAN: ES91 2100 0418 4502 0005 1332
BIC: BSCHESMMXXX
Please reference Invoice Number INV-2023-10-042 in the transfer concept.
| # | Description of Psychological Services | Quantity | Unit Price (€) | Total (€) |
|---|---|---|---|---|
| 1 |
Initial Clinical Assessment and Diagnostic Interview Comprehensive evaluation of mental health status, history taking, and formulation of a preliminary diagnostic hypothesis in accordance with DSM-5-TR and ICD-11 standards. Includes administration of standardized psychometric tests (BDI-II, STAI). |
1 | 120.00 | 120.00 |
| 2 |
Cognitive Behavioral Therapy (CBT) Sessions Individual psychotherapy sessions conducted at the clinic in Madrid. Focus on cognitive restructuring, behavioral activation, and exposure techniques for anxiety management. Each session duration: 50 minutes. |
4 | 90.00 | 360.00 |
| 3 |
Psychological Report Generation Drafting of a formal clinical report detailing assessment findings, diagnosis, treatment plan, and progress notes. This document is prepared for the patient's personal records and can be provided to referring physicians or insurance providers upon request, adhering to Spanish data protection laws (LOPDGDD). |
1 | 150.00 | 150.00 |
| 4 |
Emergency Consultation (Telehealth) Urgent video consultation session conducted via secure platform to address acute stress reaction outside of scheduled hours. |
1 | 100.00 | 100.00 |
Terms and Conditions of Service
This invoice represents the professional fees for psychological services rendered by Dr. Elena Rodriguez, a licensed Clinical Psychologist registered with the Official College of Psychologists of Madrid (Colegio Oficial de Psicólogos de Madrid). All services were provided in compliance with the ethical code of the Spanish psychological profession.
Payment Terms: Payment is due within 15 days of the invoice date. Late payments may incur a statutory interest charge as per Spanish commercial law. Please ensure the full amount, including VAT (IVA), is transferred to the IBAN provided above.
Confidentiality: All information contained within this invoice and the associated clinical records is strictly confidential. In accordance with the General Data Protection Regulation (GDPR) and the Spanish Organic Law 3/2018 on Personal Data Protection (LOPDGDD), your data is processed solely for billing and clinical management purposes.
Cancellation Policy: As per the clinic's policy in Madrid, appointments cancelled with less than 24 hours' notice are subject to a 50% cancellation fee, which may be invoiced separately.
Legal Jurisdiction: Any disputes arising from this invoice or the services provided shall be subject to the jurisdiction of the courts of Madrid, Spain.
Thank you for trusting our professional care. We are committed to supporting your mental well-being through evidence-based psychological practice.
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