Invoice Psychologist in Sri Lanka Colombo –Free Word Template Download with AI
Registered Psychologist Practice
No. 45, Galle Road, Colombo 03, Sri Lanka
Tel: +94 11 234 5678 | Email: [email protected]
Registration No: SL-PSY-2023-0892
Serving Sri Lanka Colombo & Surrounding AreasProfessional Psychological Services
Bill To:
Mr. Rajitha Perera
12/3, Lake House Road, Colombo 07, Sri Lanka
Email: [email protected]
Phone: +94 77 123 4567
NIC: 1985XXXXXXXV
Description of Psychological Services Rendered
The following invoice details professional psychological services provided by a licensed Psychologist operating in Sri Lanka Colombo. All services were conducted in accordance with the ethical guidelines set forth by the Sri Lanka Psychological Association and local healthcare regulations. These services include individual therapy sessions, psychological assessments, and specialized counseling interventions tailored to the client's mental health needs within the Colombo metropolitan area.
| # | Service Description | Date | Duration | Rate (LKR) | Amount (LKR) |
|---|---|---|---|---|---|
| 1 |
Initial Psychological Assessment & Intake Session Comprehensive evaluation conducted by licensed Psychologist in Colombo clinic. Includes clinical interview, mental status examination, and preliminary diagnostic formulation. |
Oct 01, 2024 | 90 mins | 12,000.00 | 12,000.00 |
| 2 |
Individual Cognitive Behavioral Therapy (CBT) Session One-on-one therapy session focusing on anxiety management techniques. Conducted at our Sri Lanka Colombo practice facility with full confidentiality. |
Oct 05, 2024 | 60 mins | 8,500.00 | 8,500.00 |
| 3 |
Individual Cognitive Behavioral Therapy (CBT) Session Continuation of therapeutic intervention with emphasis on cognitive restructuring and behavioral activation strategies. |
Oct 08, 2024 | 60 mins | 8,500.00 | 8,500.00 |
| 4 |
Psychological Testing & Psychometric Assessment Administration and scoring of standardized psychological instruments including Beck Depression Inventory-II and State-Trait Anxiety Inventory. Interpretation by qualified Psychologist. |
Oct 10, 2024 | 120 mins | 15,000.00 | 15,000.00 |
| 5 |
Individual Therapy Session - Trauma-Informed Care Specialized counseling session utilizing trauma-focused therapeutic approaches. Conducted in secure clinical environment in Colombo. |
Oct 12, 2024 | 60 mins | 9,000.00 | 9,000.00 |
| 6 |
Comprehensive Psychological Report Preparation Detailed written report summarizing assessment findings, diagnostic impressions, and treatment recommendations. Prepared by licensed Psychologist for client records. |
Oct 14, 2024 | 180 mins | 18,000.00 | 18,000.00 |
| 7 |
Follow-up Consultation & Treatment Planning Session Review of assessment results with client, discussion of therapeutic goals, and development of personalized treatment plan. |
Oct 15, 2024 | 60 mins | 8,500.00 | 8,500.00 |
| Subtotal: | 79,500.00 LKR |
| Value Added Tax (VAT) 8%: | 6,360.00 LKR |
| Professional Service Fee: | 0.00 LKR |
| TOTAL AMOUNT DUE: | 85,860.00 LKR |
Payment Instructions
Currency: Sri Lankan Rupees (LKR)
Bank Transfer Details:
Bank Name: Commercial Bank of Ceylon PLC
Branch: Colombo Fort Branch, Sri Lanka Colombo
Account Name: Mindful Horizons Psychological Services (Pvt) Ltd
Account Number: 1234-5678-9012-3456
SWIFT Code: COMBLKLX
Alternative Payment Methods: Cash payments accepted at our Colombo office. Digital payments via FriMi, Genie, or mCash also available. Please reference Invoice Number MH-INV-2024-0156 with all payments.
Important: All payments must be received by the due date to avoid service interruption. Late payments may incur a 2% monthly interest charge as per Sri Lankan commercial regulations.
Terms, Conditions & Professional Notes
1. This invoice represents professional psychological services rendered by a licensed Psychologist registered with the Sri Lanka Psychological Association and operating within Sri Lanka Colombo under applicable healthcare regulations.
2. All psychological services provided are confidential and protected under Sri Lankan privacy laws and professional ethical standards. Client information will not be disclosed without written consent except as required by law.
3. Payment is due within 15 days of the invoice date. Please contact our office immediately if you experience any difficulties with payment arrangements.
4. This invoice serves as an official receipt upon payment confirmation. Please retain this document for your personal records and any insurance reimbursement claims.
5. If you have any questions regarding the services provided or this invoice, please contact our administrative office in Colombo during business hours (Monday-Friday, 9:00 AM - 5:00 PM).
6. All rates quoted are in Sri Lankan Rupees (LKR) and are subject to applicable government taxes as mandated by Sri Lankan law.
7. This Psychologist practice maintains professional liability insurance coverage as required for healthcare providers in Sri Lanka Colombo.
8. For emergency mental health concerns, please contact the National Mental Health Service hotline or visit the nearest hospital emergency department in Colombo.
Authorized Signature:
Dr. Anjali Fernando, MSc, CPsycholLicensed Psychologist
Registration: SL-PSY-2023-0892
Client Acknowledgment:
Client Signature & Date(Optional)
Thank you for trusting Mindful Horizons Psychological Services with your mental health care needs in Sri Lanka Colombo. This invoice is a computer-generated document and is valid without signature upon payment confirmation.
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