Invoice Radiologist in Canada Montreal –Free Word Template Download with AI
Board-Certified Radiologist
Montreal Radiology Associates
1234 Rue Sherbrooke Ouest, Suite 500
Montreal, Quebec, Canada H3A 1B7
Phone: (514) 555-0198
Email: [email protected]
Invoice Number: INV-2024-0876
Date Issued: October 15, 2024
Due Date: November 15, 2024
Client Name: Montreal General Hospital - Imaging Department
Address: 1650 Cedar Avenue
City, Province, Postal Code: Montreal, Quebec, Canada H3G 1A4
Contact Person: Dr. Sarah Chen, Chief of Radiology
Phone: (514) 934-1934 ext. 2200
Email: [email protected]
From: September 1, 2024
To: September 30, 2024
This invoice pertains to professional radiological interpretation services provided by Dr. Jean-Pierre Lavoie, a certified Radiologist practicing in Montreal, Canada. All services were rendered in accordance with the standards set by the College of Physicians and Surgeons of Quebec (CPSQ) and the Canadian Association of Radiologists (CAR). The following procedures were interpreted and reported during the specified service period:
| Item # | Description of Service | Quantity | Unit Price (CAD) | Total (CAD) |
|---|---|---|---|---|
| 1 | MRI Brain with and without contrast - Interpretation and Report | 15 | 350.00 | 5,250.00 |
| 2 | CT Chest with contrast - Interpretation and Report | 20 | 275.00 | 5,500.00 |
| 3 | Mammography Screening - Bilateral, Interpretation and BI-RADS Assessment | 30 | 150.00 | 4,500.00 |
| 4 | Ultrasound Abdomen - Complete, Interpretation and Report | 25 | 200.00 | 5,000.00 |
| 5 | X-Ray Chest - PA and Lateral, Interpretation and Report | 50 | 75.00 | 3,750.00 |
| 6 | Emergency Radiology Coverage - Weekend Shift (12 hours) | 4 | 800.00 | 3,200.00 |
| 7 | Consultation with Referring Physicians - Complex Cases | 10 | 150.00 | 1,500.00 |
| 8 | Second Opinion Review - Prior Imaging Studies | 5 | 250.00 | 1,250.00 |
| Subtotal: | 29,950.00 | |||
| GST (5%): | 1,497.50 | |||
| QST (9.975%): | 2,987.51 | |||
| Total Amount Due (CAD): | 34,435.01 | |||
Payment is due within 30 days of the invoice date. Please make all payments in Canadian Dollars (CAD). Late payments may be subject to a 1.5% monthly interest charge. Payments can be made via bank transfer or cheque.
Bank Transfer Details:
Bank Name: Banque Nationale du Canada
Account Name: Montreal Radiology Associates Inc.
Transit Number: 00234
Institution Number: 006
Account Number: 123456789
SWIFT Code: BNOCMONT
All services provided by Dr. Jean-Pierre Lavoie, Radiologist, are performed in compliance with Canadian medical standards and regulations. This invoice reflects professional fees only and does not include facility or equipment costs, which are billed separately by the imaging center. For any questions regarding this invoice, please contact our billing department at [email protected] or call (514) 555-0198.
Thank you for your continued trust in our radiological services in Montreal, Canada.
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