Invoice School Counselor in United States Los Angeles –Free Word Template Download with AI
4521 Wilshire Boulevard, Suite 320
Los Angeles, California 90016
United States
Phone: (213) 555-0187
Email: [email protected]
CA License: LCS-104829 | EIN: 82-4471930
Bill To
Los Angeles Unified School District
Office of Student Services & Counseling
333 S. Spring Street, 14th Floor
Los Angeles, California 90013
United States
Attn: Dr. Patricia Hernandez, Director of Counseling
PO Box 4472, Los Angeles, CA 90044
Invoice Reference
Contract No.: LAUSD-SC-2025-0031
Service Period: May 1 – May 31, 2025
Program: Student Mental Health & Academic Support
Location: Los Angeles, United States
Authorized By: Dr. Patricia Hernandez
| # | Service Description | Date | Hours | Rate | Amount |
|---|---|---|---|---|---|
| 1 | School Counselor – Individual Student Sessions One-on-one counseling sessions provided by a licensed School Counselor to students experiencing academic stress, social anxiety, and family-related challenges. Conducted at Westside High School campus in Los Angeles, United States. Includes intake assessment, session notes, and progress documentation for 42 individual student sessions. | May 1–31, 2025 | 42.0 | $95.00/hr | $3,990.00 |
| 2 | School Counselor – Group Counseling Programs Facilitation of weekly group counseling sessions focused on social-emotional learning, conflict resolution, and peer relationship development. The School Counselor led 12 group sessions across three grade levels at the Los Angeles, United States campus. Each session included structured activities, facilitation, and post-session reporting to school administration. | May 1–31, 2025 | 36.0 | $110.00/hr | $3,960.00 |
| 3 | School Counselor – Crisis Intervention & Referral Services Emergency crisis intervention response by the School Counselor for students in acute distress, including suicide risk assessment, safety planning, and coordination with community mental health providers in the Los Angeles, United States area. Includes 8 crisis response instances and 14 referral coordination calls with external agencies. | May 1–31, 2025 | 18.5 | $135.00/hr | $2,497.50 |
| 4 | School Counselor – Parent & Guardian Consultations Scheduled consultations between the School Counselor and parents or legal guardians to discuss student progress, behavioral concerns, academic planning, and available support resources within the Los Angeles, United States school district. Includes 22 individual parent meetings and 6 joint family sessions. | May 1–31, 2025 | 28.0 | $100.00/hr | $2,800.00 |
| 5 | School Counselor – Administrative & Documentation Services Preparation of monthly progress reports, maintenance of confidential student records in compliance with FERPA regulations, attendance at IEP and 504 plan meetings, coordination with school administrators, and completion of required state reporting for the California Department of Education. All documentation prepared by the School Counselor for the Los Angeles, United States district office. | May 1–31, 2025 | 24.0 | $85.00/hr | $2,040.00 |
| 6 | School Counselor – Professional Development & Training Delivery of a two-hour in-service training workshop for teaching staff on recognizing signs of student mental health concerns, trauma-informed classroom practices, and effective referral pathways. Conducted at the Los Angeles, United States district professional development center. Includes preparation, delivery, and follow-up materials for 85 participating educators. | May 22, 2025 | 8.0 | $120.00/hr | $960.00 |
| Subtotal | $16,247.50 |
| Applicable Discount (Contract Rate) | -$812.38 |
| Adjusted Subtotal | $15,435.12 |
| California Sales Tax (7.25% – Los Angeles County) | $1,119.05 |
| Los Angeles Municipal Tax (0.30%) | $46.31 |
| Grand Total Due | $16,600.48 |
Invoice Notes & Terms of Service
This Invoice is issued by Westside Educational Counseling Group in accordance with Contract No. LAUSD-SC-2025-0031 between the School Counselor service provider and the Los Angeles Unified School District. All services were rendered in the city of Los Angeles, United States, and are subject to the terms outlined in the master service agreement executed on January 15, 2025.
The School Counselor services described in this Invoice were performed by a licensed professional holding California LCS license number LCS-104829, in full compliance with the California Education Code, Section 49400 et seq., and all applicable federal regulations including the Family Educational Rights and Privacy Act (FERPA).
All student records, session notes, and documentation referenced in this Invoice are maintained in strict confidence. No personally identifiable information of students is included in this billing document. The School Counselor adheres to the ethical standards set forth by the American School Counselor Association (ASCA) and the California Association of School Counselors and Administrators (CASC).
Payment for this Invoice is due within thirty (30) calendar days of the issue date. Late payments are subject to a 1.5% monthly interest charge as stipulated in the contract. Please reference Invoice Number WECG-2025-00472 on all correspondence and remittances.
Payment Instructions
Method 1 – Electronic Funds Transfer (EFT): Bank: First Republic Bank, Los Angeles, United States | Routing: 121000358 | Account: 4472-8891-003 | Reference: WECG-2025-00472
Method 2 – Check: Make payable to "Westside Educational Counseling Group" and mail to: 4521 Wilshire Boulevard, Suite 320, Los Angeles, CA 90016, United States.
Method 3 – ACH Debit: Contact our billing office at (213) 555-0187 to arrange ACH authorization. Allow 3–5 business days for processing.
For questions regarding this Invoice or the School Counselor services rendered, please contact our billing department at [email protected] or call (213) 555-0187, Monday through Friday, 8:00 AM to 5:00 PM Pacific Time.
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