Invoice School Counselor in United States San Francisco –Free Word Template Download with AI
1250 Market Street, Suite 480
San Francisco, California 94102
United States of America
Phone: (415) 555-0187
Email: [email protected]
CA License No. CS-2024-08841
From (Service Provider)
Dr. Margaret Chen, M.Ed., LPC
School Counselor – Licensed Professional Counselor
Bay Area Student Wellness & Counseling Group
1250 Market Street, Suite 480
San Francisco, CA 94102
United States
Tax ID (EIN): 84-2917365
Bill To (Client)
San Francisco Unified School District
Attn: Office of Student Services & Wellness
Dr. Robert Tanaka, Director of Student Affairs
180 Golden Gate Avenue
San Francisco, CA 94102
United States
PO Number: SFUSD-PO-2025-3341
| # | Service Description | Date(s) | Hours | Rate | Amount |
|---|---|---|---|---|---|
| 1 |
Individual Student Counseling Sessions One-on-one School Counselor sessions for at-risk students at Lincoln High School, San Francisco. Includes intake assessment, therapeutic intervention, and progress documentation for 24 students across the month. |
May 1 – May 31, 2025 | 48.0 | $125.00/hr | $6,000.00 |
| 2 |
Group Counseling & Crisis Intervention Facilitation of weekly group counseling sessions (6–12 students per group) addressing anxiety, peer conflict, and academic stress. Includes emergency crisis response for 3 incidents at San Francisco public schools during the service period. |
May 5, 12, 19, 26, 2025 | 20.0 | $140.00/hr | $2,800.00 |
| 3 |
Parent & Guardian Consultation Services School Counselor-led parent conferences and family support meetings. Includes 18 individual parent consultations and 2 community workshops held at the San Francisco Family Resource Center regarding adolescent mental health and academic planning. |
May 8, 15, 22, 29, 2025 | 16.0 | $130.00/hr | $2,080.00 |
| 4 |
Curriculum Development & Staff Training Design and delivery of a Social-Emotional Learning (SEL) curriculum module for middle school counselors in the San Francisco district. Includes 4 hours of in-service training for 35 school counselors and administrative staff at the SFUSD Professional Development Center. |
May 14 & May 21, 2025 | 12.0 | $155.00/hr | $1,860.00 |
| 5 |
Case Management & Administrative Reporting Ongoing case management for 12 high-need students, including IEP coordination, referral processing, and monthly progress reports submitted to the San Francisco Unified School District Office of Student Services. Includes end-of-month summary report and compliance documentation. |
May 1 – May 31, 2025 | 14.0 | $110.00/hr | $1,540.00 |
| 6 |
Community Partnership Coordination Coordination with San Francisco-based community mental health providers, including referrals to the San Francisco Department of Public Health, local youth shelters, and the Bay Area Children's Counseling Network. Includes 6 coordination meetings and 12 referral follow-ups. |
May 3 – May 30, 2025 | 8.0 | $120.00/hr | $960.00 |
| Subtotal | $15,240.00 |
| California State Sales Tax (8.5%) | $1,295.40 |
| San Francisco City & County Tax (1.5%) | $228.60 |
| Applicable Discounts | $0.00 |
| Grand Total Due | $16,764.00 |
Invoice Notes & Terms of Service
This Invoice is issued by Bay Area Student Wellness & Counseling Group for professional School Counselor services rendered to the San Francisco Unified School District during the month of May 2025. All services were performed in compliance with California Education Code Section 49068 and the United States federal Individuals with Disabilities Education Act (IDEA).
The School Counselor services described in this Invoice were delivered by Dr. Margaret Chen, a Licensed Professional Counselor (LPC) holding California License No. MHC-18472, and are fully covered under the district's contracted wellness services agreement (Contract No. SFUSD-WLS-2024-0091).
Payment is due within thirty (30) calendar days of the Invoice date. Late payments are subject to a 1.5% monthly interest charge as stipulated in the master service agreement. Please reference Invoice Number INV-2025-04782 and PO Number SFUSD-PO-2025-3341 on all remittances.
All student records and counseling documentation associated with these services remain confidential under the Family Educational Rights and Privacy Act (FERPA) and California Education Code Section 56050. No student-identifying information is included in this Invoice.
Payment Instructions
Method 1 – Electronic Funds Transfer (EFT): Bank: Bank of America, N.A. | Routing Number: 121000358 | Account Number: 4472-8891-003 | Reference: INV-2025-04782
Method 2 – Check: Make payable to "Bay Area Student Wellness & Counseling Group" and mail to: 1250 Market Street, Suite 480, San Francisco, CA 94102, United States.
Method 3 – ACH Debit: Contact our billing office at (415) 555-0187 to arrange ACH authorization. Processing time is 3–5 business days.
Questions regarding this Invoice: Please contact our billing department at [email protected] or call (415) 555-0187, Monday through Friday, 9:00 AM – 5:00 PM Pacific Time.
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