Invoice Social Worker in United States Houston –Free Word Template Download with AI
Professional Social Worker Services — United States Houston, Texas
Invoice Status: Pending Payment
| Invoice Number: | INV-2025-HST-00472 |
| Invoice Date: | June 12, 2025 |
| Service Period: | May 1, 2025 – May 31, 2025 |
| Due Date: | July 12, 2025 (Net 30) |
| Reference / Case No.: | HCSS-2025-0891 |
| Payment Method: | Check, ACH Transfer, or Credit Card |
| Service Description | Date(s) | Hours | Rate | Amount |
|---|---|---|---|---|
| Individual counseling session — family conflict resolution and emotional support provided by the Social Worker | May 2, 2025 | 1.0 | $150.00 | $150.00 |
| Family group therapy session — multi-generational conflict mediation conducted in the Houston, Texas office | May 7, 2025 | 1.5 | $150.00 | $225.00 |
| Home visit assessment — Social Worker conducted in-home evaluation of living conditions and support systems in the Houston metropolitan area | May 12, 2025 | 2.0 | $175.00 | $350.00 |
| Crisis intervention and emergency support planning — immediate Social Worker response to acute family distress | May 15, 2025 | 1.0 | $200.00 | $200.00 |
| Resource coordination and community referral — Social Worker facilitated connections to United States Houston community programs, food assistance, and housing resources | May 19, 2025 | 1.0 | $150.00 | $150.00 |
| Follow-up individual counseling — progress review and continued therapeutic support by the Social Worker | May 23, 2025 | 1.0 | $150.00 | $150.00 |
| Case documentation and progress reporting — preparation of clinical notes, service summaries, and compliance documentation for the Social Worker's case file | May 28, 2025 | 1.5 | $125.00 | $187.50 |
| Transportation to United States Houston community meeting — Social Worker attended inter-agency coordination meeting at Harris County Social Services Center | May 30, 2025 | 1.0 | $100.00 | $100.00 |
| Subtotal | $1,512.50 |
| Tax (Texas State & Harris County, 8.25%) | $124.78 |
| Insurance Adjustment (Medicaid Reimbursement) | -$380.00 |
| Total Amount Due | $1,257.28 |
Payment Terms & Conditions
This Invoice is issued by Dr. Margaret L. Thompson, LCSW, a Licensed Clinical Social Worker operating in United States Houston, Texas. Payment of the full amount due on this Invoice is required within thirty (30) days of the Invoice date. Late payments will incur a 1.5% monthly interest charge as permitted under Texas Business & Commerce Code.
Accepted payment methods include personal check, ACH bank transfer, and major credit cards (Visa, Mastercard, American Express). Please reference Invoice Number INV-2025-HST-00472 on all remittances. Checks should be made payable to "Houston Community Social Services, LLC."
For questions regarding this Invoice or the Social Worker services rendered, please contact the billing office at (713) 555-0142 or via email at [email protected]. All inquiries will be addressed within two business days.
Additional Notes
This Invoice reflects professional Social Worker services delivered in accordance with the Texas Occupations Code, Chapter 503, and the standards set forth by the Texas State Board of Social Work Examiners. All services were provided by a Licensed Clinical Social Worker (LCSW) in good standing with the State of Texas. The Social Worker maintains full professional liability insurance through Houston Community Social Services, LLC, and all clinical records are stored in compliance with HIPAA regulations and Texas Health and Safety Code provisions.
The client acknowledges receipt of this Invoice and agrees to the terms stated herein. A copy of this Invoice has been filed in the Social Worker's case management system for regulatory and audit purposes. Should the client dispute any line item on this Invoice, written notice must be provided within fifteen (15) days of the Invoice date to allow for review and potential adjustment by the supervising Social Worker.
Thank you for entrusting your family's well-being to our Social Worker team here in United States Houston. We remain committed to providing compassionate, evidence-based social work services to the Houston community.
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