Invoice Speech Therapist in Belgium Brussels –Free Word Template Download with AI
Lead Speech Therapist: Dr. Elena Dubois, M.Sc.
12 Rue de la Loi / Wetstraat
1040 Brussels, Belgium
Email: [email protected]
Phone: +32 2 555 0199
VAT Number: BE 0891.234.567
Bill To:
Mr. Jean-Pierre Vandenberghe
45 Avenue Louise
1050 Brussels, Belgium
Insurance Provider: Mutualité Chrétienne / Christelijke Mutualiteit
Policy Number: MC-BRU-998877
| # | Description of Speech Therapy Services | Date | Qty | Unit Price (EUR) | Total (EUR) |
|---|---|---|---|---|---|
| 1 |
Initial Comprehensive Speech Assessment Detailed evaluation of articulation, phonology, and language comprehension. Conducted in accordance with Belgian healthcare standards for speech pathology. Includes diagnostic report generation. |
Oct 02 | 1 | 120.00 | 120.00 |
| 2 |
Individual Speech Therapy Session (Articulation) Targeted therapy for /r/ and /l/ sound production. Utilization of phonetic placement techniques and auditory discrimination exercises tailored for adult speech rehabilitation in Brussels. |
Oct 05 | 1 | 85.00 | 85.00 |
| 3 |
Individual Speech Therapy Session (Fluency) Stuttering management techniques including pacing strategies and desensitization exercises. Session conducted at our Brussels clinic facility. |
Oct 09 | 1 | 85.00 | 85.00 |
| 4 |
Individual Speech Therapy Session (Language Processing) Cognitive-linguistic therapy focusing on working memory and expressive language formulation. Includes homework assignment review. |
Oct 12 | 1 | 85.00 | 85.00 |
| 5 |
Individual Speech Therapy Session (Social Pragmatics) Role-playing scenarios to improve conversational turn-taking and non-verbal communication cues. Essential for professional integration in the Brussels business environment. |
Oct 16 | 1 | 85.00 | 85.00 |
| 6 |
Progress Report & Insurance Documentation Preparation of a detailed clinical progress report for submission to the Belgian National Institute for Health and Disability (RIZIV/INAMI) or private insurer. |
Oct 20 | 1 | 45.00 | 45.00 |
| Subtotal: | 465.00 EUR |
| VAT (21%): | 97.65 EUR |
| Total Due: | 562.65 EUR |
Payment Instructions
Please transfer the total amount of 562.65 EUR to the following bank account within 30 days:
Bank Name: KBC Bank Brussels
Account Holder: Brussels Speech & Language Clinic
IBAN: BE68 5390 0754 7032
BIC/SWIFT: KREDBEBB
Reference: INV-2023-10-042
Note: In Belgium, payments are typically made via bank transfer. Please include the invoice number as the reference to ensure proper allocation of funds.
Important Notes Regarding Speech Therapy in Belgium
This invoice reflects professional services rendered by a certified Speech Therapist operating within the Brussels-Capital Region. As per Belgian regulations, speech therapy services may be partially reimbursed by your mutual insurance fund (Mutualité/Mutualiteit). We recommend submitting this invoice along with the clinical report to your provider for reimbursement processing.
The rates listed above are in accordance with the standard tariffs for private speech therapy practices in Brussels. If you have a referral from a general practitioner or specialist, please ensure it is noted on your insurance claim.
For any questions regarding this invoice or your speech therapy treatment plan, please contact our administrative office in Brussels. We are committed to providing high-quality linguistic and speech rehabilitation services to our diverse community.
Legal Disclaimer: This document serves as a formal request for payment for services rendered. It is issued in compliance with the Belgian Code of Economic Law. The Speech Therapist listed is registered with the relevant professional order in Belgium. All prices are inclusive of applicable taxes unless stated otherwise. In case of late payment, statutory interest may apply according to Belgian law. This invoice is valid for tax purposes in the European Union.
Privacy Policy: Your personal data is processed in accordance with the General Data Protection Regulation (GDPR) and Belgian privacy laws. Your medical and financial information is kept strictly confidential and is only shared with insurance providers with your explicit consent.
Thank you for choosing Brussels Speech & Language Clinic for your communication needs. We appreciate your trust in our professional expertise.
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