Invoice Speech Therapist in Canada Toronto –Free Word Template Download with AI
2200 Bloor Street West, Suite 412
Toronto, Ontario M6S 1N8, Canada
Phone: (416) 555-0187 | Email: [email protected]
HST Registration No.: 123456789RT0001
College of Speech and Language Pathologists of Ontario (CSLPO) Member
Bill To (Client)
Client Name: Sarah Mitchell
Address: 145 Maple Avenue, Unit 3B
Toronto, Ontario M4K 2T7, Canada
Phone: (416) 555-0342
Email: [email protected]
Insurance Provider: Sun Life Financial
Policy Number: SL-8842-7719
Provided By (Speech Therapist)
Speech Therapist: Dr. Emily Chen, MSc, CCC-SLP
License No.: CSLPO-2019-44782
Specialty: Pediatric & Adult Speech-Language Pathology
Referring Physician: Dr. James Okafor, MD
Referral Date: March 10, 2025
| Session Date | Service Description | Duration | Rate (CAD) | Amount (CAD) |
|---|---|---|---|---|
| May 2, 2025 | Initial Speech Therapy Assessment – Articulation and Phonological Processing Evaluation for pediatric client (age 7). Comprehensive diagnostic session conducted by the Speech Therapist in Canada Toronto clinic. | 60 min | $150.00 | $150.00 |
| May 5, 2025 | Individual Speech Therapy Session – Targeted articulation drills, oral-motor exercises, and phonological awareness activities. Progress notes documented by the Speech Therapist. | 45 min | $125.00 | $125.00 |
| May 9, 2025 | Individual Speech Therapy Session – Fluency intervention, stuttering modification techniques, and anxiety-reduction strategies. Conducted in-person at the Canada Toronto office. | 45 min | $125.00 | $125.00 |
| May 13, 2025 | Parent/Caregiver Consultation – Home practice guidance, progress review, and updated treatment plan discussion. Speech Therapist provided written recommendations for daily exercises. | 30 min | $85.00 | $85.00 |
| May 16, 2025 | Individual Speech Therapy Session – Language comprehension and expression therapy, vocabulary building, and narrative skills development. Delivered by the Speech Therapist in Canada Toronto. | 45 min | $125.00 | $125.00 |
| May 20, 2025 | Telehealth Speech Therapy Session – Remote articulation practice and progress monitoring via secure video platform. Speech Therapist verified client identity and session parameters per Ontario regulations. | 45 min | $110.00 | $110.00 |
| May 23, 2025 | Individual Speech Therapy Session – Social communication (pragmatics) therapy, role-play scenarios, and turn-taking exercises. In-person session at the Canada Toronto clinic. | 45 min | $125.00 | $125.00 |
| May 27, 2025 | Monthly Progress Report & Treatment Plan Update – Written clinical report summarizing the month's Speech Therapy outcomes, goal attainment percentages, and revised objectives for the next billing cycle. Prepared by the Speech Therapist for insurance submission. | 1 hr (documentation) | $95.00 | $95.00 |
| May 30, 2025 | Individual Speech Therapy Session – Final monthly session: comprehensive review of all therapy goals, articulation accuracy testing, and preparation for next month's treatment phase. Conducted by the Speech Therapist in Canada Toronto. | 45 min | $125.00 | $125.00 |
Subtotal (9 sessions):$1,085.00
HST (13% – Ontario, Canada):$141.05
Insurance Pre-Authorization Adjustment:-$200.00
Amount Due (CAD):$1,026.05
Payment Instructions
This Invoice is payable within thirty (30) days of the date of issue. Please reference Invoice Number INV-2025-04872 on all correspondence and payments.
Bank Transfer (EFT): ClearVoice Speech Therapy Clinic | Institution: 004 | Transit: 12345 | Account: 987654321 | Branch: Toronto, ON
Online Payment: www.clearvoicespeech.ca/pay-invoice (secure portal accepting Visa, Mastercard, Interac e-Transfer)
Cheque: Make payable to "ClearVoice Speech Therapy Clinic" and mail to the Canada Toronto address listed above.
Insurance Billing: A copy of this Invoice and the accompanying clinical progress report have been submitted to Sun Life Financial for reimbursement under your Speech Therapy benefit. Please allow 10–15 business days for processing.
Important Notes & Terms
1. All Speech Therapy services listed on this Invoice were delivered by a licensed Speech Therapist registered with the College of Speech and Language Pathologists of Ontario (CSLPO) and are compliant with the Health Professions Act, 1991 (Ontario).
2. This Invoice reflects services rendered in Canada Toronto during the billing period of May 2025. All fees are quoted in Canadian Dollars (CAD) and are subject to the applicable 13% Harmonized Sales Tax (HST) as mandated by the Canada Revenue Agency (CRA).
3. Cancellation policy: Sessions cancelled with less than 24 hours' notice are subject to a 50% fee. No-shows are billed in full. This policy was acknowledged by the client at the time of the initial intake.
4. The Speech Therapist reserves the right to adjust treatment plans based on clinical progress. Any additional sessions beyond the scheduled monthly plan will be itemized on a separate Invoice.
5. Late payments are subject to a 1.5% monthly interest charge as per the Ontario Business Corporations Act. Please contact our billing office at (416) 555-0187 if you experience any difficulty with payment.
6. This Invoice and all associated clinical records are maintained in accordance with the Personal Health Information Protection Act (PHIPA), Ontario, and the federal Privacy Act of Canada.
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