Invoice Speech Therapist in India Bangalore –Free Word Template Download with AI
Registered Speech Therapist Practice
2nd Floor, Wellness Tower, 100 Feet Road
Indiranagar, India Bangalore – 560038
GSTIN: 29ABCDE1234F1Z5
Phone: +91-80-4123-5678 | Email: [email protected]
Billed To (Client)
Mr. Rajesh Kumar Nair
45, 12th Main Road, HSR Layout
India Bangalore – 560102
GSTIN: 29FQXPK8901L1Z3
Phone: +91-98765-43210
Email: [email protected]
Provided By (Speech Therapist)
Dr. Ananya Sharma, M.S. (SLP)
Licensed Speech Therapist
Registration No: KSLP/2018/0042
ClearVoice Speech & Language Centre
India Bangalore – 560038
| Sr. No. | Description of Speech Therapy Service | Session Date | Duration | Rate (INR) | Amount (INR) |
|---|---|---|---|---|---|
| 1 | Individual Speech Therapy Session – Articulation Disorder (Child, Age 7) | 02 May 2025 | 45 min | 1,200.00 | 1,200.00 |
| 2 | Individual Speech Therapy Session – Articulation Disorder (Child, Age 7) | 09 May 2025 | 45 min | 1,200.00 | 1,200.00 |
| 3 | Individual Speech Therapy Session – Articulation Disorder (Child, Age 7) | 16 May 2025 | 45 min | 1,200.00 | 1,200.00 |
| 4 | Individual Speech Therapy Session – Articulation Disorder (Child, Age 7) | 23 May 2025 | 45 min | 1,200.00 | 1,200.00 |
| 5 | Individual Speech Therapy Session – Articulation Disorder (Child, Age 7) | 30 May 2025 | 45 min | 1,200.00 | 1,200.00 |
| 6 | Comprehensive Speech Assessment & Diagnostic Evaluation by Speech Therapist | 05 May 2025 | 90 min | 3,500.00 | 3,500.00 |
| 7 | Parent Counselling & Home Exercise Guidance Session (Speech Therapist-led) | 12 May 2025 | 30 min | 800.00 | 800.00 |
| 8 | Customised Speech Therapy Home Programme & Material Kit (India Bangalore edition) | 03 May 2025 | — | 1,500.00 | 1,500.00 |
| 9 | Progress Review & Therapy Plan Revision by Lead Speech Therapist | 28 May 2025 | 30 min | 1,000.00 | 1,000.00 |
| Subtotal (INR) | 13,700.00 |
| GST @ 18% (Applicable in India Bangalore) | 2,466.00 |
| Discount – Insurance Claim (MediClaim Policy #MC-9921) | (2,000.00) |
| Grand Total Payable (INR) | 14,166.00 |
Payment Instructions
Bank: HDFC Bank, Indiranagar Branch, India Bangalore
Account Name: ClearVoice Speech & Language Centre
Account No: 50200045678901
IFSC Code: HDFC0000123
UPI ID: clearvoicebl@hdfcbank
Payment Mode Accepted: NEFT / RTGS / UPI / Credit Card / Debit Card / Cash
Please quote Invoice No. CV/2025/00487 in the remarks field while making the payment. This Invoice is valid for 30 days from the date of issue. Late payments beyond the due date shall attract a convenience fee of 2% per month as per the terms agreed upon at the time of enrolment with our Speech Therapist practice in India Bangalore.
Important Notes & Terms
1. This Invoice has been issued by a registered and licensed Speech Therapist operating in India Bangalore under the Karnataka Speech-Language Pathology Council regulations.
2. All speech therapy services listed in this Invoice were personally conducted or supervised by Dr. Ananya Sharma, the designated Speech Therapist for the client's child.
3. The GST amount of 18% is levied as per the Goods and Services Tax Act, 2017, applicable to healthcare and allied services in India Bangalore.
4. The insurance discount has been pre-processed through MediClaim. The client is requested to retain this Invoice for any further reimbursement claims with their insurer.
5. No refund shall be issued for sessions already conducted. Rescheduling must be communicated at least 24 hours in advance to the Speech Therapist's office.
6. This Invoice serves as the official financial record for the therapy period of May 2025. A consolidated annual summary will be provided at the end of the therapy programme.
7. For any queries regarding this Invoice or the speech therapy services rendered, please contact the billing department at ClearVoice Speech & Language Centre, India Bangalore, within 15 days of the issue date.
Authorised SignatoryDr. Ananya Sharma
Lead Speech Therapist
ClearVoice Speech & Language Centre Client Acknowledgement
Mr. Rajesh Kumar Nair
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
Create your own Word template with our GoGPT AI prompt:
GoGPT