Invoice Speech Therapist in Ivory Coast Abidjan –Free Word Template Download with AI
12 Boulevard de la Paix, Cocody
Ivory Coast Abidjan, 01 BP 4521
Tel: +225 27 22 45 67 89 | Email: [email protected]
RC: CI-ABJ-2019-B-12345 | NIF: 00012345678901
Licensed Speech Therapist PracticeBill To (Client)
Mr. Kouassi Jean-Marc
45 Rue des Jardins, Plateau
Ivory Coast Abidjan, 01 BP 7890
Tel: +225 07 08 12 34 56
Email: [email protected]
Client Ref: CL-2025-0112
Service Provider
Dr. Aminata Traoré, MSc
Lead Speech Therapist
Abidjan Speech & Language Therapy Center
Ivory Coast Abidjan
License No: ST-CI-2020-0089
Member, Ivorian Association of Speech-Language Pathologists
| # | Service Description | Date(s) Rendered | Duration | Rate (XOF) | Amount (XOF) |
|---|---|---|---|---|---|
| 1 | Initial Speech Therapy Assessment & Diagnostic Evaluation – Comprehensive phonological, articulation, and language processing assessment conducted by the Speech Therapist for a 7-year-old child presenting with expressive language delay. | 02 Jun 2025 | 90 min | 45,000 | 45,000 |
| 2 | Individual Speech Therapy Session – Targeted articulation drills, oral-motor exercises, and phonemic awareness activities. Delivered by the Speech Therapist in a one-on-one clinical setting at the Ivory Coast Abidjan clinic. | 04, 09, 11 Jun 2025 | 3 × 60 min | 25,000 | 75,000 |
| 3 | Group Speech Therapy Session – Small group (4 children) interactive language enrichment session focusing on narrative skills, vocabulary expansion, and pragmatic communication. Facilitated by the Speech Therapist. | 06, 13 Jun 2025 | 2 × 75 min | 18,000 | 36,000 |
| 4 | Parent/Caregiver Consultation & Home Program Training – Guidance session for parents on implementing Speech Therapist-recommended exercises at home, including review of progress notes and adjustment of the individualized therapy plan. | 12 Jun 2025 | 45 min | 20,000 | 20,000 |
| 5 | Progress Report & Written Assessment Summary – Detailed written report by the Speech Therapist documenting milestones achieved, areas requiring continued intervention, and recommendations for the next therapy cycle. Submitted to the client and the child's school in Ivory Coast Abidjan. | 14 Jun 2025 | — | 30,000 | 30,000 |
| 6 | Audiological Screening Referral Coordination – Administrative coordination and referral letter prepared by the Speech Therapist to a certified audiologist in Ivory Coast Abidjan for supplementary hearing evaluation as part of the comprehensive care plan. | 14 Jun 2025 | — | 15,000 | 15,000 |
| Subtotal | 221,000 XOF |
| VAT (18% – Ivorian Standard Rate) | 39,780 XOF |
| Administrative & Record-Keeping Fee | 5,000 XOF |
| TOTAL AMOUNT DUE | 265,780 XOF |
Important Notes Regarding This Invoice
This Invoice is issued by the Abidjan Speech & Language Therapy Center, a registered and licensed Speech Therapist practice operating in Ivory Coast Abidjan. All services rendered are performed by a qualified, board-certified Speech Therapist in compliance with the Ivorian Ministry of Health regulations governing speech-language pathology services.
- All therapy sessions listed on this Invoice were conducted at our clinic located in the Cocody district of Ivory Coast Abidjan, unless otherwise noted.
- The Speech Therapist reserves the right to adjust the individualized treatment plan based on the client's progress. Any additional sessions beyond those itemized above will be subject to a separate Invoice.
- This Invoice covers services rendered during the period of 02 June 2025 through 14 June 2025. It does not include future therapy cycles or follow-up assessments.
- Payment is due within fifteen (15) calendar days from the date of issue. Late payments may incur a 2% monthly surcharge as per Ivorian commercial law.
- Receipt of this Invoice constitutes acknowledgment of the services described. Please retain this document for your personal records and any insurance or employer reimbursement claims.
Payment Instructions
Bank Transfer: Ecobank CI – Account Name: Abidjan Speech & Language Therapy Center – IBAN: CI18 0000 0000 0000 0000 0000 001 – BIC: EBOFABJ
Mobile Money: Orange Money / MTN MoMo – +225 07 08 12 34 56 (Registered to: Abidjan Speech & Language Therapy Center)
In-Person Payment: Cash or bank cheque payable to "Abidjan Speech & Language Therapy Center" at our Ivory Coast Abidjan office, Monday to Friday, 08:00–17:00 GMT.
Please reference Invoice No. ASTC-2025-00487 on all payments to ensure proper accounting and record-keeping by the Speech Therapist's administrative team.
Dr. Aminata Traoré, MScLead Speech Therapist
Abidjan Speech & Language Therapy Center
Ivory Coast Abidjan Client Acknowledgment
Mr. Kouassi Jean-Marc
Signature & Date: _________________________ ⬇️ Download as DOCX Edit online as DOCX
Create your own Word template with our GoGPT AI prompt:
GoGPT