Invoice Speech Therapist in Japan Kyoto –Free Word Template Download with AI
12-45 Higashiyama-ku, Gion-machi, Kyoto 605-0073, Japan
Phone: +81-75-555-0142 | Email: [email protected]
License No. JP-ST-2024-08831 | Registered in Japan Kyoto Prefecture
Billed To (Client)
Tanaka Yuki
78-3 Nakagyo-ku, Karasuma-dori, Kyoto 604-0854, Japan
Phone: +81-90-1234-5678
Email: [email protected]
Insurance Ref: NHI-2025-44821
Provided By (Speech Therapist)
Dr. Sato Haruka, CCC-SLP
Lead Speech Therapist, Kyoto Speech & Language Therapy Center
Certified by Japan Speech-Language-Hearing Association
Specialization: Pediatric & Adult Speech Therapy in Japan Kyoto Region
| Date | Service Description | Duration | Rate (JPY) | Amount (JPY) |
|---|---|---|---|---|
| May 02, 2025 | Initial Speech Therapy Assessment – Articulation and Phonological Processing Evaluation conducted by the Speech Therapist at the Japan Kyoto clinic | 60 min | 12,000 | 12,000 |
| May 05, 2025 | Individual Speech Therapy Session – Fluency Disorder Intervention (Stuttering Management Program, Session 1 of 12) | 45 min | 9,500 | 9,500 |
| May 09, 2025 | Individual Speech Therapy Session – Fluency Disorder Intervention (Session 2 of 12) with home practice review | 45 min | 9,500 | 9,500 |
| May 12, 2025 | Group Speech Therapy Workshop – Social Communication Skills for Adults, held at the Japan Kyoto community center | 90 min | 7,000 | 7,000 |
| May 16, 2025 | Individual Speech Therapy Session – Fluency Disorder Intervention (Session 3 of 12) with progress documentation | 45 min | 9,500 | 9,500 |
| May 20, 2025 | Speech Therapy Progress Report – Written evaluation by the Speech Therapist detailing milestones achieved in Japan Kyoto practice | 30 min | 6,000 | 6,000 |
| May 23, 2025 | Individual Speech Therapy Session – Fluency Disorder Intervention (Session 4 of 12) incorporating Japanese phoneme-specific exercises | 45 min | 9,500 | 9,500 |
| May 27, 2025 | Family Consultation – Speech Therapist guidance session for caregivers on supporting therapy goals at home in the Japan Kyoto area | 30 min | 5,500 | 5,500 |
| May 30, 2025 | Individual Speech Therapy Session – Fluency Disorder Intervention (Session 5 of 12) with reassessment of treatment plan | 45 min | 9,500 | 9,500 |
| Subtotal | ¥74,000 |
| National Health Insurance Reimbursement (50%) | -¥37,000 |
| Out-of-Pocket Balance | ¥37,000 |
| Consumable Materials (therapy aids, printed worksheets) | ¥2,300 |
| Total Amount Due | ¥39,300 |
Invoice Notes & Service Details
This Invoice is issued by the Kyoto Speech & Language Therapy Center, a licensed Speech Therapist practice operating in Japan Kyoto. All services rendered during the billing period were provided by Dr. Sato Haruka, a certified Speech Therapist specializing in fluency disorders, articulation therapy, and social communication interventions.
The Speech Therapist conducted all sessions in accordance with the clinical guidelines established by the Japan Speech-Language-Hearing Association and the Ministry of Health, Labour and Welfare standards applicable to the Japan Kyoto metropolitan area. Each session was documented in the client's permanent therapy record maintained at our Japan Kyoto facility.
Please note that this Invoice reflects services provided under the client's National Health Insurance enrollment. The 50% reimbursement has been pre-calculated based on the current Japan Kyoto prefectural insurance rates. The client is responsible for the remaining out-of-pocket balance as itemized above. Any additional Speech Therapist services requested outside the standard treatment plan will be subject to a separate Invoice upon completion.
The Speech Therapist recommends continuing the 12-session fluency intervention program. The next scheduled sessions will take place in June 2025 at our Japan Kyoto clinic. A follow-up progress assessment by the Speech Therapist is planned for the end of the treatment cycle to determine whether additional therapy phases are warranted.
Payment Terms & Instructions
- Due Date: Payment is due within 30 days of the Invoice issue date (by July 15, 2025). Late payments may incur a 2% monthly service charge as permitted under Japan Kyoto commercial regulations.
- Bank Transfer: Mizuho Bank, Kyoto Gion Branch, Account No. 248-105-773, Account Name: Kyoto Speech & Language Therapy Center. Please reference Invoice No. KY-2025-00472 in the transfer memo.
- Credit Card: Visa, Mastercard, and JCB accepted. Contact our Japan Kyoto billing office to arrange card payment over the phone.
- Convenience Payment: Pay-easy codes are available at major Japan Kyoto convenience stores (7-Eleven, Lawson, FamilyMart) for payments up to ¥100,000.
- Disputes: Any questions or disputes regarding this Invoice should be directed to the billing department of the Speech Therapist practice in Japan Kyoto within 14 days of receipt. Contact: +81-75-555-0142, ext. 3.
Authorized Signature: ___________________________
Dr. Sato Haruka, Lead Speech Therapist
Kyoto Speech & Language Therapy Center, Japan Kyoto
Date: June 15, 2025
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