Invoice Speech Therapist in Nepal Kathmandu –Free Word Template Download with AI
Licensed Speech Therapist Practice
Thamel Marg, Kathmandu 44600, Nepal
Phone: +977-1-4412345 | Email: [email protected]
VAT Registration No.: 80123456-789
Invoice No: CVST-2025-00472
Date Issued: 15 June 2025
Due Date: 30 June 2025
| Ref | Service Description | Date(s) | Duration | Rate (NPR) | Amount (NPR) |
|---|---|---|---|---|---|
| 01 | Initial Speech Therapy Assessment & Diagnostic Evaluation by Speech Therapist | 02 Jun 2025 | 90 min | 3,500 | 3,500.00 |
| 02 | Articulation & Phonological Intervention Session (Speech Therapist-led) | 04 Jun 2025 | 60 min | 2,500 | 2,500.00 |
| 03 | Language Comprehension & Expression Therapy Session | 07 Jun 2025 | 60 min | 2,500 | 2,500.00 |
| 04 | Fluency Disorder (Stuttering) Management Session by Speech Therapist | 10 Jun 2025 | 60 min | 2,500 | 2,500.00 |
| 05 | Oral Motor Therapy & Swallowing Assessment | 12 Jun 2025 | 45 min | 2,000 | 2,000.00 |
| 06 | Home Practice Program Design & Parent/Caregiver Training by Speech Therapist | 13 Jun 2025 | 45 min | 1,800 | 1,800.00 |
| 07 | Progress Review & Treatment Plan Adjustment (Speech Therapist Consultation) | 14 Jun 2025 | 30 min | 1,500 | 1,500.00 |
| Subtotal | NPR 16,300.00 |
| VAT @ 13% (Nepal Government Tax) | NPR 2,119.00 |
| Insurance Adjustment (Nepal Health Insurance Board) | - NPR 4,000.00 |
| Grand Total Due | NPR 14,419.00 |
* All amounts are in Nepalese Rupees (NPR). VAT is applicable as per Nepal Inland Revenue Department regulations for healthcare services exceeding the threshold.
Payment Terms & Instructions
This Invoice must be settled in full within 15 calendar days from the date of issue. The Speech Therapist at ClearVoice Speech Therapy Center, Nepal Kathmandu, accepts the following payment methods:
- Bank Transfer: Nabil Bank, Account No. 001-456789-01, Branch: Thamel, Kathmandu, Nepal. Account Name: ClearVoice Speech Therapy Center.
- Mobile Banking: eSewa / Khalti / IME Pay – registered under "ClearVoice Speech Therapy".
- Cash / Cheque: Payable at the reception desk, ClearVoice Center, Thamel Marg, Kathmandu, Nepal. Hours: 9:00 AM – 6:00 PM (Sunday closed).
Please reference Invoice No. CVST-2025-00472 on all payments. A late payment fee of 2% per month will be applied to outstanding balances after the due date of 30 June 2025.
Important Notes & Clinical Remarks
- This Invoice covers speech therapy services rendered by a licensed Speech Therapist at our facility in Nepal Kathmandu during the period of 2 June 2025 to 14 June 2025.
- The patient is enrolled in a 12-week intensive speech therapy program. The next billing cycle (Invoice No. CVST-2025-00473) will be issued on 1 July 2025 for sessions scheduled in July.
- Home practice exercises prescribed by the Speech Therapist must be completed daily. Non-compliance may affect treatment outcomes and is noted in the clinical file.
- For insurance claims, please submit this Invoice along with the clinical progress report (available upon request) to your insurance provider within 30 days.
- Any questions regarding this Invoice or the speech therapy treatment plan should be directed to the billing office at +977-1-4412345 or [email protected].
- This document serves as an official Invoice for tax, insurance, and medical record purposes in the Republic of Nepal.
Authorized Signature – Speech Therapist
Dr. Anisha Gurung, M.S. SLP
Received By – Patient / Guardian
Name & Date
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