Invoice Speech Therapist in Saudi Arabia Jeddah –Free Word Template Download with AI
Professional Speech Therapist Services
Al Rawdah District, Jeddah 23434, Saudi Arabia
Phone: +966 12 654 7890 | Email: [email protected]
CR: 1010456789 | VAT Registration: 310123456700003
Licensed by Saudi Ministry of HealthInvoice No: ANS-2025-04872
Date of Issue: 15 June 2025
Due Date: 30 June 2025
Invoice Service Details – Speech Therapist Sessions
| # | Service Description | Date of Service | Duration | Rate (SAR) | Qty | Amount (SAR) |
|---|---|---|---|---|---|---|
| 1 | Initial Speech Therapy Assessment & Diagnostic Evaluation – Comprehensive articulation and phonological analysis conducted by the Speech Therapist at the Jeddah clinic facility | 02 Jun 2025 | 90 min | 450.00 | 1 | 450.00 |
| 2 | Individual Speech Therapy Session – Articulation and phonemic awareness training for a 7-year-old patient. Delivered by the licensed Speech Therapist in a one-on-one setting at Al-Noor Clinic, Jeddah | 04 Jun 2025 | 60 min | 350.00 | 4 | 1,400.00 |
| 3 | Group Speech Therapy Session – Small group (4 children) speech and language development program. Facilitated by the Speech Therapist with structured activities targeting expressive and receptive language milestones | 07 Jun 2025 | 60 min | 200.00 | 2 | 400.00 |
| 4 | Home Visit Speech Therapy Consultation – The Speech Therapist provided in-home guidance to parents on implementing daily speech exercises. Service delivered at the client's residence in Al Shati, Jeddah, Saudi Arabia | 10 Jun 2025 | 45 min | 500.00 | 1 | 500.00 |
| 5 | Progress Report & Treatment Plan Revision – Written clinical report by the Speech Therapist documenting patient progress, updated IEP goals, and recommended next-phase interventions. Submitted to the client and referring physician | 12 Jun 2025 | — | 250.00 | 1 | 250.00 |
| 6 | Augmentative & Alternative Communication (AAC) Device Setup & Training – The Speech Therapist configured and trained the patient and family on the use of a tablet-based AAC application for non-verbal communication support | 13 Jun 2025 | 75 min | 600.00 | 1 | 600.00 |
| Subtotal | SAR 3,600.00 |
| VAT (15% – Saudi Arabia) | SAR 540.00 |
| Insurance Adjustment (CCHI) | -SAR 800.00 |
| Grand Total Due | SAR 3,340.00 |
Payment Terms & Instructions
This Invoice must be settled in full by the due date of 30 June 2025. Payment may be made via bank transfer to Al-Noor Speech & Language Clinic, Bank Al-Jazira, Account No. 1234-5678-9012, IBAN: SA03 8000 0000 6080 1016 7519. Alternatively, payment is accepted via mada, Visa, or Apple Pay at our Jeddah, Saudi Arabia clinic reception.
A late payment fee of 2% per month will be applied to any outstanding balance after the due date. Please reference Invoice No. ANS-2025-04872 in all correspondence and remittances.
For insurance claims, please submit this Invoice along with the Speech Therapist's clinical report to your CCHI-accredited provider within 30 days of the service date.
Important Notes Regarding This Invoice
1. All Speech Therapist services listed in this Invoice were performed in compliance with the Saudi Ministry of Health regulations and the Saudi Commission for Health Specialties (SCFHS) standards of practice.
2. The Speech Therapist, Dr. Sarah Al-Harbi, holds a valid license to practice speech-language pathology in Jeddah, Saudi Arabia, and all sessions were conducted at our licensed facility or at the client's approved home address.
3. This Invoice is valid for a period of 90 days from the date of issue. After this period, the charges may be subject to re-evaluation.
4. Should you have any questions regarding the line items, the Speech Therapist's clinical notes, or the billing breakdown, please contact our billing department in Jeddah, Saudi Arabia at +966 12 654 7890 or [email protected].
5. A copy of this Invoice has been filed with our records and is available for audit purposes as required by Saudi tax and health authority regulations.
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