Invoice Speech Therapist in Sri Lanka Colombo –Free Word Template Download with AI
142, Galle Road, Nugegoda
Sri Lanka Colombo 07
Tel: +94 11 234 5678 | Email: [email protected]
Registration No: SL-2019-45821 | VAT Reg: 123456789
Bill To (Client)
Mr. Anura Perera
45, Temple Road, Kandy Road
Sri Lanka Colombo 05
Tel: +94 77 890 1234
Email: [email protected]
Client Ref: CL-2025-0892
Service Provider
Dr. Nimali Fernando, MSc (SLT)
Lead Speech Therapist
Colombo Speech & Language Centre
Sri Lanka Colombo 07
License No: SLT-LIC-2020-0456
Member, Sri Lanka Association of Speech-Language Pathologists
| # | Description of Service | Date(s) of Service | Sessions | Rate (LKR) | Amount (LKR) |
|---|---|---|---|---|---|
| 1 | Initial Speech Therapy Assessment & Diagnostic Evaluation by qualified Speech Therapist | 02 Jun 2025 | 1 | 18,500.00 | 18,500.00 |
| 2 | Individual Speech Therapy Session – Articulation & Phonological Intervention (45 min) | 04, 09, 11 Jun 2025 | 3 | 12,000.00 | 36,000.00 |
| 3 | Group Speech Therapy Session – Language Comprehension & Expression (60 min, max 4 children) | 06, 13 Jun 2025 | 2 | 8,500.00 | 17,000.00 |
| 4 | Parent Counselling & Home Practice Guidance by Speech Therapist (30 min) | 13 Jun 2025 | 1 | 6,500.00 | 6,500.00 |
| 5 | Augmentative & Alternative Communication (AAC) Tool Preparation & Training | 10 Jun 2025 | 1 | 15,000.00 | 15,000.00 |
| 6 | Progress Report & Written Assessment Summary (Speech Therapist Clinical Notes) | 14 Jun 2025 | 1 | 5,000.00 | 5,000.00 |
| 7 | Therapeutic Materials & Customised Exercise Booklet (Printed, Sri Lanka Colombo edition) | 02 Jun 2025 | 1 | 3,500.00 | 3,500.00 |
| Subtotal | LKR 101,500.00 |
| VAT @ 18% (Sri Lanka Standard) | LKR 18,270.00 |
| Discount (Loyalty – 5% for repeat clients) | - LKR 5,075.00 |
| Grand Total Due | LKR 114,695.00 |
Payment Terms & Instructions
This Invoice must be settled in full within fourteen (14) calendar days from the date of issue. Payment may be made via bank transfer to the account below, or by cash/cheque at our Sri Lanka Colombo office located at 142, Galle Road, Nugegoda.
Bank: Commercial Bank of Ceylon, Colombo Main Branch
Account Name: Colombo Speech & Language Centre (Pvt) Ltd
Account No: 1010-0045-8821-33
Reference: Please quote Invoice No. CSLC-2025-0347 in all correspondence and remittances.
A late payment surcharge of 2% per month will apply to any outstanding balance after the due date of 30 June 2025.
Important Notes & Clinical Remarks
1. All speech therapy services listed on this Invoice were delivered by a licensed and registered Speech Therapist in accordance with the standards set by the Sri Lanka Association of Speech-Language Pathologists and the Ministry of Health, Sri Lanka.
2. The initial diagnostic assessment conducted on 02 June 2025 identified mild-to-moderate articulation delays in the client's child (age 5). The Speech Therapist has recommended a minimum of twelve (12) follow-up sessions over the next eight weeks for optimal progress.
3. The parent counselling session provided practical strategies for reinforcing speech therapy exercises at home. The Speech Therapist emphasised the importance of daily practice for twenty minutes to complement the clinical sessions.
4. The AAC tool prepared is a customised visual communication board designed specifically for the child's current developmental stage. The Speech Therapist will review and update this tool at the next scheduled session.
5. This Invoice is valid for ninety (90) days from the date of issue. Please retain a copy for your personal records and for any insurance or medical reimbursement claims in Sri Lanka Colombo.
6. For any queries regarding this Invoice or the speech therapy services rendered, please contact our billing department at [email protected] or call +94 11 234 5678 between 9:00 AM and 5:00 PM, Monday to Friday.
Authorised Signatory – Colombo Speech & Language Centre Client Acknowledgement (Mr. Anura Perera) ⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
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