Invoice Speech Therapist in Thailand Bangkok –Free Word Template Download with AI
128 Sukhumvit Road, Soi 21
Khlong Toei Nuea, Watthana
Thailand Bangkok 10110
Tel: +66 (0) 2 255 8890
Email: [email protected]
VAT Registration No: 0105559876543
License No: ST-TH-2024-004521 Billed To Mr. Somchai Prasert
45/12 Ratchada Road, Soi 14
Din Daeng, Din Daeng
Thailand Bangkok 10400
Tel: +66 (0) 89 765 4321
Patient ID: BSLT-2024-0893 Invoice Details Services Rendered by Speech Therapist
| Ref | Service Description | Duration / Sessions | Amount (THB) |
|---|---|---|---|
| 01 | Initial Speech and Language Assessment — Comprehensive evaluation of articulation, phonological processing, and receptive language skills conducted by a licensed Speech Therapist in Thailand Bangkok | 1 session (90 min) | 3,500.00 |
| 02 | Individual Speech Therapy Session — Targeted articulation and phonological intervention for childhood apraxia of speech, delivered by a certified Speech Therapist at our Thailand Bangkok clinic | 4 sessions (45 min each) | 6,800.00 |
| 03 | Oral Motor Therapy — Strengthening and coordination exercises for the lips, tongue, and jaw, administered by the Speech Therapist to support improved speech production in Thailand Bangkok | 4 sessions (30 min each) | 4,400.00 |
| 04 | Parent/Caregiver Training Workshop — Instruction for family members on home-based speech exercises and communication strategies, facilitated by the Speech Therapist team in Thailand Bangkok | 1 session (60 min) | 2,200.00 |
| 05 | Progress Review and Treatment Plan Update — Mid-cycle assessment of speech milestones, adjustment of therapy goals, and documentation by the Speech Therapist in Thailand Bangkok | 1 session (45 min) | 1,800.00 |
| 06 | Augmentative and Alternative Communication (AAC) Consultation — Evaluation and recommendation of communication aids, provided by the Speech Therapist specialist in Thailand Bangkok | 1 session (60 min) | 2,500.00 |
| 07 | Home Exercise Program Materials — Printed and digital speech therapy worksheets, audio recordings, and activity guides prepared by the Speech Therapist for use in Thailand Bangkok | 1 package | 850.00 |
| 08 | Follow-up Telehealth Speech Therapy Session — Remote video consultation with the Speech Therapist for progress monitoring, available to patients across Thailand Bangkok and surrounding areas | 1 session (30 min) | 1,200.00 |
| Subtotal | 23,250.00 |
| VAT (7%) | 1,627.50 |
| Insurance Adjustment (Thai Health Fund) | -4,500.00 |
| Grand Total Due | 20,377.50 |
Payment Terms and Instructions
This Invoice for Speech Therapist services rendered in Thailand Bangkok is payable within fourteen (14) calendar days from the issue date. The total amount of THB 20,377.50 may be settled via bank transfer to the account below, or by credit/debit card at our Thailand Bangkok reception. Please reference the Invoice number INV-BSLT-2024-00782 on all payments.
Bank: Bangkok Bank Public Company Limited
Account Name: Bangkok Speech & Language Therapy Centre Co., Ltd.
Account No: 441-2-88901-5
SWIFT Code: BKKBTHBK
Branch: Sukhumvit 21, Thailand Bangkok
Late payments are subject to a 1.5% monthly interest charge as per Thai commercial law. This Invoice is valid for 60 days from the issue date. After 60 days, the Speech Therapist service account will be reviewed and outstanding balances may be referred for collection in accordance with Thailand Bangkok regulatory guidelines.
Important Notes Regarding This Invoice
1. All Speech Therapist services listed on this Invoice were performed by licensed and registered professionals holding valid credentials from the Thai Ministry of Public Health and the Royal Thai Speech-Language-Hearing Association.
2. The insurance adjustment reflects coverage under the Thai Health Fund (Universal Coverage Scheme). Patients are responsible for the remaining balance as itemized on this Invoice.
3. Should you have any questions regarding the charges on this Invoice, or wish to dispute a particular Speech Therapist service line item, please contact our billing department in Thailand Bangkok within 30 days of the issue date.
4. A duplicate copy of this Invoice may be requested at no additional charge. Please provide the Invoice number and patient ID when making such a request.
5. This Invoice does not constitute a medical diagnosis. All treatment recommendations were made by the attending Speech Therapist based on clinical assessment and are subject to the patient's informed consent.
Authorized Signature — Speech Therapist (Clinic Director)Dr. Nattaporn Chaiyasit, M.S. Speech-Language Pathology
License No: ST-TH-2019-001287 Received and Acknowledged — Patient / Guardian
Mr. Somchai Prasert
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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