Invoice Speech Therapist in United Arab Emirates Dubai –Free Word Template Download with AI
Speech Therapist Practice
Office 412, Level 4, Marina Plaza Tower
Dubai Marina, United Arab Emirates Dubai
Tel: +971 4 555 0192 | Email: [email protected]
Trade License No: 1048293 | DHA License: ST-2024-00871
VAT Registration No: 100456789000003
Invoice No: INV-2025-00472
Date Issued: 15 June 2025
Due Date: 30 June 2025
PENDING PAYMENT| Ref | Description of Speech Therapy Service | Date of Service | Sessions | Rate (AED) | Amount (AED) |
|---|---|---|---|---|---|
| 01 | Initial Speech and Language Assessment – Comprehensive evaluation of articulation, phonological processes, and receptive/expressive language skills conducted by the Speech Therapist in Dubai | 02 Jun 2025 | 1 | 850.00 | 850.00 |
| 02 | Individual Speech Therapy Session – Articulation and phonological remediation targeting /r/, /l/, and /s/ sound production. Duration: 45 minutes per session. Delivered by licensed Speech Therapist at the United Arab Emirates Dubai clinic. | 04 Jun 2025 | 4 | 450.00 | 1,800.00 |
| 03 | Group Speech Therapy Session – Social communication and pragmatic language development in a small group setting (max 4 participants). Facilitated by the Speech Therapist at the Dubai Marina facility. | 06 Jun 2025 | 2 | 350.00 | 700.00 |
| 04 | Augmentative and Alternative Communication (AAC) Device Fitting and Training – Customization and initial training on a tablet-based AAC system for non-verbal communication support. Performed by the Speech Therapist in United Arab Emirates Dubai. | 09 Jun 2025 | 1 | 1,200.00 | 1,200.00 |
| 05 | Home Visit Speech Therapy Session – On-site articulation practice and parent coaching at the client's residence in Jumeirah Bay Island, Dubai. Travel surcharge included for the Speech Therapist's visit within the United Arab Emirates Dubai metropolitan area. | 11 Jun 2025 | 2 | 550.00 | 1,100.00 |
| 06 | Progress Review and Treatment Plan Update – Mid-cycle evaluation of speech therapy outcomes, adjustment of therapeutic goals, and written progress report submitted to the referring physician and insurance provider in Dubai. | 13 Jun 2025 | 1 | 600.00 | 600.00 |
| Subtotal (AED) | 6,250.00 |
| Insurance Coverage (Daman Health – 70%) | -4,375.00 |
| Client Co-Payment (30%) | 1,875.00 |
| VAT @ 5% (on co-payment) | 93.75 |
| Grand Total Due (AED) | 1,968.75 |
Important Notes Regarding This Invoice
1. This Invoice is issued by Clarity Speech & Language Centre, a registered Speech Therapist practice operating in United Arab Emirates Dubai under the supervision of the Dubai Health Authority (DHA).
2. All speech therapy services listed above were delivered by a DHA-licensed Speech Therapist holding valid professional credentials and malpractice insurance as required by UAE healthcare regulations.
3. The insurance coverage amount has been pre-authorized by Daman Health Insurance under Policy No. DHI-2025-88421. The client is responsible for the remaining co-payment balance as stated in this Invoice.
4. Payment is due within 15 calendar days from the date of issue. Late payments will incur a 2% monthly service charge in accordance with the terms agreed upon at the time of enrollment in the Speech Therapist's treatment program.
5. This Invoice does not constitute a final settlement if additional speech therapy sessions are required following the progress review. A supplementary Invoice will be issued for any further services rendered by the Speech Therapist in Dubai.
Payment Instructions & Terms
Bank Transfer: Emirates NBD Bank, Account Name: Clarity Speech & Language Centre LLC, Account No: 0020-123456789-001, IBAN: AE070240000000001234567890, SWIFT: EMIBAEAD
Credit/Debit Card: Payments accepted via the secure portal at www.clarityspeech.ae/payments. Visa, Mastercard, and Apple Pay are supported.
Cash/Cheque: Acceptable at the clinic reception, Office 412, Marina Plaza Tower, Dubai Marina, United Arab Emirates Dubai, Monday to Friday, 9:00 AM to 6:00 PM (GST).
Cancellation Policy: Sessions cancelled less than 24 hours in advance will be charged at 50% of the session fee. No-shows will be charged in full. This policy applies to all Speech Therapist appointments booked through the Dubai centre.
Confidentiality: All patient records, therapy notes, and communication related to this Invoice and the associated speech therapy treatment are protected under UAE Federal Decree-Law No. 45 of 2021 on the Protection of Personal Data and the DHA data privacy regulations.
Dispute Resolution: Any disputes arising from this Invoice or the speech therapy services provided shall be resolved through the Dubai Health Authority's patient grievance mechanism or, failing that, through the Dubai Courts in accordance with UAE civil law.
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