Date : 04.09.

2021

ADDICTION PROFORMA INVOICE

Patient’s Name : OUSSAMA LADJEROUD Date of Birth : 1995

Clinic / Branch : Addiction

Physician Name : Dr. Onur Noyan

Private : Yes : ☐ No : ☒ Corporation : ☒

TREATMENT PLAN
1 Month Hospitalisation in a Single Room
Psychiatry Physician Examination and Follow up
Nursing Services and Medicines
Brain MRI
Routine QEEG
Neurology Physician Consultation
Internal Medicine Physician Consultation
Routine Biochemistry
Toxicology ( Wide Panel )
TDM ( Therapeutic Drug Monitorisation )
Genotype and Phenotype Study
Deep TMS ( Deep Transcranial Magnetic Stimulation ) 20-30 Sessions Or ECT
Psychological Forms and Personality Tests ( SCL 90, Beck Anxiety, Beck Depression, Maudsley, Mood Disorder Scale, Turgay
Motivation Scale, Treatment Motivation Scale, Barrat’s Impulsivity Scale, Temperament and Character Inventory, Family
Assessment Scale, Experiences of Close Relationships, Drug Abuse Screening Test, Socrates Readiness Inventory, MMPI (
Personality Test),
Rorschach Test, TAT. )
Personal Psychotheraphy (5 Sessions/ Week) ( Cognitive Behavioral Theraphy, Dialectic Behavioral Theraphy, Mindfullness,
Psychodynamic Theraphy, Psychoanalytic Theraphy, Acception and Commitment Theraphy, EMDR ( Eye Movement Desensitization
and Reprogressing) are theraphy techniques used according to the patient’s condition)
Group Psychotherapies for Prevention of Relapse, Perception of Harm, Awareness and Motivation, Emotinal Regulations
are worked on.
Family Education and Therapies are performed to inform the Family about Addiction and Regulation of Their Attitudes
towards Patient.
Naltrexone or Disulfiram Implant
Professor Follow-up (1/Week)
Personal Translator ( During daytime)
Transport between Airport and Hospital

Total cost of the services mentioned above is 28.000 USD.

Signature

E-mail : np.international@uskudar.edu.tr
Phone : +90 216 633 0 633
Patient-focused Premium Healthcare Fax : +90 216 634 12 50
 Account Name Bank Branch / Code USD IBAN Swift Code

TR11 0006 7010 0000 0095 8827 51

OZEL NPI NOROPSIKIYATRI
ISTANBUL SAGLIK EGITIM DANIS. YAPI KREDI UMRANIYE / 912 EURO IBAN YAPITRISXXX
YAY. INS. SAN. VE TIC. A.S.
TR05 0006 7010 0000 0095 8827 62

 Please send the Swift Message to the given e-mail address : np.international@uskudar.edu.tr

Additional Information

 This document is valid only for one month.

 The above costs for the consultation / test listed and are intended only as a guide to assist you in the preplanning your visit.
 The exact treatment plan and cost may be only known according to the results of the initial consultations and investigations
which will be done in our hospital.
 The mentioned price may vary according to the individual diagnosis and any existing medical complications as well as any
additional or special services by senior doctors.
 If any additional treatment cost is constituted during the treatment the appertaining corporation will be informed with a proforma
invoice about remnant amount. Also USD price may vary acc. to convertible rate EUR/TL.
 The Airport and local transfers are free of charge for Inpatients. Airport and local transfers for outpatients can be arranged by
our hospital with an extra charge.
 We can assist you with the hotel arrangement.
 The interpretation services are free of charge.
 All payments for medical services are expected before or on the first appointment date for self pay patients. You may either pay
cash, credit card, money order or bank transfer. During the treatment, care or recovery process, the final state of the bill will be
checked within reasonable timely intervals to verify if any extra payments are needed beyond the estimations given and the
payments needed will be collected according to this verification.
 For patients possessing International insurance, please contact our International Department in advance.
 Any balance or credit remaining on your account at the moment of discharge will be debited or credited back to the bank account
presented or the credit card number on file.
 All deposits are based on an estimate only and we will be able to inform you of the final charges when the final bill is generated.
 The responsibility of payment of the patient’s transfer to another location by air travel or land ambulance in case of any need
during or after the treatment process must be considered in advance and taken in charge by the patient/legal representative of
the patient.
 Patients passports are necessary for the registration procedures.

Signature

E-mail : np.international@uskudar.edu.tr
Phone : +90 216 633 0 633
Patient-focused Premium Healthcare Fax : +90 216 634 12 50