Thank You for Choosing Ehimi Healthcare Group!

Your client intake form has been successfully received. Below is your official Patient Care Invoice & Service Summary. An automated copy has also been sent to your email.

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EHIMI HEALTHCARE GROUP

Providing Compassionate, Professional Home Care Support Services

INVOICE

BN: 1001679317

Invoice Details

Invoice Number: EHG-INV-2026-84920

Invoice Date: August 20, 2026

Payment Due Date: Upon Care Agreement Confirmation

Client Account Number: EHG-CLI-INTAKE

Status: INTAKE RECEIVED

Bill To (Patient / Client Information)

Client Name: Patient Intake Request

Care Coordinator: Pending Assignment

Address: Niagara Region, ON

Phone / Email: Submitted via Intake Form

Date	Description of Service	Caregiver	Hours	Rate	Amount
Initial Consultation	Comprehensive Registered Nurse In-Home Health & Care Needs Assessment	RN Staff	1.0	Complimentary	.00
Care Plan Request	Personalized Home Care Support (Personal Care, Companion Care, Housekeeping)	Assigned Caregiver	Calculated Schedule	CAD $41.00 / hr	CAD $41.00 / hr

Subtotal:.00

HST (if applicable):.00

Other Charges:.00

Total Amount Due: Pending Final Agreement

Payment Method & Banking Details

Please select your payment method:

E-Transfer

Direct Deposit

Credit Card

Debit Card

Cheque

Cash

E-Transfer Email: ehimihealthcaregroup@yahoo.com

Bank Name: Royal Bank of Canada (RBC)

Account Name: Ehimi Healthcare Group

Payment Terms

Payment is due on or before the due date shown above.
Please include the invoice number with all payments.
A late payment fee may apply to overdue balances where permitted by law.
Questions regarding this invoice should be directed to the Accounts Department (647 527 9595).

Receipt of Payment (Official Office Record)

Amount Paid:

Date Received: ____________________

Payment Method: ___________________

Transaction/Ref #: __________________

Received By: _______________________________________ Signature: ______________________

Thank You for Choosing Ehimi Healthcare Group

We sincerely appreciate the opportunity to support you and your family. Our commitment is to provide compassionate, reliable, and high-quality home care services that promote dignity, independence, and peace of mind.

Ehimi Healthcare Group | “Compassionate Care. Professional Service. Trusted Support.”