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Templates / Invoice

Free Orthodontic Invoice Template

An orthodontic invoice covers itemized charges, a totals section, and the payment terms that explain when fees are due and how late payments are handled.

Orthodontic Invoice template preview

Language:

en

Last updated:

October 2026

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Treatment starts with a clear plan, but the money part still has to stay just as clear once records, appliances, and repairs enter the picture. An orthodontic invoice gives a patient one place to see what’s included, what costs extra, and what the running total is before anything drifts.

The template keeps the numbers upfront, with Space Grotesk headings over a green teal layout, so the important bits don’t get lost. Line items hold the charges you’re billing for, then the invoice spells out when payment is due, how setup and monthly work get billed, and what happens if an account goes past due... ending with a short sign-off that closes the message without adding new terms.

  • Line items Add your own services, appliances, repairs, or adjustments, then set the prices in the same row before sending.
  • Payment is due on the date Confirms the due date, explains setup billing and monthly billing timing, and notes that non urgent appointments may pause if payment is late.
  • Totals Shows the calculated total from the line items so the patient can see the amount due at a glance.
  • Thanks, we’re glad to be part of this next step Closes the invoice with a brief sign-off after the terms, without changing the pricing or due date.

In Plutio, you replace the placeholder line and price with your own, send the invoice to the patient, and connect a payment method if you want online payment on the same invoice. The totals update from the numbers you enter, leaving the patient reading the due date and late-payment policy in the same place every time.

We went from spending hours on every proposal to creating fully customized ones in under 5 minutes. That's not an exaggeration - we timed it.

Yazan & Mawaheb
Yazan & MawahebAgency Owners

What to include in an orthodontic invoice

PartWhat it covers

Line items

Line items is where you swap the placeholder row for your own charges and prices before the invoice goes out.

Payment is due on the date

Payment is due on the date shown above carries the Totals and the written payment terms, including monthly billing timing and what happens if payment is late.

Thanks, we’re glad to be part of this next step

Thanks, we’re glad to be part of this next step adds a short closing note at the end of the invoice.

Who it is for

Orthodontists, dental clinics, and cosmetic dentistry practices that need an itemized bill for setup fees, appliances, and ongoing monthly treatment.

The invoice in full

Line items

Payment is due on the date shown above. The setup is invoiced when complete and ongoing work is billed at the start of each month. If payment is late, we will contact you and may pause non urgent appointments until the account is current.

Totals

Thanks, we’re glad to be part of this next step

Questions about this invoice template

What should an orthodontic invoice include?

An orthodontic invoice usually includes itemized charges, a total amount due, and payment terms that state when the balance is due and what happens if payment runs late. This template includes line items, totals, and written terms in one place.

How do I show setup fees and monthly orthodontic payments on one bill?

The invoice can list the setup charge and ongoing treatment charges as separate line items, with terms explaining when each gets billed. This template’s terms mention setup being invoiced when complete and ongoing work billed at the start of each month.

How do I handle broken brackets or lost retainers on an invoice?

A bill can keep repairs or replacement appliances as their own line items so the patient can see what triggered the extra charge. The line items section is where those add-on charges go when they occur.

Can an orthodontic invoice explain what happens if payment is late?

An invoice can state the late-payment policy in writing so the patient reads it next to the due date and total. This template includes terms about contacting the patient and pausing non urgent appointments until the account is current.

Do I need to put the due date on an orthodontic invoice?

A due date is one of the main details patients look for because it anchors the payment expectation to a specific date. This template’s terms refer to payment being due on the date shown above.

What’s the difference between an orthodontic invoice and a treatment plan estimate?

A treatment plan estimate prices the expected work before treatment starts, while an invoice bills for charges that are due now. This template is an invoice, built to show itemized charges, totals, and payment terms for payment.

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