I hereby authorize Neurobehavioral Health and Wellness to process the specified charges on the credit card provided via this online form, as of the present date. Please note that if multiple invoices are being settled simultaneously, distinct transactions for each invoice may be evident on the credit card statement. All returns, refunds, and cancellations adhere to Neurobehavioral Health and Wellness's terms and conditions. I affirm that I possess legitimate authorization for the use of the mentioned credit card. Furthermore, I commit not to contest the processed payment with my credit card issuer, provided the transaction is in alignment with the stipulations set forth in this online form.