Recurring Billing Authorization
By checking the authorization box or submitting payment, you authorize Vynova Health LLC and its payment processor to charge your selected payment method for the program, membership, subscription, or service selected at checkout.
1. Billing Terms
The amount, billing frequency, and renewal date will be shown at checkout before payment is submitted. If you choose a recurring program, recurring charges continue until cancelled according to the Cancellation Policy.
Recurring charges may continue even if you do not use all program benefits, unless you cancel at least 48 hours before the next scheduled billing date.
2. Failed Payments, Refunds, and Limits
If a payment fails, Vynova Health or its payment processor may retry the payment as allowed by law and payment network rules.
Once medication has shipped, medication-related, pharmacy, fulfillment, and shipping charges are not refundable, except where required by law or where Vynova determines that an error occurred.
Administrative, program setup, processing, provider coordination, and clinical coordination fees may be non-refundable once intake routing, provider coordination, administrative processing, or clinical partner review has begun.
3. Customer Acknowledgment
You agree to keep your payment and contact information current. Payment does not guarantee provider approval, treatment, prescription, medication availability, or any specific health outcome.
Acknowledgment: You reviewed the amount and billing frequency, authorize the charge(s), understand recurring billing continues until cancelled, understand cancellation must be submitted at least 48 hours before the next billing date to avoid renewal, reviewed the Refund Policy and Cancellation Policy, and understand approval and prescriptions are not guaranteed.
Name: ___________________________
Date: ___________________________
Electronic Signature / Checkbox: ___________________________
Consent Version: billing_auth_v2_2026_05