Brain r k Resource Center April 9th 2014 Patient: the brain lesoulte cento Applied Neuroscience & Personalized Medicine 263 West End Ave Suite #1D New York, NY 10023 We have charged you a deposit for Neuropsychological testing of $3,500.00. Please be advised that this charge is nonrefundable If you are okay with these conditions please sign your name below on the line. Thank You! Dr.Kamran Fallahpour Brain Resource Center ?Art PnrI Ava ft 1n Now Ynrk NY arm 1 EFTA00306962