Membership Medical Freeze Request

2. Identify Medical Freeze Period and Reason.

• Freeze may be granted for a minimum of one month to a maximum of six months. Billing of regular monthly membership fees will resume after the end date or after six months, whichever occurs first, if additional documentation from physician is not received.
• A physician's note clearly stating the reason for the request in 30 day increments for the absence must be attached. Alternatively, the physician may fax the note to DCFL at 919-545-2687. Physician's note must be received before freeze can be put into effect.
• Additional documentation will be required for periods beyond half of the membership term.
• A physician's clearance may be required to reactivate membership.
• There is no fee for a medical freeze.
• Membership contract term will be extended by the number of months of approved medical freeze.