Medical Freeze

Membership Information Dashboard > Medical Freeze Request

Please submit your request at least 3 business days (excluding weekends and holidays) before your requested freeze start date. Freeze requests cannot be applied retroactively. If your request is less than 72 hours prior to your requested freeze date, the membership freeze will go into effect on the date of processing.

Looking to submit a Standard Freeze? Please submit your request here.

Medical Freeze Request Form

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Medical Freeze Start Date (MM/DD/YYYY) *

Medical freeze requests are automatically processed for 120 days. Should you wish to resume your practice sooner or extend your medical freeze beyond 120 days, please email info@bronxyogalab.com to process this request.

Attach Doctor's Note *

Max file size: 20MB

If you cannot attach your doctor's note today, you will be assessed a $15 freeze fee to process your request to not loose any more time in your billing cycle. If you were unable to upload your doctor's note today using this form, please email a digital copy to info@bronxyogalab.com. Once we have received your doctor's note, we will refund the $15 fee to your Bronx Yoga Lab account.

I agree to have my credit card on file charged a $15 fee to process my request if I did not attach my doctor's note to my request. *

Yes, I agree.

I understand my membership maybe frozen at any point in the billing cycle. Any freeze request will change my billing cycle date. The billing cycle date will be pushed forward by the same number of days my membership remains frozen. *

Yes, I understand.

I understand that my membership will AUTOMATICALLY reactivate in 120 days. If I request to amend my medical freeze by emailing info@bronxyogalab.com, it will reactivate on the new requested date. *

Yes, I understand.

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Medical Freeze Request Form