Discount Medical Plan Application
This plan is no longer available.

This plan is not available in the states of MA, MT and VT

We Value Your Privacy
Your membership materials will arrive within 7 to 10 business days after your application is processed.

You can cancel within 30 days after receipt of membership materials and receive a full refund, less the processing fee.

FL Residents: You can cancel within 30 days of the effective date and receive a full refund, less the processing fee.

Send written cancellation requests to Careington: PO Box 2568, Frisco TX 75034; or fax to: 888 335-7330 or email: member@careington.com.

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Security Information
Careington International Corporation, Medical - Dental Discount Plans, Frisco, TX

Member Information
* Denotes Required Field
*First Name   Initial
*Last Name   Suffix
*Address
 
*City
*State
This program may not be available in all States
*Zip Code -
*Home Phone --
Work Phone --
*E-Mail Address
*Date of Birth
*Gender
Marital Status
Number of
Members

Additional members besides enrollee
*Where Did You
Hear About Us?
If other:
Marketing Code If you heard about us by mail,
please enter the marketing code referenced on the
back of the application form

  I am interested in receiving future offers for other products or
services from Careington. I understand that my information
is not shared with other companies for any purpose.
  I have reviewed the terms and conditions and wish to purchase the discount medical plan.

Desired Billing Cycle

Member + Family
   
*Effective Date

Payment Method
Credit/Debit Card
Bank Draft/Electronic Check



FORM CODE CICONLINEAPP
All contents Copyright Careington International Corporation
This is not health insurance.
Terms and Conditions