Medical Wig Insurance Claim Form

Medical Wig Insurance Claim Form

If your wig purchase qualifies as a medical cranial prosthesis, you may be eligible for insurance reimbursement. Please download, complete, and submit the form below to your insurance provider.

📄 Download Medical Wig Insurance Claim Form (PDF)

Please print form, fill it out and return to us by email at: hello@c4uwigs.com

If you need assistance completing the form or require a letter of medical necessity, please contact us and we will be happy to help.