HEALTHCARE PROVIDERS INFORMATION AND FORMS

Here is a link to the Ministry of Health website where you will find information relating to the process required for claiming free headwear - click here to find out more about this service.



DOWNLOADABLE CLAIM FORMS

To help us process your claim please select the appropriate form, download it and complete the information, then sign it and return it to us by post.

For Permanent or Temporary Hair Loss claims click here 

This form is required to enable the Ministry of Health to process  your claim for free headwear 

Proforma Provision of wigs and headwear Certification click here

Health care professionals can use this form for patients with hair loss due to medical treament or a specific medical condition. Please note "alopecia" is taken to be a general term for hair loss, so the type of hair loss eg areata, totalis etc needs to be specified. Please contact us for help with this if the hair loss is more general/diffuse in nature and of unknown cause,

Patient Claim Form Pre Filled Out For Temporary Hair Loss CLICK HERE

This form is pre-populated to file a claim with the Ministry of Health for a TEMPORARY Hair Loss Subsidy