Required Documents to Include:
Medical
- Doctor’s diagnosis
Financial
- Most recent Tax Return
- Other proof of income, Social Security, Public Assistance, Disability Income
- Other documents that verify extenuating financial circumstances
Personal
- Two letters of recommendation from reference explaining why applicant could benefit from a hair replacement
Documents can be faxed, mailed or emailed to:
514 Texas Parkway, Suite A
Missouri City, TX 77489
281.830.3497
Fax: 281.437.0332
Online Application
Please fill out the application below to the best of your ability. Once we have reviewed your information we will contact you.