Apply for a Free Human Hair Wig

If You Or A Loved One Is Experiencing Medical Hair Loss, We’re Here To Help.

Apply Today For A High-Quality Human Hair Wig At No Cost.

Wig Application

Recipient Name

First Name

Last Name

Recipient Date of Birth

YYYY

Legal Guardian Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Every application must have a doctors prescription that states reason for hair loss -Doctors prescription stating reason for hair loss

Yes

Must provide if over 18 - Most recent tax returns or other proof to verify the need for financial assistance

PLEASE NOTE:These documents must be submitted before an application can be reviewed. Over 18 must include financial documents and prescription.

Yes

My natural hair color is

Tell us about you

This section allows us to share stories of the people we help. It does not impact application review. Please provide personal anecdotes, such as interests, hobbies, or unique attributes that describe the recipient’s personality and experience. You may also attach additional information.

Yes, I understand I will nor receive communicaion from Hair We Share until the required documents are submitted

Yes

Use of information

Hair We Share Media Release

I authorize Hair We Share Inc. (HWS) to record, use, and distribute any photographs, videos, or digital content featuring me as a wig recipient (“Participant”) for promotional, advertising, and fundraising purposes. This includes my likeness, image, name, voice, and biographical information in any media format, now or in the future. I waive any rights to review or approve the final materials and understand that I will receive no compensation for their use. I release HWS and its affiliates from any claims related to this agreement. If I am under 18 or have a legal guardian, my parent/guardian agrees on my behalf. This release is binding upon me and my heirs.

Yes, I agree

No, I do not agree

Hair We Share Wig Use Agreement

I understand that wigs are provided as is and may not have been cleaned or treated per regulatory standards. I accept full responsibility for the use of the wig and acknowledge that Hair We Share Inc. is not liable for any harm, including allergic reactions or discomfort. I release Hair We Share Inc., its affiliates, and representatives from any claims, damages, or legal fees related to the use or misuse of the wig.

Yes

Hair We Share Authorization & Agreement

By submitting this form, I confirm that I am the recipient or legal parent/guardian of the Hair We Share recipient and understand the terms. I authorize Hair We Share to copyright, use, and publish any photographs of me, with or without my name, for lawful purposes, including publicity, illustration, and web content. I have provided my name and phone number for verification, and my submission serves as my electronic signature.

Date

YYYY

I agree with Privacy Policy, Terms and Condition

Yes

Eligibility & Application Process for a Free Wig

Hair We Share provides free, human hair wigs that are customizable for individuals experiencing medical hair loss. Please review the following guidelines before submitting your application.

Eligibility Requirements

Children (18 & Under): Receive a wig at no cost with proof of medical hair loss.
Adults (Over 18): Wigs are provided based on financial need and approval.
*Both must have a doctor’s prescription that states reason for hair loss

Application Guidelines

You must be 18 or older to submit an application.
Must be a U.S. resident.
Individuals with hair loss may apply once per year.
To support our mission, we ask recipients to help with fundraising efforts when possible.
We will respond via email within one week—please check your spam folder.

For any questions, contact us at care@hairweshare.org.

Required Documents

Children (18 & Under):

Doctor’s prescription confirming medical hair loss.

Adults (Over 18):

Doctor’s prescription confirming medical hair loss.
Proof of financial need (one of the following documents):
- W-2 (Income Statement)
- 1099 (Miscellaneous Income)
- Federal Income Tax Return
- Social Security Statement
- IRS Income Transcript (Request Form 4506-T here)

Application Review Process

Each application is reviewed by our board of directors—no single individual approves or denies applications.
For adults, we consider cost of living and medical expenses (receipts required).
The “Personal Information” section does not affect approval—it helps us share recipient stories to grow our mission.
Applications will not be reviewed unless all required documents are submitted. If documents are missing, send them separately to care@hairweshare.org.
Completed applications will receive a response within 5 business days.

Apply for a Free Human Hair Wig

If You Or A Loved One Is Experiencing Medical Hair Loss, We’re Here To Help.

Apply Today For A High-Quality Human Hair Wig At No Cost.

Wig Application

Eligibility & Application Process for a Free Wig

Donate Today—Change a Life

Your Gift Restores Confidence and Hope