Application

Any child or teen who is dealing with hair loss due to a medical condition and lives or is treated in the state of Oregon is eligible for an “Angel Hair System.”

To apply, please print out, complete and mail an application form to:

In addition to the form, please include a prescription from your physician for a cranial prosthesis.

To download an application form, please click here.

We will promptly review your application and contact you when we receive it.