We care about our cancer fighters! To receive your very own pink wig, simply fill out the form below and we'll send you one—free.

THIS REQUEST FORM IS DESIGNED FOR THOSE DIAGNOSED THEMSELVES AND CURRENTLY UNDERGOING TREATMENT. If you are requesting a wig on behalf of someone fighting, we ask that you donate a wig in support instead. When a pink wig is purchased, another is gifted to those fighting their disease. Through our donors' generous gifting, The Pink Wig Project can continue to provide pink wigs to fighters long-term. 

Please allow up to two months for your wig to arrive.

 
Name *
Name
Phone *
Phone
Have you been formally diagnosed? *
In order to send a complimentary wig, please provide details of your condition.
Tell us why a pink wig would mean a lot to you.