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    Please continue filling out the form below, so we can check your eligibility, coverage amount, and provide you with your wig options.

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    Tell us about yourself and provide us with your insurance information, so we can check your coverage amount and provide you with your wig/breast prosthesis options.
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  • A little bit more.

    Since each insurance plan and individual coverage is different, we will use your insurance information to call your insurance provider and ask them coverage questions specific to your policy.
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  • No worries! We can help you get one.

    Please provide your physician's information so we can contact them.

  • Please request your doctor to fill out this prescription template for a “cranial prosthesis” aka medical wig and email it back to us at hello@trscare.org or fax it to us at (281) 602-5094.

     

    Download Cranial Prosthesis Prescription Template

  • Please request your doctor to fill out this prescription template for mastectomy care products and email it back to us at hello@trscare.org or fax it to us at (281) 602-5094.

     

    Download Mastectomy Wear Prescription Template

  • Please request your doctor to fill out these prescription templates for a cranial prosthesis and mastectomy care products and email them back to us at hello@trscare.org or fax it to us at (281) 602-5094.

     

    Download Cranial Prosthesis Prescription Template

    Download Mastectomy Wear Prescription Template

  • One Last Thing...

    Just need your autograph, and you're all set! We'll process your application within 24 - 48 business hours and let you know if we need anything else :)
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