Submit a claim: Wig Program
If you’re applying for reimbursement through the Wig Program, you need to submit the Wig Claim Form.
Use the Wig Claim Form to submit your wig expense.
To get reimbursed, you need the official receipt. A cash register receipt, credit card statement or debit card statement isn't acceptable.
Who can use this form
You need to use this form to submit a claim to the Wig Program.
Patients need to submit the form within 6 months from the date of the wig purchase.
Vendors need to submit the form within 3 months from the date of the wig purchase.
What you need to do
- Complete the Wig Claim Form (PDF).
- Check the form for details on all required supporting documents.
- Submit your completed form and supporting documents.
How long it takes
It should take 1 to 2 weeks to find out if your reimbursement is approved. It can take longer if more information is needed or if your application hasn’t been filled in correctly.
Cost
There is no cost to submit the form.
Before you start
Make sure you have:
- funding approval from the Assistance for Cancer Patients Program - Boarding, Transportation and Ostomy Program
- Health Card number
- copy of the official receipt for the wig
Online
When you submit the form online you need to create an account or sign in. You also need to upload the Wig Claim Form PDF and any supporting documents.
You can use the Wig Claim Form (PDF 134 kB) if you’re unable to submit the form online. Send your completed form and supporting documents by mail or fax.