Stylist Approval Acceptance Form

• Our non-profit is required to collect this form confirming the hairpiece has been received.
• The recipient guardian will complete guardian approval and acceptance form upon receipt of the hairpiece.
• The stylist will complete the stylist approval and acceptance form at the cut-in/styling appointment.
• If the family does not return to the salon, or child has worn the hairpiece, then this form is due immediately.

This process is not complete without submission of the Guardian form.

Stylist Approval Acceptance Form

Name of Recipient (Child)(Required)

Name of Salon(Required)

Name of Stylist(Required)

Where Do You Live?

Salon Address(Required)

Street Address City State ZIP Code

Salon Address(Required)

Street Address City Province Postal Code

Salon Phone(Required)

This is to confirm that on this date(Required)

that I have inspected the unit and acknowledge that it is in good condition. I understand that once the hairpiece has been styled, it cannot be returned.

Stylist Signature:

Enter Today's Date

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About Wigs For Kids

Wigs For Kids is a nonprofit organization that helps children experiencing hair loss stemming from chemotherapy, radiation therapy, alopecia, trichotillomania, burns, and other medical causes. Stylists and regular people just like you work together to give recipients the self-esteem and self-image they deserve.

24231 Center Ridge Road Westlake, OH 44145

Stylist Approval Acceptance Form

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