Forms

Cranial Prosthesis Patient Intake Form

Fill out our patient intake form to provide us with essential information before your appointment. Please forward your documents to info@treasuredlocsandtipsmedical.com.

Download your docs

Download the HIPAA doc

Microloc Client Intake Form

Fill out our client intake form to provide us with essential information before your appointment. Please forward your documents to info@treasuredlocsandtipsmedical.com.

Download your form

Schedule your Microloc Services

Trichology Intake Form

Download and complete your intake form before your scheduled appointment. Please forward your documents to info@treasuredlocsandtipsmedical.com.

Download your docs

Repair Request Form

If you require repairs for your Cranial Prosthesis or Custom Lace Wig, submit a repair request using this form.

Submit Repair Request