P.O. Boxes are not accepted. Please use street address.
Please upload a prescription from your oncologist for a wig/cranial prosthesis OR an official letter from your oncologist stating that you are under his/her care and require a wig due to hair loss from ongoing cancer treatment. Prescription/letter must be addressed to the Verma Foundation and dated within 30 days of submission. Other forms will not be accepted and will delay your application approval process. (Allowed file extensions: .jpg, .jpeg, .doc, .pdf, .png)
Acceptable documents to show proof of income:
W-2 – Income Statement
1099 – Miscellaneous Income
Federal Income Tax Return
If you do not have income and have no filed taxes, you can request a free “Income Transcript” from the IRS (https://www.irs.gov/forms-pubs/about-form-4506-t)