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Wishcaps Cares

Patient Financial Assistance Program

Helping make cold cap therapy more accessible to patients experiencing financial hardship.

Apply for Assistance
  • ApplyShort confidential application
  • ReviewIndividual eligibility review
  • SupportReduced lease rates if approved

Helping Make Cold Cap Therapy More Accessible

At Wishcaps, we believe every patient deserves the opportunity to explore options for preserving their hair during chemotherapy, regardless of their financial circumstances.

We understand that a cancer diagnosis can bring unexpected financial challenges, including medical expenses, reduced income, and changes in employment.

As part of our commitment to making cold cap therapy more accessible, Wishcaps offers a limited Patient Financial Assistance Program for individuals who may have difficulty affording the cost of their cold cap kit lease.

Our goal is simple: Help more patients access cold cap therapy when they need it most.

Who May Qualify?

Financial assistance may be available to patients experiencing financial hardship, including those who:

  • Live on a fixed or limited income.
  • Receive Social Security retirement or disability benefits.
  • Have experienced reduced employment or loss of income.
  • Face significant out-of-pocket medical expenses.
  • Are experiencing financial hardship related to cancer treatment.

Eligibility is determined individually based on household income, financial circumstances, and available program funding.

We recognize that financial hardship looks different for every family and encourage patients who need assistance to apply.

What Assistance Is Available?

Qualifying patients may receive reduced monthly lease rates for their Wishcaps cold cap therapy kit.

Assistance amounts vary based on individual financial need and available funding.

Approved assistance applies to the monthly kit lease unless otherwise specified in writing. Dry ice, shipping upgrades, and other additional services are not automatically included.

No deposit is required for standard Wishcaps kit leases, including approved financial assistance leases.

How to Apply

Applying for assistance is simple and confidential.

1

Complete the Application

Submit our short Patient Financial Assistance Application with basic contact, treatment, and financial information.

2

Application Review

Our team will review your information and may contact you if additional details are needed.

3

Assistance Decision

We strive to provide an application decision within 1–2 business days after receiving all necessary information.

4

Getting Started

If approved, our team will explain your adjusted lease rate and help coordinate your cold cap kit order and delivery before your scheduled treatment.

Apply for Financial Assistance

Wishcaps Cares

Patient Financial Assistance Application

Assistance is based on individual circumstances and available program funding. Completing this application does not guarantee approval.

Prefer paper? Download the printable application (PDF) →
Section 1 — Patient Information
Section 2 — Treatment Information
Have you already started chemotherapy?
Section 3 — Financial Information
Current employment or income status (select all that apply)
Total annual household income (before taxes)
Are you experiencing financial hardship related to your medical treatment?
Section 4 — Assistance Requested
What level of financial assistance would help you participate in cold cap therapy?
Section 5 — Patient Acknowledgment

By submitting this application, I confirm that the information provided is accurate to the best of my knowledge. I understand that:

  • Financial assistance is subject to approval and available program funding.
  • Assistance applies only to the charges specifically identified in my approval.
  • Approved assistance does not guarantee hair preservation or treatment results.
  • Standard lease terms and equipment return requirements remain in effect unless otherwise agreed in writing.
  • Wishcaps may request reasonable additional information to verify eligibility.
  • My application information will be handled confidentially and used to evaluate my request.

Date: October 31, 2026 (added automatically when you submit)

Confidential — reviewed only by authorized Wishcaps personnel. Applications are generally reviewed within 1–2 business days.

Your Privacy Matters

We understand that financial information is personal.

All applications are handled confidentially and reviewed only by authorized Wishcaps personnel for the purpose of determining financial assistance eligibility and administering approved assistance.

We request only information reasonably necessary to evaluate your application.

Frequently Asked Questions

Does applying for assistance affect my ability to lease a Wishcaps kit?
No. Applying for financial assistance does not affect your ability to lease a kit at our standard rates.
Do I need to provide tax returns or financial statements?
Not initially. Most applications can be reviewed using the information provided on the application. Additional verification may be requested when necessary.
Will financial assistance cover my entire treatment period?
Approved assistance will specify the applicable monthly discount and duration. Any extension is subject to review and available funding.
Can I apply if my chemotherapy treatments have already started?
Yes. However, starting cold cap therapy after chemotherapy has begun may reduce its effectiveness. Our team will discuss this with you before processing your order.
Is financial assistance guaranteed?
No. Assistance is limited, based on financial need and program availability, and subject to approval.

We're Here to Help

We believe financial challenges should not prevent patients from asking about cold cap therapy. If you have questions about our Patient Financial Assistance Program or need help completing your application, please contact our team.

Apply for Financial Assistance Call 1-844-WISHCAP

Program Notice: Wishcaps reserves the right to modify, suspend, or discontinue the Patient Financial Assistance Program at any time, subject to any written assistance commitments already approved. Financial assistance is not guaranteed and does not constitute insurance coverage. All standard lease agreement terms remain applicable unless specifically modified in writing.