DPC Waitlist Sign-up

Waitlist Sign-up:

TRUE by K. Nicole™Specialty DME Provider | Cranial Prosthesis Solutions P: (912) 602-4953 • F: (912) 452-1171E: info@truebyknicole.com • W: truebyknicole.com
Thank you for your interest in our custom cranial prosthesis and wig solutions. We are honored to support you on your journey with medical-grade, premium-quality units designed for comfort, confidence, and style.

This form is for new clients only who wish to join our waitlist. Please read carefully before completing:

✨ How It Works

Fill out the form with your contact details and style preferences.

Upload inspiration photos of your desired look (length, texture, or color).

Select your cap and construction preferences (HD lace, transparent lace, silk, closure, frontal, etc.).

Submit your form to secure your place on the waitlist.

⚠️ Important Notes

Joining the waitlist does not guarantee an immediate appointment.

Spots are offered in the order received and based on availability.

Once your spot opens, our team will contact you to schedule your consultation and review next steps.

Production begins only after your consultation and once your payment or insurance authorization has been confirmed.

We appreciate your patience and can’t wait to create a custom piece just for you.
Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Preferred Contact Method
Section 2: Style & Cap Preferences
Are you interested in wigs, toppers, or other hair pieces?
What texture do you prefer?
What type of hair do you prefer?
Are there specific colors or highlights you’re interested in?
Cap/Top Construction Preferences (Check all that apply)

HD LaceTransparent LaceSilk TopMonofilamentPU/Skin BaseClosureFrontalFull LaceLace FrontGlueless ConstructionAdjustable StrapsOther
Upload inspiration photo(s) or desired style

Cancelof
Do you have any concerns, allergies, or specific preferences we should be aware of?
Purpose & Usage
Will you be wearing your unit daily?
Are you currently experiencing or being treated for hair loss?
Do you know your head measurements? Note: If not, we offer virtual consults to guide you.
Budget & Payment
What is your preferred price range
How do you plan to pay?
If you selected Insurance as a payment method, our team will send you a separate Insurance Verification Form while you are on the waitlist. Completing this step ensures faster processing when your spot opens.

Once your spot is available, our team will reach out to schedule your consultation.

⚠️ Please note: Joining the waitlist does not guarantee an immediate appointment. Spots are offered in the order received and based on availability.

We look forward to connecting with you!
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Waitlist Sign-up:

Section 2: Style & Cap Preferences

Purpose & Usage

Budget & Payment