TRUE Pre-Consultation Form

Welcome to TRUE Praxis™ — Professional Practice
This pre-consultation form is designed to help us understand your current practice, goals, and the type of guidance you are seeking so we can recommend the most appropriate next step.

TRUE Praxis™ provides applied operational guidance for cranial prosthesis specialists and related professionals seeking clarity, structure, and ethical growth within their business. This may include guidance related to business structure, documentation and in-house practices, insurance-aligned workflows, medical wig integration, professional positioning, and care standards.

Some specialists engage with TRUE Praxis™ to navigate insurance-aligned cranial prosthesis care within a U.S.-based model. Others seek strategic guidance on integrating medical wigs into an existing practice, refining service delivery, improving visibility and credibility, or gaining clarity around their current business model, without insurance billing.

Your responses allow us to prepare intentionally and determine whether support is best provided through a strategy session, framework-based education, or mentorship.

Completion of this form does not guarantee a booking. You will be contacted with recommended next steps after your intake has been reviewed.
SECTION 1 — CONTACT & PRACTICE INFORMATION
Facility/Business Name:*
Owner/Administrator Name:*

First NameLast Name
Facility Location:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country & Time Zone
Contact Email:*
example@example.com
Phone Number:*
Please enter a valid phone number.Format: (000) 000-0000.
Website and/or Instagram (if applicable):*
SECTION 2 — PRACTICE BACKGROUND
Which best describes your current role?*

Cranial Prosthesis SpecialistTrichologistSalon Owner / StylistDME ProviderMedical or Clinical PracticeOther
How long have you been in the hair-loss industry?
SECTION 3 — PATHWAY SELECTOR

If you are unsure which option best fits your needs, select the one that feels closest to your current challenges. Your responses will be reviewed and guidance will be provided accordingly.
What best describes the type of guidance you are seeking at this time?*

Insurance-Aligned Cranial Prosthesis Workflow (U.S.-based)Professional Practice Strategy & Medical Wig Integration
What best describes the type of guidance you are seeking at this time? Select the option that most closely aligns with your current goals.

Insurance-Aligned Cranial Prosthesis Workflow (U.S.-based)- Guidance related to insurance-aligned cranial prosthesis care, documentation standards, reimbursement workflows, and DME-compliant practice structure.Professional Practice Strategy & Medical Wig Integration- Strategic guidance related to business structure, in-house practices, ethical care standards, medical wig integration, service delivery, professional positioning, and sustainable growth. This option is appropriate for non-insurance, international, cash-pay, or mixed-model practices.Not sure, seeking clarity
SECTION 4 — INSURANCE & BILLING

(Complete this section only if insurance alignment is relevant to your practice.)
Have you ever billed or attempted to bill insurance for cranial prostheses?

YesNoNot yet, but planning to
Which best describes your experience so far? (select all that apply)

I have verified benefitsI have submitted claimsI have received reimbursementI have experienced claim denialsI operate primarily as self-payNot applicable
If applicable, what challenges have you encountered? (optional)

Cosmetic / non-covered determinationsDocumentation issuesAuthorization issuesOut-of-network limitationsCoding or claim errorsNot sure
Do you currently have a CAQH profile? (optional)

Yes — active and attestedStarted but not completedAuthorization issuesNoNot sure
Optional CAQH Readiness Support (If you would like guided support with CAQH) setup and attestation:

No thank youYes — CAQH Readiness GuideYes — CAQH Guide + Upload Checklist
SECTION 5 — PRACTICE STRATEGY & MEDICAL WIG
What best describes your current business model?

Cosmetic / cash-pay onlyMedical or clinical practiceTrichology-focusedInternational practiceMixed or evolving model
What are you hoping to improve or clarify? Checkboxes (select all that apply)

Integrating medical wigs into my practiceProfessional positioning and credibilityBusiness structure or workflowsService model or pricingGrowth clarity or next steps
SECTION 6
What is the primary challenge or question you are hoping to address?
What outcome would make this engagement valuable for you?
SECTION 7 — PROFESSIONAL READINESS CHECKLIST
Please indicate which items you currently have in place (if applicable):

Business entity (LLC or equivalent)EIN / Tax IDNPICAQH profileCranial prosthesis or medical wig training
Which level of support are you most interested in?

One-on-One Strategy Consultation (60-120 minute session(sessions) - to clarify your structure and integration path.Mentorship Program (4-8 weeks) - virtual sessions and templates for guided implementationNot sure yet – I’d like guidance
Logistics & Uploads
Preferred Contact Method

EmailCallText
Upload any relevant materials (optional)

Cancelof
How did you hear about TRUE by K. Nicole™?
SECTION 7 — PROFESSIONAL READINESS CHECKLIST
Acknowledgment Checkbox (Required)

I understand this form is used to assess readiness and fit for professional guidance through TRUE Praxis™ — Professional Practice. Submission does not guarantee booking.
🌸 Thank you for completing your Pre-Consultation Form!Our team will review your responses within 3-4 business days and follow up to schedule your consultation.We’re excited to help you build a sustainable, client-centered medical wig model through TRUE by K. Nicole™.💌 Questions? Email info@truebyknicole.com or visit truebyknicole.com
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Welcome to TRUE Praxis™ — Professional Practice

SECTION 1 — CONTACT & PRACTICE INFORMATION

SECTION 2 — PRACTICE BACKGROUND

SECTION 3 — PATHWAY SELECTOR

SECTION 4 — INSURANCE & BILLING

SECTION 5 — PRACTICE STRATEGY & MEDICAL WIG

SECTION 6

SECTION 7 — PROFESSIONAL READINESS CHECKLIST

Logistics & Uploads

SECTION 7 — PROFESSIONAL READINESS CHECKLIST