Highest Quality Human Hair Wigs-Highest Quality Hairpieces - Highest Quality Human Hair Wigs-Highest Quality Lace Front Wigs
Fill Out The Form Below or CALL US at 877 769-9447 for more information.  If you want to get a head start on finding a wig or making a custom wig, please click here to go to the  Detailed Client Contact Form.

 Please fill out the form below & a Wiggin Out Salon staff member will
contact you by the following business day or call us directly at
 
877 769-9447 (WIGS)
 
If your requesting an appointment, you will need to complete the detailed '
questionairre below so we may better service your needs.
 
If you are writing to us from out of the state or the country we
ask that you include the following photos:
 
1. photo of you when you were the "happiest" before your hair  loss
2. a photo of your "dream hair"  this photo should be the hair that
moves touches and excites you.  It does not have to look like your own hair
3. a photo of you or your loved in your/his/her present condition.
 
If you are feeling ill or for convenience reasons please let us know if
your interested in a home or office visit. 
 
If your sending photos of yourself or love ones please email to
 
Wiggin Out Salon services clients all over the USA, Canada and Europe
 
Please state if your interested in visiting one of our specialists in Thousand Oaks, CA, Newport Beach, CA, Santa Monica, CA, West Hollywood  or Charlotte, NC
 
We are currently taking appointments for "in home visits" in Los Angeles County,  Ventura County and surrounding county's of Charlotte, NC.
 
If your sure that you will be visiting one of our locations we would like to request that you fill out the
This form must be completed prior to your appointment with a Wiggin Out Salon Wig Designer, so we may assist in providing you with the best possible wig or hair piece that may provide a transformation in your life.
 
Detailed Client Wig & Hairpiece Submission Form
 
(must be filled out prior to consultation)
 
Contact Form
Name: First & Last
I am a (or the person I am inquiring for is)
Birthdate (Day, Month and Year)
Street Address
City & State
Zip Code
Email Address:
Daytime Contact Phone Number
Evenng Contact Phone Number
Best time to call
Hours
 
 : 
Minutes
 
I am inquiring today about a
I am interested in
A followup phone call
Email Contact
In Salon Consultation
Phone Consultation
In home visit
In hospital visit
Making plans to visit a Wiggin Out Salon location
Check all that apply
I have just began loosing my hair.
I have been experiencing hair loss for years
I have bald spots or a bald spot
I have severe thinning
I believe that my hair loss is from stress
My hair is falling out in clumps
I am going to begin chemotherapy soon.
I am not sure when I start chemotherapy
I am very distressed from my hair loss
I am not ready to wear a wig
I am ready to look at wigs.
I would like to look into wearing a hair piece
I am bald
No hair loss-Just want thicker or longer hair
I am almost bald
I have had bad experiences with wearing wigs
I have no experience wearing wigs
I am not sure about wearing a wig
I have been wearing wigs for years
I have experience wearing hair pieces
I have been diagnosed with Alopecia
I have hair loss from hair extensions
I am inquiring for a friend or family member
I am inquiring about making a wig using own hair
I am inquiring about Post Chemo hair re-attachment
I am inquiring about children's wigs
I am inquiring about hair extensions
I would like to learn more about my options
I am not sure why I am here. Please help.
Medications I am currently taking
Please state any surgurys in the past 5 years
Have you had in the last 5 years experienced childbirth?
Are you going to begin chemotherapy? If yes when do you start your treatments?
If you have alopecia, are you scheduled to have any type of treatments performed? If so, please decribe your treatments.
Please tell us who referred you to our website?
Are you eating healthy? On supplements? Please decribe your health regimen if you have one.
I will need a wig by the date below:
I really do not want to wait for a wig to be made for me. I am interested in seeing your pre-custom made wig selection
Activities that I participate in. (Please check all that apply)
Swimming
Sailing
Crusing
Volleyball
Scuba Diving/Snorkling
Diving
Gymnastics
Theater
Acting/TV/Motion Picture
Artist
Musician /studio/stage
Walking
Running
Biking
Yoga (regular)
Heated Yoga
Horseback riding
Wrestling
Social Events
Socializing
Boxing
Farm/Ranch Activity
Atv's
Motercycles (I wear a helmet)
Acrobats
I am not active
I am not active since my hair loss
My hair loss has not stopped my being active
I would like to engage in other activities soon
I have a wedding to attend in the near future
I have an important social event to attend
Just please help
Preferred Date for my appointment
Preferred Time
Hours
 
 : 
Minutes
 
If your planning an in salon visit, please state which location you will be visiting
Do you live out of the area or out of state?
Will you need a Wiggin Out Salon staff member to help you with plane and hotel reservations? Please state your needs.
Will you be cutting off your own hair to make a wig? Are you bringing in donated hair to make your wig? Please explain below:
Monday - Fri: 10AM - 5PM
Sat: 10AM - 4PM
Sun: Closed
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