Refer a Patient for Assistance

Purdy Crown of Confidence Program

Support patients in need through the Purdy Crown of Confidence Program, sponsored by Anu Community Development.

This program provides assistance to individuals experiencing medical hair loss who may require financial support for wigs and related services.

Refer a Patient Now

ABOUT THE PROGRAM

The Purdy Crown of Confidence Program is designed to help individuals facing medical hair loss regain confidence and dignity during a difficult time.

Through this program, eligible patients may receive financial assistance for cranial prostheses (medical wigs) and related services.

WHO SHOULD USE THIS FORM

This referral form is intended for healthcare providers, hospitals, oncology centers, and clinics referring patients experiencing medical hair loss who may need financial assistance.

👉 Refer patients who:

Are experiencing medical hair loss
Have limited or no insurance coverage
May benefit from financial assistance

HOW IT WORKS

Submit the referral form
Our team reviews the patient’s eligibility
We contact the patient directly
Assistance is determined based on program guidelines and available funding May benefit from financial assistance

IMPORTANT INFORMATION

✔ This form is secure and designed to protect patient information

✔ Referring providers must have patient consent before submitting

✔ Submission does not guarantee approval

✔ Assistance is based on eligibility and available funding

READY TO REFER?

Help your patients access support and care today.

Submit a Patient Referral

Need to Apply Directly?

Patients may also apply directly for assistance through the program.

Apply for Assistance

Supporting Families in Need-Who we can help

Who we serve

ANU Community Development provides support to individuals and families who are often caught in the gap — earning too much to qualify for government assistance, but too little to afford private care. We serve:

— Seniors and unpaid family caregivers navigating Alzheimer's, dementia, or aging-in-place challenges

— Veterans and their families seeking housing stability or VA benefit navigation

— Low-income families facing eviction, foreclosure, or financial hardship

— Individuals experiencing medical hair loss due to cancer, alopecia, or autoimmune conditions

— Households needing food, childcare, or transportation assistance

Not sure if someone qualifies? Submit a referral anyway — we will follow up and help connect them with the right resources.

What happens after you refer

Every referral is handled with confidentiality, compassion, and care.

Once we receive your referral, a member of the ANU team will reach out within 2–3 business days to learn more about the situation and connect the individual or family with the right programs and resources. If the need is urgent, please call us directly at (678) 439-8319.

Every referral you make is an answer to the gap that families like ours fell through.

Thank you for showing up for someone who needs it.

Refer a patient or loved one now