Please fill out this form to learn more about treating your hair loss and your options with hair transplants or alternative treatments. You can also submit to us your hair loss photos which will give us a better understanding of your hair loss and an approximate idea of your hair replacement needs. One of our doctors will review your photos and provide you with an evaluation and recommendation.
Your information and photos become a part of your medical file at HRC and we will not sell, trade, lease or give that information to anyone – ever. If you have more questions, comments or helpful information to give us after you have completed this form, please do not hesitate to contact us again. An asterisk (*) indicates a required field.