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We take pride in providing each patient with an individual treatment plan. In order to obtain a quote, please provide photographs of the back of your head, both sides and the area affected with hair loss. Please ensure proper lighting.

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    Enter your data

    * Required



    Place of hair loss*

     Your file

    Back of the head*

     Your file

    Left side*

     Your file

    Right side*

     Your file

    * Max size of file 5MB

    Send additional information

    Type of hair loss


    Male hair loss

    Female hair loss

    Hair type


    Applied treatment


    Oral anti-hair loss medications

    Medicion for topical application to the scalp




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