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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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    Photos

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    Place of hair loss *

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    Back of the head *

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    Left side *

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    Right side *

    * Max size of file 1MB

    Dodatkowe informacje

    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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