Virtual consultation

Please fill in this form. Our specialists will consider your problem and personally write you about the optimal solution for you.

Contact information

Name:
Country:
City:
E-mail:
Phone:

Personal information

Age:
Gender:
Hair color:
Hair type:
Hair structure:

Norwood Baldness Classification

Please indicate which of this picture looks like your hair the most, when they are wet.

Ludwig Baldness Classification

Please indicate which of this picture looks like your hair the most, when they are wet.

Aditional information

When did you begin to suffer from hair loss?

Did masses of baldness increase in the past few years?

Yes

Which part of head is missing the most hair?

Is head visible through wet hair?

Yes

Is head visible through dry hair?

Yes

Have you ever talked with doctor about your problem?

Yes

What kind of medications against baldness have you taken?

Have you ever had a hair transplantation operation?

Yes

Do you think hair transplantation could solve your hair loss problems?

Yes

Please attach the picture of your head, especially parts where hair is missing...
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If you have comments or aditional information please write it here: