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Online Consultation for Hair Loss

If due to any reason you are unable to come for consultation , Kindly fill up this form. It takes 5 minutes to do so. We generally respond to these Queries within one working day.

Our team of American Board Certified Hair Transplant Surgeons make a customized plan for you depending on your grade of baldness & various other factors.

  • It is essential that no information should be hidden from the Doctor.
  • Complete information is kept confidential.
Dr. Satya and Preeti Saraswat

Hair Loss Info

    What are your hair restoration goals?

    Have you had any hair transplants? Please provide details
    (i.e., dates and types)

    Any Medical Problem –

    Family History of hair loss (Both Father & Mother Side)

    Past Surgical History

    Significant Medical Problem in Family

    History of Allergies

    Any Medications & Therapies taken for hair loss

    Photo Uploads

    Instructions for Photos:

    1. Submit one different photo for each of the four views (Front, Side/Angle, Top, and Rear)

    2. Photos with dry hair only

    3. Include your entire head. You may block out your face, but very close-up photos are not useful. The doctor needs to see the overall pattern of your hair loss

    4. Click below to upload your photos

    Reasons for Inquiry

    You may select more than one option:

    How Would You Prefer To Be Contacted?

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