Hair Medical Restoration

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Hair Medical Restoration

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Fill up this format or call us on the phone to get more information about our alopecia treatments. You will get an answer in less than 12 hours.

You are one step away from recovering your hair, please fill out the form and we will contact you as soon as possible.

Fields marked with an asterisk (*) are required.

1. Personal Information

2. How did you hear about us?

3. In order to give you a better service, please attach the following photos

You can take the photos with your cell phone, we recommend that you take them in a place with good lighting and that you take them with the hair pulled back.

It´s ok! you can send us the photos later.

But we still recommend that you send them to us as soon as possible to give you a more fast and personalized service.

Hair Medical Restoration