Free Quick Consultation

Please fill out the following form and we’ll contact you to discuss your options.

Name*
First Last
Email*
Phone*
Gender*
- Male
- Female
Age*
Closest Location*
How long have you experienced hair loss?*
What steps have you taken to deal with your hair loss? Please be specific.*
ex: Hair transplants, monoxidil, rogaine, etc.
How often do you shampoo your hair and what do you use?*
ex: product types and names
Do you have any conditions or disorders that contribute or could contribute to hair loss?*
ex: Medical conditions or prescriptions you may be taking
Are you currently taking any medications or vitamins to help with hair loss?*
If yes, please explain.

Visit our contact and locations page to find your nearest North Dakota location.

Free Hair Loss Consultation