Pre-examination

At Haarklinikken, our commitment is to our patient’s success and happiness.  For this reason we do not accept patients unless we are confident that we can offer them significant hair restoration results.  Not all candidates for hair restoration will see the same results, so the first step to conduct a preliminary examination to determine your prospects for successful hair restoration.

To speak to a Haarklinikken Hair Restoration Professional about your hair loss and have your prospects for successful hair restoration evaluated, please fill out the following form:

Your Name (required)


Please leave this field empty.

Your Email (required)

Your Phone Number (required)

Your Age

For how long have you been on any medication, if at all?
(NA) if never.

How long ago did you first notice hair loss?

Is hair loss common in your family?

Your questions or concerns

Insert the code captcha

Gender

Interest

Male Hair Loss Scale
Men, click on the image closest to your hair loss condition.

 1
 6
 2
 7
 3
 8
 4
 9
 5
 10

Have you used the following treatments?

Rogaine
 1Past
 2Present
 3Never
Propecia
 1Past
 2Present
 3Never