Hair Transplant Surgery- Hair Transplant Surgery Cost in NY & NJ

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Drs. True and Dorin are recommended by
The Hair Transplant Network

Information Request

True & Dorin customer service is awaiting your call. Please call our toll-free number at 1-866- HAIR MDS (424-7637) for any questions and inquiries. At your request, we will send you, free of charge, our literature on hair loss.

Complete this form to submit it electronically for ONLINE CONSULTATION or print it out and fax it to us at (212) 980-5696 and we will call you back during working hours to answer your questions or schedule and IN OFFICE CONSULTATION

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Current Age:
Age first noticed:
Are you still losing hair?
Has hair loss pattern stabilized, and for how long?

Do you use Propecia?	Yes No
Do you use Rogaine?	Yes No
Do you use any other hair loss products?
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Have you had prior procedures?
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If yes, are you satisfied with your results?
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For online consultation please attach pictures:

Provide these four views of you now:

Provide picture of you showing the hairline and look you would like to recover: