START YOUR VIRTUAL CAPILLARY VALUATION

We want to know your case and give you a personalized orientation according to your hair situation. Complete the following form with your data and a brief description of your case. Our medical team will evaluate the information and will contact you to continue with the process.

It is the first step towards a hair solution adapted to your needs. Tell us about yourself, your history and your goals – every detail helps us to provide you with better care.
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1. Personal data

2. Areas you want to treat

What areas do you want to treat? (Select one or more)

3. Medical history and hair history

Have you had any hair restoration treatments before?
Do you suffer from any relevant medical conditions (autoimmune, hormonal, metabolic, etc.)?

4. Photographs for evaluation

Please attach 4 clear, recent photographs of the areas to be treated:

If treating the scalp:
• Front view
• Right side view
• Left side view
• Top view (crown)

If eyebrows or beard:
• Front photo with good lighting
• Photo of the specific area to be improved (close-up from the side)
• Photo with no facial expression
• Photo of the area clean and without makeup or products

Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.

EXAMPLES FOR PHOTOGRAPHS