Our Address

278 Franklin Rd, Suite 247
Brentwood, TN 37027
Ph: 800-496-7225 or 615-376-6010
Fax: 615-376-7010

We are located in Building Four of the Synergy Business Park.

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AM PM

Select the image that best describes your hairloss condition when your hair is wet. Male:

Female:

Please rank the concerns that apply to your feelings about hair restoration surgery in order of importance to you

1 2 3 4 5 - Camouflaging after surgery
1 2 3 4 5 - Affordability
1 2 3 4 5 - Discomfort
1 2 3 4 5 - Final result
1 2 3 4 5 - Time off work
1 2 3 4 5 - Other

<20 20-30 31-40 41-50 50+

Please indicate in which areas your hair loss affects you

When I see pictures or videos
My self-esteem
At the beach or swimming
In my social life
When I get dressed up
When I see old friends
When I have to wear a hat
It doesn't bother me

What would you like to achieve with hair transplantation (restore the front hairline, mid scalp, back, or your entire balding area)?

Have you consulted with a doctor about your hair loss condition?

Yes No

If so, with whom?

Have you ever had surgical hair restoration performed?

Yes No