Photo Consultation for Hair Loss

Note: In-person consultations are preferred because an exam allows the doctor to better evaluate your hair loss. Schedule a consult with the doctor.

Can’t visit our hair restoration facility in New York City? Use our photo consultation service. Fill out the form below as completely as possible. After reviewing the information and photos you submit, the doctor will contact you by e-mail. All information and photos that you supply are kept strictly confidential.

Instructions:

  1. Submit one different photo for each of the four views (Front, Side or Angle, Top, and Rear). Please check to be sure that you included 4 distinct photos.
  2. Photos with dry hair only.
  3. Include your entire head. You may block out your face, but very close-up photos are not useful. The doctor needs to see the overall pattern of your hair loss.

Alternate submission: you may submit your photo consultation directly to Bernstein Medical by emailing your photos to contact@bernsteinmedical.com.


* = required


Personal Information
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Reason(s) for Inquiry
  1. You may select more than one option:





Hair Loss Info
Photo Uploads
  1. Important: Please carefully follow the instructions listed above or your submission might be rejected. Thank you.
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General Info & Comments
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