Home » Consultations » Photo Consults (Outside New York Area)

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 at our office with Dr. Bernstein or Dr. Shah.

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.

Photos may only be submitted as JPGs and must be under 6 megabytes in size.

* = required

Personal Information

First Name *
Last Name *
Email Address *
Phone
City
State (if U.S.) or Country *
Date of Birth *
Current Age *
Gender *

Reason(s) for Inquiry

You may select more than one option:
Cause of My Hair Loss
Medical Treatment
Surgical Treatment
Follicular Unit Transplant (FUT)
Follicular Unit Extraction (FUE)
Robotic Hair Transplant (R-FUE)
Repair Old Hair Transplant

Hair Loss Info

What are your goals for your hair restoration?
Have you had any hair transplant procedures? Please provide as much detail as possible (incl. dates and types).
List any relevant information that might affect a hair transplant procedure (i.e. keloids, bleeding, diabetes).
Date you started treatment with Propecia
Date you started treatment with Rogaine
Other medications you are taking

Photo Uploads

Instructions: Please take photos with your hair dry. Include your entire head. You may block out your face, but a very close-up photo is of little value. The doctor needs to see the overall pattern of your hair loss.
Front View
Angle or Side View
Top View
Rear View

General Info & Comments

How Did You Hear About Bernstein Medical? *
Other Referral?
Comments

Newsletter

Check box to receive information from Bernstein Medical via email

Please verify that this is a legitimate inquiry

Two plus two equals

Share This Page

Post this page to your favorite social media site:

Robotic Hair Transplantation

We use the ARTAS System Robot for all FUE Hair Transplants.

Robotic Hair Transplantation

Hair Transplant Photos

Before & after hair transplant photos of our patients.

Hair Transplant Photos

Hair Loss Consultation

Schedule a consultation to find out how best to treat your hair loss.

Schedule a Consult

Hair Transplant Video & Audio

Videos from Dr. Bernstein's television appearances and Q&A sessions on hair transplant surgery and hair loss treatment.

Hair Transplant Video & Audio

Hair Loss For Dummies

New edition updated to include the latest in surgical hair restoration, FUE, medical treatments, hair cloning and laser therapy.

Read more

Bernstein Medical Newsletter

Receive email updates on hair transplant surgery, hair loss, hair cloning, events, news, and more.

Sign Up Newsletter Archive

Dr. Bernstein on Oprah

Dr. Bernstein appeared on the Oprah Winfrey Show to explain hair transplant surgery and show Oprah and Dr. Oz the results of a Bernstein Medical patient's procedure.

Watch the video

Bernstein Medical - Center for Hair Restoration
Offering hair transplant surgery and hair loss treatment to patients
from New York, New Jersey, Connecticut, and elsewhere around the world

110 East 55th Street, 11th Floor, New York, NY 10022
Phone: 212-826-2400 - Toll Free: 1-866-576-2400
Email: contact@bernsteinmedical.com

Hair Transplant | Hair Transplant Blog | Before & After Photos | Video & Audio | Dr. Robert M. Bernstein
Contact Us | About Us | Patient Info | New York Hair Restoration Center | Hair Transplant UK
Home | Sitemap | Privacy Statement | Top of Page