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Robotic Hair Transplants & Hair Restoration
Flagship: 110 East 55th Street, New York, NY
212-826-2400 - [email protected]

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Online Consultation for Hair Loss

Fill out the form below and Dr. Bernstein or Dr. Shaver will review your case.

The doctor will respond via email or phone as soon as possible.

If you would like to schedule an in-person physician consultation at our New York City office, please use our Physician Consult Form.

Physician Consult Form

Online Physician Consultation Form
How Would You Like To Be Contacted?*
- Email
- Phone
Hair Loss Info
What are your hair restoration goals?
Have you had any hair transplants? Please provide details (i.e., dates and types).
List relevant health info that might affect a surgical procedure (i.e. keloids, bleeding, diabetes).
Are you currently taking finasteride (Propecia)?*
- Yes
- No
Date you started finasteride (Propecia)*
Date Format: MM slash DD slash YYYY
Are you currently taking minoxidil (Rogaine)?*
- Yes
- No
Date you started minoxidil (Rogaine)*
Date Format: MM slash DD slash YYYY
Other medications?
Photo Uploads
Instructions for Photos:
1. Submit one different photo for each of the four views (Front, Side/Angle, Top, and Rear)
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
4. Click below to upload your photos
*
- Click Here
Front View*
Select a photo of your frontal hairline
Side/Angle View*
Select a photo of your hair from the side
Top View*
Select a photo of the top of your scalp
Rear View*
Select a photo of the back of your scalp
Reasons for Inquiry
You may select more than one option:
- Cause of Hair Loss
- Robotic Hair Transplant (R-FUE)
- Follicular Unit Transplant (FUT)
- Eyebrow Transplant
- Repair Old Hair Transplant
- Scalp Micro-pigmentation (SMP)
- Platelet Rich Plasma (PRP)
- Surgical Treatment
- Medical Treatment
Personal Information
First Name*
Last Name*
Email Address*
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Phone Number
Location*
City State / Province / Region ZIP / Postal Code Country
Date of Birth*
Date Format: MM slash DD slash YYYY
Age*
Gender*
Current Patient of Bernstein Medical?*
General
How Did You First Hear About Bernstein Medical?*
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Name of Family Member or Friend
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Physician Name
Other Referral?
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Alternate Submission

Submit your online consultation directly to Dr. Bernstein or Dr. Shaver by emailing your photos to [email protected].

Physician Consults

Meet with our board certified doctors to diagnose your hair loss and discuss treatments. Schedule A Physician Consult

Before & After Photos

Before & after photos of more than 200 patients.

All FUE procedures at Bernstein Medical use the ARTAS Robot

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Dr. Bernstein on The Oprah Winfrey Show

Dr. Bernstein discusses hair restoration with Oprah and Dr. Oz and shows them results in a patient.

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Reasons to Visit

Reasons to visit our hair restoration facility in NYC.

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Hair Loss For Dummies

The layman's guide to hair loss and its treatment.

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Bernstein Medical Newsletter

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By: Dr. Robert M. Bernstein
Updated: 2020-06-19 | Published: 2009-07-15

State-of-the-art surgical hair restoration and advanced medical hair loss treatment to patients from New York, New Jersey, Connecticut, and around the globe.

Mannhattan Office: 110 East 55th Street, 11th Floor
New York, NY 10022

Long Island Office: 229 7th Street, Suite 105
Garden City, NY 11530

212-826-2400 866-576-2400 (Toll Free) [email protected] Patient Portal & Forms

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Bernstein Medical is a Division of Schweiger Dermatology Group.