To ensure we deliver the highest quality care and develop the most effective treatment plans for our clients, we require our clients to complete a new health history form on annual basis.

This comprehensive form is crafted to offer valuable insights into your overall health and lifestyle patterns. By answering the questions thoroughly, you enable us to understand better your unique health needs and the factors influencing your well-being.

Please note that the health history form is not intended to provide a medical diagnosis.

Instead, it helps us identify your current health strengths and any potential risk factors. This information is crucial in allowing us to tailor our care specifically to you, ensuring you receive the best possible support for your health journey.

Your Information

Country

Lifestyle Questions

Treatment History

Health Background

Your Goals

If YES: you are interested in our hair restoration services please ensure you complete our hair loss questionnaire.

Your Understanding