Virtual Pre-Consultation Form
The information you provide below allows us to gain a general understanding of your situation/hair concerns and provide you with initial recommendations. This form and any reply thereafter does not constitute a patient-physician relationship nor does it replace the in-person, comprehensive consultation with Dr. Max.
The in-person evaluation with Dr. Max includes a thorough medical history assessment, diagnostic hair loss evaluation, and advanced scalp microanalysis. A full consultation can be scheduled through our office for a fee of $150. This consultation fee would go towards any hair restoration procedure you opt for following your assessment
Please provide your details below to begin a Virtual Pre-Consultation. Any photos and personal information you share with Hair By Dr. Max, Restoration Center is treated confidentially, and will not be sold or shared with any third party.