CONSULTATION - Los Angeles Hair Restoration

Hair Surgery Clinic Online Consultation

This form is for both hair transplant patients and scalp tricopigmentation.

This is not a formal consultation and it is not a substitute for an actual face-to-face history and examination by Dr. Umar. Any response to an inquiry is tentative and subject to review after actual examination by the doctor.

Are you looking to ask Dr. U a quick question? Click here

Note that any information submitted through this form is held in strictest confidence.

Please fill out as much information as possible. The * marked fields are required.

First Name*

Last Name*

E-mail*

Phone Number*

Zip Code

Age*

Gender

Preferred method of contact

How did you find Dr. Umar?

What donor source do you anticipate using? Head hair uGraft FUE only, body hair uGraft FUE only or a combination?

Head only transplant

Body hair transplant

Combination hair transplant

Scalp micro/trico pigmentation

Other

What are your expectations from the procedure?

Additional Questions