VIRTUAL

HAIR RESTORATION

Consultation

Thank you for visiting our website! We are still open, however due to COVID-19 Mandated State of California business closures, we are not able to meet with all of our incredible patients in our offices at this current time. However, regardless of where you live or what time zone you are in, we can bring the expertise of Ziering Medical to you. We invite you to get started by completing the form below.

VIRTUAL HAIR RESTORATION CONSULTATION (OB)

First Name*
Last Name*
Email*
Phone*
Age*
Address*
Street Address City State / Province / Region Country
Zip Code*
Family History Of Hair Loss
- Father
- Mother
- Maternal Grandparents
- Paternal Grandparents
Describe Any Underlying Medical Conditions You May Have:
What are you currently using to manage or treat your hair loss:
Describe Previous Hair Transplant Procedure(s):
Which procedures are you considering?
- FUT
- FUE
- ARTAS Robot
What Are Your Hair Restoration Goals:
- Coverage
- Density
To provide the best and most complete consultation please provide photos following the directions below.
Upload Your Hair Photo:
Max. file size: 128 MB.
Frontal view; straight on
Upload Your Hair Photo:
Max. file size: 128 MB.
Right view; hair combed back
Upload Your Hair Photo:
Max. file size: 128 MB.
Left view; hair combed backed
File
Max. file size: 128 MB.
Top view; top of head
File
Max. file size: 128 MB.
Back of the head
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Source
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Medium
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Campaign
Name
This field is for validation purposes and should be left unchanged.

At Ziering Medical, we appreciate the value of your time, the challenge that distance presents, and the reality of personal limitations. Our patients are busy — many are leaders in their respective professional fields, high profile celebrities and successful entrepreneurs who need alternatives to in-person appointments. If you are unable to visit one of our hair restoration clinics, the good news is discussing your hair loss with a Ziering physician just got easier. To provide you with the quality hair loss consultation you deserve combined with the highest level of convenience, Ziering Medical offers three virtual consultation appointment options: Phone, SKYPE and Face Time.

Regardless of where you live or what time zone you are in, we can bring the expertise of Ziering Medical to you. We invite you to get started by completing the form below.

Virtual Consult Website Form

First Name*
Last Name*
Age*
Email*
Phone*
Address*
Street Address City State / Province / Region Country
Zip Code*
Family History Of Hair Loss
- Father
- Mother
- Maternal Grandparents
- Paternal Grandparents
Describe Any Underlying Medical Conditions You May Have:
What are you currently using to manage or treat your hair loss:
Describe Previous Hair Transplant Procedure(s):
Which procedures are you considering?
- FUSS (Follicular Unit Strip Surgery)
- FUE (Follicular Unit Excision and Extraction Surgery)
- Non-Surgical Therapies and Treatments
What Are Your Hair Restoration Goals:
- Coverage
- Density
To provide the best and most complete consultation please provide photos following the directions below.
Upload Your Hair Photo:
Max. file size: 128 MB.
Frontal view; straight on
Upload Your Hair Photo:
Max. file size: 128 MB.
Right view; straight on
Upload Your Hair Photo:
Max. file size: 128 MB.
Left view; straight on
Upload Your Hair Photo:
Max. file size: 128 MB.
Top view; straight on
Upload Your Hair Photo:
Max. file size: 128 MB.
Back view; straight on
Hidden
Source
Hidden
Medium
Hidden
Campaign
Hidden
gclid_field
Comments
This field is for validation purposes and should be left unchanged.