c y b e r - c o n s u l t a t i o n

Welcome to Gardel Hair Restoration Institute's Cyber-Consultation.

By filling and submitting the data in the form below, you'll be working with us on finding a solution for your baldness problem.. only here at Gardel, where your investment does grow.

Thank you!!
Dr. Gastón de la Garza

 

First, please indicate your baldness type

MALE
FEMALE


2 2A


3 3A 3V


4 4A


5 5A 5V


6


7

1
2
3

4

5

 

Now, just fill out these questions:

1) Mi hair in the back / lateral zone (donor zone) is:

Color:
Black
Brown
Blonde
Grayish
Color-treated
Red
Gray
 
Type:
Quality:
Density:
Straight
Thick
Increased
Wavy
Normal
Normal
Curly
Thin
Diminished
Coarse, curly
Very thin
Very diminished
Insufficient

 

2) My affected zone (receiving zone) is:

 Bald
Fuzzy
Hair and fuzz
Sparce

 

3) How long ago did the baldness started?

 Days
Months
How many?
Years

 

4) How did your hair loss ocurr?

 Fast
Slow and progressively

 

5) Have you used any treatments to stop this baldness?
Si
 
Massages
 
Minoxidil
 
Finasteride
 
Anti hair-loss shampoo
 
Others
No

 

6) Are you under any treatments right now?

 Yes
No

 

7) Do you have any balndess family background?
Yes
 
Inherited from the mother's side
 
Inherited from the father's side
No

 

8) For a more precise diagnosis, we offer you the possibility of sending your own pictures taken from the following angles (Not a requirement)


You may send the pictures at info@gardelhair.com in TIF or JPEG format or through post-mail.

Gardel Hair Restoration Institute guarantees absolute confidentiality.


9) We ask you to be very precise with the following information, this will allow us to get in contact with you as soon as possible.

Complete name (required)
E-mail address (required)
Phone number (required)
City and country (required)

Age
Is this your first hair transplant?
Gender

 

10) For your best interest, please let us know how and when you prefer to be reached:

 E-mail
Post-mail
Telephone
    from 9 to 13
    from 13 to 17
    from 17 to 20
    from 9 to 20

 

11) Additional comments that you may consider important.
Feel free to ask whatever your like or give us any comment. All of this information will be used for your own benefit.

You're all done! just click on the button to finish

All given information is strictly confidential and will be used for cyber consultation purposes only. Thank you!.

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