Your name?

Mobile Number

Email id

How old are you?

Where did you hear from?

Which City are you from?

Do you visit Mumbai often?

How long have you been suffering from hair loss?

Have you done a hair transplant before?

Have you gotten a hair system before?

Do you ride a bike often?

How thick is your hair on the sides and at the back of your head?

I am interested in :

Which method of attachment do you prefer?

Which kind of hair system would you prefer?

1: Most Natural
Front hairline ( 4.5/5)
Life : 3 - 4 months
Hair volume : light ( if front hairline is the priority , this will be the best option for you ) 2 : Natural
Front hairline( 3.5/5 )
Hair volume : light
Life : 4 - 6 months (Hairline will be slightly natural but the life be more than type1 ) 3 : Durable
Front hairline (⭐️ ⭐️ ⭐️)
Hair volume : medium-heavy
Life : 8 -12 months (most suitable for those who:
1. Plan on choosing a hairstyle which covers their hairline
2. Would prefer a longer lasting hair system which would be more cost effective
3. Have a good amount of hair in the front, hence plan on using their natural hairline)

What density (quantity of hair) would you prefer in a hair system?

High density system lasting from 5-12 months, depending on the method of attachment Low density system lasting from 3-6 months, depending on the method of attachment Not sure, need guidance

How soon are you looking for a solution?

What’s your budget?

Help us understand your hair loss

(PS: You can skip this step if images are not available )

Please attach photos of your hair below.
Make sure you wet your hair a bit for us to get an idea of your hair density

Front view

Back View

Would you like to book a video consultation before you visit Mumbai?

Would you like to book an in-person Consultaion in Mumbai?

How would you like to go ahead with the treatment?

I prefer a video consultation and I am comfortable placing the order online , and need your guidance where/how to fix in my city. I prefer a video consultation . Later , I will come to mumbai for the first fixing ( sticking one ) I prefer video Consultation for clip on system. You can deliver at my address and guide me.