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How would you describe your hair loss?
*
None
Few
Few-Middle
Middle
Middle-Large
Large
Select the hair loss on the front side.
None
Few
Few-Middle
Middle
Middle-Large
Large
Select the hair loss in your crown area.
Choose Your Hair Color
Yellow
Brown
Red
Black
How long has your hair been falling out?
Less than 1 year
1 Year
2 Year
3 Year
4 Year
5 Year
6 Year
7 Year
8 Year
9 Year
10 Year
More than 10 Years
Have you had a hair transplant before?
Yes
No
When did you have the operation?
Enter if you have had an operation!
When do you plan to have a hair transplant?
Recently
İn 3 Months
İn 1 Year
Not planned
Do you have any medications?
Do you have any chronic diseases?
Frist Name
Last Name
Your E-Mail Address
Your Phone Number
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Haartransplantation
Haartransplantation
Frauen Haartransplantation
Schmerzfreie Haartransplantation
Waschen nach Haartransplantation
Augenbrauentransplantation
Barttransplantation
Haartransplantation Medhode
Hybrid-Haartransplantation
Sapphire Fue Haartransplantation
DHI-Haartransplantation
Blog
Kontakt
Patient Form
FAQ
Deutsch
Deutsch
English
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