Online Consultation

Thank you for visiting our website. Many of our patients visit us for Hair Restoration and many other cosmetic surgical procedures from across the country and around the world. In order to better serve you and address individual concerns we have created this online consultation form which allows you to communicate directly with Dr. Wasserbauer.

Please fill out the form below completely and a patient coordinator will reply with Dr. Wasserbauer's evaluation and suggestions. For a personal consultation call toll free: 1-877-8-HAIRMD

Online Hair Loss Consultation Form

(This form is not intended to replace a physical exam and personal consultation with a physician.)

  • Family Members

    Please indicate if any of your following relatives have suffered mild, moderate or severe hair loss.
  • This field is for validation purposes and should be left unchanged.