Schedule a no-obligation Hair Loss Consultation

To schedule your private, confidential consultation, call us at 585-475-0010 or simply fill out the form below. We will contact you by email or telephone (whichever you prefer) to schedule your private consultation at a time that most convenient for you. It’s absolutley private, completely confidential, and with no obligation whatsoever.

Your Name (required)

Your Email (required)

Your Phone Number(required)

How would you like to be contacted?
PhoneEmail

Date of Birth

Date of Birth
MaleFemale

Type of Hair and Ethnicity

Which Integrated Hair Solutions Treatment Method are you most interested in?

What best describes your hair loss condition?

How long have you been experiencing hair loss?
1-3 Years3-7 Years7-15 Years>15 Years

Is your scalp visible in the area where you have lost your hair?
YesNo

Do you suffer from any of the following conditions?
DandruffItchy ScalpDry ScalpOily ScalpExcessive Shedding

Have you attempted to do anything about your hair loss situation?
Rogaine/PropeciaHair TransplantHerbal SolutionHair ExtensionsHair SystemsLotions/ShampoosNothing

Have you consulted a doctor or other professional about your hair loss?
YesNo

How often do you think about your hair loss situation?
Not MuchSometimesAll the time

Does your hair loss situation ever make you feel depressed?
YesNo

Do you feel that your hair loss prohibits you from being “who you really are”?
YesNo

Do you feel that your hair loss adversely effects your self-confidence?
YesNo

Do you feel that your hair loss adversely effects your self-esteem?
YesNo

In which areas of your life do you feel your hair loss adversely impacts you?(Choose all that apply)
HomeWorklifeSocial LifeDatingIntimacyNone

Are you ready to do something about your hair loss immediately?
YesNo

Please enter any additional information and/or comments regarding your hair loss:

Contact Us

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Call 585-475-0010

To schedule a no obligation

Private Consultation

INTEGRATED HAIR SOLUTIONS

3445 Winton Pl suite #209

Rochester, NY 14623

585-475-0010

ROCHESTER HAIR LOSS and HAIR REPLACEMENT SPECIALISTS

With more than 50 years of experience serving the greater Rochester area, we know hair loss and baldness. We have the latest hair replacement and treatment programs as well as a complete line of hair care products.