Next steps.



If your hairline is sparse or even completely lost, we can re-establish it at its original forward point and add hair immediately behind it, interspersed with your own hair, depending on your balding condition.
       
  How about some more detailed information? To find out what exactly can be done with your particular pattern of hairloss, answer the questions below and email the form back to us. We'll send you detailed information, as well as before and after photos of clients who have suffered, and have now recovered from, a balding condition similar to yours.
       
  How long have you been losing your hair for?
       
  Has the rate of hair loss increased in the past year?   yes no
       
  Is your own hair?  
       
  Do you suffer from any of the following?  
       
  Do you have any family members (father, uncle, grandfather) who has suffered from hair loss?   yes no
       
  Have you ever attempted any of the following
(check as many that apply)?		  

Rogaine*
Propecia*
weaves
transplants
(or other surgical)
       
 
Name:  *
   
 
Address 1:
   
 
Address 2:
   
 
City:
   
 
Province:
   
 
Post:  *
   
 
Region:
   
 
E-Mail:  *
   
 
Phone:  *
   
       
  When is the best time to contact you?  
 
When you are ready to submit the above information just click on the button below. After submitting, you will be taken back to the Freedom Hair Systems home page.
       
  *Rogaine and Propecia are registered trademarks of Pharmacia Upjohn, Inc. and Merck, Inc.