Online Consultation Form

The best way to devise the correct treatment for your case is a personal hair restoration consultation with Dr. Civas. However this is not always possible, particularly if you live abroad. If you are not able to come to our clinic for an initial consultation, you can also contact us by filling the online consultation form below.

Make sure to attach your photos as described below. In response, we will give you an estimate of to the number of grafts, the  total cost of the surgery including accommodation in a 4-stars hotel, and detailed information on the surgery. We try to respond within one day with all the information you need.

Note: Before the surgery can actually take place, and usually one day before, you will have a face-to-face consultation with Dr Civas. This will allow him to check your scalp health, your skin type, your follicle density and hair type. Because an online consultation based on photos cannot replace a real consultation, it is possible that the diagnosis is different, including graft count. In order to minimize the risk of discrepancies, please send us good quality pictures. Out of focus, blurry or poorly lit pictures are not helpful. If you do not have good pictures, ask a friend or family member to take them for you.



Patients with urgency should contact Appointments are allocated on first come first served basis.


Please submit at least two photos using the buttons below.
Each image must be smaller than 2MB and in Gif, Jpeg or Png format.

Your photos should be as follows:

Click on the Submit button and wait until all photos are uploaded. Do not quit or refresh the page until you see a success message displayed here. Thank you.