+90 546 437 07 38
[email protected]
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civas hair transplant online consult

Online Consult

Online Consultation for Hair Transplant.
Fill out the form below and Dr. Civas will review your case.
The doctor will respond via email or phone as soon as possible.
(please check your spam box)

Online Physician Consultation Form

How Would You Like To Be Contacted? *
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Hair Loss Info

What are your hair restoration goals?
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Have you had any hair transplants? Please provide details (i.e., dates and types).
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List relevant health info that might affect a surgical procedure (i.e. keloids, bleeding, diabetes).
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Are you currently taking finasteride (Propecia)?
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Are you currently taking minoxidil (Rogaine)?
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Other medications?
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Photo Uploads

Instructions for Photos:

1. Submit one different photo for each of the four views (Front, Side/Angle, Top, and Rear)

2. Photos with dry hair only

3. Include your entire head. You may block out your face, but very close-up photos are not useful. The doctor needs to see the overall pattern of your hair loss

Front View
Select a photo of your frontal hairline (.jpg, .jpeg, .png)
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Side Angle View
Select a photo of your hair from the side (.jpg, .jpeg, .png)
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Top View
Select a photo of the top of your scalp (.jpg, .jpeg, .png)
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Rear View
Select a photo of the back of your scalp (.jpg, .jpeg, .png)
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Reasons for Inquiry

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Personal Information

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General

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Contact Us

+90 546 437 07 38
[email protected]
Ümit Mahallesi, Meksika Caddesi 2479. sokak , NOKTA ANKARA No: 2 Kat:7, Daire: 7 , 06810 Çankaya/Ankara-Turkey