The fastest way from “I’m thinking about this” to “I have a written plan from a senior surgeon.” Submit five photos and a few details — Dr. Jones reviews personally and sends back a written assessment within 48 hours.
The submitted form goes directly to Dr. Jones — not to a coordinator, not to a sales team, not to an automated triage tool. He reviews each case personally and sends back a written assessment within 48 hours covering:
Candidacy. Yes, no, or wait. If “wait”, you’ll be told why and when to revisit. If “no”, you’ll be pointed at the right next step (medical therapy, dermatology, scalp micropigmentation, or just continued observation).
Recommended technique. FUE, FUT, body hair transplant, repair, or non-surgical. Sometimes a combination. The recommendation is based on your specific case, not what books a surgery slot.
Estimated graft count. A range based on what you’ve sent. Refined further at your Zoom or in-person consultation.
What the result would look like. Realistic outcome description — what to expect at month four, month twelve, and beyond. No before-and-after photos of unrelated patients.
What it does not include: pricing pressure, time-limited offers, or a follow-up sequence designed to convert you. There’s no follow-up unless you ask for one.
Submit your photos and a few details. You'll get back a written assessment from Dr. Jones — your candidacy, the right procedure, an estimated graft count, and a cost range. Then you decide what to do next.
Your information is encrypted, never shared, and used solely for your medical review. Privacy policy.
The form above is hosted on Jotform — a TLS-encrypted submission platform used by medical clinics for HIPAA-compliant intake. Your photos and details are submitted directly into the clinic’s secure intake system. Photos are stored on Jotform’s encrypted servers and accessible only to the clinical review team.
Files are kept under standard medical-records retention rules. If you don’t proceed, your data is deleted on request. See the full privacy policy for specifics.
1. Front view. Standing facing the camera, looking straight ahead. Hair styled the way you usually wear it. Natural daylight (window light or outside, not a bathroom mirror).
2. Top-down view. Camera held above your head pointing down. Capture the full crown and any thinning. Easiest with someone else holding the phone.
3. Left profile. Side view of the left half of your head. Capture the temple, hairline, and side donor area.
4. Right profile. Same as left, on the right.
5. Back of head. The donor area at the back. Critical for assessing donor density and surgical candidacy. Have someone else take this one.
No hat. Hair dry. Natural daylight. Hair styled normally (not freshly washed and slicked back). Rough-and-ready photos with good lighting are better than studio-quality photos in bathroom fluorescent.