Contact Us for Your Complimentary Consultation

We are a medical practice dedicated solely to hair restoration. When you correspond with us please identify yourself and fill in any information completely. All information shared with us will be treated confidentially. You will not be added to any mail solicitation list. Nor will your information be passed on to any other entities. We will not solicit you in any way. We know you have choices and hope you choose us for your care.

Sincerely,
Brian O. Goertz MD

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Preferred Appointment:
	Monday | AM	Monday | PM
	Tuesday | AM	Tuesday | PM
	Thursday | AM	Thursday | PM
	Friday | AM	Friday | PM
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Requesting:	FreeConsult Information
Hair Loss Stable?	Yes No
Hair Loss Scale:	2 2A 3 3A 3V 4 4A 5 5A 5V 6 7 Female Unsure
Comments:
(Applies to Male Hair Loss Only)