Online Assessment Form

Get a free, personalized evaluation

Each patient is unique and our diagnosis is therefore developed on a case-by-case basis.


Would you like an evaluation? It is simple. Just Complete and submit the following form for a confidential online assessment and send us pictures by following the instructions below:

Portrait framing (passport photo type), without close-ups, they must be of good quality and taken under natural light (not electric).
For a hair transplant (5 photos): one photo of the front, both sides, top and back of your head (donor area).
For a beard transplant (4 photos): one photo of the front, both sides and the back of your head (donor area).
One of our specialists will get back to you within 2 to 5 working days.

Assessment Form

Your form in 5 minutes

Gender and age
Your hair
Further Information
Your Details

Gender and age

Your hair

Please fill in the information relating to your hair

Further Information

Please fill in your information.

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jpg, jpeg, png, gif

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Your Details

Please fill in your information.

your phone number

All personal data remains strictly confidential.

The information collected from this form is necessary to process your request. They are transmitted to the Customer Service department of the CLINIQUE DE RESTORATION CAPILLAIRE in charge of processing your request and are kept by the CLINIQUE DE RESTORATION CAPILLAIRE for a limited period of time, corresponding to the purpose of the processing. You may exercise your rights of access, rectification, portability, cancellation, opposition and limitation to the processing of your personal data by sending a request using this form or by contacting us by e-mail at the following address: hairtransplantfrance@gmail.com

CRC Paris