- A LANDLINE or MOBILE phone number - whichever serves you - will facilitate our DIRECT COMMUNICATION.It is compulsory to fill out one phone number at least.- If you wish to enter the International Country Call Number, please use the format below:00306971234567 (Mobile) or 00302101234567 (Landline)Mobile or Landline Phone *Your Email *Please choose which Scientific Center you are interested in arranging an appointment *
Your Message *File attachmentIMPORTANT NOTES1) Maximum file size is 5MB2) For security reasons of our communication only the following seven (7) file types are accepted:gif, png, jpg, jpeg, pdf, mp3, mp4
E-mail CENTRALE firstname.lastname@example.org
Fill in this Remote Diagnosis Form. Collect information about your hair loss case. Confirm that you are a suitable Hair Transplant candidate. Simply and in the comfort of your own space. In any case, we will be glad to see you.