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Hair Restoration Consultation | Salon East

Salon East · Fine & Thinning Hair Specialists

Discover Your Personalized
Hair Restoration Plan

Complete this brief consultation and our specialists will review your profile before your appointment — so every minute of your visit is dedicated to your goals.

Scalp & Hair Analysis Hair Growth Recommendations Restoration Programs Toppers & Hair Systems Extensions for Fine Hair Custom Color Solutions
Section 1
Contact Information
Tell us how to reach you
Section 2
Your Hair Story
Help us understand your journey
If Yes, what is your diagnosis?  ·  If No, please skip to the next question.
Section 3
Hair Thinning Assessment
Which image best describes your hair thinning? Select one.
Female Hair Loss Scale
Hair loss stage I-1
I-1
Minimal thinning
Hair loss stage I-4
I-4
Crown thinning
Hair loss stage III
III
Diffuse thinning
Hair loss stage I-2
I-2
Slight widening
Hair loss stage II-1
II-1
Moderate thinning
Hair loss stage Advanced
Advanced
Extensive loss
Hair loss stage I-3
I-3
Widened part
Hair loss stage II-2
II-2
Significant thinning
Hair loss stage Frontal
Frontal
Frontal recession
Section 4
Previous Treatments
What solutions have you tried?
TreatmentNever UsedPreviously UsedCurrently Using
Hair Fibers (Toppik)
Minoxidil / Rogaine
Prescription Treatments
Hair Growth Supplements
Laser Therapy
Scalp Treatments
PRP
Hair Transplant
Other
Section 5
Current Hair Enhancements
Are you currently wearing any hair enhancements?
Section 6
Your Goals
What would you most like to achieve? Select all that apply.
Section 7
Consultation Focus
What are you most interested in discussing?
Section 8
Recent Health History
Have you experienced any of the following within the past 12 months? Select all that apply.
Anything Else?
Is there anything else you'd like us to know?
Share your concerns, goals, frustrations, or anything that would help our specialists prepare for your consultation.

A member of our team will be in touch within 1 business day.

✦

Thank You for Submitting

Your information has been received. A member of our Fine & Thinning Hair Team will review your assessment and contact you within 1 business day to schedule your personalized consultation.

We look forward to helping you achieve healthier, fuller-looking hair.

Salon East · Hamptons, NY & Naples, FL
Salon East  ·  Luxury Fine & Thinning Hair Specialists  ·  Hamptons, NY & Naples, FL