Free Consultation Application

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Free Consultation Application

1Personal Details

2Transplant Details

3Photo Upload

Name*
First Last
Phone*
Email*
Age*
Height*
Weight
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How did you hear about Hasson and Wong?*

Preferred Method of Extraction*
Have you had hair transplant surgery before?*
- Yes
- No
Previous Surgery Details*
Please enter information for each of your past surgeries including: - Name of Doctor - Year of Surgery - Type of Surgery - Number of Grafts.
Have you used Propecia / Proscar / Finasteride?*
- Never Used
- Stopped using more than 2 months ago
- Stopped using less than 2 months ago due to side effects
- Stopped using within last 2 months
- Currently using, but not consistently
- Currently using as frequently as prescribed
- Using another medication such as Dutasteride
Please elaborate below in your hair loss story.
Please indicate medication type and dose below in your hair loss story.
Are you using*
- Name brand Propecia from Merck, 1 mg per day
- Name brand Proscar from Merck, one 5mg tablet cut into quarters, 1/4 tab per day
- Name brand Propecia or Proscar, if taking another dose other than above, please indicate in your hair loss story below
- Generic Finasteride, 1 mg per day
- None of the above, please indicate medication and dose in your hair loss story below
Have you used Rogaine / Regaine / Minoxidil?*
- Never Used
- Stopped using more than 2 months ago
- Stopped using less than 2 months ago due to side effects
- Stopped using within last 2 months
- Currently using, but not consistently
- Currently using as frequently as prescribed
Approximate date you would like to have your procedure?*
Tell us your hair loss story:*
Describe your restoration goals:*

Upload Photo Instructions
1. Ensure the room is evenly lit and bright. This is best accomplished in the daytime using natural light.
2. Do not use a flash. It obscures the scalp. If you think you need a flash, you need a brighter room.
Please note the following:

Maximum file size: 5 MB per image, images must measure less than 3200px x 3200px.
FRONT Photo*
Drop files here or

Max. file size: 10 MB, Max. files: 1.
BACK Photo*
Drop files here or

Max. file size: 10 MB, Max. files: 1.
Side Photo*
Drop files here or

Max. file size: 10 MB, Max. files: 1.
TOP/CROWN Photo*
Drop files here or

Max. file size: 10 MB, Max. files: 1.
Upload Additional Photo's
If you would like to upload additional photo's, please use this section.
Drop files here or

Max. file size: 10 MB, Max. files: 5.
Submit your photo's*
By clicking "I agree" you are allowing Hasson & Wong to provide an accurate estimate about your case, based on the photo's you provide. Your Photo's will be private and secure and will not be used without your permission.
- I agree

Free Consultation Application was last modified: April 28th, 2023 by Hasson & Wong

What you need to know

Approximate duration: 3 minutes

We are usually able to review your submission and provide an assessment within 2-4 business days.

We’ll let you know:

If you're a candidate for hair transplant surgery
Whether your goals can be realistically obtained
An estimate of the number of grafts required to achieve your goals
An estimate of cost for the procedure

Send Us Your Pictures
To help us provide an accurate estimate we ask you to send us your contact information, transplant history and pictures of your hair loss and donor area.

Need Some help?

Call us free at 1-800-859-2266 or locally at 604-739-4247 to learn more about the Hair Transplant Procedure at Hasson and Wong.

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Suite 600 - 1001 West Broadway Vancouver BC Canada V6H 4B1
1–800–859–2266 or 604–739–4247
info@hassonandwong.com

Useful Links

Hair Transplant Before & After Photos
Online Consultation
Hair Transplant Blog
Why Choose Hasson & Wong?
Travelling to Vancouver

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Inside the Clinic

The Hasson and Wong Hair Transplant Clinic is located in Vancouver BC. Dr. Wong and Dr. Hasson have been practicing hair transplant surgery for more than 20 years each. They are world-renowned for their consistently outstanding results and for the advances they have made in Lateral Slit Technique, mega-sessions and FUT.

Free Consultation Application

Please elaborate below in your hair loss story.

Please indicate medication type and dose below in your hair loss story.

Upload Photo Instructions

Useful Links

From the Blog

Inside the Clinic