New Client Consultation Form

Make Your Payment*

ConsultationOnce you have made your payment, completed this form and submitted it; we will then schedule your consultation appointment. During your consultation, you will be able to ask all the questions you have and based on the results from your consultation, we will then discuss the hair replacement system that will be the best fit for you. When you have made your decision on the unit and the direction in which you would like to go, an invoice is then submitted to be paid prior to booking an appointment, the $250 consultation fee is credited to that invoice. Once the invoice is paid, you can then receive your Game Changing appointment.

$259.90

Total

$0.00

Credit Card

I acknowledge and fully understand that:*

I must call the office to schedule my appointment next. (Office: 832.632.8655).All services are non-refundable.If you decide to wait for service, you will have a credit that will expire after 90 days.
By signing this, I acknowledge that all the information I have provided in this form is accurate and true to the best of my knowledge.
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