NBR® APPLICATION

Are you struggling with hair loss and ready to find a solution that WORKS?

Well, you're in the right place! We are so excited to consider you as a case study while we build the foundation for this service at Elle Society.
What's Your First and Last Name?*
What's Your Email Address?*
example@example.com
What's Your Phone Number?*

Area CodePhone Number
Please tell us a little about your hair loss journey & why you're excited to work with us!*
Below, we would like you to provide 3 pictures. Don't worry, these photos will never be shared outside of this form or posted publicly! (No selfies, please) Please try to take these photos with your hair completely down, in natural light, and remember, the better the photos - the greater the possibility that we can find the perfect solution for you!

These photos will be:
1) From the FRONT.
2) From the BACK.
3) From the TOP.

These photos should show the full length of your hair and show the current color of your hair.
Please upload your BACK shot:

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Please upload your FRONT shot:

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Please upload your TOP shot:

Browse Files

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Thank you for taking the time to fill out this form! We appreciate your consideration and can’t wait to work with you to get you LOVING your hair again.

What should you expect next?

We will be reviewing your submission to determine if you’d be a good fit as a case study. If we believe you might be a candidate, one of our team members will reach out to you for a full consultation and to answer any of your burning questions.
If you are selected to participate as a case study, you will receive 50% off the custom piece as well as free labor to install. This exclusive offer comes with the requirement to participate as a model for marketing materials for this service. This includes photo and video documentation so we can showcase the service to others and document the results.*

Yes, I want more information on how to become a Case Study!No, I am not interested in being a Case Study, but I would like more information about this service at full price to experience it as a guest in the future.
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Are you struggling with hair loss and ready to find a solution that WORKS?